AUTISM SPECTRUM DISORDERS (ASD)

1. AUTISM SPECTRUM DISORDERS (ASD) Lorena, Jenny, Sarah, Lydia, Tara

2. Living with Autism Video http://www.youtube.com/watch?v=BTDmdClWtkc (3:57)

3. History • First Studied by Leo Kanner and Hans Asperger in 1934 and 1944 • Both referred to the children they observed as Autistic • Kanner said there were 3 main ways to distinguish Schizophrenics from Autistic children • Asperger’s Paper • 1981 Lorna Wing quoted his paper and referred to the disorder as Asperger’s Syndrome • Since 1990 disorders with similar symptoms are categorized under a broader term called Autism Spectrum Disorders (ASD)

4. Definition • Autism is a disorder and not a disease. • Autism, as defined by the Individuals with Disabilities Education Act (IDEA) is: a developmental disability affecting verbal and nonverbal communication and social interaction, generally evident before age 3, that affects a child’s performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. The term does not apply if a child’s educational performance is adversely affected primarily because the child has serious emotional disturbance. (34 C.F.R., Part 300, 300.7[b][l]) Individuals With Disabilities Education Improvement Act, 2004)(pg. 425 “Learners with Autism Spectrum Disorders” Exceptional Learners)

6. Autism Spectrum Disorder • Types of Autism • High Functioning to Low Functioning • Asperger Syndrome • P.D.D.-N.O.S. • Austistic Disorder • Rett’s Disorder • Childhood Disintegrative Disorder

7. Personal Experience • Does anyone have an personal experiences they would like to share with the class?

8. Prevalence • 1 of 166 people have Autism Spectrum Disorder • HOWEVER, only 1 of 370 people 6-17 yrs old are identified with Autism and receive special education. • Many see this rate is increasing… • Why the increase? Potential answers: harmful toxins in environment, widespread use of vaccinations for babies and toddlers. • Some say there is no increase due to… • 1. Widening of criteria used to diagnose • 2. Greater awareness of Autism • 3. “Diagnostic Substitution”

9. Prevalence (cont) • Males outnumber females 3:1 or 4:1in Autism Spectrum Disorders • Exception: Rett Syndrome – occurs primarily in females

10. Causes • No known single cause • Could be a mixture between heredity, genetics and medical problems • Genetic Vulnerability • Autism tends to occur more frequently than expected among individuals who have certain medical conditions • Fragile X syndrome • Tuberous sclerosis • Congenital Rubella syndrome • Untreated Phenylketonuria (PKU) • Some harmful substances ingested during pregnancy also have been associated with an increased risk of Autism

11. Causes (cont) • Environmental Factors • Environmental Toxins • Heavy Metals such as mercury • Which are more prevalent in our current environment than in the past • Those with ASD (or who are at risk) may be especially vulnerable, as their ability to metabolize and detoxify these exposures can be compromised • Vaccine Misconceptions

12. Debate: Vaccinations http://www.youtube.com/watch?v=J7h-DPr_x2w (4:37)

13. Methods of Identification • There is no universally used diagnostic test for ASD. For autism, the clinician uses criteria that focus on communication skills, social interactions, and repetitive and stereotyped patterns of behavior • Behavior symptoms are so severe that it is easy to diagnose • Autistic Regression: Children appear to progress normally until about 16 to 24 months of age and then begin to show signs of being autistic and will later be diagnosed as autistic

14. Psychological and Behavioral Characteristics • 4 Core Characteristics Involve: • Social Development • Communication • Limited Interests • Repetitive Behavior

15. Stephen Wiltshire http://www.youtube.com/user/AutTV#p/u/2/mskqFK3mHwU (5:28)

16. Signs to Watch for • Lacks interest in others • Avoids prolonged eye contact • Resists being touched • Seems oversensitive to sounds and bright lights • Has mastered few words by 16 months • Does not point to share interests • Repeats words or phrases • Has frequent tantrums • Shows little interest in pretend play • Has difficulty taking turns • Resists change

17. Signs to Watch for (cont) • Spins objects • Has difficulty catching a ball, buttoning or tying shoes • Shows little fear of dangers • Flaps hands, flicks fingers, rocks body or hurts self • Speaks with a flat voice • Has one-sided conversations • Stands too close to others • Misunderstands jokes, slang or teasing • Tunes others out • Displays anxiety or rage • Has intense interests

18. Educational Considerations • Direct Instruction Skills • Behavior Management • Instruction in Natural Settings • Children with Asperger’s • Social Interpreting • Coaching

19. Diet • Eliminate Gluten and Casein • Children with Autism could be gluten addicts • Solutions • School lunches could be changed

20. Assess the Progress of Students • Progress in language Development • MacArthur- Bates Communicative Development Inventory-Second Edition (CDI-II) • Assesses both “normal” children AND those with disabilities

21. Assess the Progress of Students (cont) • Progress in Social/Adaptive behavior • PDD Behavior Inventory (PDDBI) • Monitors progress of students 2-12 years • Detects changes in students • Parent and Teacher versions of the test • Assesses: • Sensory/Perceptual Behaviors • Rituals, resistant to change • Social problems • Semantics (Meaning) Problems • Arousal Regulation Problems • Fears • Aggressiveness • Receptive Social Communication Abilities • Expressive Social Communication Abilities

22. Assess the Progress of Students (cont) • Social Responsiveness Scale (SRS) • Parent/Teacher scale monitoring progress of students 4-18 • Monitors • Social Awareness • Social Information Processing • Reciprocal Social Communication • Social Anxiety • Avoidance • Evaluates Severity of Social Impairment

23. Assess the Progress of Students (cont) • Outcome Measuring • These tests can also be used to evaluate effectiveness of interventions • Autism Social Skills Profile (ASSP)- standardized outcome measurer • Examines social skills of children & adolescents with ASD • Completed by teachers/parents • Includes 3 subscales/parts • Social reciprocity • Social participation/avoidance • Detrimental Social behaviors

24. Assess the Progress of Students (cont) • Childhood Autism Rating Scale (CARS) • Purposes: Screen/test, diagnose, as well as measuring effectiveness • Focuses on behaviors that deviate from “normal” development • 2 years of age and older

25. Assess the Progress of Students (cont) • Testing Accommodations/Alternate Assessments • Test Accommodations • Vary based on severity of disability • Include changes in setting, scheduling, presentation format, and response format • Strategies • Environmental and Curricular Modifications • Attitudinal and Social Support • Coordinated Team Commitment • Recurrent Evaluation of Inclusion Practices • Home-School Collaboration

26. Assess the Progress of Students (cont) • Students with ASD must receive a modified/alternative curriculum • Alternative Assessment • Portfolio: Collection of items providing evidence of growth on specific goals

27. Early Intervention • The most effective early intervention programs are intensive, highly structured, and involve families • Early intervention programs often use natural interactions to teach students in natural environments, including general education classrooms to the extent possible. • Most early intervention programs focus on children with severe degrees of ASD rather than milder degrees • If intervention is early and intensive it can produce remarkable gains in many children • There is no intervention yet can claim universal success in enabling children to completely overcoming their disabilities

28. Early Intervention (cont) • Essential features of an effective program (according to the National Research Council) • Entry into intervention programs as soon as an ASD is seriously considered • Active engagement in intensive instructional programming for a minimum of the equivalent of a full school day, 5 days (at least 25 hours) a week, with full year programming varied according to the child’s chronological age and development level • Repeated, planned teaching opportunities generally organized around relatively brief periods of time for the youngest children (e.g. 15-20 minute intervals), including sufficient amounts of adult attention in one-to-one and very small group instruction to meet individualized goals • Inclusion of a family component, including parent training • Low student/teacher ratios (no more than two young children with ASD per adult in the classroom) • Mechanisms for ongoing program evaluation and assessments of individual children’s progress, with results translated into adjustments in programming

29. Transition to Adulthood • Self-Determination • Community Adjustment • Employment

30. Simulation Video http://simulations.magnify.net/video/Autism-Sensory-Overload-Simul (3:21)

31. Simulation Stations

32. Resources • Autism Society of Minnesota. Supporting People Living with Autism in Your Community. St. Paul, MN: n.d. Print. • Hallahan, Daniel P., James M. Kauffman & Paige C. Pullen. “Learners with Autism Spectrum Disorders.” Exceptional Learners. Boston: Pearson, 2009. 420-455. • Hirsch M.D., David. “Autism Spectrum Disorders” Web MD. 3 September 2009. Web. 1 April 2010.http://www.webmd.com/brain/autism/autism-spectrum-disorders. •  "KNOW. . .The Autism - Vaccine Connection"  K.N.O.W. Web. Accessed 4 April 2010.  http://www.know-vaccines.org/autism.html. • McGee, Susie. "Diet for Autistic Children." love to know. N.p., 2010. Web. 5 Apr 2010. http://autism.lovetoknow.com/Diet_for_Autistic_Children. • "Misconceptions about Immunizations" Quackwatch. Revised 17 November 2002.  Accessed 4 April 2010.  http://www.quackwatch.org/03HealthPromotion/immu/autism.html. • "What Causes Autism" Autism Society.  Revised 25 January 2008.  Accessed 4 April 2010.  http://www.autism-society.org/site/PageServer?pagename=about_whatcauses.

33. Additional Web Sites • Autism Speaks • http://www.autismspeaks.org/ • Autism Society of America • http://www.autism-society.org/site/PageServer • Autism Society of Minnesota • http://www.ausm.org/