Strengths and weaknesses in High Functioning Autism

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Strengths and weaknesses in High Functioning
Autism

• Ina van Berckelaer-Onnes
• University of Leiden
• Cardiff
• 10-05-2006

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Autism Research levels

• Behavioural level
• cognitive level
• Neurobiological level

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Wings triad of ASD

• Social interactions
• Communication
• Imagination versus DSM IV stereotyped
  patterns
• cognition behaviour

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Underlying triad deficit

• Limited intentionality
• Limited symbol formation

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Limited intentionality

• Pointing
• Imitation
• Play

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Limited symbol formation

• Language
• Imagination (play, etc.)

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Consequences for

• interaction
• a) Behaviour
• communication
• perception
• b) Cognition attention
• memory

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Cognition HFA

• Perception information processing
• Attention set-shifting ( inhibition??)
• Memory memory for facts versus functional
  memory

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Perception Information processing language

• Receptive language
• versus
• Expressive language

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Levels of perception

• Sensation
• Presentation
• Representation
• Metarepresentation

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Cognitive Deficits (Styles)

• Theory of Mind (ToM)
• Executive Function (EF)
• Central Coherence (CC)

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Perception/language ToM

• Pronoun reversal (perspective taking)
• Inappropriate questions

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Perception/language Executive Function.

• Stereotyped phrases
• Perseverations
• Inflexibility

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Perception language Weak CC.

• Poor context use
• Associative language use
• Literal language

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AttentionWCC and EF

• Strong fixations / obsessions
• Weak lack of interest
• Set-shifting versus inhibition

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Memory WCC

• Strong facts,
• encyclopedial knowledge
• Weak social coherence

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Diagnostic Protocol

• Classification and individual assessment
• Psychometric Evaluation

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Cognition

• Intelligence IQ
• Profile
• Neuropsychological tests
• (ToM, EF,WCC)

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Pitfalls

• Generalization
• Verbalizing versus Doing

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Bridging Assessment to Treatment

• From Profile to Interventions
• Support Strengths and Build up Weaknesses

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Treatment strategies

• 1st grade strategy environmental coaching
• (augmentative communication)
• 2nd grade strategy individual treatment
• 3rd grade strategy individual colouring

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Environment 1st grade strategy

• TEACCH principle
• structure in space
• in time
• in activity
• in approach

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Individual treatment 2nd grade strategy

• Focusing on the individual needs
• - speech therapy
• - social skill training
• - job coaching
• - psychotherapy
• (mostly cognitive behavioural therapy)
• - etc.

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Individual colouring 3rd grade strategy

• Personal characteristic
• Associated features
• Comorbid Disorders

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HFA from the cradle to the grave

• Treatment across the ages!