Autism: the Brain, Thinking and Behavior

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Autism the Brain, Thinking and Behavior

• Mary Joann Lang, Ph.D., A.B.P.N.
• Beacon Day School
• Orange, California

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Course Objective

• To understand basic concepts related to the
  brain, thinking and behavior and how to make
  appropriate interventions for children with ASDs,
  which help each individual reach his or her
  maximum potentials.

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Autism DefinedAccording to the NIH

• Autism is characterized by three distinctive
  behaviors
• difficulties with social interaction
• problems with verbal and nonverbal communication
• repetitive behaviors or narrow, obsessive
  interests. 
• These behaviors can range in impact from mild to
  disabling.  Autism varies widely in its severity
  and symptoms and may go unrecognized, especially
  in mildly affected children or when more
  debilitating handicaps mask it. 

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• Systems Theory

A system is greater than the sum of its parts.
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Systems TheoryCommon Elements

• input-signal going into a system
• output-the act of turning out
• throughput (or process)-raw material processed
  within a given time
• feedback-response to a particular process
• control-ability to manage or direct
• environment-the entire set of conditions under
  which one operates
• goal-the result toward which effort is
• directed

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Systems Theory

• Open Systemcapable of growth, development
  adaptation. Interaction occurs within the
  environment. (i.e. The Rules of a Classroom)
• Closed Systemrelationships among system
  components are set and inflexible no interaction
  with the environment (i.e. The Laws of Physics)

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Systemic Approach to Understanding the Brain

• In order to understand an individual with Autism,
• it is necessary to understand him or her as an
• individual from a systems approach
• How do mind and body function?
• How does the individual fit into the
• community and society?
• What interventions can be provided
• to help an individual reach
• his or her potential?

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Systemic Approach to Understanding the Brain

• Functions of the
• Conductor
• Inhibit
• Shift Flexibility
• Modulate Emotions
• Initiate
• Working Memory
• Planning
• Organizing
• Self-monitoring and Evaluating
• Ref. Peter Isquith, Executive Function
  Concepts and Assessments

• Functions of the
• Orchestra
• Perception
• Attention
• Language Processes
• Visual-spatial Processes
• Memory
• Sensory Inputs
• Motor Outputs
• Knowledge and Skills

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Systems Theory Medical Issues Human Body
Systems
System Location Nervous
System Brain and Nerves Skeletal System Bones
and Skull Muscular System Skeletal, Cardiac and
Smooth Muscles Endocrine System Glands and
Hormones Cardiovascular System Heart and
Blood Lymphatic and Immune Systems Lymphocytes
and Macrophages Respiratory System Lungs and
Airways Digestive System Mouth and
Gastrointestinal Tract Urinary System Kidneys
and Bladder Reproductive System Male and Female
Organs Integumenary System Hair, Skin and
Nails
A person with Autism will experience System
Interruptions with many of the above.
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Systems TheoryBreaks in the System

• It is becoming clear that the normal trajectory
  of neurodevelopment is altered in autism.
  Abnormalities in brain growth, neuronal
  patterning and cortical connectivity are often
  seen.
• Changes to the structure and function of synapses
  and dendrites have also been strongly suggested
  in the pathology of autism .
• Finally, environmental factors are likely to
  interact with the underlying genetic profile, and
  foster the clinical heterogeneity seen in autism
  spectrum disorders.
• reference Pardo CA, Eberhart CG, The
  neurobiology of autism, Brain Pathol. 2007
  Oct17 (4) 434-47. Department of Neurology,
  Johns Hopkins University School of Medicine

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System Theory
The Beacon Model
Supports Physical Emotional Cognitive Behavioral
Individual Functioning
Cognition Educational Achievement Adaptive
Behavior Participation/Social Roles Health Context

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Cognition/Thinking
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Cognition/Thinking

• Exploring Brain Behavior with Respect to
• Attention
• Memory
• Language
• Visual-Spatial Functioning
• Executive Function, and
• Emotional Functioning

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School Neuropsychological Assessment Model
Overall Cognitive Functioning and Academic
Achievement
Speed and Efficiency of Cognitive Processing
Social, Emotional, Cultural, Environmental and
Situational Factors
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Cognition/Thinking Attention

• What happens when an individual interacts with
  environment?
•        Always assimilating and accommodating info
•        Take in, process and act
•        In order to thinkone must pay attention

             
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Cognition/Thinking Attention

• Why do children with ASD
• have trouble with attention?
• Theyre not able to determine whats
  importantcreating a system overload!
• Sensory input is too much
• Frequently dont have organizational strategies.
• Dont see relationships in environment
•  Rate of info is provided in too much volume
• Information is too complex

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Cognition/Thinking Memory

• We are required to process information, store it
  and retrieve it as needed.
• Some people are simply unable to keep pace with
  the demands of society. They suffer from one or
  more forms of memory dysfunction.

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Cognition/Thinking Memory

• Memory requires systematic handling of
  information, including
• Receiving new information and holding it in
  short-term memory
• Temporary storage of information as active
  working memory
• Processing information and knowledge in long-term
  memory
• Recalling information from long-term memory

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Cognition/ThinkingVisual/Spatial Processing
The ability to visualize and process information
is needed for school success and for practical
use. Interpretation of relationships involves
spatial processingknowing how objects relate to
each other (size, order, etc.)
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Cognition/Thinking Visual/Spatial Processing
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Cognition/Thinking Language

• Aphasiainability to produce or understand
  language caused by brain damage or dysfunction
• Speech Production (Oral Expression)
• Speech Comprehension (Receptive Language or
  Listening Comprehension)

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Cognition/Thinking Language

• Problems Can be Associated with Weak Processing
  when Deficiencies involve
• Phonological Abilities (sound)
• Morphology (root words and adaptations)
• Semantics (word meanings)
• Syntactic (word groupings/sentences)
• Discourse (larger word groupings/paragraphs)
• Metalinguistics (how language works)
• Pragmatics (understanding in context)

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Cognition/Thinking LanguageImpairments

• Mixed aphasia displays both receptive and
  expressive deficits
• Receptive aphasia impaired comprehension
• Transcortical motor aphasia impaired expressive
  aphasia
• Transcortical sensory aphasia language
  comprehension is impaired, but repetition is
  preserved
• Wernickes aphasia receptive language and
  repetitions are severely impaired.

• Brocas aphasia
• non-fluent aphasia with
• effortful, often
• agrammatic speech production.
• Conduction aphasia fluent aphasia with severely
  impaired repetition, but relatively preserved
  language comprehension
• Expressive aphasia non-fluent output
• Global aphasia complete loss of all linguistic
  function

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Cognition/Thinking Language

• Wernicke-Geshwind Model of Language

Primary Motor Cortex
Arcuate Faciculaus
Brocas Area
Angular Gyrus
Primary Auditory Cortex
Primary Visual Cortex
Wernickes Area
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Cognition/Thinking Executive Function

• Neuroanatomy
• Frontal Lobe Involvement
• is associated with
• Executive Function.
• Identification of problem areas allows us to
  develop adaptive behavior skills for individuals
  with ASD.

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Cognition/Thinking Executive Function

• Executive Functions include those behaviors that
  include
• Abstract and Critical Thinking
• Choosing to Take Action
• Voluntary Response to Stimulation
• Planning and Organizing

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Cognition/Thinking Executive FunctioningTerms
Associated with Executive Functions

• Abstract Reasoning
• Anticipation
• Attention Control
• Behavioral Initiation/
• Productivity
• Behavioral Regulation
• Common Sense
• Concept Formation
• Creativity
• Estimation
• Fluency
• Goal Setting

• Hypothesis Generating
• Inhibition of Impulsiveness
• Mental Flexibility
• Organization
• Planning Problem Solving
• Rule Learning
• Self-control
• Self-monitoring
• Set Formation and Maintenance
• Set Shifting
• Working Memory
• Source Miller, Dan Essentials of School
  Neuropsychological Assessment Wiley, 2007, p.
  235.

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Cognition/Thinking Executive Functioning
Development
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Cognition/Thinking Emotional Function

• Emotions are the feelings that color our lives
  and allow us to experience all of the joys and
  sorrows of life. Core emotions that are
  universally experienced and recognized
• fear
• anger
• sadness
• enjoyment
• Enjoyment can enhance learning but fear,
• anger and sadness interfere with learning.
• People with ASD experience all of the same
  emotions as other peoplebut they cant always
  communicate their feelings.

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Cognition/Thinking Summary
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Breaks in the System

• Stored Energy
• Autistic children dont know how to manage
  information overloads.
• Energy builds uplooking for a release.
• Eventually, the child discharges energy in any
  available manner.

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Cognition/Thinking Visual/Spatial Processing

• Overloadthe body responds by seeking a situation
  to reduce the overload.

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Cognition/Thinking Visual/Spatial Processing

• Reactions to System Overload Include
  Sensory-Seeking Behaviors, such as
• Screaming,
• Aggression,
• Rocking
• Etc

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System Theory
The Beacon Model
Supports Physical Emotional Cognitive Behavioral
Individual Functioning
Cognition Educational Achievement Adaptive
Behavior Participation/Social Roles Health Context