AUTISM

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AUTISM

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Overview

• What is Autism?
• Is there more than one type of Autism?
• What causes Autism?
• How is Autism diagnosed?
• What are the characteristics of Autism?
• What are the most effective approaches to
  treating Autism? Is there a cure?

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WHAT IS AUTISM?

• Very complex, often baffling developmental
  disability
• First described by Leo Kanner in 1943 as early
  infantile autism
• Auto children are locked within themselves.
• For next 30 years, considered to be an emotional
  disturbance

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WHAT IS AUTISM?

• 3 categories for autism in IDEA?
• Today, autism is a severe form of a broader group
  of disorders
• These are referred to as pervasive developmental
  disorders (later)
• Typically appears during the first 3 years of life

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WHAT IS AUTISM?

• Very likely neurological in origin not
  emotional, not the refrigerator mom
• Prevalence figures vary widely (textbook says
  5/10,000, but recent data say as high as 1/1000
  or even 1/500.
• 4 times more prevalent in boys
• No known racial, ethnic, or social boundaries
• No relation to family income, lifestyle

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WHAT IS AUTISM?

• Autism impacts normal development of the brain in
  areas of social interaction and communication
  skills.
• Difficult to communicate with others and relate
  to the outside world.
• Occasionally, aggressive and/or self-injurious
  behavior may be present.

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WHAT IS AUTISM?

• May exhibit repeated body movements (hand
  flapping, rocking).
• Unusual responses to people
• Attachment to objects
• Resistance to change in routine
• Sensory sensitivities

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WHAT ARE THE TYPES?

• Actually, the umbrella heading is Pervasive
  Developmental Disorder (PDD).
• Autism is one of the 5 PDDs.
• All have commonalities in communication and
  social deficits
• Differ in terms of severity

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1. Autistic Disorder

• Impairments in social interaction, communication,
  and imaginative play.
• Apparent before age 3.
• Also includes stereotyped behaviors, interests,
  and activities

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2. Aspergers Disorder

• Impairments in social interactions, and presence
  of restricted interests and activities
• No clinically significant general delay in
  language
• Average to above average intelligence

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3. Pervasive Developmental Disorder Not
Otherwise Specified (PDD-NOS)

• Often referred to as atypical autism
• Used when a child does not meet the criteria for
  a specific diagnosis, but there is severe and
  pervasive impairment in specified behaviors

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4. Retts Disorder

• Progressive disorder which, to date, has only
  occurred in girls.
• Period of normal development and then the loss of
  previously acquired skills
• Also loss of purposeful use of hands, which is
  replaced by repetitive hand movements
• Beginning at age of 1-4 years

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5. Childhood Disintegrative Disorder

• Normal development for at least the first 2 years
• Then significant loss of previously acquired
  skills

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Conclusions on Types

• Autism is a spectrum disorder
• This means that symptoms and characteristics can
  present themselves in wide variety of
  combinations, from mild to severe
• Autistic individuals can be very different from
  each other
• Autism is still commonly used to refer to any
  of the 5 PDDs

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What causes (and doesnt cause) autism?

• Good agreement in general that autism is caused
  by abnormalities in brain development,
  neurochemistry, and genetic factors
• Bettleheims theory of psychogenesis?

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How is Autism Diagnosed?

• No definitive medical test
• Team uses interviews, observation, and specific
  checklists developed for this purpose.
• Team might include neurologist, psychologist,
  developmental pediatrician, speech/language
  therapist, learning consultant, etc.
• Must rule out MR, hearing impairment, behavior
  disorders, or eccentric habits

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CHARACTERISTICS

• 1. Communication/Language
• 2. Social Interaction
• 3. Behaviors
• 4. Sensory and movement disorders
• 5. Resistance to change (predictability)
• 6. Intellectual functioning

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1. Communication/language

• Broad range of abilities, from no verbal
  communication to quite complex skills
• Two common impairments
• A. Delayed language
• B. Echolalia

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A. Delayed language

• 50 of autistic individuals will eventually have
  useful speech (?)
• Pronoun reversal You want white icing on
  chocolate cake.
• Difficulty in conversing easily with others
• Difficulty in shifting topics
• Look away poor eye contact
• Facilitated communication??????

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Elements of Facilitated Communication

• 1. Physical Support
• 2. Initial training/introduction
• 3. Maintaining focus
• 4. Avoiding competence testing
• 5. Generalization
• 6. Fading

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B. Echolalia

• Common in very young children (Age 3)
• Immediate or delayed (even years)
• Is there communicative intent with echolalia?

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2. Social Interaction

• One of hallmarks of autism is lack of social
  interaction
• 1. Impaired use of nonverbal behavior
• 2. Lack of peer relationships
• 3. Failure to spontaneously share enjoyment,
  interests, etc. with others
• 4. Lack of reciprocity
• Theory of mind?

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3. Behaviors

• Repetitive behaviors, including obsessions, tics,
  and perseveration
• Impeding behaviors (impede their learning or the
  learning of others)
• Will need positive behavior supports
• A. Self-injurious behavior
• B. Aggression

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4. Sensory and movement disorders

• Very common
• Over- or under-sensitive to sensory stimuli
• Abnormal posture and movements of the face, head,
  trunk, and limbs
• Abnormal eye movements
• Repeated gestures and mannerisms
• Movement disorders can be detected very early
  perhaps at birth

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5. Predictability

• Change in routine is very stressful
• May insist on particular furniture arrangement,
  food at meals, TV shows
• Symmetry is often important
• Interventions need to focus on preparing students
  for change if possible

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6. Intellectual functioning

• Autism occurs in children of all levels of
  intelligence, from those who are gifted to those
  who have mental retardation
• In general, majority of individuals with autism
  are also identified as having mental retardation
  75 below 70
• Verbal and reasoning skills are difficult
• Savant syndrome

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Interventions

• 1. Individualization and early intervention are
  the keys
• 2. Include life skills, functional academics,
  and vocational preparation
• 3. Positive behavior support
• 4. Social stories (music therapy?)
• 5. Lovaas model