AUTISMChapter 13This PowerPoint includes additional information not found in your text

OverviewWhat 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?

WHAT IS AUTISM?Very complex, often baffling developmental disabilityFirst 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

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

WHAT IS AUTISM?Very likely neurological in origin – not emotional, not the refrigerator momPrevalence 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 boysNo known racial, ethnic, or social boundariesNo relation to family income, lifestyle

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.

WHAT IS AUTISM?May exhibit repeated body movements (hand flapping, rocking).Unusual responses to peopleAttachment to objectsResistance to change in routineSensory sensitivities

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 deficitsDiffer in terms of severity

1. Autistic DisorderImpairments in social interaction, communication, and imaginative play.Apparent before age 3.Also includes stereotyped behaviors, interests, and activities

2. Asperger’s DisorderImpairments in social interactions, and presence of restricted interests and activitiesNo clinically significant general delay in languageAverage to above average intelligence

3. Pervasive Developmental Disorder – Not Otherwise

Specified (PDD-NOS)

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

4. Rett’s DisorderProgressive disorder which, to date, has only occurred in girls.Period of normal development and then the loss of previously acquired skillsAlso loss of purposeful use of hands, which is replaced by repetitive hand movementsBeginning at age of 1-4 years

5. Childhood Disintegrative Disorder

Normal development for at least the first 2 yearsThen significant loss of previously acquired skills

Conclusions on TypesAutism is a spectrum disorderThis means that symptoms and characteristics can present themselves in wide variety of combinations, from mild to severeAutistic individuals can be very different from each other“Autism” is still commonly used to refer to any of the 5 PDDs

What causes (and doesn’t cause) autism?

Good agreement in general that autism is caused by abnormalities in brain development, neurochemistry, and genetic factorsBettleheim’s theory of psychogenesis?

How is Autism Diagnosed?No definitive medical testTeam 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

CHARACTERISTICS1. Communication/Language2. Social Interaction3. Behaviors4. Sensory and movement disorders5. Resistance to change (predictability)6. Intellectual functioning

1. Communication/languageBroad range of abilities, from no verbal communication to quite complex skillsTwo common impairments:A. Delayed languageB. Echolalia

A. Delayed language50% of autistic individuals will eventually have useful speech (?)Pronoun reversal: “You want white icing on chocolate cake.”Difficulty in conversing easily with othersDifficulty in shifting topicsLook away; poor eye contactFacilitated communication??????

Elements of Facilitated Communication

1. Physical Support2. Initial training/introduction3. Maintaining focus4. Avoiding competence testing5. Generalization6. Fading

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

2. Social InteractionOne of hallmarks of autism is lack of social interaction1. Impaired use of nonverbal behavior2. Lack of peer relationships3. Failure to spontaneously share enjoyment, interests, etc. with others4. Lack of reciprocityTheory of mind?

3. BehaviorsRepetitive behaviors, including obsessions, tics, and perseverationImpeding behaviors (impede their learning or the learning of others)Will need positive behavior supportsA. Self-injurious behaviorB. Aggression

4. Sensory and movement disorders

Very commonOver- or under-sensitive to sensory stimuliAbnormal posture and movements of the face, head, trunk, and limbsAbnormal eye movementsRepeated gestures and mannerismsMovement disorders can be detected very early – perhaps at birth

5. PredictabilityChange in routine is very stressfulMay insist on particular furniture arrangement, food at meals, TV showsSymmetry is often importantInterventions need to focus on preparing students for change if possible

6. Intellectual functioningAutism occurs in children of all levels of intelligence, from those who are gifted to those who have mental retardationIn general, majority of individuals with autism are also identified as having mental retardation – 75% below 70Verbal and reasoning skills are difficultSavant syndrome

Interventions1. Individualization and early intervention are the keys2. Include life skills, functional academics, and vocational preparation3. Positive behavior support4. Social stories (music therapy?)5. Lovaas model