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MCA – Short intro film

Middletown Centre for Autism

Autism, The Facts and How to Help

An Introduction to Autism

Learning Outcomes

Parents will:

• Be aware of services and resources offered by Middletown Centre for Autism

• Have a better understanding of how children with autism perceive the world.

• Be aware of core strengths and deficits that may be associated with a diagnosis of autism.

• Have a better understanding of how to use children’s strengths to help them reach their potential.

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Centre for Autism

Transdisciplinary Approach

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Educational Psychologists

Teachers

Three Core Services

Research

Learning Support & Assessment

Training

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Training Events, Research projects, Bulletins,

Online Resources . . .

https://www.middletownautism.com/

Online Resources – Sample

• a neurologically based developmental disability• characterised by developmental impairments

in – Communication and language, – Reciprocal social interactions and – Restricted and repetitive repertoire

behaviours• Pervasive - it is evident in all settings (although

this may be variable)

Autism is …

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• Autism is not caused by family dynamics or parenting style or anything a parent did.

Autism is not …

Research

•Autism can be diagnosed in children, young people and adults if their presentation meets criteria defined in the DSM 5.

•Boys 4-5 times more likely than girls

•Prevalence: 1/68 (CDC; US)

• Identical twins if one twin has then 46% chance the other will have a diagnosis.

•1 child with autism 10% chance other siblings with have a diagnosis.

Prevalence . . . .

• Increased awareness and knowledge about autism (e.g. clinicians, educators, parents) has led to increased assessment and accurate diagnosis.

•Change in diagnostic criteria (1943 - 2017)

•Better screening now – e.g. children with Developmental Delay are often routinely screened for autism

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Autism and Girls

x5

There’s a growing body of empirical literature indicating that autism in girls presents differently and face different challenges to their male counterparts.

Diagnostic Criteria

DSM-IV

Triad of core symptoms

DSM-5

Dyad of core symptoms (May 2013)

Social Communication

Triad

Social communication

Restricted interests and repetitive behaviours

Social interaction

Dyad

Restricted interests and repetitive Behaviours

Core feature - unusual sensory responses

DSM 5

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DSM 5 Severity Descriptors

Characteristics of Autism

• Core behaviours are typically present in early childhood, although some features may not manifest until a change of situation/transition in their lives i.e. the start of pre-school.

• Regression or stasis of language and social behaviour is reported for at least a third of children with autism.

• The presentation of autism differs across ages and therefore for any individual this may change as they grow and mature. In response to environmental demands, intervention and in the context of coexisting conditions.

• Adam Harris• Ted Talk

Video – Adam Harris

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If you know one person with autism then you know one person with autism.

Stephen Shore.

How to Help . . .

•Deep understanding of core features of autism• Autism: Possible strengths and challenges

• Impact of Visual Methodologies• Social Communication

• Sensory Processing

• Behaviour

•Collaborative team approach

•Positive attitude; open and honest communication

•Evidenced Based Practice / Interventions• Reference

The ‘Culture of Autism’

‘Culture of autism’ refers to the way autism is viewed.

Mesibov & Shea

A different brain not a damaged brain

•Developmental Difference, not Damage

•Some similarities

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Dyad of Impairments -

Social Communication &

Interaction

Deficits in non-verbal communication

Communicating with others-Receptive/

Expressive

Deficits in developing and maintaining social

relationships

Social Communication and Interaction

Only 7% of communication

conveyed in words,

remainder dependent on

immediate context, shared

past experiences, tone of

voice, facial expressions,

eye contact.

Deficits in non-verbal

communication

Social Communication and Interaction

• Difficulties understanding spoken language.

• Delay in processing spoken language

• Difficulties attending to speaker.

• Difficulty following instructions or multi-step directions

• Literal interpretation of language

• Difficulty understanding jokes, sarcasm, metaphors

• Receptive language problems less obvious in higher functioning individuals masking problems with verbal understanding.

Communicating with others-

Receptive language difficulties

Social Communication and Interaction

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•Be very literal in their interpretation; may have difficulty understanding jokes, metaphors and sarcasm.

Social Communication and Interaction

•Varies from no communication at all to fluent grammatical speech.

•May lack understanding about reciprocal conversation and the two way flow of communication; may dominate conversations / class-time with one-way interactions.

•Speak excessively about a special interest

•Difficulty expressing thoughts and emotions.

Communicating with others-

Expressive language difficulties

Social Communication and Interaction

One-way interaction . . .

Social Communication and Interaction

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Difficulty with

• Beginning, maintaining and ending social exchanges

• Giving and receiving compliments

• Turn-taking and sharing

• Exercising self-control; may react aggressively to good natured teasing.

• Poor or limited understanding of social rules

• Difficulties with Theory of Mind

Deficits in developing and maintaining social relationships

Social Communication and Interaction

Impact of Autism - Eve

TOM difficulties

Theory of Mind (mind reading – reading yours!!!):

Child with autism will have difficulty•understanding another person’s thoughts

• recognising when someone is hurt or distressed

• ‘seeing’ things from another person perspective

Pupils with TOM difficulties live with higher levels of

anxiety.

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Sheldon – Theory of Mind

• Video

• https://www.youtube.com/watch?v=4_0Hx5ey35c

Central Coherence

•How information is processed. E.g. Most individuals will recall the overall impression or gist of something – e.g. of a story or a conversation.

• Individuals with autism tend to overly focus on specific details, at the expense of understanding the actual meaning or the overall ‘gist’.

• ‘Rolled up’ paper view of the world

•Difficulty with what is relevant and what is redundant.

•NNB – Be concise; use direct instructions; say less

The test requires the participant to spot a simple

form within a more complex figure;

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Weak Central Coherence:

Anyone notice what time it was?

Seen by Group 1

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Overall ‘picture’

Discussion:Your Child’s Strengths and Challenges• Social Communication

Non-verbal Communication

Receptive and Expressive language

Developing and maintaining friendships

Break

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Restrictive Interests & Repetitive Behaviours

Frustration and Anxiety

Change and transitions

Restricted/ fixated interests

Sensory processing

Stereotyped / Repetitive Motor movements

Gomot & Wiker 2012

Wendy Lawson

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Restricted range of interests and repetitive behaviours

• Impairment of imagination may affect the way children develop play skills, may not engage in any pretend play, or pretend play related to special interests, DVDs

• Play may be repetitive, solitary or if it involves others then only on the child’s terms

Repetitive Questions

•Social echolalia.

•To maintain the interaction.

•Predict what you are going to say next: What colouris your car?

•Reassurance that you have not changed your mind

Donna Williams

“I loved to copy, create and order things. I loved our set of encyclopedias. They had

letters and numbers on the side, and I was always checking to make sure they were in

order or putting them that way. I was making order out of chaos.”

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Sean Barron

“I loved repetition. Every time I turned on a light I knew what would happen. When I

flipped the switch, the light went on. It gave me a wonderful feeling of security, because it

was exactly the same each time.”

Restricted Interests & Repetitive Behaviours

Behavioural Characteristics Impact on Learning and

Behaviour

• Preference for only one or a

few activities.

• Difficulty with transitions,

changes in routine and

unexpected events.

• Difficulties with maintaining

attention without external

structure and support

• Difficulties moving from one

activity to another

• Over-focus on particular

items of interest.

• Rigid adherence

• Repetitive, stereotyped

motor mannerisms

• Preoccupation with object

parts rather than whole

•5 commonly known sensory systems–Visual–Auditory–Touch (Tactile)–Smell –Taste

•Additional sensory systems–Proprioceptive (body awareness) –Movement (vestibular) Qualified OT assessment

Sensory Processing

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Sensory Sensitivity

• Acute auditory sensitivity to specific sounds (Hyperacusis)

• Sudden or ‘sharp’ noises, ( dog barking, coughing, click of a pen top)

• Small electric motors or a specific pitch

Sensory processing

Responses to Sensory Input

• Anxiety escalates in sensory-rich environments e.g. a noisy

supermarket, playground, classroom

• Anxiety is also triggered when they receive specific input which

they dislike e.g. a child crying, light touch, smells

• Responses include

➢‘Fight or flight’- (hits out or escapes from situation)

➢Child appears to be distractible and ‘on edge’

➢Emotional outbursts

Temple Grandin

“ Sudden loud noises hurt my ears like a dentist’s drill hitting a nerve. High

pitched continuous noises such as hair dryers and other small motors are

annoying”.

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A world of difficult sensory experiences

•Hyper-vigilant

•Exhausting

• Life long

•Environments: supermarkets and shopping centres, playground, birthday parties, bathrooms, meals

• Increases and is increased by anxiety• Need a coping or escape mechanism• Self hypnosis, being mesmerized by a repetitive action or

sensation

Tactile Defensive: Stephen Shore

“Haircuts were always a major event. They hurt! To try to calm me, my parents would say

that hair is dead and has no feeling. It was impossible for me to communicate that the

pulling on the scalp was causing the discomfort.”

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Therese Jolliffe

“Reality to an autistic person is a confusing, interacting mass of events, people, places,

sounds and sights. There seems to be no clear boundaries, order or meaning to anything. A

large part of my life is spent just trying to work out the pattern behind everything.

Set routines, times, particular routes and rituals all help to get order into an unbearably

chaotic life.”

Autism Friendly Environment

•Quiet, well-structured.

•Avoid sensory overload.

•Minimal changes in routines.

•Visible schedule of activities and preparation for transitions.

Structure

• Routines

• Timetables

• Consistency

• Predictability

• Visual systems

• Low arousal areas

• Learning breaks

• Timers (where appropriate)

NO SURPRISES

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Don’t forget the positives!!

•People with autism are often:

• Loyal

•Unique perspective

•Dependable

•Honest

•Excellent memory

•Attention to detail

•Persistent in pursuing topics

•Have a particular area of knowledge, skills, etc

•Adhere meticulously to routines and appreciate order

Autism and Learning Style

Think differently

Learn differently…Teach differently

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Interpretation . . .

“You are an automobile and you run on highways, you go this way and

that. You turn off on different places. Sometimes you take the

scenic route. Sometimes you listen to the radio. You entertain a

thousand options but we (people with autism) are not automobiles we are locomotives – we run on a single track. We consider one idea

at a time and your mistake is making us like cars and trying to

make us run on your highway. We cannot run like that. Help us find our track among your system of

highways”

Learning style

Learning style of young person with autism ?

✓ Visual

Visual and Auditory Processing

NT Brain Autism Brain

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T

10 Things Every Child with Autism Wishes You Knew.

1. I am a child.

2. My senses are out of sync.

3. Distinguish between won’t (I choose not to) and can’t (I am not able to).

4. I’m a concrete thinker. I interpret language literally.

5. Listen to all the ways I’m trying to communicate.

6. Picture this! I’m visually oriented.

7. Focus and build on what I can do rather than what I can’t do.

8. Help me with social interactions.

9. Identify what triggers my meltdowns.

10. Love me unconditionally.

Ref: 10 Things Every Child with Autism Wishes You Knew

Ellen Notbohm

Next Session

•Autism, Learning Style and Visual Methodologies

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