Autism Spectrum Disorders


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Autism Spectrum Disorders

  1. 1. Chapter 12 Presented by: Hannah Paris Autism Spectrum Disorders
  2. 2. <ul><li>What is Autism? </li></ul><ul><ul><li>History </li></ul></ul><ul><ul><li>Definition </li></ul></ul><ul><li>Asperger Syndrome </li></ul><ul><li>Pervasive Developmental Disorder (PDD-NOS) </li></ul><ul><li>Causes and Prevention </li></ul><ul><li>Assessment & Early Intervention </li></ul><ul><li>In the Classroom </li></ul>Topics
  3. 3. <ul><li>Always part of human condition, only recently identified </li></ul><ul><li>ASD (Autism Spectrum Disorders) was first identified by Johns Hopkins psychiatrist Leo Kanner in 1943 </li></ul><ul><li>“ Autism” term was coined in 1911 by Swiss psychiatrist, Eugene Bluer </li></ul><ul><li>Viennese psychiatrist, Hans Asperger described a similar condition later called Asperger Syndrome </li></ul><ul><li>Early on, ASD was falsely viewed as being caused by bad parenting and specifically the “Refrigerator Mother” theory (p. 404) </li></ul><ul><ul><li>This theory states that autistic behaviors were a result of emotional frigidity from the children’s mothers (50s and 60s). –(wikipedia) </li></ul></ul><ul><ul><li>Video on this at - explores the guilt of mothers who were labeled as such during this time </li></ul></ul>History of Autism p. 404-405
  4. 4. <ul><li>When no evidence supported bad parenting as a cause, experts began to believe ASD was genetically based on neurobiological problems </li></ul><ul><li>Researchers demonstrated the effectiveness of “behaviorally based teaching techniques” in the improvement of language and intellectual skills with Autistic children (p. 404) </li></ul><ul><li>Bernard Rimland, a psychologist who’s son was diagnosed with ASD, helped other ASD parents form the National Society for Autistic Children, now called the Autism Society of America ( ). </li></ul>History Continued
  5. 5. <ul><li>Our book defines ASD as “a diverse set of three syndromes: </li></ul><ul><ul><li>Autism </li></ul></ul><ul><ul><li>Asperger Syndrome </li></ul></ul><ul><ul><li>Pervasive developmental disorder – not otherwise specified (PDD-NOS) (p.406) </li></ul></ul><ul><li>Think of these three syndromes as an “umbrella of disorders,” (p.406). Autism is in the middle, since the others share a range of traits with it. </li></ul><ul><li>“ These conditions share similar behavioral characteristics in the areas of: </li></ul><ul><ul><li>Social interaction </li></ul></ul><ul><ul><li>Verbal or nonverbal communication </li></ul></ul><ul><ul><li>Repetitive behaviors or interests </li></ul></ul><ul><ul><li>Sometimes unusual responses to sensory stimuli are present </li></ul></ul><ul><ul><li>(p. 406 – bottom) </li></ul></ul><ul><li>Different views are still developing </li></ul>Definition
  6. 6. <ul><li>Two similar conditions were recently considered as part of the ASD umbrella, but are currently not. </li></ul><ul><li>Important to distinguish </li></ul><ul><ul><li>Rett Syndrome: genetic condition in which signs appear early in life, but only after a seemingly normal development that then stops and begins to reverse. Characterized by hand wringing, lack of muscle control and social deficits. Occurs only in girls (p.407). </li></ul></ul><ul><ul><li>Childhood disintegrative disorder (CDD): develop as their peers do until 5 or 6 yrs. old, at which time a developmental regression begins (lose acquired language and social skills). Behaviors are similar to Autism, but regression is far worse as it continues to deepen (p. 407). </li></ul></ul>Similar Conditions p. 407-408
  7. 7. <ul><li>Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction generally evident before age three, that adversely affects a child’s educational performance (U.S. department of Education) (see page 408 for full definition). </li></ul><ul><li>Characteristics: </li></ul><ul><ul><li>Difficulty communicating (50% do not talk) </li></ul></ul><ul><ul><li>Restricted range of interests </li></ul></ul><ul><ul><li>Prefer time alone </li></ul></ul><ul><ul><li>Repetitive behavior </li></ul></ul><ul><ul><li>75% have intellectual disabilities, therefore 25% have average or above average intelligence (p.410) </li></ul></ul><ul><ul><li>Some are “autistic savants,” – less than 1% of those diagnosed (Raymond in Rain Man) </li></ul></ul><ul><ul><li>Some have outstanding artistic or musical abilities </li></ul></ul><ul><ul><li>Diagnostic Criteria in table on page 409 </li></ul></ul>Autism Defined p. 408-411
  8. 8. <ul><li>Asperger syndrome is a collection of behavioral characteristics that are associated with problems developing adequate social skills and with restricted or unusual interests (p.411). </li></ul><ul><ul><li>one of the autism spectrum disorders (ASD) where cognition is usually in the average or above-average range </li></ul></ul><ul><ul><li>Social awkwardness results from: </li></ul></ul><ul><ul><ul><li>Literal thinking (ie. Not understanding jokes). </li></ul></ul></ul><ul><ul><ul><li>Difficulty interpreting the behavior of others, such as nonverbal cues </li></ul></ul></ul><ul><ul><ul><li>Tendency to focus on favorite conversational topic </li></ul></ul></ul><ul><ul><li>List of characteristics on page 412 (Smith Myles & Simpson) </li></ul></ul>Asperger Syndrome p. 411-412
  9. 9. Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS) p. 412-413 <ul><li>PDD-NOS is one of the autistic spectrum disorders (ASD) in which not all three ASD characteristics (problems in communication, social interaction, and repetitive or manneristic behaviors) are present or they are mild (p.413). </li></ul><ul><li>The PDD part of the diagnosis signifies characteristics very similar to those of autism and Asperger syndrome, but the characteristics are not as clearly expressed. </li></ul><ul><li>The NOS part refers to other specified disorders or syndromes. </li></ul><ul><li>Although they share characteristics, PDD-NOS is currently considered as distinct from the other types of ASD. </li></ul>
  10. 10. Causes p.415-416 <ul><li>Not caused by bad parenting, as first thought </li></ul><ul><li>ASD is a genetic neurobiological disorder </li></ul><ul><li>People who have siblings with ASD are more likely to have ASD themselves because it is genetic </li></ul><ul><li>Scientists have not yet discovered which genes put people at risk </li></ul><ul><li>There are many false beliefs about the causes of ASD, such as: </li></ul><ul><ul><li>Environmental toxins </li></ul></ul><ul><ul><li>Gastrointestinal anomalies </li></ul></ul><ul><ul><li>Vitamin deficiencies </li></ul></ul><ul><ul><li>Vaccines – especially the measles/mumps/rubella (MMR) vaccine </li></ul></ul><ul><ul><li>(*many parents are currently withholding these vaccines because of their concern) </li></ul></ul><ul><li>Many websites provide inaccurate or out-of-date information, therefore is recommended </li></ul>
  11. 11. <ul><li>Because there is still so much to learn, prevention is not currently possible </li></ul><ul><li>Currently, we can work on improving symptoms with educational interventions </li></ul>Prevention p. 416
  12. 12. <ul><li>Teachers should be aware that most instruction at school is socially mediated and language based, which are problem areas for students with ASD (p. 417) </li></ul><ul><li>Screening is recommended early on so that children can be diagnosed younger and start interventions sooner (p. 417) </li></ul><ul><ul><li>Early signs of ASD (less than 24 months old) include: </li></ul></ul><ul><ul><ul><li>A family history, including siblings that are diagnosed with ASD </li></ul></ul></ul><ul><ul><ul><li>Poor eye contact </li></ul></ul></ul><ul><ul><ul><li>Poor response to other’s voices </li></ul></ul></ul><ul><ul><ul><li>Poor attempts at interactive play </li></ul></ul></ul><ul><ul><ul><li>More interest in looking at objects than people </li></ul></ul></ul><ul><ul><ul><li>Delayed pointing to request or share </li></ul></ul></ul><ul><ul><ul><li>Decreased to-and-fro babbling and jargoning </li></ul></ul></ul><ul><ul><ul><li>Lack of warm, joyful, reciprocating expressions </li></ul></ul></ul><ul><ul><ul><li>(Figure 12.3 on p. 417) </li></ul></ul></ul>Assessment
  13. 13. <ul><li>Until recently, children were not diagnosed until the age of 5 </li></ul><ul><li>It is now possible to diagnose children at age 2 </li></ul><ul><li>Research is ongoing to make diagnosis possible at an even younger age </li></ul><ul><ul><li>One such activity that can be monitored earlier than 2 years old is “Joint Attention.” </li></ul></ul><ul><ul><li>Joint attention happens when: </li></ul></ul><ul><ul><ul><li>Two people are together such as a child and parent </li></ul></ul></ul><ul><ul><ul><li>First, one person looks at an object and then at the other person </li></ul></ul></ul><ul><ul><ul><li>Then, both people jointly look at the same object </li></ul></ul></ul><ul><ul><li>Children with ASD do participate in Joint Attention, but they do so differently than children without ASD </li></ul></ul><ul><li>Two current screening tools are the Checklist for Autism in Toddlers (CHAT) and the Childhood Autism Rating Scale (CARS) . CARS can describe the severity of problems. </li></ul>Assessment Continued p. 418
  14. 14. <ul><li>Early intervention strategies have not been developed for children under age 3, even though diagnosis is now possible at that age </li></ul><ul><li>Some psychotropic medications reduce the behavioral excesses of ASD, including stereotypies and aggression (recommended only when other strategies have been exhausted) </li></ul><ul><li>Although no one educational program is consistently effective or appropriate for every child with ASD, there are a few key features of effective programs: </li></ul><ul><ul><li>Highly supportive teaching environments </li></ul></ul><ul><ul><li>Low staff-to-student ratios </li></ul></ul><ul><ul><li>Plans for generalization </li></ul></ul><ul><ul><li>Interventions to promote language and communication </li></ul></ul><ul><ul><li>Predictable and routine schedules </li></ul></ul><ul><ul><li>Behavioral approaches to address challenging behaviors </li></ul></ul><ul><ul><li>Supports to facilitate program transitions </li></ul></ul><ul><ul><li>Parent involvement and support </li></ul></ul><ul><ul><li>(p. 421) </li></ul></ul>Early Intervention
  15. 15. <ul><li>TEACCH – intervention program that uses “structured teaching” </li></ul><ul><ul><li>Structured teaching involves adapting materials and environments to help children make sense of the world. </li></ul></ul><ul><ul><li>The philosophy is that missing skills can be compensated for through visual supports and other forms of structure. </li></ul></ul><ul><ul><li>Parents are considered “co-therapists,” (p. 420) </li></ul></ul><ul><li>YAP – the Young Autism Program </li></ul><ul><ul><li>Incorporates “discrete trial teaching,” a highly structured technique involving teacher-directed activities, repetition of skills through practice, and careful application of rewards. </li></ul></ul><ul><ul><li>Teaches one skill at a time to promote independence in daily living (p. 420). </li></ul></ul>Early Intervention Continued
  16. 16. <ul><li>Comprehensive approaches such as the “Pyramid Approach,” </li></ul><ul><li>(p. 421) </li></ul><ul><ul><li>Uses a ‘broad spectrum of data-based techniques to support skill acquisition across domains’. </li></ul></ul><ul><li>Teaching ASD students effectively involves addressing the following (p. 421-425): </li></ul><ul><ul><li>Access to the general education curriculum (provides academic challenges and development of social skills). </li></ul></ul><ul><ul><li>Implementing instructional accommodations in the general ed classroom </li></ul></ul><ul><ul><li>Technology such as communication aides, interactive programs, and multimedia programs (promote reading/writing and social skills). </li></ul></ul><ul><ul><ul><li>Augmentative and alternative communication (AAC) – p. 424 </li></ul></ul></ul><ul><ul><ul><li>Picture exchange communication system (PECS) – p. 424 </li></ul></ul></ul>In the Classroom
  17. 17. <ul><ul><li>Data Based Practices such as: </li></ul></ul><ul><ul><ul><li>Positive Behavior Support, including ‘functional behavioral assessment,’ where the educator assess which events trigger problem behaviors. </li></ul></ul></ul><ul><ul><ul><li>Functional Communication Training, where the student is taught a more appropriate response in place of the problem behavior. </li></ul></ul></ul><ul><ul><ul><li>Using Activity schedules which give ASD students a visually supportive way to gain independence (help with skills and routines). </li></ul></ul></ul><ul><ul><li>Collaboration (p. 428-429) </li></ul></ul><ul><ul><ul><li>Providing peer supports for ASD students </li></ul></ul></ul><ul><ul><ul><li>Utilizing behavior analysts </li></ul></ul></ul><ul><ul><ul><li>Partnering with families and community </li></ul></ul></ul>In the Classroom Continued
  18. 18. <ul><li>Preparing Students for success after school (p.427): </li></ul><ul><ul><li>Skills taught in the classroom can help prepare students for working: </li></ul></ul><ul><ul><ul><li>Social skills – general communication </li></ul></ul></ul><ul><ul><ul><li>Adapting to new routines </li></ul></ul></ul><ul><ul><ul><li>‘ Navigating’ social interactions with employers and co-workers </li></ul></ul></ul>Beyond the Classroom