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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?
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
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
WHAT IS AUTISM?
Very likely neurological in origin – not emotional,
not the refrigerator mom
Prevalence is 2-6/1000 individuals (1/2 to 1 ½
million affected)
4 times more prevalent in boys
No known racial, ethnic, or social boundaries
No 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 people
Attachment to objects
Resistance to change in routine
Sensory 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
deficits
Differ in terms of severity
1. Autistic Disorder
Impairments in social interaction,
communication, and imaginative play.
Apparent before age 3.
Also includes stereotyped behaviors, interests, and
activities
2. Asperger’s Disorder
Impairments in social interactions, and presence of
restricted interests and activities
No clinically significant general delay in language
Average to above average intelligence
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
4. Rett’s 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
5. Childhood Disintegrative Disorder
Normal development for at least the first 2 years
Then significant loss of previously acquired skills
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
What causes (and doesn’t cause) autism?
Good agreement in general that autism is caused by
abnormalities in brain development,
neurochemistry, and genetic factors
Bettleheim’s theory of psychogenesis?
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
CHARACTERISTICS
1. Communication/Language
2. Social Interaction
3. Behaviors
4. Sensory and movement disorders
5. Resistance to change (predictability)
6. Intellectual functioning
1. Communication/language
Broad range of abilities, from no verbal
communication to quite complex skills
Two common impairments:
A. Delayed language
B. Echolalia
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??????
Elements of Facilitated Communication
1. Physical Support
2. Initial training/introduction
3. Maintaining focus
4. Avoiding competence testing
5. Generalization
6. Fading
B. Echolalia
Common in very young children (Age 3)
Immediate or delayed (even years)
Is there communicative intent with echolalia?
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?
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
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
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
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
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

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Autism 2

  • 1.
  • 2. 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?
  • 3. 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
  • 4. 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
  • 5. WHAT IS AUTISM? Very likely neurological in origin – not emotional, not the refrigerator mom Prevalence is 2-6/1000 individuals (1/2 to 1 ½ million affected) 4 times more prevalent in boys No known racial, ethnic, or social boundaries No relation to family income, lifestyle
  • 6. 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.
  • 7. 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
  • 8. 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
  • 9. 1. Autistic Disorder Impairments in social interaction, communication, and imaginative play. Apparent before age 3. Also includes stereotyped behaviors, interests, and activities
  • 10. 2. Asperger’s Disorder Impairments in social interactions, and presence of restricted interests and activities No clinically significant general delay in language Average to above average intelligence
  • 11. 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
  • 12. 4. Rett’s 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
  • 13. 5. Childhood Disintegrative Disorder Normal development for at least the first 2 years Then significant loss of previously acquired skills
  • 14. 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
  • 15. What causes (and doesn’t cause) autism? Good agreement in general that autism is caused by abnormalities in brain development, neurochemistry, and genetic factors Bettleheim’s theory of psychogenesis?
  • 16. 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
  • 17. CHARACTERISTICS 1. Communication/Language 2. Social Interaction 3. Behaviors 4. Sensory and movement disorders 5. Resistance to change (predictability) 6. Intellectual functioning
  • 18. 1. Communication/language Broad range of abilities, from no verbal communication to quite complex skills Two common impairments: A. Delayed language B. Echolalia
  • 19. 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??????
  • 20. Elements of Facilitated Communication 1. Physical Support 2. Initial training/introduction 3. Maintaining focus 4. Avoiding competence testing 5. Generalization 6. Fading
  • 21. B. Echolalia Common in very young children (Age 3) Immediate or delayed (even years) Is there communicative intent with echolalia?
  • 22. 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?
  • 23. 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
  • 24. 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
  • 25. 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
  • 26. 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
  • 27. 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