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Autism

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  • 1. AUTISM
    • Dr shabeel pn
  • 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 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
  • 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

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