Transcript Students with Autism Spectrum Disorder

Chapter 10
Students with Autism Spectrum
Disorder
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Development of the Field
Early belief in “refrigerator mothers”
1981 –distinguished autism and
Asperger syndrome
 1990 – Autism category added to IDEA
 1994 – Autism added to the DSM IV
 2013 – DSM only Autism Spectrum
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Disorder. Dimensional system.
IDEA Definition of Autism Spectrum
Disorder
…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.
Persistent deficits in social communication and social
interaction across multiple contexts
◦ Deficits in social-emotional reciprocity, ranging, for example, from
abnormal social approach and failure of normal back-and-forth
conversation; to reduced sharing of interests, emotions, or affect;
to failure to initiate or respond to social interactions.
◦ Deficits in nonverbal communicative behaviors used for social
interaction, ranging, for example, from poorly integrated verbal
and nonverbal communication; to abnormalities in eye contact and
body language or deficits in understanding and use of gestures; to
a total lack of facial expressions and nonverbal communication.
◦ Deficits in developing, maintaining, and understanding
relationships, ranging, for example, from difficulties adjusting
behavior to suit various social contexts; to difficulties in sharing
imaginative play or in making friends; to absence of interest in
peers.
Autism Spectrum Disorder

Restricted, repetitive patterns of behavior, interests, or activities,
as manifested by at least two of the following:
◦ Stereotyped or repetitive motor movements, use of objects, or speech (e.g.,
simple motor stereotypies, lining up toys or flipping objects, echolalia,
idiosyncratic phrases).
◦ Insistence on sameness, inflexible adherence to routines, or ritualized
patterns of verbal or nonverbal behavior (e.g., extreme distress at small
changes, difficulties with transitions, rigid thinking patterns, greeting rituals,
need to take same route or eat same food every day).
◦ Highly restricted, fixated interests that are abnormal in intensity or focus
(e.g., strong attachment to or preoccupation with unusual objects,
excessively circumscribed or perseverative interests).
◦ Hyper- or hyporeactivity to sensory input or unusual interest in sensory
aspects of the environment (e.g., apparent indifference to
pain/temperature, adverse response to specific sounds or textures,
excessive smelling or touching of objects, visual fascination with lights or
movement).
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With or without accompanying intellectual impairment
With or without accompanying language impairment
Autism Spectrum Disorder
Characteristics

Language Development
 Ranging from no verbal communication to complex
communication
 Delayed Language
 Receptive vs Expressive Skills
 Echolalia

Social Development
 Delays in social interaction and social skills
 Lack of peer relationships
 Failure to spontaneously share enjoyment,
interests, and achievements
 Lack of reciprocity
 Lack of Proxemics
Common characteristics
Repetitive behavior
 Fixations, tics, and perseverations. Self
stimulatory.
 Problem behavior
 Self-injurious behavior
 Studies indicate the less communication
needs are met, the more self-injurious
behavior
 Aggression
 Need for environmental predictability/sameness
 Sensory and movement disorders
 Intellectual functioning
 Approx. 75% have intellectual disabilities

Prevalence of Autism Spectrum
Disorder
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Much controversy about prevalence. No consensus
exists.
Some organizations say 1 : 166 children; others
1:100
IDEA estimates ~5% of students
DSM-V reported rate of 1% of population
Males outnumber females 4 to 1
Increased prevalence in last decade
Greater public awareness
More refined diagnostic procedures
Causes of ASD
Biological
Brain-Based
Environmental
May be inherited
Abnormalities
in cerebellum
Higher frequency
of siblings with
autism
No single gene
responsible
Abnormalities
in frontal and
temporal lobes
Controversy
over
immunization
NOTHING has
been
established!
Autistic Savant
◦ About 10% of the population with
autism have splintering skills in areas
such as
 Mathematical calculations
 Memory feats
 Artistic and musical abilities
 Reading
◦ Hyperlexia– ability to read without
formal instruction
Cognitive and Academic
Characteristics

Cognitive abilities vary
widely

Over-reliance on rote
memory

Lacking a theory of mind

Problem solving
challenges
Behavior Characteristics
 Stimulus
overselectivity
 Generalization
difficulties
Assessment
Intellectual
◦ 75 % of individuals with autism have mental
retardation; IQ norms between 35-50
 Behavioral
◦ Behavior screening examples
 Childhood Autism Rating Scale; Autism
Diagnostic Interview (ADI)
◦ Functional behavior assessment
 Required by IDEA
 Functional Assessment
◦ Measures skills needed for independent living

Early Childhood Education
Typical programs often include:
 Intervention prior to age 3
 20 – 45 hours of intervention weekly
 Active family involvement
 Focus on communication and development
 Individualized interventions
Educational Placements of Students Ages Six to
Twenty-One Who Have Autism Spectrum
Disorders
(in percentages)
Planning for the Transition to
Adulthood
 Teach
work skills
 Teach self-help skills
 Teach play, leisure and
recreation skills
 Teach social skills
 Teach home management skills
Recommended Educational
Practices
Environmental supports
◦ Visual supports
 Assistive technology
 Instructional practices
◦ Priming - familiarize students with
academic material ahead of time
◦ Discrete trial training (DDT) - highly
specialized approach to teaching skills
◦ Prompting - providing physical or verbal
cues to specific behaviors

Interventions
Applied Behavior Analysis (Lovaas)
Discrete Trial Training (DTT)
(1) Discriminative Stimulus - the trainer's
command
(2) the child's response
(3) the consequence (reward)
(4) a short pause between the
consequence and the next instruction
(between interval trials).
“Copyright© Allyn & Bacon
2006”
Interventions
Psychological and Medical Services
Sensory Perception Programs address issues of
tactile defensiveness or extreme reaction to
auditory stimulus
 Medications used to alleviate symptoms such
as aggression, anxiety, or obsessive compulsive
disorder, ADHD

Technology
◦ Apps for tablets
◦ Manual sign language
◦ PECS: Picture Exchange
Communication System
Social Skills Supports
 Instruction
in social
skills
 Social stories
 SOCCSS
◦ Situation
◦ Options
◦ Consequences
◦ Choices
◦ Strategies
◦ Simulation
Perspectives of Parents and
Families
Parents need information and support
◦ Need for intensive, early intervention
for child
◦ Role of parent is very demanding
 Siblings also need support
◦ Siblings play an important role
◦ Need resources appropriate to age

Current Needs in the Field of
Autism Spectrum Disorder
 Better
techniques for early
diagnosis and assessment
 Evidence-based
 More
interventions
programs to train
professionals