Transcript Early Identification of Infants and Toddlers With Autism

The Emotional Signaling Component
Sharing Emotion
Shares affect
vs.
Does not share or
reduced sharing
The Emotional Signaling Component
Signals Emotion through a variety of facial
expressions, appropriate to the situation
Signals affect appropriately
vs.
Flat affect
The Emotional Signaling Component
Signals affect appropriately
The Emotional Signaling Component
Signals affect appropriately
The Emotional Signaling Component
Signals affect appropriately
The Emotional Signaling Component
Flat affect
The Emotional Signaling Component
Flat affect
The Emotional Signaling Component
Flat affect
BUT There are some children with autism who are
happy and outgoing. They appear social but they lack
the ability to sustain social interaction.
Social Interaction Behaviors
What are the COMPONENTS?
1. Social Interest: How does a child show that they are
interested in and “tuned in” to other people?
2. Emotional Expression or Signaling: How does a
child share emotions and how “readable” are they?
3. Capacity for Interaction: How much
“back and forth” can they do?
The Interactive Component
Imitation: Spontaneous and frequent
Imitates easily and frequent vs.
Low rate of
imitation
The Interactive Component
Spontaneous Turn-taking
Takes turns easily
and frequently
vs.
Low rate of
turn-taking
The Interactive Component
SUSTAINED SOCIAL INTERACTION
The Behaviors
•Social Interaction
•Communication
•Repetitive Behaviors
Communication Behaviors
What are the COMPONENTS?
1. Degree of Language Delay
2. Social language: Coordinating verbal and
nonverbal
3. Social language: Communicative intent: Having
different types of messages
4. Presence of atypical language
Degree of language delay
Continuum of Communication Delay in
Autism Spectrum Disorder
severe
No spoken
language into
adulthood
mild
(regression
between 15 and 24
months)
Speaking by
2-3 years with
persisting
characteristic
differences
Communication Behaviors
What are the COMPONENTS?
1. Degree of Language Delay
2. Social language: Coordinating verbal
and nonverbal
3. Social language: Communicative
intent: Having different types of
messages
4. Presence of atypical language
LANGUAGE DELAY:
Delay in acquiring words,
phrases, sentences,
grammar, etc.
SOCIAL USE
OF LANGUAGE:
How child uses language
in interaction with other
people
SOCIAL USE OF LANGUAGE
WHAT IT DOES FOR THE CHILD:
•Regulates others’ behavior
• Engages others interpersonally
• Carry on a sustained, reciprocal conversation
HOW IT DOES IT:
• Combines verbal and nonverbal means to be an
effective communicator
• Conveys a variety of types of messages
SOCIAL USE OF LANGUAGE
COORDINATING COMMUNICATION
MODALITIES
1. VOCAL/VERBALIZATION
2. EYE CONTACT, GAZE SHIFT, FACIAL
EXPRESSION
3. GESTURES
SOCIAL USE OF LANGUAGE
1.
VOCAL/VERBALIZATION
2.
EYE CONTACT, SHIFT, EXPRESSION
3.
GESTURES
“Unnh.”
“Open?”
SOCIAL USE OF LANGUAGE
SOCIAL USE OF LANGUAGE
SOCIAL USE OF LANGUAGE
SOCIAL USE OF LANGUAGE
USING AND COMBINING MODALITIES:
Age at which this develops:
12 To 18 months
INTENTIONAL COMMUNICATION:
Having a variety of things you can
DO with your communications
 Requesting an object or action
 Commenting on an object or action
 Answering
 Greeting
 Negating/refusing
 Protesting
 Acknowledging other’s communication
SOCIAL USE OF LANGUAGE: Different Messages
SOCIAL USE OF LANGUAGE: Different Messages
SOCIAL USE OF LANGUAGE
COMMUNICATIVE INTENTION
REPERTOIRE:
Age at which this develops:
12 To 18-24 months
Communication Behaviors
What are the COMPONENTS?
1. Degree of Language Delay
2. Social language: Coordinating verbal and nonverbal
3. Social language: Communicative intent: Having different
types of messages
4. Presence of atypical language
Atypical Language
ECHOLALIA
SCRIPTING
INSTRUMENTAL COMMUNICATION
ATYPICAL BABBLING OR JARGONING
Communication
Atypical Language
The Behaviors
•Social Interaction
•Communication
•Repetitive Behaviors
Repetitive Behaviors
What are they?
Research : 3-5 categories
“Lower” vs. “Higher”
Physical sensation vs.
Obsessions
An Organizational system for Observation
Repetitive Behaviors
Repetitive Behaviors
Repetitive Behaviors
Repetitive Behaviors
Repetitive Behaviors
SENSORY BEHAVIORS:
Seeking or avoiding
TACTILE:
Avoids: Light touches, unexpected touches, sensations
against skin, certain clothing and clothing tags, certain
tastes and textures in the mouth--may lead to diet
restriction
Seeks: Deep pressure, certain sensations and textures
controlled by the child himself.
SENSORY BEHAVIORS:
Seeking or avoiding
AUDITORY:
May be averse to: Noisy environments, or very
particular sounds
May Seek: Unusual sounds that the child
makes himself, sounds he produces himself by
banging on toys, pushing buttons.
SENSORY BEHAVIORS:
Seeking or avoiding
TASTE, SMELL:
Screening: the Vocabulary
 Broad-band vs. autism-specific
Broad-band screens for developmental delay =
DEVELOPMENTAL SURVEILLANCE
Ages & Stages Questionnaire
 Areas screened - Communication, gross motor, fine
motor, problem solving, and personal-social
 Who completes it - Parents/caregivers complete
questionnaires; professionals, paraprofessionals, or
clerical staff score them
 Time Each questionnaire takes 10–15 minutes to
complete and just 1-3 minutes to score
Screening Instruments
M-CHAT
(MODIFIED CHECKLIST FOR AUTISM IN TODDLERS)
What: Checklist, 23 items
For What Ages: 16-30 months
Who: Parent fills out - < 5minutes
Scoring: At risk: fail 3 items total
or fail 2 out of 6 critical items
Note: Must be used with follow-up interview for best
predictive value
How to obtain: download from the internet
Screening Instruments
Infant-Toddler Checklist
What: Checklist, 25 items
For What Ages: 8-24+ months
Who: Parent fills out - < 5minutes
How to obtain: download from the internet