Transcript AUTISM

AUTISM
Chapter 13
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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 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
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 selfinjurious 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.
2.
3.
4.
5.
6.
Communication/Language
Social Interaction
Behaviors
Sensory and movement disorders
Resistance to change (predictability)
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.
2.
3.
4.
5.
6.
Physical Support
Initial training/introduction
Maintaining focus
Avoiding competence testing
Generalization
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