Autism Spectrum Disorder

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Autism Spectrum Disorder An Overview Presented
by Pennsylvania Training and Technical Assistance
Network Statewide Autism Initiative Lynn Dell
M.S. Educational Consultant
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Objectives for this session

• Identify characteristics, features of autism and
  domain areas for assessment
• Identify tools to aid in appropriate assessment
  (Autism Select Assessment Protocol)
• Identify team members to facilitate a
  comprehensive assessment
• Identify your next steps in effective program
  application (design and delivery)

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(No Transcript)
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• Meet
• Dustin Geoffrey

Videotape Autism Awareness Video Autism
Society of America
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Pennsylvanias standards

• Autism is defined as
• a pervasive developmental disability
  characterized by qualitative distortions in the
  development of cognitive, language, social or
  motor skills.

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Cause ?

• Autism is behaviorally defined syndrome that is
  reflected in some type of developmental
  dysfunction in the central nervous system within
  the areas responsible for social and
  communication development
• Gillberg, 1989Volkmar Cohen, 1988)
• The precise neurobiological process that causes
  autism is yet to be identified (Gillberg, 1990)

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Autism Spectrum Disorder
Pervasive Developmental Disorder Not
Otherwise Specified (PDD - NOS)
Autism
Aspergers Syndrome
Childhood Disintegration Disorder
Retts Syndrome
DSM IV
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Core Features of Autism Spectrum Disorder

• A Qualitative Impairment of Social Development
• A Qualitative Impairment of Communication
• Restricted repertoire of behaviors and interests
• DSM IV 1994

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Social Difficulties

• Social difficulties are some of the primary
  challenges for individuals with autism dual to
  lack of social reciprocity
• Even high functioning children and adults on the
  autism spectrum have difficulties with social
  interaction.
• These problems are often associated with a
  limited number of successful peer relationships
  and behavior problems.

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Eye Gaze

• Many individuals with autism avoid making eye
  contact.
• Some think this may be to avoid social
  interactions.
• Eye contact often relates to the familiarity or
  complexity of the task.
• Subtle social cues are picked up by observationa
  difficulty for learning or attending to social
  cues (facial expressions).

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Affect

• Some (not all) individuals on the autism spectrum
  may demonstrate a more detached expression on
  their face.
• This may be because they are not experiencing the
  same emotion as others in the situation but they
  do feel and have emotions

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Stages of Social Involvement

• Parallel Play - Parallel Activities
• Sharing
• Turn Taking
• Simple Rules
• Reciprocal Social Interaction

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Social Skills of Focus

• Level One
• eye contact responding
• turn taking requesting
• waiting attending skills
• physical proximity accepting physical
• making choices contact
• imitation watching
• functional play participation

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Social Skills of Focus

• Level 2
• Seek attention (e.g. vocal, gestural)
• Initiating interactions greetings
• Joint attention
• Scripting
• Reciprocal sharing
• Agreeing
• Follows classroom rules/routines
• (e.g. hand up, line up)

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Communication Language Domains

• There is a complex interdependence of cognitive
  learning style, social understanding, language
  learning and communication patterns.
• Communication/Language and Social skills do not
  emerge as a series of isolated behaviors!

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Comments on Cognitive Learning

• The use of standardized assessment tools to
  determine level of cognition are only marginally
  relevant to instruction and intervention
• These tools may be more helpful when an item by
  item analysis is done or when reviewing
  accumulated test profiles
• This helps to better understand the cognitive
  ramifications or learning modesDeMyer

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Cognitive Learning

• For example
• when child is required to attend to transient
  visual cues-performance drops, but may see
  success when visual stimuli remained present
• may see decrease in performance when asked to
  increase sequential motor tasks, may see
  improvement when perform discrete steps,
  methodically presented
• may see decrease in inability to imitate body
  movements, may see improvement when systematic
  prompts are used
• may show stimulus overselectivity (the tendency
  to tune into a single stimulus component),
  improve when adjust presentation order, types of
  materials
• May see strength in concrete associations, but
  demonstrate poor abstract skills

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Cognitive Learning

• For example...
• May show difficulty in generalizing newly learned
  information (shifting or transitioning)
• Show strengths in gestalt, chunking information
• Showing strengths in spatial skills vs
  language-based thinking
• May show strengths of visuo-spatial arrays from
  samples block construction, jig saw puzzels,
  formboards, block designs
• May see strength in rote memory, but difficulty
  with working memory
• May see strength in knowledge of objects but not
  people
• So How do we use this information???

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Cognitive Profile (Summary)

• Abilities
• Concrete Associations
• Gestalt processing
• Visuo-spatial thinking
• Knowledge of objects
• Functional Play
• Rote memory

• Difficulties
• Abstract Meaning
• Analytical Processing
• Auditory-temporal language
• Knowledge about people (social)
• Imaginative Play
• Generalization

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MEET THE CHILDREN!

• Videotape samples

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Communication

• Often considered to be the central disability
  associated with autism spectrum disorder.

Everyone Communicates!
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What is Communication?

• The process of imparting/exchanging to one
  another ideas, information, messages, thoughts,
  feelings or opinions by means of signs, signals,
  and symbols expressed consciously or
  unconsciously
• A broader and more inclusive term than language
  and speech (Handbook of Speech Pathology and
  Audiology)

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Communication/Language Learning

• Early Development
• Begin to develop memory, representations of
  objects and events, imitate, match facial
  expression, use mouth as exploratory organ,
  coordinate vision and audition to look at person
  talking to them ...

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Communication/Language/Speech Characteristics of
Autism

• Inconsistent auditory responding
  hypersensitivity or lack of response
• Difficulty with categories (related to difficulty
  with joint attention)

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Communication/Language/Speech Characteristics of
Autism

• Limited comprehension of verbal and gestural
  communication.
• Difficulty with abstractions, more literal
  interpretation of language in more cognitive
  aware (literal comprehension of idioms, sarcastic
  comments, multi-meaning words, requires
  flexibility and consideration of nuances of
  context)
• Difficulty following others topics interpreting
  communicative attempts forming a gist

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Communication/Language/Speech Characteristics of
Autism

• Communicative profiles of autism generally range
  from persons who are nonverbal to those who use
  speech as their primary means of communication.
• Why some individuals learn to speak and others do
  not?
• Absence or difficulty in many critical
  pre-linguistic skills limited conventional
  gesture development
• Neuro-motor issues related to apraxia of speech
• ( Marquardt, Dunn, Davis, 1985)

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Communication/Language/Speech Characteristics of
Autism

• Limited range of communicative functions
  (preverbal and verbal levels)
• for meeting immediate needs (behavior
  regulation/communicative intent)
• slower acquisition or absence of communication
  for more social purposes (social interaction,
  joint attention)
• Generativity (routinized ways of using words,
  coming up with novel ideas)
• Grammar (syntax) relatively good but rigid
• Vocabulary Development (limited social jargon)

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Communication/Language/Speech Characteristics of
Autism

• Pragmatics or (rules for social use of language
  in context) social initiation, exchange,
  shifting, repairing, ending conversation often
  difficult
• Variable speech intelligibility / Overly precise
  articulation/ Syllable substitution errors
  (e.g.,teapotmental/departmental)
• Praxis, coordination (respiratory-stimulatory)

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Communication/Language/Speech Characteristics of
Autism

• Echolalia (process auditory/visual information in
  a gestalt fashion/remember and produce chunks of
  information) (Prizant, 1983)
• Exact echolalia (copy intonation patterns seen
  as representing stage of language development
  can be self-stimulatory with little communicative
  value)
• Delayed echolalia (chunks used to communicate
  functionsdeficits in receptive language can be
  masked by more advanced echolalic expressions)
• Perseverative/incessant questioning (may be
  related to levels of emotional arousal and/or
  processing difficulties)

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Communication/Language/Speech Characteristics of
Autism

• Voice Quality and Prosodic Features
• poor pitch modulation
• inappropriate loudness- use of whispered speech
• monotonous tempo-inconsistent tempo

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Communication/Language/Speech Characteristics of
Autism

• Proxemic problems
• problems in use of space and proximity in
  communicating with others body orientation issues

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Patterns of Behavior

• Preoccupation w/one or more stereotyped and
  restricted patterns of interest
• Inflexible adherence to specific, nonfunctional
  routines or rituals
• Stereotyped and repetitive motor mannerisms
• Persistent preoccupation w/parts of objects

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Visit website for more detailed diagnostic
information!

• www.pattan.k12.pa.us
• Autism Page

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Assessment

• The process of understanding the performance of
  students in their current ecology
• Salvia Ysseldyke, 1995
• Is a dynamic process accomplished through a
  multidisciplinary team approach
• Data should allow Team to evaluate features of
  programming the student will need then match and
  adapt to provide the appropriate program

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Autism Assessment Protocol

• Domains to Assess
• Communication/Language
• Social
• Cognitive
• Sensory/Motor
• Type of Assessments- See Protocol
• Who Assess?? Those with knowledge and skills who
  can best assess the domain areas listed above
  Speech Pathologist and
• Need both authentic and standardized!

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Autism Assessment Protocol

• Relies heavily on OBSERVATION of the student in
  learning and natural environments
• Collecting information from and interviewing
  parents, teachers and therapists
• The assessment should produce info on
  characteristics (verification of disorder for
  special ed eligibility) and (summative)
• Should indicate strengths and weaknesses to
  assist in development of appropriate, realistic
  instructional/behavioral objectives and
  interventions

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Visit website for Assessment Protocol
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Key Assessment Information needed

• Enough information to judge
• Is the visual input you are using _at_ appropriate
  level of complexity
• Is child verbal, non-verbal, emerging verbal,
  inconsistent verbal
• What is the Single word vs multiple-word,
  (written language) comprehension
• What is level of peer involvement?
• What behaviors are problematic?
• What contexts promote success?
• What are preferred interests, learning
  environments

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Results of Assessment

• will assist in the development of appropriate,
  realistic instructional/behavioral objectives for
  intervention
• will lead to program design and delivery
  choices
• will establish a baseline against which measures
  of progress can be compared

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To Begin Program Development

• Link skills/level of functioning to Standards and
  Benchmarks
• Refer to Curriculum/Connections??
• Consider recommended instructional design and
  delivery components
• Know how to take.and use data to drive/adjust
  your instruction .Can you respond to SHOW ME
  THE DATA?

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Curriculum

• School District General Education Curriculum
  (aligned with State Standards?)
• Any IU Curriculum (augmentation)
• Other Curriculum (advertised to serve students
  with autism)
• Early Childhood Indicators

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Receptive Language Skill Curriculum (samples)

• Demonstrates functional use of objects
• Follows one concept commands
• Responds to identification cue
• Identifies objects/pictures with distractors
• Identifies body parts
• Follows two concept related commands
• Discriminates pronouns
• Identifies object or body parts when function
  described
• Identifies actions
• Discriminates prepositions
• Identifies categories of objects

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Instructional Design

• Classroom Design Examples
• environment (e.g. furniture, lighting, seating
  arrangement, visuals)
• grouping size, type
• stimulus characteristics (materials used for Sd,
  examples vs non examples)
• lesson plan development (knowing background
  knowledge, choice making, novel responses)
• order of activities (schedule/skills
  sequencing/sequence of daily instructional
  activities/subjects)
• Strategic instruction, controlled practice,
  cummulative review

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Instructional Delivery

• Classroom Delivery Examples
• Pacing of instruction, prompt hierarchy
• of trials, successful practice, data collection
  procedures
• Feedback given cues required level of explicit
  instruction models required
• Progress monitoring to make instructional
  adjustments
• Stimulus (e.g., language level for verbal
  instruction)

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Resources

• Autism Select Assessment Protocol
• Instructional Strategies for Students with
  ASD-All ages/skill levels
• Joint Action Routines
• Common Developmental Social Skills
• Linking Standards and Benchmarks to Specially
  Designed Instruction and Assessment
• Videos Using Visual Strategies to Increase
  Independence/ Autism Awareness ASA
• Visual Strategies Booklet/ Short Term Loan
• Data Collection Tools