Autism Spectrum Disorder

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Autism Spectrum Disorder

• FRIEND CH 12,
• SPED 281
• Dr. Schneider

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Learning Objectives

• Definition of Autism Spectrum Disorder
• Characteristics of ASD
• Causes of ASD
• Prevalence Data
• Identification procedure of ASD
• Types of services for students w/ ASD
• Best Teaching strategies for students w/ ASD
• Perspectives of family members
• Issues affecting the field of ASD

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Definition of Autism Spectrum Disorder

• FEDERAL DEFINITION added to IDEA 1990
• Developmental disability that adversely affects
  verbal non-verbal communication and social
  interaction before age 3
• Adversely affects educational performance
• Characteristics repetitive activities,
  resistance to environmental changes, unusual
  responses to common sensory experiences
• Term DOES NOT APPLY when EMOTIONAL DISTURBANCE
  CAUSES such symptoms

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Definition of Autism Spectrum Disorder

• American Psychiatric Association DEFINITION
  (DSM-4) 1 of 3 pervasive developmental
  disabilities (PDD)
• Out of 12 characteristics in 3 categories, the
  child must display at least 2 in category1, and 1
  each in category 2 and 3 amounting to 6 or more
  symptoms total
• (1) qualitative impairment in social interactions
• Improper or no use of eye-contact, facial
  expressions, body posture, gestures to regulate
  soc. interaction
• No peer relationships
• Lack of wanting to share emotions, experiences
• Lack of social emot. Reciprocity (proper response
  to env. stimuli)

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Definition of Autism Spectrum Disorder

• American Psychiatric Association DEFINITION
  (DSM-4) cont.
• (2) qualitative impairments in communication
• Delay or lack of spoke language
• Lack of sustaining or initiating conversation
• Repetitive language patterns
• Lack of varied make-believe play
• (3) restricted, repetitive, stereo-typed patterns
  of behavior, interests, activities
• Preoccupation w/ one ore more nonfunctional
  routines
• Abnormal intensity of focus on one pattern, habit
• Repetitive motor mannerisms
• Persistent fascination with parts of objects

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Definition of Autism Spectrum Disorder

• American Psychiatric Association DEFINITION
  (DSM-4) cont.
• B)Delays or abnormal functioning in one of these
  areas at onset of age 3
• Social interaction
• Language used in social interaction
• Symbolic or imaginary play
• C) Disturbance is not better accounted by Retts
  disorder or childhood disintegrative disorder

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Historic facts about ASD

• 1943, psychologist Leo Kanner identified 11
  children with for first time with autism term
• 1940s in Vienna, Austria, Dr. Asperger, a
  physician, identified children with chronic
  neuro-developmental social disorder today called
  Aspbergers syndrome
• In 1960-70 it was thought that cause was uncaring
  mothers refrigerator mothers
• 1980s Wing study brought distinction between
  Aspergers and Autism syndrome

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Historic facts about ASD

• 1990 autism integrated into IDEA
• 1994 autism added into APA
• 1996 Autism-Europe prepared a Charter for People
  wjth Autism approved by the European Parliament
  Individuals with autism have same rights as other
  citizens of Europe
• TODAY 3 TERMS grouped under Pervasive
  Developmental Disorder (PDD)
• (1) Autism
• (2) Aspergers
• (3) pervasive developmental disorder not
  otherwise specified (PPD-NOS)

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Comparison of AUTISM-ASPERGERs

• Aspergers differs from Autism in
• (1) no significant delay in language development
• (2) normal or above average IQ
• (3) no lack of age-appropriate curiosity about
  environment during childhood

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Comparison of AUTISM-ASPERGERs

• Aspergers is similar to Autism in
• (1) impaired social interaction (eye contact,
  gestures, body postures, sharing of experiences
  and emotions, social-emotional reciprocity)
• (2) restricted, repetitive stereotyped behaviors,
  interests, activities
• (3)consequently significant impairment in
  social, occupational or other important areas of
  functioning

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Prevalence data

• 0.12 of all students age 6-21 (2002, Dept. of
  Ed., IDEA data) low incidence disability)
• Non consensus exists regarding data b/c some
  children display mixed symptoms along the PDD
  spectrum
• Adults are also increasingly identified
• Increased awareness leads to better assessment
  with better assessment tools gt higher numbers to
  be expected in the future

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Causes of ASD

• BIOLOGICAL FACTORS
• Abnormalities in cerebellum ( brain bridge
  between right and left brain half) gt balance,
  motor control, cognition
• Abnormalities in frontal lobe (social cogn.
  Functions) and temporal lobes (facial
  expressions, cues) gt would explain issues with
  social cognitive issues
• During early part of gestation, brain stem may
  develop differently gt would explain high
  sensitivity to light, tough, change of routines

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Causes of ASD

• ENVIRONMENTAL FACTORS
• Maternal neglect not confirmed
• BUT positively highly structured home environment
  beneficial, not a cause
• Immunization for measles, mumps and rubella not
  confirmed as a cause

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Characteristics of ASD

• COGNITIVE ACADEMIC
• Motivation
• Difficult b/c student can change preference w/o
  pre-warning
• Problem-solving
• one strategy for one situation,a cannot select
  another when one does not lead to success
• Abstract concepts present problems b/c
• Language
• often flat, no intonation, pronunciation
  awkward limited language patterns used
• ECHOLALIA repeats words, phrases
• difficulties with idioms, figurative language
• problems with PROXEMICS or PRAGMATICS when to
  say what how to get what you want

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Characteristics of ASD

• SOCIAL-EMOTIONAL
• Increased tantrums, self-stimulatory behavior in
  uncomfortable situations
• Communication difficulties make them comfortable
  loners
• BEHAVIOR
• Oversensitive to stimuli (light, touch,
  materials, sound, tast (food), smell) gt
  tantrums, withdrawal
• Overselective of stimuli focus on detail not
  whole of entire functioning of something
• Self-stimulatory behavior hand flapping,
  rocking, any other repetitive behavior
• Difficulties generalizing takes info literally

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Identification procedure of ASD

• (1) Autism Spectrum Assessment
• Autism Spectrum Interview-revised (ADI-R, 1994)
  by psychiatrist, psychologist
• Autism screening instruments, or rating scales
• (2) Cognitive, academic and adaptive skills
• DEVELOPMENTAL MEASURES
• Parent, care-taker interview Psycho-educational
  Profile assessment (PEP-R, 1990)
• BEHAVIOR ASSESSMENT
• Parent/caretaker, teacher interview using
  behavior check list
• Functional behavior analysis
• STUDENT LEARNING TRAITS through observations,
  interviews, student work portfolio
  analysis/documentation

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Identification procedure of ASD

• ELIGIBILITY CRITERIA
• Negative impact on educational performance
• Will student benefit from services?
• Is disability officially documented?

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Types of services for students w/ ASD

• Early Childhood
• Models range from developmental to behavioral
  ones and combined ones common features were
• Intervention prior to age 3
• 20-45 hours of intervention per week
• Active family involvement
• Highly trained staff
• On-going child assessment
• Systematically implemented curriculum
• Focus on communication goals
• Plans to assist child K-12 (transition)
• Individualized intervention
• Practice applying learned skills in variety of
  settings

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Types of services for students w/ ASD

• Elementary Secondary
• Student is covered under IDEA 2004
• Currently only data for Autism is available, not
  for Aspergers
• Generally served in general ED classroom (21)
• Currently 51 still served 60 of school day in
  special Ed setting with paraprof. support

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Types of services for students w/ ASD

• Inclusive Practices need is
• (1) environmental curricular modifications to
  general classroom
• (2) attitudinal social support for planning
  carrying out programs across environments
• (3) field component in home-school collaboration
• Transition into adulthood
• Need explicit training in how to communicate with
  colleagues, superiors
• Careful planning with priming, prompting and
  other transition practices are essential for
  successful integration
• Utilize strengths

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Best Teaching strategies for students w/ ASD

• Environmental supports
• Visual supports
• Labeling room, visual schedule of the day, task
  cards, travel cards (middle high school setting)
• a reliable home base
• in room where they can calm themselves down when
  needed
• assistive technology
• Talking word processors, audible scanning
  devices, pencil grips, multimedia social support
  training programs

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Best Teaching strategies for students w/ ASD

• Priming
• Preview upcoming events of the day-week with
  autistic student to familiarize him/her with
  upcoming routines or changes to a routine
• Discrete trail training (DTT)
• Highly specialized approach usually carried out
  by specially trained personnel commonly
  implemented with preschool children time
  consuming
• Follows the pattern stimulus-student
  response-reward
• If teacher rewards student for a behavior that is
  similar to target behavior, this is referred to
  as shaping behavior

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Best Teaching strategies for students w/ ASD

• Prompting
• A cue designed to get a student to perform a
  specific behavior they can vary in their
  intensity, intrusiveness
• (1) very intrusive physical prompt
• (2) less intrusive gesture such as pointing or
  signing
• (3) least intrusive written prompt

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Best Teaching strategies for students w/ ASD

• Social Skills support
• A) use of social stories
• An individualized text or story that describes a
  social situation from the students perspective
  where-why situation occurred, feelings,
  reactions can be paired with pictures,
  audio-video-tapes
• B) direct instruction of social skills
• Power card strategy that facilitates
  understanding of social situations, routines and
  language patterns with a script describing the
  situation and the desired behavior in
  child-appropriate language the power card is the
  size of a business card and can be carried along
  at all times. It includes a brief summary of the
  situation and desired behavior/language.

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Best Teaching strategies for students w/ ASD

• Social Skills support
• c) Interpretation
• Students practice situation-options-consequences,
  choices, strategies, simulations of often
  occurring situations so that they can participate
  in society more easily. (SOCCSS) very
  sequentional, explicit, predictable

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Perspectives of family members

• parents need support groups and training in best
  educational approaches
• Parents worry how to best achieve the goal of
  helping their child become as independent as
  possible
• Mothers of children with autism are reported to
  be more stressed than those of children with
  other disabilities
• Roles of siblings
• often take on a parenting role for their autistic
  sibling
• Often can understand autistic sibling better than
  parents
• Often lack appropriate attention because the
  autistic sibling consumes parents so much

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Issues affecting the field of ASD

• Difficult to identify autism, Aspergers and
  other disabilities along the spectrum
• More research is needed to understand
  neurological, behavioral and developmental
  characteristics of autism spectrum disorder
• Often interventions are not research-based but
  personal preference-based.
• Research studies are needed to compare and
  contrast effectiveness of different educational
  approaches
• Teachers and parents need to stay informed about
  rapidly changing information in the field.

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Relevant websites

• www.autism-pdd.net Autism PDD resources network
• www.sinetwork.org Sensory Integration Resource
  Center
• www.nichd.nih.gov/autims National Institutes of
  Child Health and Human Development (NICHHD) with
  government sponsored research on autism
• www.autism.org
• www.asperger.org
• www.autims-society.org
• www.teacch.com/teacch.htm TEACCH treatment
  and education of autistic and related
  communication handicapped children