Autism A Low Incidence Disability and the Challenges with Assistive Technology Lisa Rudolph Summer 2009 892.560.

AutismA Low Incidence Disability and the Challenges

with Assistive Technology

Lisa Rudolph

Summer 2009

892.560

Definition of Autism developmental disability appears during the first three years of life the result of a neurological disorder that affects the

normal functioning of the brain impacting development in the areas of social

interaction and communication skills Both children and adults with autism typically show

difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities.

(ASA, 2009)

Description of Autism Characterized by impairments in the areas of:

– Socialization

– Communication

– Ritualistic Behavior

– (sometimes) Sensory Impairments

(Quill, 2000)

Description cont. Autism is one of five disorders that falls

under the umbrella of Pervasive Developmental Disorders (PDD)

PDD is a category of neurological disorders characterized by “severe and pervasive impairment in several areas of development.”

(http://www.definitionofautism.com/)

Etiology: Theories(Just a few . . .)

Opioid Excess Theory Gluetin/Casein Theories Free Sulphate Theory Autoimmune Theories Viral Infection Theory Vaccinations Theory

(Dr. Mehl-Mardona, 2009)

Opioid Excess Theory The opioid excess theory of autism says that

autistic children are symptomatic due to excess opioid-like substances, whose effects on the brain produce the symptoms of autism.

Opioids and opioid-like substances, especially when in excess, have many effects upon hormones and hormonal regulation.

(Dr. Mehl-Mardona, 2009)

Gluetin/Casein Theories some individuals who cannot metabolize

gluten, a-gliadin is produced. The body cannot metabolize A-gliadin, which binds to opioid receptors C & D. These receptors are associated with mood and behavior disturbances.

A strict gluten and casein-free diet does appear to reduce the level of opioid peptides and improve autism for some people.

(Dr. Mehl-Mardona, 2009)

Free Sulphate Theory An inadequately functioning sulphur-

transferase system will also affect the metabolism of some neurotransmitters.

Similar sulphate deficiencies have been reported in people with migraine, rheumatoid arthritis, jaundice and other allergic conditions all of which are anecdotally reported as common in the families of people with autism.

(Dr. Mehl-Mardona, 2009)

Autoimmune Theories The parallels between autism and other

autoimmune diseases suggest that autoimmunity may be a critical factor in the cause of autism.

An essential part of the autoimmune mechanism should involve antibody-mediated immune response or antibodies against brain, the affected organ in autism.

(Dr. Mehl-Mardona, 2009)

Viral Infection Theory The viral theory of autism relies upon a

relative immunosuppression, often thought to be in the intestinal tract, and a viral infection to produce the central nervous system symptoms of autism.

Secretory immunoglobulin A is an important defense in the intestines against viral infections and is often postulated to be deficient in autism.

(Dr. Mehl-Mardona, 2009)

Vaccinations Theory a possible connection between autism and viral

infection associated with the MMR vaccination. The damage from autism is thought to be provoked by the an allergic type reaction initiated by the body’s reaction to the vaccine.

If an individual is injected with vaccines,most of which have adjuvants like mercury and aluminum compounds unprotected nerves may be impacted.

a role of vaccines in the development of autistic disorders hinges on these biological effects upon nerves, damaging them in a way that influences behavior and learning patterns.

(Dr. Mehl-Mardona, 2009)

Rett’s Syndrome neurological disorder that

affects girls only and is one of the most common causes of mental retardation in females.

normal development during the first 6-18 months of life followed first by a period of stagnation and then by rapid regression in motor and language skills.

autistic-like phase of social withdrawal

The only subgroup of the pervasive developmental disorders in DSM-IV that is based on etiology (Volkmar, 2005).

Rett syndrome is caused by mutation in the gene encoding methyl-CpG-binding protein-2 (MECP2).

Autism Etiology???“The specific underlying psychological or neuro-

physiological mechanisms are simply not known. Although a number of different theories have been put forward, none has withstood closer scrutiny. Probably several causes and etiological pathways lead to disorders in the autism spectrum. There is no reason to suppose there is only one pathway. The search must continue” (CCBS, 2009).

Social Symptoms Lack of appropriate eye gaze

Lack of warm, joyful expressions

Lack of sharing interest or enjoyment

Lack of response to name (First Signs,

2009)

Communication Symptoms

Lack of showing gestures Lack of coordination of nonverbal

communication Unusual prosody (little variation in

pitch, odd intonation, irregular rhythm, unusual voice quality)

(First Signs, 2009)

Ritualistic Behavior Symptoms

Repetitive movements with objects

Repetitive movements or posturing of body, arms, hands, or fingers

Demonstrates sensory seeking behaviors

(First Signs, 2009)

Sensory ImpairmentsSymptoms (a few)

more prominent in older children (3-5)

Fearful of loud noises Does not like to be touched Constantly moving Picky eaters; often related to textures

of food Bites nails or chews hands Lighting effects mood

What to do next … If your child demonstrates two or more of

the aforementioned indicators, contact your pediatrician and schedule an immediate appointment to go over your concerns and get a thorough evaluation.

Your pediatrician will have information regarding local Infants and Toddlers agencies.

Effect on Classroom Functioning

The nature of a “spectrum” is to encompass a variety of levels/qualities under one category.

Children with autism are all different from one another.

Children with autism demonstrate a “spectrum” of functioning.

Classroom Functioning High-Functioning

– Fewer struggles with language

– Typically have a higher IQ

– Able to be included in the general education classroom with minimal accommodations and supports

Low-Functioning– Language is a

significant barrier – Often are non-

verbal– Require a self-

contained setting for academic instruction

– Work is often modified

Tips for the Classroom Routine and structure Reduce distracting stimuli Provide frequent/built-in breaks Chunk work Use multi-modal approaches when teaching Prep student for changes (schedule,

learning materials, etc) Consult your special education teacher with

any questions/concerns!

Assistive Technology “an assistive technology means any

item, piece of equipment, or product system, whether acquired commercially, off-the-shelf, modified or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.” (Susan Stokes, 2009)

Assistive Technology Devices Appropriate for Use with an

Individual with AutismPicture Schedule

What is currently happening What is coming up next (the

sequence of events) When they are "all done"

with something Any changes that might

occur. Schedules can …

– Use pictures

– Use objects

– Be written words

Assistive Technology Devices Appropriate for Use with an

Individual with Autism

First/Then Board "first you do ___,

then you do ___” building in a

balance of "high stress" (non-preferred) and "low stress"(preferred) activities

Assistive Technology Devices Appropriate for Use with an

Individual with Autism

Communication Books "Low-tech" strategies

designed to focus on a child's expressive communication skills

Organize books by category: dinner, play, home, store, math, reading, gym, etc.

Touch or exchange as a form of communication

Assistive Technology Devices Appropriate for Use with an

Individual with AutismAdapted Books Adapt for:

– Use Page thickeners (ease

page turning) Laminated pages

(ease page turning, lessen page tearing)

Provoke interest using tactile approaches

– Comprehension Modify text by using

pictures; simplified text Add communication

boards to intensify answering questions and general participation

Assistive Technology Devices Appropriate for Use with an

Individual with Autism

Sensory Cushion Provides some sensory

input for our sensory seeking friends, when having to sit for extended periods of time

Aids in keeping the child focused and seated

Assistive Technology Devices Appropriate for Use with an

Individual with Autism

Social Stories Children with autism need to

be directly taught various social skills in one-to-one and/or small group settings.

The use of Social Stories, developed by Carol Gray, provides the child with the use of visual information/strategies that will improve his understanding of various social situations and teach him specific behaviors to use when interacting with others .

Assistive Technology Devices Appropriate for Use with an

Individual with Autism

Spring-Board (high-tech communicator)

Augmentative and Alternative Communication (AAC)

includes electronic “talkers”, or devices that produce speech output

the next step for someone who has demonstrated success with manual communication boards or static display devices with limited message capacity

Great for students who are nonverbal

Assistive Technology Devices Appropriate for Use with an

Individual with AutismIntellikeys alternative keyboard Standard overlays: alphabet,

numbers, mouse direction and a 'single switch hit'

various overlays can also be created to go with numerous software programs through the purchase and use of additional Intellitools software programs

Touch Window The purpose of the touch

window is to allow the child to "navigate" and "interact" with the computer by touching the screen, rather than operating the mouse.

Implementation Idea #1Kindergarten Free Play

Child is demonstrating mal-adaptive behaviors during free play in a kindergarten classroom. The children are allowed, once they have completed their work, to play with blocks, books, puzzles, toys, Play Doh, or on the computer.

1. Create a choice board.2. Utilize a first/then board.3. Prior to finishing classwork,

have the child choose an activity he/she would like to do upon completion of work.

4. Using the first/then board (with words, pictures, or objects), represent first you will finishing “writing” then you will “play with blocks”

5. The choice board can be utilized during free time if the child changes his/her mind on what they would like to do.

6. This visual representation helps the child organize his/her thoughts and lessen anxiety during an unstructured time.

Implementation Idea #2Kindergarten Science

Lesson The children have been

asked to access a website on the computer during centers. On this website they have to sequence the life of a butterfly.

The child with autism demonstrates very poor fine motor skills and cannot manipulate the mouse independently.

1. Encourage the child to work with 100% independence

2. Hook up a touch window screen onto one of the computers.

3. Spend time with the student in question prior to this lesson to make sure he/she knows how to manipulate the screen.

4. Be sure the monitor is hooked up properly for the student prior to asking him/her to complete this assignment.

5. The child should be able to independently manipulate the objects on the screen to accurately sequence the life of a butterfly!

6. Pair with a peer-buddy if necessary.

Implementation Idea #3Kindergarten Reading

Lesson Students are reading Wishy-

Washy Day by Joy Cowley. The lesson is focusing on

retelling the story and where the different animals are going to hide from Mrs. Wishy-Washy.

“Where and Who” questions will be asked.

You have a child in your classroom with autism who is non-verbal but demonstrates strong receptive language skills. How can we encourage him to participate functionally and independently?

Low-Tech Create a communication

board related to the story (utilizing story-related vocabulary, questions and comments).

Use the board during the lesson to point to the different vocabulary.

Spend time with your student with autism to make sure he knows how to use it independently.

Provide the child with the board during whole group instruction and allow him to use it to answer questions. For example: “Where did the dog hide in the story?” And the boy would touch the picture or word, “shed.”

References CAST. (2009). Curriculum Access for Students with Low-Incidence Disabilities: The Promise of

UDL. Retrieved June 14, 2009 from

http://www.cast.org/publications/ncac/ncac_lowinc_section4.html.

Cambridge Center for Behavioral Studies. (2009). Causes and etiology of autism. Retrieved June

14, 2009 from

http://www.behavior.org/autism/index.cfm?page=http%3A//www.behavior.org/autism/autism_causes.

cfm.

First Signs. (2009). Red Flags of Autism Spectrum Disorders. Retrieved June 15, 2009 from

http://www.firstsigns.org/concerns/flags.htm.

Lacava, P.G., Golan, O., & Baron-Cohen, S. (2007). Using assistive technology to teach emotion

recognition to students with asperger syndrome. Remedial and Special Education, 28 (3), 174-181.

Mehl-Madrona, L. (2009). Autism: an overview. Retrieved June 15, 2009 from

http://www.healing-arts.org/children/autism-overview.htm#7.

Mirenda, P. (2001). Autism, augmentative communication, and assistive technology: what do we

really know? Focus on Autism & Other Developmental Disabilities, 16 (3), 141-152.

Quill, K.A. (2000). Do-Watch-Listen-Say. Baltimore, Maryland: Paul H. Brookes Publishing Co.

Stokes S. (2009). Assistive Technology for Children with Autism. Wisconsin Department of Public

Instruction. Retrieved on June 14, 2009 from http://www.specialed.us/autism/assist/asst10.htm.

Unknown Author. Retrieved June 14, 2009 from http://www.definitionofautism.com/.

Volkmar, F.R., Paul, R., & Klin, A. (2005). Handbook of Autism and Pervasive Developmental

Disorders Volume One and Two: Third Edition. Hoboken, New Jersey: John Wiley & Sons, Inc.