Autism: Getting Informed

Autism: Getting Autism: Getting InformedInformed

By: Erica ShortBy: Erica Short

Marshall UniversityMarshall University

CD 315CD 315

What is autism?What is autism?

• Autism is pervasive developmental disorder Autism is pervasive developmental disorder that is characterized by varying degrees of that is characterized by varying degrees of impairment in communication skills, social impairment in communication skills, social interaction, and restricted repetitive and interaction, and restricted repetitive and stereotyped patterns of behaviors stereotyped patterns of behaviors (http://autismspeaks.com/whatisit/index.php). (http://autismspeaks.com/whatisit/index.php).

Communication DeficitsCommunication Deficits

• Characterized by limited communication skills which Characterized by limited communication skills which includes a delay in, or total lack of development of includes a delay in, or total lack of development of verbal language verbal language ((http://www.en.wikipedia.org/wiki/Autismhttp://www.en.wikipedia.org/wiki/Autism))

• Approximately 50% of people with autism are Approximately 50% of people with autism are nonverbal (Zager, 2005).nonverbal (Zager, 2005).

• 35-40% fail to develop functional speech35-40% fail to develop functional speech• Both speech and nonverbal communication are Both speech and nonverbal communication are

effected (Shipley & McAfee, 2005)effected (Shipley & McAfee, 2005)• Echolalia, which is repetition of words or phrases Echolalia, which is repetition of words or phrases

usually with little or no comprehension, often occurs usually with little or no comprehension, often occurs in autism. Echolalia may occur in an immediate or in autism. Echolalia may occur in an immediate or delayed fashion. delayed fashion. ((http://www.nlm.nih/medlineplus/autism.htmlhttp://www.nlm.nih/medlineplus/autism.html).).

Communication Deficits Communication Deficits ContinuedContinued• Often demonstrates limited communicative Often demonstrates limited communicative

functions (Shipley & McAfee, 2005)functions (Shipley & McAfee, 2005)• May demonstrate hyperlexia, which is an above May demonstrate hyperlexia, which is an above

normal ability to read words accompanied with normal ability to read words accompanied with difficulty understanding spoken language difficulty understanding spoken language ((Http://Http://www.en.wikipedia.org/wiki/Hyperlexiawww.en.wikipedia.org/wiki/Hyperlexia).).

• Often exhibits poor eye contact Often exhibits poor eye contact • Concrete vocabulary (Shipley & McAfee, 2005)Concrete vocabulary (Shipley & McAfee, 2005)• May exhibit issues with prosody such as high-May exhibit issues with prosody such as high-

pitched, flat, or robotic-like voice pitched, flat, or robotic-like voice ((http://http://en.wikipedia.org/wiki/Autismen.wikipedia.org/wiki/Autism))

• Often do not understand non literal language Often do not understand non literal language ((http://http://en.wikipedia.org/wiki/Autismen.wikipedia.org/wiki/Autism))

Social DeficitsSocial Deficits

• Often socially withdrawn and would rather Often socially withdrawn and would rather isolate themselves from othersisolate themselves from others

• Lack of interest in peersLack of interest in peers• Very little indication of social awarenessVery little indication of social awareness• Does not read or respond to social cuesDoes not read or respond to social cues• Poor perceptive takingPoor perceptive taking• Often have difficulty with conversing with Often have difficulty with conversing with

others (initiating, staying on topic, turn-others (initiating, staying on topic, turn-taking)taking)

• Impairment in use of eye-to-eye gaze, facial Impairment in use of eye-to-eye gaze, facial expression, body postures and gesturesexpression, body postures and gestures

(Shipley & McAfee, 2005)(Shipley & McAfee, 2005)

Theory of Mind (ToM)Theory of Mind (ToM)

• ToM- impaired ability to think about ToM- impaired ability to think about thoughts or imagine another individuals thoughts or imagine another individuals state of mindstate of mind

• This theory often interferes with individuals This theory often interferes with individuals with autism and their ability to interpret with autism and their ability to interpret and interact with the world.and interact with the world.

((http://www.nidcd.nih.gov/health/voice/autism.asphttp://www.nidcd.nih.gov/health/voice/autism.asp))

Repetitive BehaviorsRepetitive Behaviors

Although individuals with autism appear Although individuals with autism appear physically normal and with adequate muscle physically normal and with adequate muscle control, unusual repetitive behaviors typically control, unusual repetitive behaviors typically occur.occur.

This is also known as self-stimulation or This is also known as self-stimulation or “stimming”, and include behaviors such as:“stimming”, and include behaviors such as:

• Arm- flappingArm- flapping• Rock body or swinging back and forth motionRock body or swinging back and forth motion• Random outbursts and vocalizationsRandom outbursts and vocalizations• Wiggle toes or fingersWiggle toes or fingers• Lining up or spinning objects and toysLining up or spinning objects and toys

Routines and ObsessionsRoutines and Obsessions

• Many individuals with autism need extreme Many individuals with autism need extreme consistency in their environment.consistency in their environment.

• Changes in routine may be very frustrating Changes in routine may be very frustrating and upsetting to an individual with autism and upsetting to an individual with autism ((http://http://en.wikipedia.org/wiki/Autismen.wikipedia.org/wiki/Autism).).

• Some have obsessions and extreme interests Some have obsessions and extreme interests in with certain objects and topics (computers, in with certain objects and topics (computers, numbers, symbols, etc.)numbers, symbols, etc.)

• Perseverations is often common and may Perseverations is often common and may become apart of a person’s daily routine become apart of a person’s daily routine (perseveration is uncontrollable repetition of (perseveration is uncontrollable repetition of a particular response, such as a word, a particular response, such as a word, phrase, or gesture).phrase, or gesture).

((http://www.nlm.gov/medlineplus/autism.htmlhttp://www.nlm.gov/medlineplus/autism.html) )

Cognitive Abilities Cognitive Abilities

• Cognitive abilities range from low Cognitive abilities range from low functioning to high functioning. functioning to high functioning.

• Many exhibit mental retardation to expert Many exhibit mental retardation to expert level of knowledgelevel of knowledge

• Most individuals will demonstrate difficulty Most individuals will demonstrate difficulty in processing abstract information.in processing abstract information.

• Many demonstrate difficulties with tasks Many demonstrate difficulties with tasks and functions of the left hemisphere.and functions of the left hemisphere.

(Shipley & McAfee, 2004)(Shipley & McAfee, 2004)

Emotional DevelopmentEmotional Development

• May be considered egocentricMay be considered egocentric

• Have reduced emotional expressionHave reduced emotional expression

• Trouble with emotional regulationTrouble with emotional regulation

• Exaggerated emotional expressionExaggerated emotional expression

• Emotional disorders (anxiety, mood, Emotional disorders (anxiety, mood, depression, over-compulsive)depression, over-compulsive)

(Shipley & McAfee, 2005)(Shipley & McAfee, 2005)

Motor SkillsMotor Skills

• Usually portray normal development of Usually portray normal development of gross motor skillsgross motor skills

• Repetitive stimulatory movements and Repetitive stimulatory movements and behaviorsbehaviors

• Fine motor development is usually delayedFine motor development is usually delayed• Usually have late development and poor Usually have late development and poor

handwriting skillshandwriting skills• Lack fear of real dangerLack fear of real danger (Shipley & McAfee, 2005)(Shipley & McAfee, 2005)

Sensory SystemSensory System

• Many experience problems coping with sensory Many experience problems coping with sensory input, some may actually have a sensory input, some may actually have a sensory integration dysfunction.integration dysfunction.

• Most people have some degree of sensory Most people have some degree of sensory integration difficulty. integration difficulty.

• Hypersensitivity or hyposensitivity to touch, Hypersensitivity or hyposensitivity to touch, movement, sights or sounds (being oversensitive movement, sights or sounds (being oversensitive or undersensitive to sensory stimuli).or undersensitive to sensory stimuli).

• Difficulty with making transitions from one Difficulty with making transitions from one situation to the next.situation to the next.

• Sensory perception differencesSensory perception differences• Overselective to various stimuliOverselective to various stimuli• Hypersensitive hearingHypersensitive hearing ((http://en.wikipedia.org/wiki/Autismhttp://en.wikipedia.org/wiki/Autism))

Severity levelsSeverity levels

• Autism ranges from mild to very severe Autism ranges from mild to very severe deficitsdeficits

• The low end of the spectrum includes what The low end of the spectrum includes what is referred to as low functioning autism.is referred to as low functioning autism.

• The high end of the spectrum includes “high The high end of the spectrum includes “high functioning autism and Asperger’s functioning autism and Asperger’s syndrome.syndrome.

FactsFacts

• Autism is a spectrum disorder that includes: Autism is a spectrum disorder that includes: autism, Asperger’s syndrome, childhood autism, Asperger’s syndrome, childhood disintegrative disorder, Rett syndrome, and disintegrative disorder, Rett syndrome, and pervasive developmental disorder-not pervasive developmental disorder-not otherwise specified (PPD-NOS).otherwise specified (PPD-NOS).

• This group of spectrum disorders include a This group of spectrum disorders include a range of similar featuresrange of similar features

• Autism effects approximately one in every Autism effects approximately one in every 166 children 166 children (http://autismspeaks.com/whatisit/index.php).(http://autismspeaks.com/whatisit/index.php).

• Boys are four times more likely to get Boys are four times more likely to get autism than girls.autism than girls.

CausesCauses

• Though current research is being Though current research is being conducted, the cause of autism is still conducted, the cause of autism is still unclear. unclear.

• Possible causes of autism include: genetic, Possible causes of autism include: genetic, neurological, infectious, organic, neurological, infectious, organic, neurobiological, metabolic, vaccines, neurobiological, metabolic, vaccines, medical, chemical and environmental medical, chemical and environmental factors factors (http://www.nidcd.nih.gov/health/voice/autism.asp).(http://www.nidcd.nih.gov/health/voice/autism.asp).

Onset and diagnosisOnset and diagnosis

• Autism is usually diagnosed by the age of Autism is usually diagnosed by the age of three.three.

• Some children are being diagnosed as early Some children are being diagnosed as early as six months of age (Zager, 2005).as six months of age (Zager, 2005).

• Some caregivers do not like to label there Some caregivers do not like to label there child as “autistic” at such a young age.child as “autistic” at such a young age.

• However, research shows that early However, research shows that early intervention is key to optimal benefits for intervention is key to optimal benefits for your child. your child.

Early Signs of AutismEarly Signs of Autism

• Does not establish eye contact during Does not establish eye contact during interactionsinteractions

• Does not imitate the actions of othersDoes not imitate the actions of others• Does not show interest in other childrenDoes not show interest in other children• Does not use gestures to communicateDoes not use gestures to communicate• Does not understand language or gesturesDoes not understand language or gestures• Does not engage in functional play activitiesDoes not engage in functional play activities• Does not engage in imaginative or symbolic Does not engage in imaginative or symbolic

playplay• Does not smile responsivelyDoes not smile responsively (Shipley and McAfee, 2004)(Shipley and McAfee, 2004)

Co-morbid ConditionsCo-morbid Conditions• Other conditions may co-occur with the autism Other conditions may co-occur with the autism

disorder:disorder:• Approximately 70-75% also have some form of Approximately 70-75% also have some form of

mental retardation mental retardation • Tourette’s syndrome (motor and phonic tics occur)Tourette’s syndrome (motor and phonic tics occur)• Many exhibit signs and symptoms of ADHDMany exhibit signs and symptoms of ADHD• Mood changes (depression and bipolar symptoms)Mood changes (depression and bipolar symptoms)• Symptoms of anxiety (include panic-like and Symptoms of anxiety (include panic-like and

compulsive-like episodes)compulsive-like episodes)• Compulsive-like symptoms (ritualistic ordering and Compulsive-like symptoms (ritualistic ordering and

intolerance for changes in daily routine)intolerance for changes in daily routine)• Seizure disorders (occurs in about 20% of autism Seizure disorders (occurs in about 20% of autism

cases)cases) (Zager, 2005)(Zager, 2005)

Therapy and Treatment Therapy and Treatment OptionsOptions• Behavioral therapy ( Applied Behavior Behavioral therapy ( Applied Behavior Analysis- ABA, TEACCH. Tomatis method)Analysis- ABA, TEACCH. Tomatis method)• Biomedical therapy (Auditory Integration Biomedical therapy (Auditory Integration

Training, Secretin, etc)Training, Secretin, etc)• Dietary/Nutritional (Gluten-free diet)Dietary/Nutritional (Gluten-free diet)• Occupational therapy (Sensory Integration Occupational therapy (Sensory Integration

Therapy)Therapy)• Physical therapyPhysical therapy• Speech therapy (goals for improving speech Speech therapy (goals for improving speech

and language, communication, social skills, and language, communication, social skills, etc)etc)

(Zager, 2005)(Zager, 2005)

Is There a Cure?Is There a Cure?

• Currently autism cannot be prevented or Currently autism cannot be prevented or cured.cured.

• Autism persists throughout lifeAutism persists throughout life

• It can only be managed and improved with It can only be managed and improved with the proper therapy options and educationthe proper therapy options and education

(Zager, 2005)(Zager, 2005)

PrognosisPrognosis

• The goal is for early intense intervention The goal is for early intense intervention and therapy approaches.and therapy approaches.

• Collaboration of a variety or professionals Collaboration of a variety or professionals and family is needed in order to have the and family is needed in order to have the best outcome for children with autism. best outcome for children with autism.

• With proper education, support, and With proper education, support, and treatment, hopefully improvements will be treatment, hopefully improvements will be made in various areas such as made in various areas such as communication and social interaction skills. communication and social interaction skills.

ResourcesResources

• Autism Speaks. Autism Speaks. What is Autism? an overviewWhat is Autism? an overview. Retrieved on . Retrieved on October 17, 2006 from October 17, 2006 from http://http://autismspeaks.com/whatisit/index.phpautismspeaks.com/whatisit/index.php. .

• Medline Plus. (2006). Medline Plus. (2006). Autism. Autism. Retrieved on October 17, 2006 from Retrieved on October 17, 2006 from http://www.nlm.nih.gov/medlineplus/autism.html.http://www.nlm.nih.gov/medlineplus/autism.html.

• National Institute of Deafness and other Communication National Institute of Deafness and other Communication Disorders. (2006). Disorders. (2006). Autism and Communication. Autism and Communication. Retrieved on Retrieved on October 26, 2006 from October 26, 2006 from http://www.nidcd.nih.gov/health/voice/autism.asp. http://www.nidcd.nih.gov/health/voice/autism.asp.

• Shipley, K. G., & McAfee, J. G. (2004). Assessment in Shipley, K. G., & McAfee, J. G. (2004). Assessment in Speech-   Language Pathology: A   Resource Manual (3rd Speech-   Language Pathology: A   Resource Manual (3rd ed.).  Clifton Park, NY: Delmar Learning.  ed.).  Clifton Park, NY: Delmar Learning.  

• Zager, D. (2005). Zager, D. (2005). Autism Spectrum DisorderAutism Spectrum Disorder (3rd ed.). (3rd ed.). Mahwah,  NM: Lawrence Erlbaum  Associates.Mahwah,  NM: Lawrence Erlbaum  Associates.

•     Wikipedia: the free encyclopedia. (2006). Wikipedia: the free encyclopedia. (2006). Autism. Autism. Retrieved on Retrieved on November 5, 2006 from http://www.en.wikipedia.org/wiki/Autism.November 5, 2006 from http://www.en.wikipedia.org/wiki/Autism.