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Autism Spectrum Disorders

Feb 24, 2016

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Autism Spectrum Disorders. Introductory notes for the development of an effective support service. 1911 Bleuler coins ‘autism’ from the Greek for self: ‘autos’ 1940s Kanner identifies traits such as aloofness, rigidity of routine, repetitiveness, anxiety - PowerPoint PPT Presentation

Autism Spectrum Disorders

Autism Spectrum DisordersIntroductory notes for the development of an effective support service

History of the autism label1911Bleuler coins autism from the Greek for self: autos

1940s Kanner identifies traits such as aloofness, rigidity of routine, repetitiveness, anxietyAsperger identifies similar traits in adolescentsBethelheim wrongly infers mental illness1964Rimland identifies a neuro-behavioural condition

1994Autistic Spectrum Disorder (ASD) is defined as a pervasive developmental disorderMyths about ASDEveryone with ASD has a special talentEveryone with ASD is a potential geniusEveryone with ASD is mentally retardedASD means no emotions or attachmentsOnce autistic, always autisticConfrontation must be avoided at all timesConversely, All behaviours must be normalised

The truth is: Everyone is a unique human beingThe three main impairmentsTo social relationships

To social communication

To imaginative thought

But the combination of impairments is individual

And other characteristics are also common:sensory sensitivity,monotone voice, bowel problemsand more

ASD types or diagnosesAutistic Disorder (classification)Childhood Disintegrative DisorderBetts DisorderAspergers SyndromePervasive developmental disorder: not otherwise diagnosed (a typical autism)

What counts is the actual behaviour, not the labelPotentially relevant medical testsHearingGeneticEEG (tumours)MetabolismMRICAT scanThese may augment understanding of ASD condition, or adjust diagnosis

For example, some behaviours may be due to diet or hearing impairment, not ASD

Causes of ASD (I)Unknown

But probably a mix of:

Genetic make-up

Environmental factors (eg: toxins, serotonin, viruses, possibly vaccines, etc)Causes of ASD (II)This mix of genetic and environmental factors then appears to affect the following:

Sensory nervous system- sensory sensitivitiesThe brain- problems understanding the worldGastro-intestinal tract - bowel problems are common

Research continues - it is important to support & learn from researchUnderstanding behaviours (I)Sensitivities to different senses often need to be explored

Such sensitivities may explain behaviours, such as those oppositeVery specific food choices (or is it an allergy?)

Avoidance of noise and talk

Minimal reactions to touch

Not wanting to wear clothes

Understanding behaviours (II)How would you behave if your environment was physically painful, or made no sense?

You might display some of the behaviours opposite.

Dont assume. Explore.Lack of eye contact and desire for own space

Unusual body movements

Not interacting or imitating

Lining up objects / liking furniture to stay the same

Tantrums and aggressionSensory sensitivitiesReally get to know peoples issues

Strike a balance between:

desensitising the person - and

changing or avoiding environments

Make commonsense practical arrangements:

Sunglasses or a visor

Ear plugs or a walkman

Padded chair legs

At home, avoid fluorescent lights

To push or not to push?Pampering peoples autistic traits may avoid short term conflict but can greatly limit their quality of life and health People will often benefit from individual development plans with an element of challengePeople should be challenged for Quality of Life and safety reasons not to make them normal

It is essential that everyone is careful, sensitive, and well informed.

Treatments and ProgrammesThere are many different variations

The right teacher is more important than the type of programme

Dr Temple GrandinPortage - home teachingFloor Time join persons worldSPELL approach of Nat Aut SocTEACCH -approach of Aut Ind UKABA applied behavioural analysisPECS picture exchange comm sysSocial StoriesAnd more

The S.P.E.L.L programme A National Autistic Society approachStructure Positive approaches and expectations Empathy Low arousal (a measured approach to challenging and stretching people)Links (involving and building on family and other relationships)

Applied Behavioural AnalysisUnderstanding and shaping peoples behaviour

Exploring peoples environment and experiencesWhat happens before a behaviourWhat happens after a behaviour

Keeping records and looking for patterns

ABA is an essential tool in any programme

P.E.C.SPicture Exchange Communication SystemA system for developing initial understanding of language by using pictures of items and rewarding appropriate use

For example, a request for a drink using a picture of a drink is rewarded with a drink

A range of courses and materials are available for purchaseSocial StoriesSocial Stories are relatively short, straightforward descriptions of social situations, specifically detailing what an individual might expect from the situation and what may be expected of him. They describe the events and rules which usually apply when (for example) shoppingThey help to overcome peoples problems in understanding the world

Specialist inputsProfessions:

Psychology

Speech Therapy

Occupational TherapyTechnologies:

Assistive (Environmental) Technology

Information Communication TechnologyAssistive TechnologiesMovement SensorsFloor Sensors prone alarmsStaff pagers prone alarmsFlood sensorsHeat / height controls, inside and outsideBed sensors

The holistic nature of ASDNo single response will suit all or anyIndividualised responses are neededBut with some common patterns of some needs:Communication impairmentsSensory sensitivitiesSocialization sensitivityRhythms and routines etcIndividual Support PlanningCartrefi Cymrus person-centred approachGet to know the personPast & presentImportant relationshipsLikes & dislikesRhythms and routinesSkills & potentialHealth Dreams & aspirationsPlan togetherBuild on Care PlansOptimise participationReal communicationTurn goals into actionsBe focused & consistentResponsive & respectfulCelebrate achievements

Enabling people to have ties and connectionsIdentify useful activities and opportunities which can connect to the persons own likes and wants

Identify the information and skills they need

Help others to be understanding and accepting

Develop safety skills and getting around skills, maps etc

Promote community participation in all its forms from work and learning to leisure and relationships

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