Autism Spectrum

Autism Spectrum, Socialization Problems, and Communication Disorders

Autism Spectrum, Socialization Problems, and Communication Disorders

Elyssa BakerCourtney Reinhold

Elizabeth StaabAmanda Woloshin

Elyssa BakerCourtney Reinhold

Elizabeth StaabAmanda Woloshin

Kuder, 2003

Introduction to Autism Spectrum Disorders

Introduction to Autism Spectrum Disorders

Includes: Autism, Aspergers Syndrome, Childhood Disintegrative Disorder, Rett’s Syndrome, and PDD-NOS

Disorders are distinguished from each other based on Age of onset Presence of language or cognitive delay Presence of co-morbid factors Specific neurological features

Includes: Autism, Aspergers Syndrome, Childhood Disintegrative Disorder, Rett’s Syndrome, and PDD-NOS

Disorders are distinguished from each other based on Age of onset Presence of language or cognitive delay Presence of co-morbid factors Specific neurological features

Communication Disorders and Socialization Problems

Communication Disorders and Socialization Problems

Communication disorder- condition that partially or totally prevents human communication. The defect can be in producing, receiving or understanding the communication.

Socialization problem- an inability to perform social skills other than language. (ex. Eye contact, respond appropriately to others, initiate interactions)

Kauffman, 2005

Communication disorder- condition that partially or totally prevents human communication. The defect can be in producing, receiving or understanding the communication.

Socialization problem- an inability to perform social skills other than language. (ex. Eye contact, respond appropriately to others, initiate interactions)

Kauffman, 2005

Kauffman, 2005

Pervasive Developmental Disorder (PDD)

Pervasive Developmental Disorder (PDD)

Distortion of or lag in all or most levels of development

Includes Autism, Rett's disorder, childhood disintegrative disorder, Aspergers, PDD-NOZ

Distortion of or lag in all or most levels of development

Includes Autism, Rett's disorder, childhood disintegrative disorder, Aspergers, PDD-NOZ

Kauffman, 2005

Pervasive Developmental Disorder-Not Otherwise

Specified (PDD-NOS)

Pervasive Developmental Disorder-Not Otherwise

Specified (PDD-NOS) Pervasive delay in development

that does not fit into any of the other diagnostic categories

Doesn’t fit classification of other PDD disorders, placed here

Pervasive delay in development that does not fit into any of the other diagnostic categories

Doesn’t fit classification of other PDD disorders, placed here

Childhood Disintegrative Disorder (CDD)

Childhood Disintegrative Disorder (CDD)

Rare condition characterized by late onset (greater than 3 years of age) of developmental delays in 3 areas

Language Social Function Motor Skills

Similar to Autism, but an apparent period of fairly normal development is noted before regression in skills

Children already experience some delay, but delay is not always obvious in young children

Kauffman, 2005/wikipedia.com

Rare condition characterized by late onset (greater than 3 years of age) of developmental delays in 3 areas

Language Social Function Motor Skills

Similar to Autism, but an apparent period of fairly normal development is noted before regression in skills

Children already experience some delay, but delay is not always obvious in young children

Kauffman, 2005/wikipedia.com

Rett’s SyndromeRett’s Syndrome Normal development for 5 months to 4 years, then regression and

mental retardation

Similar to Autism, especially behavior characteristics

X-linked dominant: affecting most exclusively girls, mutation

Affects 1/12,500 girls by the age of 12

Girls are very prone to gastrointestinal disorders and about 30% have seizures

Typically have no verbal skills, and about 50% of females are not ambulatory

Kauffman, 2005/Wikipedia.com

Normal development for 5 months to 4 years, then regression and mental retardation

Similar to Autism, especially behavior characteristics

X-linked dominant: affecting most exclusively girls, mutation

Affects 1/12,500 girls by the age of 12

Girls are very prone to gastrointestinal disorders and about 30% have seizures

Typically have no verbal skills, and about 50% of females are not ambulatory

Kauffman, 2005/Wikipedia.com

AutismAutism

Kauffman, 2005

AutismAutism A Pervasive Development Disorder Onset before age of 3 Qualitative impairment of social

interaction and communication Restricted, repetitive, stereotyped

patterns of behavior, interests, and activities

A Pervasive Development Disorder Onset before age of 3 Qualitative impairment of social

interaction and communication Restricted, repetitive, stereotyped

patterns of behavior, interests, and activities

Kuder, 2003

Symptoms of AutismSymptoms of Autism

TRIAD OF IMPAIRMENTS Communication

In young children, language delay is a strong indicator of Autism (RISK FACTOR)

Social Reciprocity Restricted Interests and Repetitive Behaviors

TRIAD OF IMPAIRMENTS Communication

In young children, language delay is a strong indicator of Autism (RISK FACTOR)

Social Reciprocity Restricted Interests and Repetitive Behaviors

Autism SpectrumAutism Spectrum

Autism Spectrum Disorders

PDD-NOS

AUTISM

ASPERGER SYNDROME

Childhood Disintegrative Disorder

Rett’s Disorder

PrevalencePrevalence 1 in 150 children is diagnosed with

autism 1 in 94 boys is on the autism spectrum 67 children are diagnosed per day

http://www.autismspeaks.org/whatisit/facts.php

1 in 150 children is diagnosed with autism

1 in 94 boys is on the autism spectrum 67 children are diagnosed per day

http://www.autismspeaks.org/whatisit/facts.php

FactsFacts Autism costs the nation over $90 billion per year,

a figure expected to double in the next decade Boys are four times more likely than girls to have

autism Autism is the fastest-growing serious

developmental disability in the U.S. More children will be diagnosed with autism this

year than with AIDS, diabetes & cancer combined

http://www.autismspeaks.org/whatisit/facts.php

Autism costs the nation over $90 billion per year, a figure expected to double in the next decade

Boys are four times more likely than girls to have autism

Autism is the fastest-growing serious developmental disability in the U.S.

More children will be diagnosed with autism this year than with AIDS, diabetes & cancer combined

http://www.autismspeaks.org/whatisit/facts.php

EtiologyEtiology There is no real cause of autism. Recent studies suggest a strong genetic basis for

autism -- up to 20 sets of genes may play a part in its development.

Studies are also looking at possible environment origins and triggers.

Movie Cliphttp://www.youtube.com/watch?v=u4uGWiQgRYs

http://www.autismspeaks.org/whatisit/faq.php

There is no real cause of autism. Recent studies suggest a strong genetic basis for

autism -- up to 20 sets of genes may play a part in its development.

Studies are also looking at possible environment origins and triggers.

Movie Cliphttp://www.youtube.com/watch?v=u4uGWiQgRYs

http://www.autismspeaks.org/whatisit/faq.php

AssessmentAssessment

Most children are diagnosed by observation.

http://www.youtube.com/watch?v=oE9zN1OSKdE

Most children are diagnosed by observation.

http://www.youtube.com/watch?v=oE9zN1OSKdE

IDEA/EBD QualificationsIDEA/EBD Qualifications

IDEA defines autism as “a developmental disability that primarily results in significant deficits in verbal and non-verbal communication and social interactions, generally evidenced before the age of 3 years and adversely affects the child’s educational performance.”

(Dowdy, Patton, Polloway, and Smith, 2006)

IDEA defines autism as “a developmental disability that primarily results in significant deficits in verbal and non-verbal communication and social interactions, generally evidenced before the age of 3 years and adversely affects the child’s educational performance.”

(Dowdy, Patton, Polloway, and Smith, 2006)

IDEA/EBD Qualifications (cont.)IDEA/EBD Qualifications (cont.)

Fits under IDEA if… Adversely effects the student’s educational

performance. An inability to build or maintain satisfactory

interpersonal relationships with peers and teachers.

Inappropriate types of behavior of feelings under normal circumstances

(Kauffman, 2005)

Fits under IDEA if… Adversely effects the student’s educational

performance. An inability to build or maintain satisfactory

interpersonal relationships with peers and teachers.

Inappropriate types of behavior of feelings under normal circumstances

(Kauffman, 2005)

Comorbidity IssuesComorbidity Issues

anxiety and depression ADHD mental retardation a behavior disorder problems with hearing odd and eccentric behavior(Autism Society of America, 2000)

anxiety and depression ADHD mental retardation a behavior disorder problems with hearing odd and eccentric behavior(Autism Society of America, 2000)

Prevention StrategiesPrevention Strategies There are two types of prevention

according to Kauffman:1. Primary

-involves physiological prevention strategies that include genetic counseling and prenatal care

2. Secondary -consists of early identification and intervention-educational programs play an important role in secondary prevention

(Kauffman, 2005)

There are two types of prevention according to Kauffman:

1. Primary-involves physiological prevention strategies that include genetic counseling and prenatal care

2. Secondary -consists of early identification and intervention-educational programs play an important role in secondary prevention

(Kauffman, 2005)

InterventionIntervention Importance of intensive early intervention for

young children across the autism spectrum These children share a common diagnostic label,

each has own individual needs. Intervention should address the core deficits that

the ASD share communication social problems sensory problems academic difficulties

(Autism Society of America, 2000)

Importance of intensive early intervention for young children across the autism spectrum

These children share a common diagnostic label, each has own individual needs.

Intervention should address the core deficits that the ASD share communication social problems sensory problems academic difficulties

(Autism Society of America, 2000)

Intervention (cont.)Intervention (cont.) For effective intervention, parents and

professionals should consider the following: 1. A curriculum which addresses deficit

areas Deficit areas include: Inability to attend to relevant aspects of the environment, to shift attention, and to imitate language and the actions of others;

2. Difficulty in social interactions;

For effective intervention, parents and professionals should consider the following: 1. A curriculum which addresses deficit

areas Deficit areas include: Inability to attend to relevant aspects of the environment, to shift attention, and to imitate language and the actions of others;

2. Difficulty in social interactions;

Intervention (cont.)Intervention (cont.)

3. Difficulty with language comprehension and use, and functional communication

4. Programs that focus on routines, schedules, and predictability

5. Coordinated transitions between early intervention/preschool programs, and kindergarten environments

3. Difficulty with language comprehension and use, and functional communication

4. Programs that focus on routines, schedules, and predictability

5. Coordinated transitions between early intervention/preschool programs, and kindergarten environments

Intervention (cont.)Intervention (cont.)

6. Family involvement, including coordination between home and involved professionals, an in-home training component, and family training and support

(Autism Society of America, 2000)

6. Family involvement, including coordination between home and involved professionals, an in-home training component, and family training and support

(Autism Society of America, 2000)

Treatment OptionsTreatment Options There is no one symptom or behavior that

identifies individuals with ASD which leads to having no single treatment that will be effective for all people on the spectrum

Treatment must begin as early as possible and be tailored to the child's unique strengths, weaknesses and needs.

Treatments may be obtained through either the medical or educational community, depending on the nature of the treatment

There is no one symptom or behavior that identifies individuals with ASD which leads to having no single treatment that will be effective for all people on the spectrum

Treatment must begin as early as possible and be tailored to the child's unique strengths, weaknesses and needs.

Treatments may be obtained through either the medical or educational community, depending on the nature of the treatment

Medical TreatmentMedical Treatment There are no drugs, vitamins or special diets that can

correct underlying neurological problems associated with autism

Changes to diet and the addition of certain vitamins or minerals may also help with behavioral issues that occur with Autism

Stimulants, such as Ritalin, Adderall and Dexedrine, used to treat hyperactivity in children with ADHD have also been prescribed for children with ASD due to the behavior problems that are common in children with ADHD

(Autism Society of America, 2000)

There are no drugs, vitamins or special diets that can correct underlying neurological problems associated with autism

Changes to diet and the addition of certain vitamins or minerals may also help with behavioral issues that occur with Autism

Stimulants, such as Ritalin, Adderall and Dexedrine, used to treat hyperactivity in children with ADHD have also been prescribed for children with ASD due to the behavior problems that are common in children with ADHD

(Autism Society of America, 2000)

Aspergers SyndromeAspergers Syndrome

Aspergers SyndromeAspergers Syndrome “Children with Asperger syndrome do not show

clinically significant general delay in language, nor do they show significant delay in cognitive development or the development of age appropriate self-help skills or adaptive behavior. Thus, although they have significant problems in socialization and manifest some of the peculiarly obsessive or repetitive behaviors of children with autism, their language and cognitive development are much more normal than is typical for autism.”

(Kauffman, 2005)

“Children with Asperger syndrome do not show clinically significant general delay in language, nor do they show significant delay in cognitive development or the development of age appropriate self-help skills or adaptive behavior. Thus, although they have significant problems in socialization and manifest some of the peculiarly obsessive or repetitive behaviors of children with autism, their language and cognitive development are much more normal than is typical for autism.”

(Kauffman, 2005)

Aspergers Syndrome Characteristics

Aspergers Syndrome Characteristics

Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction

Failure to develop peer relationships appropriate to developmental level

A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)

Lack of social or emotional reciprocity

http://www.autism-society.org/site/PageServer?pagename=about_whatis_asperger

Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction

Failure to develop peer relationships appropriate to developmental level

A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)

Lack of social or emotional reciprocity

http://www.autism-society.org/site/PageServer?pagename=about_whatis_asperger

Intervention and TreatmentIntervention and Treatment Aspergers syndrome can be treated

and can take the same intervention methods as a person with autism

People with Aspergers syndrome need special attention with socialization problems when intervening

Aspergers syndrome can be treated and can take the same intervention methods as a person with autism

People with Aspergers syndrome need special attention with socialization problems when intervening

ASD Spectrum PrognosisASD Spectrum Prognosis

Because of such a wide spectrum, there are not any certain characteristics that can be applied to each person with autism

No two children will have the same outcome later in life living with autism

Because of such a wide spectrum, there are not any certain characteristics that can be applied to each person with autism

No two children will have the same outcome later in life living with autism

Case StudyCase Study Charlie’s parents noted something different about their child

when he was about 2 years old. Up until that time he had developed perfectly. He walked at 13 months, started babbling at about 15 months, and loved to play with adults and other children. Then things began to change. His babbling stopped, he developed sort of a blank stare, his early success at toilet training seemed to be reversed, and he stopped paying attention to other children and adults. When he was about 3 years old, his parents took him to the state children’s hospital, and the diagnosis was autism. What a shock! Charlie was placed in a preschool program and has been in special education services ever since. Now at the age of 7 he is enjoying being in a regular second grade classroom. In his kindergarten and first grade experience he was placed in a self-contained special education classroom. During these two years Charlie seemed to regress. He actually started picking up some of the other children’s stereotypical, self-stimulating behaviors. His parents convinced the school to give Charlie a try in the regular second grade, with some special education support. Now, in December, Charlie seems to be doing very well. While he has very little oral language, he seems to enjoy being with his nondisabled peers and is able to do most of the academic work with the assistance of a paraprofessional.

(Dowdy, Patton, Polloway, and Smith, 2006)

Charlie’s parents noted something different about their child when he was about 2 years old. Up until that time he had developed perfectly. He walked at 13 months, started babbling at about 15 months, and loved to play with adults and other children. Then things began to change. His babbling stopped, he developed sort of a blank stare, his early success at toilet training seemed to be reversed, and he stopped paying attention to other children and adults. When he was about 3 years old, his parents took him to the state children’s hospital, and the diagnosis was autism. What a shock! Charlie was placed in a preschool program and has been in special education services ever since. Now at the age of 7 he is enjoying being in a regular second grade classroom. In his kindergarten and first grade experience he was placed in a self-contained special education classroom. During these two years Charlie seemed to regress. He actually started picking up some of the other children’s stereotypical, self-stimulating behaviors. His parents convinced the school to give Charlie a try in the regular second grade, with some special education support. Now, in December, Charlie seems to be doing very well. While he has very little oral language, he seems to enjoy being with his nondisabled peers and is able to do most of the academic work with the assistance of a paraprofessional.

(Dowdy, Patton, Polloway, and Smith, 2006)

Case Study QuestionsCase Study Questions1. Where on the ASD would you place Charlie and

why?2. Is there a preferred placement for children with

autism?3. What kinds of supports should be available for

Charlie to facilitate his success in the regular classroom?

4. Is a child ever ready for inclusion, or does the school have to make the placement decision and provide the necessary supports to make it work?

5. As a parent where would you want Charlie placed, and what could you do to ensure Charlie is receiving supports at home as well as school?

1. Where on the ASD would you place Charlie and why?

2. Is there a preferred placement for children with autism?

3. What kinds of supports should be available for Charlie to facilitate his success in the regular classroom?

4. Is a child ever ready for inclusion, or does the school have to make the placement decision and provide the necessary supports to make it work?

5. As a parent where would you want Charlie placed, and what could you do to ensure Charlie is receiving supports at home as well as school?