What is Autism?

What is Autism?

• What is Autism?

• Is there more than one type of Autism?

• What causes Autism?

• How is Autism diagnosed?

• What are the characteristics of Autism?

• What are the most effective approaches to treating Autism? Is there a cure?

Very complex, often baffling developmental disability

• Very complex, often baffling developmental disability

• First described by Leo Kanner in 1943 as early infantile autism

• “Auto” – children are “locked within themselves.”

• For next 30 years, considered to be an emotional disturbance

3 categories for autism in IDEA?

• 3 categories for autism in IDEA?

• Today, autism is a severe form of a broader group of disorders

• These are referred to as pervasive developmental disorders (later)

• Typically appears during the first 3 years of life

Very likely neurological in origin – not emotional, not the refrigerator mom

• Very likely neurological in origin – not emotional, not the refrigerator mom

• Prevalence is 2-6/1000 individuals (1/2 to 1 ½ million affected)

• 4 times more prevalent in boys

• No known racial, ethnic, or social boundaries

• No relation to family income, lifestyle

Autism impacts normal development of the brain in areas of social interaction and communication skills.

• Autism impacts normal development of the brain in areas of social interaction and communication skills.

• Difficult to communicate with others and relate to the outside world.

• Occasionally, aggressive and/or self-injurious behavior may be present.

May exhibit repeated body movements (hand flapping, rocking).

• May exhibit repeated body movements (hand flapping, rocking).

• Unusual responses to people

• Attachment to objects

• Resistance to change in routine

• Sensory sensitivities

Actually, the “umbrella” heading is Pervasive Developmental Disorder (PDD).

• Actually, the “umbrella” heading is Pervasive Developmental Disorder (PDD).

• Autism is one of the 5 PDDs.

• All have commonalities in communication and social deficits

• Differ in terms of severity

Impairments in social interaction, communication, and imaginative play.

• Impairments in social interaction, communication, and imaginative play.

• Apparent before age 3.

• Also includes stereotyped behaviors, interests, and activities

Impairments in social interactions, and presence of restricted interests and activities

• Impairments in social interactions, and presence of restricted interests and activities

• No clinically significant general delay in language

• Average to above average intelligence

Often referred to as atypical autism

• Often referred to as atypical autism

• Used when a child does not meet the criteria for a specific diagnosis, but there is severe and pervasive impairment in specified behaviors

Progressive disorder which, to date, has only occurred in girls.

• Progressive disorder which, to date, has only occurred in girls.

• Period of normal development and then the loss of previously acquired skills

• Also loss of purposeful use of hands, which is replaced by repetitive hand movements

• Beginning at age of 1-4 years

Normal development for at least the first 2 years

• Normal development for at least the first 2 years

• Then significant loss of previously acquired skills

Autism is a spectrum disorder

• Autism is a spectrum disorder

• This means that symptoms and characteristics can present themselves in wide variety of combinations, from mild to severe

• Autistic individuals can be very different from each other

• “Autism” is still commonly used to refer to any of the 5 PDDs

Good agreement in general that autism is caused by abnormalities in brain development, neurochemistry, and genetic factors

• Good agreement in general that autism is caused by abnormalities in brain development, neurochemistry, and genetic factors

• Bettleheim’s theory of psychogenesis?

No definitive medical test

• No definitive medical test

• Team uses interviews, observation, and specific checklists developed for this purpose.

• Team might include neurologist, psychologist, developmental pediatrician, speech/language therapist, learning consultant, etc.

• Must rule out MR, hearing impairment, behavior disorders, or eccentric habits

1. Communication/Language

• 1. Communication/Language

• 2. Social Interaction

• 3. Behaviors

• 4. Sensory and movement disorders

• 5. Resistance to change (predictability)

• 6. Intellectual functioning

Broad range of abilities, from no verbal communication to quite complex skills

• Broad range of abilities, from no verbal communication to quite complex skills

• Two common impairments:

• A. Delayed language

• B. Echolalia

50% of autistic individuals will eventually have useful speech (?)

• 50% of autistic individuals will eventually have useful speech (?)

• Pronoun reversal: “You want white icing on chocolate cake.”

• Difficulty in conversing easily with others

• Difficulty in shifting topics

• Look away; poor eye contact

• Facilitated communication??????

1. Physical Support

• 1. Physical Support

• 2. Initial training/introduction

• 3. Maintaining focus

• 4. Avoiding competence testing

• 5. Generalization

• 6. Fading

Common in very young children (Age 3)

• Common in very young children (Age 3)

• Immediate or delayed (even years)

• Is there communicative intent with echolalia?

One of hallmarks of autism is lack of social interaction

• One of hallmarks of autism is lack of social interaction

• 1. Impaired use of nonverbal behavior

• 2. Lack of peer relationships

• 3. Failure to spontaneously share enjoyment, interests, etc. with others

• 4. Lack of reciprocity

• Theory of mind?

Repetitive behaviors, including obsessions, tics, and perseveration

• Repetitive behaviors, including obsessions, tics, and perseveration

• Impeding behaviors (impede their learning or the learning of others)

• Will need positive behavior supports

• A. Self-injurious behavior

• B. Aggression

Very common

• Very common

• Over- or under-sensitive to sensory stimuli

• Abnormal posture and movements of the face, head, trunk, and limbs

• Abnormal eye movements

• Repeated gestures and mannerisms

• Movement disorders can be detected very early – perhaps at birth

Change in routine is very stressful

• Change in routine is very stressful

• May insist on particular furniture arrangement, food at meals, TV shows

• Symmetry is often important

• Interventions need to focus on preparing students for change if possible

Autism occurs in children of all levels of intelligence, from those who are gifted to those who have mental retardation

• Autism occurs in children of all levels of intelligence, from those who are gifted to those who have mental retardation

• In general, majority of individuals with autism are also identified as having mental retardation – 75% below 70

• Verbal and reasoning skills are difficult

• Savant syndrome

1. Individualization and early intervention are the keys

• 1. Individualization and early intervention are the keys

• 2. Include life skills, functional academics, and vocational preparation

• 3. Positive behavior support

• 4. Social stories (music therapy?)

• 5. Lovaas model