Presented by: Emily Childress, M.A. & Amanda Gilmore,

M.S.

Pervasive Developmental

Disorders

Barclay and Associates, P.C.1525 Airport Road, Suite 101

Ames, Iowa 50010515-292-3023

What are PDDs?AKA Autism Spectrum Disorders(ASDs)Impairment in development; reciprocal

social interaction skills, communication skills, or presence of stereotyped behavior, interests and activities

Evident in first years of lifeAssociated with some degree of Mental

RetardationRange from a severe form called Autistic

Disorder, through Pervasive Development Disorder Not Otherwise Specified), to a milder form, Asperger’s Disorder

Includes Rett’s and Childhood Disintegrative Disorder

Autistic DisorderSix or more from 1, 2, and 3, with two from 1,

and one each from 2 and 31. One impairment in social interaction

marked impairment in the use of multiple nonverbal behaviorseye-to-eye gaze, facial expression, body

postures, and gestures to regulate social interaction

failure to develop peer relationships appropriate

to developmental levellack of spontaneous seeking to share

enjoyment,interests, or achievements with other

people No showing, bringing, or pointing out objects of interest

lack of social or emotional reciprocity  

Autistic Disorder 2. One impairment in communication Delay or lack of development of spoken languageno attempt to compensate through alternative modes of communication (gestures, mimes)in individuals with adequate speech, impairment in ability to initiate or sustain a conversation

Stereotyped and repetitive use of language or idiosyncratic language

lack of varied, spontaneous make-believe play or social imitative play

Autistic Disorder3. One restricted repetitive and

stereotyped pattern of behavior, interests, or activities preoccupation with stereotyped and restricted patterns of interest that is abnormal in intensity or focus

inflexible adherence to specific nonfunctional routines or rituals

stereotyped and repetitive motor mannerisms

hand/finger flapping or twistingcomplex whole-body movements

persistent preoccupation with parts of objects

Rett’s DisorderNormal development for the first 5 months of life followed by a deceleration of head growth between 5 and 48 months

Loss of previously acquired purposeful hand movement

between 5 and 30 monthsLoss of social engagement, development of poorly coordinated gait or trunk movements

Severely impaired expressive and receptive language development with severe psychomotor retardation

Childhood Disintegrative Disorder

Normal development for the first 2 years

Significant loss of 2 previously acquired skills:Expressive or receptive languageSocial skillsBowel or bladder controlPlayMotor skills

Two abnormalities of functioning:Social interactionCommunicationRestricted, repetitive and stereotyped

patterns of behavior, interests and activities

Asperger’s DisorderNo significant delay in language or

cognitive developmentTwo social interaction impairments

including: use of multiple nonverbal behaviors

eye-to-eye gaze, facial expression, body postures, and gesturesFailure to develop peer relationshipsLack of spontaneous seeking to share

enjoyment, interests or achievements with other people

no showing, bringing or pointing out objects of interest

Lack of social or emotional reciprocity

Asperger’s DisorderOne restricted repetitive

and stereotyped behavior, interests, and activities including:Preoccupation with stereotyped and restricted patterns of interest that is abnormal in either intensity or focus

• Inflexible adherence to specific, nonfunctional routines or rituals•Stereotyped and repetitive motor mannerisms • Hand/finger flapping or twisting, or complex whole body movements

• Persistent preoccupation with parts of objects

Signs of Autism:Characteristic behaviors of Autism

Spectrum Disorders may or may not be apparent in infancy (18-24 months) but usually become obvious during early childhood (2-6 years)

•5 red flag behaviors:•Does not babble or coo by 12 months•Does not gesture (point, wave, or grasp) by 12 months•Does not say single words by 16 months•Does not 2 word phrases on his/her own by 24 months•Has any loss of any language or social skill at any age

Symptoms of Autism: SocialDifficulty interacting with others and avoid eye contact

Prefer being alone and resist attention

Passively may accept hugs and cuddling

May fail to seek comfort or respond to a parent’s display of anger or affection in a typical way

Unusual and difficult attachment-lack of expected showing of affection

Slow to interpret what people are thinking/feeling

Poor judgment or miss of social cues

Difficulty seeing things from another person’s perspective

Unable to predict or understand other people’s actions

Symptoms of Autism: Social..

Difficulty regulating emotions (may cry,

get angry, be disruptive)

Tendency to lose control and can show self destructive behavior

Symptoms of Autism: Communication

Some may remain mute throughout lifetimeMost develop spoken language and

all learn to communicate in some way using pictures or sign language

May repeat or parrot words (normally passes by age 3)

Slight delays in language Precocious language or seemingly advanced

vocabularyDon’t understand body language/tone of

voice/phrases of speech Their tone of voice may not reflect real

feelingsLess able to let others know what they needDo whatever they can to get through to othersAt a greater risk for becoming depressed or

anxious

Symptoms of Autism: Repetitive Behaviors

Odd repetitive motions set them apart from other children

Behavior can be extreme (arm flapping, walking on toes, freezing in position)

May spend hours lining up toys in a specific way

Need/demand absolute consistency in environment

Slight change in routines can be extremely stressful

Intense preoccupation with certain things trains, lighthouses, fire hydrants, symbols

Signs and Symptoms of Asperger’sInappropriate or minimal social interactionsConversations revolving around self versus

others“Scripted”, “robotic” or repetitive speech Lack of common senseProblems with reading, math, or writing skillsObsession with complex topics such

as patterns or music Average to below average nonverbal

cognitive abilities though verbal cognitive abilities are usually average to above average

Awkward movementsOff behaviors or mannerisms

Causes of Pervasive Developmental Disorders

Scientists are finding surprising new information about genetics, brain structure, and environmental impacts •Currently no

agreement exists on causes

Causes of PDDsSpeculations include:

VaccinationsGenetic vulnerabilityAbnormal brain development

Larger brain sizeIncreased white matter volume

Environmental factorsToxins/ Infectious agents

Lead and cadmium poisoning (in Iowa)

Prenatal exposure to chemicals• Thalidomide and valproic acid

Strategies: Physical Environment

Structure physical environment to facilitate learning and minimize frustration –visual/physical order assists in focusing

Watch for peers who obviously/subtly annoy her

Watch for peers who feed off and feedback inappropriate behaviors –she may like these peers but the relationships are not necessarily the best for either student

Ensure that she is in a position of least distraction up front and away from visual and auditory “clutter”

Consider isolating her for short periods to teach new concepts or build on pre-existing knowledge

She may be defensive of personal space  

Strategies: In Class Structure

Create a predictable environment with routine and prepare student for changesSet behavioral limits and monitor to implement consequences or provide

coping strategiesGive brief and precise instructions that

she understandsState clearly what is expected-be

concrete and allow time for her to process the information

Break tasks up into manageable segments and train her to schedule and plan

Teach her to ask for help and methods of doing so  

Video Clip from Parenthood

Strategies: Presentational Issues

Know and use the student’s strengths

Present new concepts in a concrete manner

Use activity based learning where possible

Use visual prompts as appropriateBreak work into small stepsHave written instructions for students,

include visual cues and mark clearly the

things that need to be completedShow examples of what is requiredKeep chalk/whiteboard neat

Strategies: Teaching IssuesDo not do for him what he can do for selfDo not expect the him to automatically generalize instructions

Use language to tie new situations to old learning

Do not rely on emotional appeals or presume that he will want to please you

Concentrate on changing unacceptable behaviors and do not worry about those that are “simply” odd

Use the obsessive or preferred activity as a reward

Use opportunities which arise to teach him about how other students feel and react when they are hurt or upset

Be consistent and do not give options if there are no options

Strategies: Child Focused for Development

Provide “peer support network/buddy system” for safety

Teach safety phrases such as “are you pretending?” or “what do you mean?” or “why should I do that?” to help her gain information (this does not come naturally) so she can determine the situation’s nature and respond accordingly

Teach rules of social conduct so she does not constantly interrupt

Explain metaphors and avoid where possible (frog in your throat)

Have a time out area for discipline (enforce consequences & ensure ‘time out’ isn’t more attractive than the activity)

Have a strategy to employ when she cannot cope due to overstimulation or confusion

Written timetables can help primary aged children stay on task 

Strategies: Parent FocusedIf abnormal behaviors surface, touch base with parents to see if they are seeing these behaviors (parents prefer more information than less and often something minor points to a serious issue)

Provide parents with a timetable to ensure rehearsal of what will be required the following day (equipment, activities)

Have a daily planner to inform parents of successes and failures, ask for parental advice/information from parents

It is vital that parents know what is happening at school so they can inform doctors and therapists of issues for future collaboration

Give parents options regarding classroom modifications and the possibility of seeking outside help as an additional resource

Working with Professionals

Barclay and Associates, P.C.1525 Airport Road, Suite 101Ames, Iowa 50010515-292-3023

•Parents and professionals should work together for the child’s benefit•While professionals do have experience, remember that parents posses unique knowledge about their child•When a treatment plan is in place, parents and professionals need to have good communication in order to monitor a child’s progress•Guidelines for working with professionals:• Be informed• Be prepared, ask for clarification• Be organized• Communicate

Additional ResourcesArticle

Jackel, S (2006). “Asperger’s Syndrome-Educational Management Issues”

Asperger’s Syndrome Survival Guide: www.aspergerssociety.org

Autism Society of America: www.autism-society.orgAutism Speaks: www.autismspeaks.orgDiagnostic and Statistical Manual of Mental Disorders

Fourth Edition Text RevisionKid’s Health: http://kidshealth.orgThe Mayo Clinic: www.mayoclinic.comNational Institute of Mental Health

http://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-pervasive-developmental-disorders/index.shtml

Organization for Autism Research: www.researchautism.org

Questions?