introduction to autism session one. what is autism presented by marc tardif social skills program...
TRANSCRIPT
Learning Objectives:
After the workshop participants will be able to:
Label the disorders which fall under the PDD umbrella
Label the three Autism Spectrum Disorders
Describe impairments in social interaction, communication, & behaviour
Possible Causes of Autism
Genetic:Current research links ASD to biological or
neurological differences in the brain
Organic:Some research suggests that environmentalfactors play a part in the expression of ASD
DSM IV Diagnostic Criteria
At least two impairments in social interaction
At least one impairment in communication
At least one impairment in restricted or repetitive behaviour
A diagnosis requires a total of 6 or more impairments
present in total
Impairment in Social Interaction
Impairment in the use of nonverbal behaviours
Failure to develop peer relationships appropriate to age level
Lack of spontaneous seeking and sharing
Lack of social or emotional reciprocity
*requires at least two impairments from this category
Impairments in Communication
Delay or total lack of the development of spoken language In individuals with adequate speech, marked impairment in ability to initiate or sustain
conversation Stereotyped, repetitive use of language or
idiosyncratic language Lack of make-believe play or social imitative play
*requires at least one impairment from this category
Restricted, Repetitive and Stereotyped Patterns of Behaviour
Preoccupation with one or more stereotyped andPreoccupation with one or more stereotyped and
restricted patterns of interest restricted patterns of interest
Apparently inflexible adherence to specific,Apparently inflexible adherence to specific,
nonfunctional routines or ritualsnonfunctional routines or rituals
Stereotyped and repetitive motor mannerisms Stereotyped and repetitive motor mannerisms
Persistent preoccupation with parts of objectsPersistent preoccupation with parts of objects
*requires at least one impairment from this category*requires at least one impairment from this category
Diagnosis
A diagnosis is reached after an assessment is completed by a pediatrician or a psychologist
Diagnosis can take place as early as 18 months
There is no proven cause or cure for autism
(Scientific American Journal, 2000)
Pervasive Developmental Disorder
CDD
Rett’s
Syndrome PDD-NOS
AspergerSyndrome
Autism
Autism Spectrum Disorders (ASDs)
Childhood Disintegrative Disorder
Extremely rare: Prevalence rate 1.7/100 000
Typical development until age two
Onset usually between 36 – 46 months
Significant loss of skills
More common in boys than girls 4:1
(Canadian Journal of Psychiatry- In Review)
Rett’s Syndrome
1 in 10,000-23,000
Have normal head size at birth and normal development
Between 5 – 48 months head growth slows
Develop stereotypic hand movements
Poor coordination and social withdrawal occurs
(Source: Canadian Journal if Psychiatry- In Review)
Pervasive Developmental Disorder –Not Otherwise Specified
(PDD-NOS) Referred to as “Atypical” autism
Do not meet criteria for full autism diagnosis
Traditionally seen as a “milder” form of autism
Is a diagnosis by exclusion of other disorders in autistic spectrum Screening and assessment is the same as for autism
Asperger Syndrome Must have both:
1. Qualitative impairment in social interaction
2. Restricted and repetitive patterns of behaviour, interests and activities
No delay in language development, though language development may be peculiar
Fail to make connection between thoughts/feelings and behaviour/actions
Symptoms may be subtle or even undetected until child is over 3 years of age
Facts about Asperger’s Syndrome (AS)
First identified by Dr. Hans Asperger in 1944
Approximately 5 out of every 10,000 people 15,000 Canadians
More common in boys than girls (4:1)
(Autism Society, 2005)
Autism Usually manifests itself during the first three
years of life
Problems with social interactions is the hallmark symptom as people with ASD have problems relating to others
The range and intensity of disability varies widely
Associated with developmental disability
High-functioning Autism (HFA) vs. Asperger’s Syndrome (AS)
DSM-IV-TR criteria:
History of language delay in HFA but not in AS
Intact cognitive functioning in AS but not in HFA
(Tsai, 2005)(Tsai, 2005)
DifferencesAutism Asperger’s
Onset 1-3 years After 3 years
Early Language Impaired proficient
Motor Skills Developmental level Below developmental level
Cognitive Level Often below chronological age
At or above chronological age
Visual Spatial Skills Strength weakness
Verbal Skills Weakness strength
Social Pragmatic Aspects of Language
Weakness weakness
Repetitive Behaviour Actions, objects/physical mannerisms
Verbal cognitive mannerisms
(Condillac, 2003)
Social Deficits
Lack of reciprocal social interactions
Unusual reaction to other’s emotions
Lack of joint attention
May not seek out the company of peer
Avoidance of eye contact
Communication Deficits
Idiosyncratic use of language
Literal interpretation of language
Echolalia or delayed echolalia
Use of unusual expressions
Tend to use third person
Difficulty initiating/sustaining a conversation
Communication Deficits
Literal Interpretation
http://www.boreme.com/boreme/funny-2007/police-helps-kid-p1.php
Temple Grandin
“During the last couple of years I have become more aware of a kind of electricity that goes on between people. I have observed that when several people are together and having a good time, their speech and language follow a rhythm. They will all laugh together and then talk quietly
until the next laughing cycle…”
“I have always had a hard time fitting in with this rhythm, and I usually interrupt
conversations without realizing my mistake. The problem is that I can’t follow
the rhythm.”
(Grandin, 1995)
Behavioural Deficits
Insistence on sameness No real fear of dangers Hand or arm flapping Spins objects Tantrums Inappropriate attachment to objects
Uneven gross or fine motor skills
Restricted and Repetitive Behaviours
Social Interactions Language and
Communication
Triad
Anxiety
Sensory
+ 2
Anxiety and PDD
Neurological differences responsible for anxiety coping
Anxiety is a subjective response to stimuli Difficulty using “buffers”
Behaviours quickly become an anxiety reduction tool
Kevin Baskerville (2005)
Sensory Issues
Children with Autism tend to overreact or under react to sensory input
Under react (hyposensitive): don’t respond to small or even moderate amounts of stimulation in the area of their sensitivity (i.e., fail to respond to ordinary speech)
Over react (hypersensitive): find small or moderate amount of stimulation overloading or irritating (i.e., speech or television)
Sensory Issues
Auditory- hearing appears to be selective
Visual- attraction or aversion to particular visual stimuli
Tactile- attachment to objects may be related to tactile qualities
Taste- non-food items are sometimes tasted
Smell- sometimes become fixated on the smell of something
Risk Markers ("Red Flags")
Social
Little or no eye contact Difficulty mixing with other children No functional play but uses objects in a
repetitive manner (lining up, stacking) Prefers to be alone May not want to be held or cuddled
Risk Markers ("Red Flags")
Communication
Inappropriate laughing or giggling Echolalia Not responsive to verbal cues Difficulty in expressing needs, failure to use
gestures or pointing in place of words
Risk Markers ("Red Flags")
Behavioural Insistence on sameness, resists change in routine No real fear of danger Toe walking Hand or arm flapping Apparent insensitivity to pain Spins objects Noticeable physical over/under activitiy Tantrums Uneven gross/fine motor skills
Autism Society (2005). Retrieved March 12, 2005 from www.autismsocietycanada.ca
American Psychiatric Association. Quick Reference to the Diagnostic Criteria from DSM-IV-TR. Arlington, VA.
Baron-Cohen, Simon (1995). Mindblindness. MIT Press, United States.
Baskerville, Kevin (2005). Mapping your way through the ASD maze: reducing anxiety to assist individuals with ASD. Autism Inclusion Coordinator, Autism Team. Warwickshire, DISCS, England.CAIRN(2006). Canadian autism intervention research network. Retrieved May 20, 2006 from www.cairn-site.com
Collins, Paul (2004). Not even wrong; adventures in autism. Bloomsbury, New York & London.
Cutler, Eustacia. A Thorn In My Pocket.
Gaining Face www.ccoder.com/GainingFace
Gray, Carol (2005). The national autism conference presents: from kid-tastrophe to cooperation: loss, learning and students with ASD. Progress through partnership. National Autism Conference. Penn State, Pennsylvania.
Gray, Carol. (2005) From Kid-tasphrope to Cooperation: Loss, Learning and Students with ASD. The Gray Center for Social Learning and Understanding, Grand Rapids, Michigan.
Grandin, T. (June 2000) http://www.cdrcp.com/aut_teachingtips.html
Grandin, Temple. (1995) Thinking in Pictures and Other Reports From My Life With Autism. Vintage Books, New York.
Gwynne, Fred (1970). The king who rained. Windmall Books, New York.
.
References
Haddon, Mark (2003). The curious incident of the dog in the night-time. Anchor Canada.
Howlin, Patricia (2000) Geneva centre international symposium on autism. Canadian Management Centre.
Hodgdon, L. (2005) ASD ProvincialConference
Hodgdon, L., (1995). Visual Strategies for Improving Communication – Practical Supports for School and Home. Troy, Michigan, USA: QuirkRoberts Publishing
Integrated Services Division Ontario Ministry of Community, Family and Children’s Services. Intensive behavioural intervention: a manual for instructor-therapists Version 2.
Jackson, Luke (2002). Freaks, geeks and asperger syndrome. Jessica Kingsley Publishers. London & Philadeplhia
Leaf & McEachin (1999). A Work In Progress: Behavior management strategies and a curriculum for intensive behavioural treatment of autism. New York, NY: DRL Books, L.L.C.
Metro-Goldwyn-Mayer Studios Inc (1998). Rainman. Best Picture, MGM Studios Inc.
Michaels, Alex (2005). Executive functioning. Educational Consultants of New England, Inc. Waltham, MA. Retrieved May 5, 2006 from http://www.stopthatbehaviour.com/i_executive_functioning.html
References
Ministry of Education Ontario. Special Education Monographs No.4: Students with Autism. April 1990. Retrieved October 19, 2005. http://www.edu.gov.on.ca/eng/general/elemsec/monog4.html
Newport, Jerry (2005). The person is more important than the label. Progress Through Partnership. National Autism Conference. State College, Pennsylvania.
Notbohm, Ellen. (2005). Ten things Every Child With Autism Wishes You Knew. Arlington, Texas:Future Horizons
Perry A, Condillac R.L (2003). Evidence-based practices for children and adolescents with autism specturm disorders: review of the literature and practice guide. Children’s Mental Health of Ontario.
Toronto, Ontario, Retrieved September 15th 2005.
Pennsylvania, State College (2005). Progress through partnership, national autism conference. Penn State.
Robledo, S.J & Ham-Kucharski, D (2005). The autism book, answers to your most pressing questions. Penguin Group Inc. New York.
References
References
Stokes, S. (2001). Structured teaching: Strategies for supporting students with autism? Written under a contract with CESA 7 and funded by a discretionary grant from the Wisconsin Department of Public Instruction. http://www.cesa7.k12.wi.us/sped
Tidmarsh, Lee & Volkmar, Fred (2003). The canadian journal of psychiatry-in review. Vol 48, No 8, September 2003. Pg. 518, 519
Tsai, Luke. M.D. (2005). Autism spectrum disorder and co-morbid neuorpsychiartric disorders. Progress Through Partnership. National Autism Conference. State College, Pennsylvania.
Training & Inservice- Autism Module Complied by Gateway SocietyWorld Class Communication Technologies(2004). Souls, beneath and beyond autism.
Books That Touch.
Winter, Matt (2003). Asperger syndrome, what teachers need to know. Jessica Kingsley Publishers, London & Philadelphia.
References