THE OVERALL EFFECT ON THE LIVES OF CHILDREN WITH AUTISM

M I C H E L L E G I E L A R O W S K IU N I V E R S I T Y O F P I TT S B U R G H

Speech and Language Development

Contents

Overview of autism Description and Definition Symptoms and Diagnosis Causes Prevalence

Speech and Language Development Typical Development vs. Development in Autism Effect on child Effect on family (parents and siblings)

Implications for Intervention Early Intervention Response to Intervention (RTI) Functional Communication Training (FCT)

Definition Description

Complex developmental disability appearing during the first three years of life affecting the ability to communicate and interact

PDD (Persuasive Developmental Disorder)

Leo Kanner 1943Difficulties with

social interaction and communication, and displaying repetitive behaviors

Overview of Autism

(Autism Society of America, 2008; Landa, 2007)

Overview of Autism

SymptomsReciprocal social interactionVerbal and nonverbal communicationRepetitive/unusual behavior and/or interests

Symptoms

Reciprocal Social InteractionA social deficit that involves withdraws from

social interaction and difficulty with maintaining relationships.

Isolation preferableIgnoring others, unresponsive behavior, showing

no interest in playing with others, and rarely initiating social contact

Difficulty with social sharingBrief eye contact, infrequent facial expressions,

and difficulty with establishing joint attention(Brown & Percy, 2007)

Bono, Daley, & Signman Study

Relations Among Joint Attention, Amount of Intervention, and Language Gain in Autism (2004)

Investigated relationship between amount of intervention and language development

Proposed joint attention skills as characteristics to moderate relationship

Results showed conditional relationship between amount of intervention and language development with dependence on joint attention skills

Symptoms

Verbal and Nonverbal CommunicationA delay in, or complete lack of, the

development of spoken languageDifficulty with semanticsUse of gestures/pointing to communicate

needsDifficulty with pragmaticsExhibits echolalia

(Allman, Eidine, & Helmy, 2008; Brown & Percy, 2007; Koegel, Koegel, & Shirotiva, 2009)

Symptoms

Repetitive and Unusual Behaviors and Interests

Obsessive preoccupationsDifficulty dealing with changeRepetitive behaviors that include motor

movements

(Brown & Percy, 2007)

Diagnosis

Understand the complexity of the disabilityConsider all possible symptomsDo not rule out autism immediately; look at

all aspectsAccurate assessment through observations,

knowledge of history, interviews with family, and various assessment tools provides guidance

(Brown & Percy, 2007)

Overview of Autism

CausesNo known cause of autismPossibility of multiple causes with similar

pattern of behavior

(Fombonne, 2003)

Overview of Autism

PrevalenceChildren diagnosed with autism increased

from 4 to 6 per 1,000 (or 1 in approximately 1,600) live births to 1 in every 150 live births

More prevalent in males vs. females1 in 3 people are nonverbal

(Sansosti, 2010)

Typical Children Children with Autism

Paralinguistic stage: includes body movements and sounds

Linguistic Stage; communicates orally

Forms sensible sentences; first simple then compound

Vocabulary extends

Early sharing of affective expression

Delayed onset of babbling

Delay in use of gestures and responsiveness

Speech and Language Development

(Allen & Marotz, 2003; Landa, 2007)

Effect on the Family

Higher levels of stressSigns of depressionResponsibility is shifted to siblingsDifficult for family to maintain social

interaction and positive relationships

Siblings Mother

Exposed to increased parental expectations, decreased parental involvement, and increased responsibilities

Traditional sibling role changes; the potential responsibility of becoming the primary caregiver is likely

Increased amount of stress

Minimal affective expression

Increased difficulty in managing interpersonal situations

Effect on the Family

McIntyre & Quintero Study

Sibling Adjustment and Maternal Well-Being: An Examination of Families With and Without a Child with an Autism Spectrum Disorder (2010)

Differences in social, behavioral, and academic adjustment in siblings of children with and without autism

Results showed siblings in both groups were in the average range for academic competence, social skills, and behavioral functioning

Hastings Study

Brief Report: Behavioral Adjustment of Siblings of Children with Autism (2003)

Data was collected on 22 siblings of children with autism and rated by their mothers as having more behavior problems and fewer pro-social behaviors

Results showed that children with siblings who have autism, and also those younger than their sibling with autism, engaged in fewer pro-social behaviors

Filipek, Goldberg, Jarvis, Laulhere, Osan, Spence, & Straub Study

Brief Report: Early Social Communication Behaviors in the Younger Siblings of Children with Autism (2005)

Data was collected on young children with autism, younger siblings in families with an older child with autism, and young typically developing children

Results showed the social communicative behaviors of the younger siblings differed from typically developing children but not from the behaviors displayed by the autism group

Hodge, Hollman, Looney, Lopez-Wagner, & Sweeny Study

Mothers of Typically Developing Children and Mothers of Children with Autism (2000)

Data using the Parenting Stress Index was collected on stress levels of mothers of children with autism and mothers of typically developing children

Results showed higher stress levels in mothers of a child with autism versus mothers of a typically developing child

Bordin, Duarte, Mooney &Yazigi Study

Factors Associated with Stress in Mothers of Children with Autism (2005)

Investigated possible reasons for stress in mothers of children with autism

Results showed that poor affective expression, little interest in people, being an older mother, and having a younger child contributed to increased stress level

Implications for Intervention

Early InterventionResponse to Intervention (RTI)Functional Communication Training (FCT)

Early Intervention

Improves cognitive level, language, and ability to function in school

Successful early intervention programs include: early start, intensive, structured behavioral teaching principals, comprehensive, individualized, trained staff

Involves parents; supports inclusion

Dr. Ole Ivar Lovaas responsible for developing first early intervention program utilizing applied behavior analysis

Implications for Intervention

Lovaas Study

Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children (1987)

Investigated the effects of behavior modification treatment on children with autism

Results showed that the participants involved functioned successfully by first grade in the mainstream classroom while maintaining success

Response to Intervention

Approach for providing interventions to students at increasing levels of intensity based on progress monitoring and data analysis

Believes all children deserve equal, effective, quality instruction

3 tiers of support: quality teaching/use of

research-based interventions

data-collection procedures educational decision-

makingSchool-wide, small

group and individualized supports combine for success

Implications for Intervention

Functional Communication Training

Addresses communication and behavioral needs

Involves assessing the function of a behavior through analogue assessment methodology; then replacing challenging behavior by teaching a communicative response

Success with verbal/nonverbal children

Restructures aggression, tantrums, oppositional behavior, and hand flapping

3 step process: Assessment of the function of

behavior Identification of a

communicative response Replacement of the challenging

behavior with a communicative response

Implications for Intervention

Alter, Conroy, Mancil, & Nakao Study

Functional Communication Training in the Natural Environment: A Pilot Investigation With a Young Child with Autism Spectrum Disorder (2006)

Investigated FCT in the child’s natural environment

Results showed an increase in communication/decrease in challenging behavior

Conclusions

Language is a fundamental componentIndependence in speech and language

development is difficult to achieve for children with autism

Affects the child and also the family; siblings, parents, mother

Interventions improve overall well-being and development