Strengths and weaknesses in High Functioning Autism

Ina van Berckelaer-OnnesUniversity of Leiden

Cardiff10-05-2006

Autism Research levels

Behavioural level

cognitive level

Neurobiological level

Wing’s triad of ASD

Social interactions Communication Imagination versus DSM IV

stereotyped patterns

cognition behaviour

Underlying triad deficit

Limited intentionality

Limited symbol formation

Limited intentionality

Pointing

Imitation

Play

Limited symbol formation

Language

Imagination (play, etc.)

Consequences for:

interactiona) Behaviour

communication

perceptionb) Cognition attention

memory

Cognition HFA

Perception: information processing

Attention: set-shifting (+ inhibition??)

Memory: memory for facts versus functional memory

Perception – Information processing: language

Receptive language

versus

Expressive language

Levels of perception

Sensation Presentation Representation Metarepresentation

Cognitive Deficits (Styles)

Theory of Mind (ToM)

Executive Function (EF)

Central Coherence (CC)

Perception/language: ToM

Pronoun reversal (perspective taking)

Inappropriate questions

Perception/language: Executive Function.

Stereotyped phrases

Perseverations

Inflexibility

Perception language: Weak CC.

Poor context use

Associative language use

Literal language

Attention:WCC and EF Strong fixations /

obsessions Weak lack of interest

Set-shifting versus inhibition

Memory: WCC

Strong facts, encyclopedial

knowledge Weak social coherence

Diagnostic Protocol

Classification and individual assessment

Psychometric Evaluation

Cognition

Intelligence IQ ProfileNeuropsychological tests(ToM, EF,WCC)

Pitfalls

Generalization

Verbalizing versus Doing

Bridging Assessment to Treatment

From Profile to Interventions: Support Strengths and Build

up Weaknesses

Treatment strategies

1st grade strategy: environmental coaching

(augmentative communication)

2nd grade strategy: individual treatment

3rd grade strategy: individual colouring

Environment; 1st grade strategy

TEACCH principlestructure: in space

in timein activityin approach

Individual treatment; 2nd grade strategy

Focusing on the individual needs - speech therapy

- social skill training- job coaching- psychotherapy (mostly cognitive behavioural therapy)

- etc.

Individual colouring; 3rd grade strategy

Personal characteristic

Associated features

Comorbid Disorders

HFA: from the cradle to the grave

Treatment across the ages!