Difference and first signs of atypical development
Motor development
Visual attention
interest in objects
Social interaction behavioral differences for ASD noticed
Between 1st and 2nd year
Characteristics of ASD
withdrawn from interpersonal contact
ritualistic behavior
cognitive delays
stimulus selectivity and sensitivity
language impairments
Early Social disturbance in ASD
Non interest in human face (lack of social smiling)
Lack of eye contact
Reduced response to own name
Poor/absent attachments to family
Lack of social interest and social imitation
Cognitive Characteristics in ASD
ASD with above average intelligence -rare 3%
Most of them under 70 IQ
28% of them are average
[Outcomes are poorer with lower cognitive abilities]
On WISC-C High IQ than verbal, block design is highest subtest score, and comprehension is lowest.
Executive functions in ASD
Deficits in planning, inhibition, mental flexibility, mental representation of tasks and goals. Working memory may be a strength.
Executive functioning and ASD 2
Restricted interest
Problems in integrating info
Deficits in social cognition
Deficits in understanding speaker's intention
Attention in ASD
general attention problems
stimulus over selectivity
overfocused attnetion
Problems in shifting attention
Other problems in sustaining attention
Hypersensitive to sounds.
Interest in nonfunctional aspects of objects. Stereotypic movements- hand flapping,
Theory of mind for ASD
problems in understanding mental states of themselves and others (beliefs, desires, intentions, and emotions).
Language characteristics
Extremely variable
High percentage develop language by age 9
Autism Language Normal neurocognitive
language form unimpaired
typical patterns of neuroantomical assymetry observed (left hem larger than right)
Autism Language impaired (neurocognitive)
language form impaired
associated with left hem. structure
ALI and DLD brain similar and have similar issues
Form for ASD
Articulation not impaired, but variability. Syntax issues cooccur with other issues. Telegraphic , less morphological markers than peers.
Phonological short-term memory impaired.
Phonological processing difficulties like rhyme awareness.
Problems in asses
Content in ASD
Lack of understanding that all people and things have names.
Impoverished vocabulary-deficient semantic system.
Words used in limited context.
Problems in lexical org.
Don't use info for encode and recall.
Use in ASD
Span the spectrum
Preverbal have deficit in nonverbal functions.
Impairment in learning social skills.
Conversational skills and narratives poor.
Trouble talking about non-personal topics.
Lack of politeness markers.
Poor topic maintenance, poor referenci
Semantic and pragmatic problems in ASD
Sometimes children can memorize scripts, and have good form (but not content and use)
Literacy for ASD
Hyperlexia (reading at higher levels) yet struggling with reading comprehension
Infant populations with ASD
Parent involvement in intervention
Individualizations to each infant's developmental profile
Focusing on broad learning targets (not narrow)
Note differences in behavior and increase intensity and duration in intervention as soon as risk is detected.
Pragmatic Language Impairment (Semantic-Pragmatic Disorder)
do not fit ASD, not restricted or repetitive patterns of behaviors, interests, or activities
Pragmatic difficulties
Nonverbal learning disability
opposite of DLD
nonverbal is below verbal scores
problems with visual-spatial, visual-motor, fluid reasoning measures
Social judgement problems, verbosity, repetitive speech, problems in novel situation adaptation.
Pragmatic difficulties
Social-communciat
Echolalia for ASD
meaningless repetition of speech
immediate
delayed
mitigated (content is changed)
Seven Communicative functions of immediate echolalia
interactive and noninteractive
interactive echolalia
turn-taking
declarative
yes-answer
request
noninteractive echolalia
nonfocused
rehearsal
self-regulatory
Pronoun reversal
major language characteristic of autistic children
themselves as "you" and the other person as "me"
Maybe because of echolalia, problems in cognitive deficiencies, lack of attention to pronoun usage
Comprehension deficits
always present in young children with autism
Prosody in Autism
choppy monotonous voice
pitch- too high
abnormal inflectional patterns
alternating rising and falling intonations
Verbal auditory agnosia
Extreme deficiences in acknowledging, processing, and using verbal symbols for communicative purposes. (word-deafness)
Phonology for ASD
many can use this
deficits in the discrimination and sequencing of rapid speech sounds.
School Age with ASD
Many children will develop assoc. and attachments to parents
May display some differential social responsiveness
Minimal communication skills may emerge, but deviant
Self-stimulating behaviors and self abuse may begin
Marked developmental gains make take
Adults with ASD
May remain significantly impaired
may have self sufficiency
causes of asd
myriad, but not parents relationships or personality traits
Biological factors, genetic
Damage to brain stem area
Damage to limbic system
smaller cerebellum
Larger than normal head circumference and brain size
Biological Mechanism and ASD
Increased freq of physical anomalies
persistent primitive reflexes
neurological soft signs
abnormal EEG
high incidence of seizures
Occurs more often in:
Congential rubella, fragile x, tuberous Schlerosis, PKU, but less in Down's Syndrome
Biochemical differences in ASD
HIgh level of serotonin
abundance of opoid peptides (don't need the pleasure of social interactions as much)
Neurological factors (low muscle tone, poor coordination, toe walking)
Prognosis for ASD
Outcome related to intelligence and language ability
Better prognosis if higher cognitive skills, and if no regression.
Acquisition of language in ASD
Gestalt processing mode- multiword utterances are processed and then used as single word units
Use analytic model or combination of gestalt/analytic
1) high freq. of echolalia
2) gestalt language
3) gradual use of analytic language (generated utterances)
Assessment for ASD
non-speech test
TPBA (observation)
REEL (Receptive/expressive emergent langauge scale)
Developmental communication curriculum
Preschool language scale (PLS-5)
Determining functionality
communication basic needs
social language
academic language
ability to initiate speech/language
speech capabilities/intelligibility/motor skills
symbolic capabilities
Intervention and autism
First development of joint attention and imitation on demand
focus on reciprocal communication interactions and play, and social reinforcers
pointing to objects and people are often taught to nonverbal preschoolers
must know hat people, places, and things
Areas to focus on for ASD
scripts
comprehension deficits
reduce complexity of utterances
make appropriate responses
hyperlexia- written language used to facilitate naming and verbal learning
Areas of focus for ASD
use pictures with written words
use strengths to help with weaknesses
semantic relationships with older children
practice discourse
org of verbal material
topic is weighted more than secondary themes
Communication enhancement guidelines for non-speaking children with autism
1) establish anticipatory and intentional behaviors
2) replace unconventional communication means
3) expand the range of communicative functions
More tips for nonverbal
Develop strategies to maintain communication and repair breakdowns
Provide environmental supports to enhance social communication
Enhancing communication in verbal children with autism
expand- vocab
reward- efforts for communication and speech
teach- clients to direct attention
encourage- multiword utterances
expand- sentence types
develop- emergent literacy
Other tips for ASD
teach functional use of imitation
capitalize on memorized forms
developing and advanced language
talk about there and then
address conversational skills
provide scripts for specific events
use reading and writing for communicative purposes