FRHD2110 - Autism Spectrum Disorder

Autism Spectrum Disorder

Three similar conditions: autism, Asperger syndrome, and persuasive developmental disorder not otherwise specified; all involve varying degrees of problems with communication skills, social interactions, and repetitive and stereotyped patterns of behaviou

Characteristics of ASD

Characterized by severe and persuasive impairment in several areas of development: reciprocal social interactional skills; communication skills; or the presence of stereotyped behaviour, interests, and activities

When is autism usually evident?

Usually evident in the first years of life

What is ASD usually associated with?

sometimes associated with some degree of intellectual disability
other conditions (ie. chromosomal abnormalities)

What is the term now used by professionals and researchers in Canada?

Autism Spectrum Disorder

All of the disorders that are classified as ASD are characterized by varying degrees of impairment in 3 areas

(1) communication skills
(2) social interactions
(3) repetitive and stereotyped patterns of behaviour

Autism

One of the five persuasive developmental disorders; characterized by extreme social withdrawal and impairment in communication; other common characteristics are stereotyped movements, resistance to environmental change or change in daily routines, and unu

What does autism affect

Affects verbal and nonverbal communication and social interaction

What characterizes children with autism?

severe cognitive deficits

Asperger Syndrome

One of five persuasive developmental disorders; a milder form of autism without significant impairments in language and cognition; characterized by primary problems in social interaction (not adept at reading social cues)

Hidden Curriculum

The dos and don'ts of social interactions that most people learn incidentally or with little instruction but that remain hidden for those with Asperger syndrome; behaviours we often take for granted

Impaired communication skills of Aspergers

According to DSM, does not involve clinically significant general delay in language
May express themselves using age appropriate vocab and grammar but they often exhibit idiosyncratic language and language related behaviours
Problems with pragmatics: the

Other characteristics of aspergers

Restricted, repetitive patterns of behaviour, interests or activities
Clinically significant impairment in social, occupations or other areas of functioning
No delays or deviance in language development
No cognitive impairment, no intellectual disability

Characteristics of aspergers?

Higher intelligence and communication skills ten those with autism
Display most, if not all of the other characteristics
Primary difficulty with social interactions

Pervasive Developmental Disorder not otherwise specified (PDD_NOS)

One of five pervasive developmental disorders; pervasive delay in development that does not fit into any of the other diagnostic categories
schizophrenia, schizotypal personality disorder, avoidant personality disorder- this is on the spectrum, but before

is comorbidity common in the new DSM

yes

Rett Syndrome

One of five pervasive developmental disorders; normal development for five months to four years, followed by regression, and developmental delay; much more prevalent in females

what does rett syndrome affect?

speech, hand skills and gait

what is rett syndrome caused by?

Usually caused by a mutation of the MECP2 gene on the X chromosome
known for its genetic contribution
genetic neurological disorder

is rett syndrome on the autism spectrum?

no

Developmental consequences of rett syndrome

Social isolation
maladaptive behaviour
peer relations

Rett syndrome: social isolation

hard to communicate even if they want to, can be nonverbal but still be successful

Rett syndrome: maladaptive behaviour

agressive
self-stimulating
heading banging, behaviours that people engage in to cope with all the sensations

Childhood disintegrative disorders

One of five pervasive developmental disorders; normal development for at least two and up to ten years, followed by significant loss of skills; much more prevalent in males
exhibit same characteristics as autistic disorder

What are all of the disorders characterized by impairments in three years?

1. communication skills
2. social interactions,
3. repetitive and stereotyped patterns of behaviour

Leo Kanner's paper

Reported on the cases of 11 children from the child Psychiatric unit of Johns Hopkins

Major characteristics of Leo Kanner's paper

An inability to relate to others in an ordinary manner
An extreme autistic aloneness that seemingly isolated the child from the outside world
An apparent resistance to being picked up or held by the parents
Deficits in language including echolalia
Extreme

Conclusion of Leo Kanner's paper

these children should be set apart from children with schizophrenia: A disorder characterized by psychotic behaviour manifested by loss of contact with reality, distorted thought processes, and abnormal perceptions

differences between schizophrenia and autism

(1) the children with schizophrenia tended to withdraw from the world, whereas the children with autism never seemed to have made any social connections to begin with
(2) the children with autism exhibited some unique language patterns, such as pronoun re

Hans Asperger's paper

Reported four cases of children he observed in summer camp who preferred to play alone and not interact with other children

How were aspergers children different than kanners children?

(1) they had average intelligence, but they seemed to channel their intellectual pursuits into obsessive preoccupation in narrow areas (machinery or mathematical calculations)
(2) their language was perceived as normal

Characteristics of ASD on social interaction

Might not smile in social situations
Don't like to be picked up or cuddled
Might not show differential response to parents, siblings or teachers compared to other stingers
might not learn to play normally
might not smile in social situations or laugh when

communicative intent

The need to communicate for social reasons; thought to be lacking in most children with autism

Mute

Possessing no, or almost no, language; characteristics of many with autism

what percentage of children with autism are mute?

50%

Impaired communication (ASD)

lack the desire to communicate, confuse wording, or not speak, sound robotic
using language as a tool for social interaction is particularly difficult for most people with autism
if they do not acquire language, they may have considerable difficulty using

Markedly restricted repertoire of activity and interests

repetitive and stereotypical pattern- twirling, spinning objects, flapping hands, rocking, do not like changes
Many display stereotypic behaviour
Extreme fascination or preoccupation with objects and a very restricted range of interests
May play with an o

Stereotypic Behaviour

Any of a variety of repetitive behaviours that are sometimes found in individuals who are autistic, blind, severely intellectually disabled, or psychotic; sometimes referred to as stereotypies or blindness

Impaired cognition

Most show cognitive deficits in the form of developmental delays

Savants

a person with severe autism whose social skills are markedly delayed but who also has advanced skills in a particular area, such as calculation or drawing

Abnormal Sensory Perceptions

More sensitive to the stimuli in the outside world
Overly sensitive to touch
Can be non-responsive to auditory, visual or tactile stimuli

what characterizes ASD?

Deficits in social communication and social interaction
Restricted repetitive behaviours, interests, and activities

has the prevalence of ASD increased

YES

Canadian prevalence (2015) ages 5-17

1 in 66 Canadian children and youth are diagnosed with brains

Prevalence of autism

20 in 10000

Prevalence of asperger's

5 in 10000

Prevalence of rett syndrome

1 in 10000

Prevalence of childhood disintegrative disorders

0.2 in 10000

is the herditary basis for ASD strong?

yes! even higher if someone in the family has it

Vaccines and ASD

some people link autism to vaccines, measles, mumps, rubella but this is fraud

ASD is more prevalent in males then females, except for which of the 5 disorders?

rett syndrome

What happens when girls have autism?

usually results in more cognitive deficits

Etiology

Neurobiological basis of ASD
Hereditary Basis of Autism spectrum disorders

Neurobiological basis of ASD?

Suggested by the fact that people with autism have a high incidence of brain seizures and cognitive deficits
Neurological imaging studies have implicated a number of areas of the brain
Studies indicate that the brains and heads of young children with auti

Recent evidence strongly suggests the following for many people with autism

(1) at birth, their brains are of average size or perhaps even smaller than average
(2) Their brains grow suddenly and excessively in the first two years of life
(3) After age 2, their brain growth slows and it reaches its maximum size around four or five

Hereditary basis of autism spectrum disorders

Scientific evidence for autism having a hereditary comment is very strong component
When one family member is diagnosed, the chances are 50 to 200 times higher that another family member also has autism than in the population as a whole
When a monozygotic

The three most prominent theories identify the major impairments as being accounted for by problems in:

(1) Executive Functions
(2) Central Coherence
(3) Theory of mind

Executive Function

ability to regulate one's behaviour through working memory, inner speech, control of emotions and arousal levels, analysis and communication of problem solutions to others

Central Coherence

inclination to bring meaning to stimuli by conceptualizing it as a whole

Theory of Mind

ability to take another's perspective in social exchange, infer another's feeling, intentions, desires etc.

Social interpreting

difficulty determining social cues and stimuli

Coaching

specifically recognizing emotions in other people also understand behaviours of other people

Behaviour management

build skills, very structured, behavioural interventions for those in moderate category to help them develop behaviours that are more acceptable for the rest of society
use FBAs and PBS to minimize or eliminate inappropriate behaviours

Social developmental approach

build relationship, child leads, unstructured

Educational considerations for children with autism

direct instruction
behaviour management
instruction in a natural setting

Direct instruction

highly structured, directive approach that uses basic principles of behavioural psychology for analyzing tasks and how to best teach them

Functional Behavioural Assessment

Evaluation that consists of finding out the consequences antecedents, and setting events that maintain inappropriate behaviours; this information can help teachers plan educationally for students

Positive Behavioural Support

Systematic use of the science of behaviour to find ways of supporting desirable behaviour of an individual rather than punishing the undesirable behaviour

Instruction in a natural setting

educating student in a natural setting that a child without exceptionalities would enjoy

Educational Strategies for children with aspergers

social interpreting and coaching

Person centered planning

based on persons interests and strengths, planning for a person's self-determination; planning activities and services on the basis of a person's dreams, aspirations, interests, preferences, strengths, and capacities

community residential facility

a place, usually a group home, in an urban or residential neighbourhood where about three to ten adults with exceptionalities live under supervision

supported living

An approach to living arrangements for those with exceptionalities that stresses living in natural settings rather than institutions, big or small

competitive employment

A workplace that provides employment that pays at least minimum wage and in which most workers do not have exceptionalities

Supported competitive employment

A workplace where adults who have exceptionalities earn at least minimum wage and receive ongoing assistance from a specialist or job coach; the majority of workers in the workplace do not have exceptionalities