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Autism

Diagnosis and symptoms Theories of autism Instructional strategies. Autism. Diagnosis and prevalence. Affects 1/165 Canadians DSM-IV-TR Criteria At least 2 impairments in social interaction Impairment in communication

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Autism

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  1. Diagnosis and symptoms Theories of autism Instructional strategies Autism

  2. Diagnosis and prevalence • Affects 1/165 Canadians • DSM-IV-TR Criteria • At least 2 impairments in social interaction • Impairment in communication • Engage in restricted and repetitive behaviour, interests, and activities • Non-triad impairments • Restricted interests, obsessive desire for sameness, preoccupation with parts of objects, exceptional proficiency in very specific skills

  3. Academic profile • Strengths • Visual reasoning • Vocabulary knowledge • Word reading • Math • Weaknesses • Working memory • Processing speed • Reading comprehension • Written expression • Graphomotor abilities

  4. Theories of autism • Theory of mind • Weak central coherence • Executive dysfunction • Hyper-systemizing • Excess neural excitation

  5. Evaluation of theories • Explanatory Power: how well does it account for the FULL pattern of symptoms? • Universality: Is this deficit evidenced in ALL individuals with autism? • Specificity: Is the proposed deficit evidenced ONLY in individuals with autism

  6. Impairments in theory of mind • Baron Cohen (1985)

  7. Theory of mind • Theory of mind: the ability to attribute independent mental states to oneself or to others in order to explain or predict behaviour. • In the Sally Anne test, 80%of children with autism failed to demonstrate theory of mind.

  8. Explanatory power • Triad of impairments • Impairments in social interaction • Impairments in communication • Restrictive, repetitive, and stereotyped patterns of behaviour

  9. Explanatory power • Non-triad Impairments X Restricted interests X Obsessive desire for sameness X Islets of ability, idiot savant abilities X Excellent rote memory X Preoccupation with parts of objects

  10. Universality and specificity X Universality X Specificity

  11. Impairments in central coherence • Frith (1989)

  12. Impairments in central coherence • Central coherence theory asserts that autism is characterized by an imbalance in the integration of information at different levels; individuals with autism see the parts rather than the wholes, and lack the cognitive capacity to integrate the parts into the wholes.

  13. Explanatory power • Triad of impairments • Impairments in social interaction • Impairments in communication • Restrictive, repetitive, and stereotyped patterns of behaviour

  14. Explanatory power • Non-triad Impairments • Restricted interests • Obsessive desire for sameness • Islets of ability, idiot savant abilities • Excellent rote memory • Preoccupation with parts of objects

  15. Universality and Specificity • Universality • Specificity

  16. Impairments in executive function • Ozonoff (1991) • Tower of Hanoi Test

  17. Impairments in executive function • Executive function is defined as the ability to maintain an appropriate problem solving set for attainment of a future goal. It includes: • planning • impulse control • inhibition of irrelevant responses • set maintenance • organized search • flexibility of thought and action

  18. Explanatory power • Triad of impairments • Impairments in social interaction • Impairments in communication • Restrictive, repetitive, and stereotyped patterns of behaviour

  19. Explanatory power • Non-triad Impairments • Restricted interests • Obsessive desire for sameness • Islets of ability, idiot savant abilities • Excellent rote memory • Preoccupation with parts of objects

  20. Universality and specificity • Universality • Specificity

  21. Hyper-systemizing • Baron-Cohen (2006) • According to this theory all individuals fall on a continuum in their ability to process systemizable (law-governed) information. process information that is systemized and unsystemized process highly-systemized information 1 8

  22. Hyper-systemizing • Baron-Cohen (2006) • According to this theory all individuals fall on a continuum in their ability to process systemizable (law-governed) information. process information that is systemized and unsystemized process highly-systemized information 1 8

  23. Explanatory power • Triad of impairments • Impairments in social interaction • Impairments in communication • Restrictive, repetitive, and stereotyped patterns of behaviour

  24. Universality and specificity ? Universality ? Specificity

  25. Neurological explanations • Courchesne (2010) – Excess neural excitation

  26. My thesis • Word level decoding summary • Very poor phonological processing • Word reading/spelling performance ranges from 10th-12th percentile • Uses a visual route more than phonological route • Does not use semantic knowledge to help identify words

  27. My thesis • Reading comprehension summary • Ranges from 12th to 14th percentile • Strengths • Literal and vocabulary based comprehension • Weaknesses • Inferential comprehension when implicit • Evaluative comprehension when a feeling

  28. My thesis • Explanation of findings • CG performed better when the task was law governed • Ease with literal and vocabulary-based comprehension • Difficulty with understanding feelings and inferences • Ease with whole words • Difficulty with reading phonetically • Theory of hyper-systemizing (Baron Cohen, 2006) • CG was only able to engage one processing center at a time • In word reading she engaged visual system and neglected phonological and semantic • In reading comprehension she had difficulty integrating knowledge from different areas • Theory of excess neural excitation (Courchesne et al., 2007)

  29. Importance of theory

  30. Intervention • Early intensive behavioural intervention (EIBI) • Most widely recognized approach • McEachin, Smith, & Lovaas (1993) found that after 4.5 years of EIBI treatment, 9 of the 19 participants were indistinguishable from their peers • Involves discrete trial training (breaking down teaching steps and systematically, repetitively teaching each step).

  31. Exercise • Follow the program procedure on your handout and teach a classmate the skill using discrete trial training. • Discuss which theory/theories of autism could account for the success of EIBI • Discuss what elements are involved in EIBI that could translate to teaching practice.

  32. Intervention in schools • Once children are school, EIBI often ceases • Teachers are not trained in EIBI • Philosophical differences • Requires one-on-one instruction, which is largely not available

  33. Interventions based on excess neural excitation theory • Education needs to be • Law-governed, explicit instruction • Provide more support for abstract tasks • Ensure automaticity of each distinct task prior to requiring integration across tasks • Explicitly require integration when several processes are required to complete one task • Reading example....

  34. Instructional strategies • Language • Anchor instruction in visual cues • Video-modelling • Take advantage of echolalia • echolalia, delayed non-functional echolalia, delayed functional echolalia • Modeling • Explicitly teach pragmatic language skills (i.e., respond to the intended message rather than correcting grammar, practice asking questions, etc...) • Have students practice noticing non-verbal signals

  35. Instructional strategies • Social behaviour • Social stories • Video modelling • Explicit practice in social situations • Preparation (visual schedules, practice for situations, etc...) • Modelling emotion recognition in social situations

  36. Instructional strategies • Restricted, repetitive, stereotyped behaviours, interests, and activities • Reducing 'stimming' • Redirect attention (incompatible behaviour) • Replace with socially acceptable alternative • Provide safe space for stimming • Limit perseveration on particular interest and activity. • Encourage development of new interests and activities • May use those interests and activities to motivate learning in difficult areas

  37. Differentiated instruction • Visual supports • Video-modelling • Explicit teaching • i.e, teaching theme identification • Task analysis • Could use graphic organizers to help work on each part and then draw together • Reinforcement for motivation • Pre-teaching • Predictable classroom environment (schedules, transition preparation) • Cognitive credit cards (with visuals)

  38. Exercise • Imagine that you have a student with autism in your class and for your lesson plan: • Task analysis – determine all of the steps needed to complete the task • Plan how you will ensure understanding of each step of each task and how you will support your student with autism in integrating all the steps involved. • Identify which steps might be more difficult and suggest ideas to support your student.

  39. Reflection • In one short paragraph outline: • The concepts from the readings/course notes that you were hoping to apply • Your contribution • How your contribution successfully applied those concept

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