Intro to Autism: Different Perspectives

1. Marion Staff Training 2009 Intro to Autism: Different Perspectives Lisa Anderson M.S. Education, Autism Consultant, CESA 8

2. http://video.google.com/videoplay?docid=-7057999856625517002&q=Jason+McElwain&ei=PAMMSIKPD6PsrAKkjrG6BA&hl=enhttp://video.google.com/videoplay?docid=-7057999856625517002&q=Jason+McElwain&ei=PAMMSIKPD6PsrAKkjrG6BA&hl=en Video: “J-Mac”

3. Autism Spectrum Disorders… What does this mean?

4. Autism Spectrum Disorders Pervasive Developmental Disorders Childhood Disintegrative Disorder PDD-NOS: Not Otherwise Specified Asperger Syndrome Rhett Syndrome Autistic Disorder

5. Autism is a complex neurological disorder that affects one’s communication and socialization ability. • Autism is typically evident by Age 3 (can now be diagnosed as early as 6 months old) • 1 in 150 children (1 in 94 boys) are now diagnosed with autism in the U.S. In the United Kingdom, 1 in 58 children has some form of autism. • The rate of autism is highest in California of those born after 1980. • Just over a decade ago, the prevalence rate was 1 in 10,000. • Current research suggests that it is caused by the lack of coordination and proper connectivity within the brain. • Common: Rapid Brain Growth in 1st year of life (Journal of the American Medical Association, 2003) . What is Autism? (a.k.a. Autism Spectrum Disorders or ASD)

6. A new case of autism is diagnosed every 20 minutes • Autism currently affects more than 1.5 million people in the U.S. alone • http://dpi.wi.gov/sped/autdata.html What is Autism? (continued)

7. Neurological Disorder Cerebral Cortex: Most highly developed area of the brain which includes gray matter in right & left hemispheres. Activities within this area of the brain include: Thinking, Perceiving, Producing Language , Sensing & Interpreting input from various sources. Temporal Lobe: Auditory Processing, visual input, semantics of language, verbal memory. Cerebellum: Coordinated, smooth movements of the skeletal muscular system including abilities to walk, talk, eat, and to perform other self care tasks. Amygdala: Memory & Emotions.

8. Autism impairs one’s ability to Communicate; affecting Receptive Language, Expressive Language and Pragmatic or Social Language abilities. • Autism affects socialization. • Autism affects the sensory system. • Autism can impact cognitive skills where brain is wired differently. What is Autism? (Continued)

9. Autism impacts every individual differently… Autism Spectrum Disorders Mild Moderate Severe

10. Children can move from one end of the spectrum to another with intensive Evidenced-Based intervention… Autism Spectrum Disorders Mild Moderate Also known as High Functioning Autism or Asperger’s Disorder Severe Autistic Disorder

11. Wisconsin is currently a part of the project that is being done to “Promote optimal development and learning of infants, children, and youth with ASD and provide support to their families through the use of evidence-based practices .” National Professional Development Center for Autism Spectrum Disorders

12. A-F • Computer-Aided Instruction • Differential Reinforcement • Discrete Trial Training • Extinction • Functional Behavior Assessment • Functional Communication Training M-R • Naturalistic Interventions • Parent-Implemented Interventions • Peer-Mediated Instruction And Intervention • Picture Exchange Communication System (PECS) • Pivotal Response Training • Prompting • Reinforcement • Response Interruption/Redirection S-Z • Self-Management • Social Narratives • Social Skills Training Groups • Stimulus Control • Structured Work Systems • Task Analysis • Time Delay • Video Modeling • Visual Supports Evidence based practice briefs

13. Login Login EmailPassword [ Forgot password? ] [ Create an account ] Picture Exchange Communication System (PECS) According to the developers of PECS, it is a behaviorally based intervention that teaches the learner to use visual-graphic symbols to communicate with others (Bondy & Frost, 1994; Frost & Bondy, 2002). This module will provide information on this augmentative and alternative communication system. www.autisminternetmodules.org

14. Autism is now the most common childhood disability with more cases than pediatric cancer, childhood diabetes, and AIDS combined! • It is estimated that lifetime individual costs for raising a child with autism ranges from $3.5 to $5 million dollars. What is Autism?

15. The Department of Health and Human Services Projections over the next 15 years as the current wave of individuals with autism become adults… • 27 Billion annually will be spent on living costs alone for the autism population by 2023; more than 1/3 of this year’s budget and larger than the entire current budget of the U.S. Energy Department. • More than 380,000 individuals expected to need extensive services, often requiring 1:1 care in many cases The Washington Post, April 07, 2009 Future Autism Expenditures

16. What Causes Autism???

17. Nobody knows for sure! • There is no medical detection or cure for autism. • Abnormalities in the shape and structure of the brain (brain imaging) • Theories: • Genetic Predisposition • Environmental toxins (i.e. heavy metals) • Controversy: • Immunizations • Mitochondria? (Hannah Poling) What Causes Autism?

18. Epidemic

19. “Autism in the U.S. has reached epidemic levels, 1 in 150 children. Dr. Julie Gerberding, Director of the Center of Disease Control and Prevention has recently upgraded autism to “an urgent health threat.” • “The most contentious issue of the autism debate is the link to routine childhood vaccinations.” • “Hannah Poling v. U.S. Dept. of Health and Human Services, has changed this debate forever. Epidemic

20. What to Look For… Early Signs

21. No big smiles or warm, joyful expressions by six months or thereafter • No back and forth sharing of sounds, smiles, or other facial expression by 9 months or thereafter • No babbling by 12 months • No back and forth gestures such as pointing, showing, reaching, or waving by 12 months • No words by 16 months • No two-word meaningful phrases (without imitating or repeating) by 24 months • Any loss of speech or babbling or social skills at any age What to Look For…(early signs)

22. Autism Society of America Autism Characteristics

23. Insistence on Sameness • Difficulty in expressing needs; uses gestures instead of words • Repeating words or phrases in place of normal responsive language • Laughing, crying, showing distress for reasons not apparent to others • Prefers to be alone, aloof manner • Tantrums Autism Characteristics…

24. Difficulty mixing with others • May not want to cuddle or be cuddled • Little or no eye contact • Unresponsive to normal teaching methods • Sustained odd play • Spins objects • In appropriate attachment to objects • Apparent over-sensitivity or unsenstivity to pain Autism Characteristics (cont.)

25. No real fear of danger Noticeable physical over-activity or extreme under-activity Uneven gross/fine motor skills Not responsive to verbal cues; acts as if deaf although hearing tests in normal range ASA…if over half of these characteristics, then autism is possible Autism Characteristics (cont.)

26. http://www.talkaboutcuringautism.org/video/hope-video.htm Parents’ Perspective

27. Myths about Autism

28. Children with autism don’t make eye contact. • They do and can. It may look different than neuro-typical children • Children with autism do not show affection. • Children with autism do show affection and may be extremely loving of others • Children with autism cannot communicate effectively • They may develop good, functional language skills where it may be difficult to distinguish them from others Myths

29. Working With Families through the Diagnostic Process…

30. Parents are your BEST RESOURCE and best source of information…they know their child better than anyone else. But, they go through a grieving process when informed that something may be wrong with their child. • Help parents feel comfortable and assist them through the diagnostic process Work Closely with Parents/Families

31. Grieving Process… • Shock - What? • Denial- Autism…No way! You are crazy! They like to be held…they smile, laugh, look at us…they are just late talkers! • Anger - How dare you…? • Bargaining - God, please let them be wrong! • Acceptance - Where do we go from here? Working with Parents/Families Try not to take uncomfortable parent reactions personally!!!

32. The grieving process is ONGOING… • Consider the emotional aspects of raising a child with autism • Autism Everyday… • http://www.youtube.com/watch?v=FDMMwG7RrFQ&feature=related The Autism Emotional Roller-Coaster…

33. Medical Diagnosis vs. Educational Eligibility

34. Medical Consideration: • Medical Diagnosis NOT REQUIRED in Wisconsin to determine educational disability of autism • Medical information, if available, should be considered as part of an education evaluation…not sole component Medical Diagnosis vs. Educational Criteria

35. School cannot require parents to obtain medical diagnosis during an educational diagnosis • Medical terms such as Asperger’s Disorder, PDD, and others do not automatically qualify students under the educational disability category of autism. • Labels do not transfer between systems (i.e. education and medical) Medical Diagnosis vs. Educational Criteria

36. Autism vs. Asperger’s

37. What distinguishes Autism from Asperger’s is the severity of symptoms and… By definition: There is an absence of language delays with individuals with Asperger’s Syndrome • Individuals with Asperger’s Syndrome cannot possess a “clinically significant” cognitive delay and must possess average to above average intelligence • Individuals with Asperger’s Syndrome may be only mildly affected and they frequently have good language and cognitive skills Autism vs. Asperger’s

38. Individuals with Asperger’s Syndrome usually want to “fit in” and have interaction with others…they just don’t know how to do it. • Individuals with Asperger’s Syndrome may appear to be socially awkward and clumsy. They may lack empathy, may display limited eye contact, may talk about interests excessively and may not understand gestures Autism vs. Asperger's

39. Autism • Children with Autism are frequently seen as aloof and uninterested in others • Many individuals with autism display cognitive delays (though it is difficult to obtain accurate IQ scores as they experience significant difficulties with language ability • Children can receive a diagnosis of autism when young and make substantial progress. They appear to look more like individuals with Asperger’s as they get older (move on the continuum)…Developmental history is important for diagnosis of Autism vs. Asperger’s Autism vs. Asperger’s

40. Is There a Cure???

41. * Some claim recovery…reversing effects possible. • Neuro-pathways can be changed with autism. • Brain Plasticity…Early intervention can strongly impact progress. • Cure??? Not so Sure!!! • Improve and live a relatively “normal” life is VERY Possible! • Several reports of children “overcoming” autism. • Not “Gloom and Doom” as once thought. Cure?

42. Research

43. Rewiring the Brain

44. Neuroplasticity, a.k.a. “plasticity” is the lifelong ability of the brain to reorganize neural pathways based on new experiences. • The Brain in NOT Hardwired from Birth • We all have a lifelong power to change • As we learn, we acquire new knowledge and skills through instruction or experience. • The ability of the brain to change with learning is what is known as neuroplasticity. Neuroplasticity

45. Neuroplasticity occurs in the brain under two primary conditions: • During normal brain development when the immature brain first begins to process sensory information through adulthood (developmental plasticity and plasticity of learning and memory). 2. As an adaptive mechanism to compensate for lost function and/or to maximize remaining functions in the event of brain injury. • The environment plays a key role in influencing plasticity. Neuroplasticity

46. Brain changes can occur with… • Positive or negative environments • Exercise • Nurturance • Learning • Other experiences… Neuroplasticity

47. Applied Behavior Analysis – research based…positive results for nearly half of children who received intensive therapy at a young age (between ages 3-8) • Original research in peer-reviewed journals indicating that 90% of children substantially improved when utilizing the Lovaas Model of Applied Behavior Analysis, compared to the control group. • Close to half attained a normal IQ and tested within the normal range on adaptive and social skills. Research : Lovaas

48. This research reported that 47% of those children that had received 30–40 hours of intensive therapy were mainstreamed into regular classrooms, and were classified as "indistinguishable" from their peers in follow-up studies. • Wisconsin Waiver Program supports this • Early intervention is imperative to future outcomes Research: Lovaas

49. Intensive In-home therapy and schools working together…strengthens generalization of skills, gets everyone on the same page. Learn from on another! Research: Lovaas

50. Traditional and Non-Traditional Interventions…