Children with Autism Spectrum Disorders

1. Chapter 5 Children with Autism Spectrum Disorders

2. Historical Overview • History • Kanner (1943) • Asperger (1944) • Rutter (1966) • Bettelheim (1974) • Neurological Disorders (Current)

3. Leo Kanner (1943) first described children who had significant impairments in their social functioning and language skills. • In 1944, Viennese physician Hans Asperger described another type of autism within the autism spectrum disorder. One of the distinguishing characteristics of students with Asperger’s syndrome (AS) is an observable developmental imbalance. On the one hand, they can be of average or superior intelligence; on the other, they are years behind in social development. • .

4. England, Michael Rutter (1996) reported a study that compared children diagnosed as autistic with children who displayed other emotional disorders. He found three characteristics that almost always were present in the children with autism, but only occasionally in children with emotional disorders: (1) failure to develop social relationships, (2) language retardation with impaired comprehension, and (3) ritualistic or compulsive behaviors. • Bettelheim and others believed during the 1960s and 1970s that autism was caused by cold and unfeeling mothers. Currently there is widespread acceptance that autism is a neurophysiological condition

5. Federal Definition A developmental disability significantly affecting verbal and non-verbal communication and social interaction, usually evident before age 3, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movement, resistance to environmental change or change in daily routines, and unusual sensory experiences. Source: http://idea.ed.gov/explore/search/p/,root,regs,300,A,300%252E8

6. Federal Definition A developmental disability significantly affecting verbal and non-verbal communication and social interaction, usually evident before age 3, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movement, resistance to environmental change or change in daily routines, and unusual sensory experiences. http://www.youtube.com/watch?v=lbXjW-cX9kQ&feature=related http://www.youtube.com/watch?v=w9N0_7D_Re8&feature=related Source: http://idea.ed.gov/explore/search/p/,root,regs,300,A,300%252E8

8. Federal Definition A developmental disability significantly affecting verbal and non-verbal communication and social interaction, usually evident before age 3, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movement, resistance to environmental change or change in daily routines, and unusual sensory experiences. Source: http://idea.ed.gov/explore/search/p/,root,regs,300,A,300%252E8

9. Autism spectrum disorders • Autism spectrum disorders is a term that refers to a variety of neurological disorders affecting the child’s social development and ability to communicate. Included in this group are pervasive developmental disorder not otherwise specified (PDDNOS), Asperger’s syndrome, Rett’s syndrome, and childhood disintegrative disorders. One of the subgroups of special interest is Asperger’s syndrome. Children with Asperger’s syndrome may be high-functioning with respect to their cognitive abilities but have impairments in their social and language skills.

10. Autism & PDD Prevalence • Occurs between 2 to 6 per 1000 children. • Autism & PDD 4 times more common in boys than in girls. From NICHCY, 2008.

11. Etiological Factors • Genetic factors • Environmental factors • Mirror neurons system

12. Genetic factors—Evidence is accumulating for a strong genetic linkage for autism. The advances in our genetic knowledge through the Human Genome Project and other research have even identified two of the chromosomes (7 and 15) as the possible sites for the disorder in many children with autism. • Environmental factors—During the 1970s and 1980s, it became popular in the social sciences to emphasize the effects of environment on children and adults. Now, with the growing capabilities of genetic research, it seems clear that many conditions that produced special needs in children are linked to an intertwining of genetics and environment.

13. Mirror neurons system—Mirror neurons are brain cells that respond equally whether we perform an action or someone else performs the same action. This capability of mirror neurons allows us to imitate others’ actions or speech or even emotions (Winerman, 2005). Children with autism appear to have problems in the mirror neuron system. This could explain several common behaviors, such as the lack of eye contact, limited social interaction, communication delays, and even some repetitive motor movements, such as rocking. Scientists are working to see if stimulating this system would allow these children to experience what children with normal systems can experience.

14. Identifying Autism • Early screening conducted by pediatricians can help to identify children who may be at risk. The Checklist for Autism (CHAT) measures the presence or absence of three key factors, which, if absent, indicate an 80 percent risk of autism. Those factors are protodeclarative pointing, gaze monitoring, and pretend play. • Also refer to www.firstsigns.org for more information and video regarding identifying autism.

15. Early Identification and Intervention • Language and social skills develop rapidly during the critical developmental ages of 18 months to 3 years. Therefore, early identification of children with autism is one of the key elements of treatment. In addition, imitation of motor behaviors and using eye gaze to communicate need to be fostered at that time.

16. Characteristics • Lack of Theory of Mind: The ability of human beings to understand the thinking and feelings of other people. A theory of mind is necessary for understanding, predicting, and shaping the behavior of others. Typical 4-year-old children have a developing theory of mind (Twachtman-Cullen, 2000). The Sally and Anne Test (see Figure 8.2) can evaluate the concept of theory of mind.

17. Hypersensitivity to Sensory Stimuli: Many children with autism also have a hypersensitivity to noises in the environment. In addition to sound sensitivity, sensitivity to stimuli can extend to the tactile—some children with autism are sensitive to touch. This sensitivity is part of a larger condition called sensory integration dysfunction (or sensory processing disorder). • Social and Communication Difficulties—This is a major area of limitations and delays for child with autism. • Motor Skills Difficulties—Difficulty with a range of motor skills—such as gross motor skills (examples are running and jumping), fine motor skills, and motor planning (moving one’s body in space.) Although children with ASD may meet motor milestones on time, the quality of the child’s movements can appear stiff or clumsy.

18. Programs for Children with ASD • During the preschool years, intervention programs for children with autism spectrum disorders should focus on the development of a functional communication system and basic social skills such as attending to a speaker. An applied behavior analysis approach is the most effective method for teaching initial basic skills

19. As children master the basic skills for developing language and social competence, many educators shift to a child-centered approach where the teacher responds to the child’s natural communicative needs. If a child is unable to respond, augmentative and alternative communication may be used and can serve to avoid the development of behaviors such as head banging, which may stem from the child’s frustration at not being able to communicate her needs

20. UCLA Young Autism Project • TEACCH : North Carolina • LEAP program at the University of Colorado • Pivotal Response Model at the University of California at Santa Barbara.

21. Commonalities AmongTreatment Program • Common curriculum content • Highly supportive and structured teaching environment • Predictability and routine • Functional approach to problem behaviors • Transition between preschool and kindergarten Source (Dawson and Osterling, 1997)

22. As the child with autism progresses through school, a multidisciplinary team, including a specialist in the education of children with autism, should plan the child’s IEP and a comprehensive set of activities and experiences to meet his or her individual needs. • Assignments should be short. Tiered assignments that are adjusted to the developmental level of the child can be designed to accommodate the child in an inclusive classroom, and inappropriate behaviors should be addressed in the context of a functional behavioral analysis. The use of functional analysis of behavior can be an effective means of identifying the motivation behind maladaptive behavior and identifying a more acceptable way for the child to achieve his goals. • As children get older, classroom teachers should have teaching assistants and easy access to consultation from specialists.

23. An adaptive strategy for assisting children with autism is called structured teaching (Mesibov, 1999). The child is presented with an individual daily schedule that describes what will happen at each time in the school day. Providing a consistent physical environment, providing assignments in a clear and predictable fashion, and using direct instruction to teach both social and cognitive concepts are all effective teaching strategies for children with autism spectrum disorders. • .

24. Technological supports can be addressed in many ways. The use of communication devices such as the Picture Exchange Communication System (PECS) and Voice-Output Communication Aids (VOCA) can also reduce challenging behaviors by reducing the frustration associated with not being able to communicate.

25. School-Age Programs for Children with ASD • Inclusion-based • IEP - clear goals and objectives • Tiered assignments • Functional behavior assessments • Structured teaching • Technological supports

26. Social Skills Approaches • Ecological Variations • Collateral skills interventions • Child-specific interventions • Peer-mediated intervention procedures • Comprehensive interventions

27. A wide variety of approaches have been used to enhance the social abilities of children with autism spectrum disorders. McConnell (2000) identified five major categories of these approaches and assessed the research efficacy of each. • Ecological approaches modify the physical environment to enhance social functioning and produce weak to moderate effects • Collateral skills interventions may increase social interactions of children with autims by bringing them into contact with typically developing peers • .

28. Child-specific interventions have limited potential because they focus on social initiations rather than sustained interactions, peer-mediated intervention procedures have demonstrated powerful treatment effects, and comprehensive interventions that contain two or more of the previously mentioned components can be very effective

29. Parents of children with autism need specialized training in teaching strategies that will enable them to help their child acquire new skills, manage challenging behaviors, and thus reduce family stress. For some families, having a child with autism creates considerable stress, and professionals should be prepared to coordinate support services for family members. In particular, siblings should be considered part of a comprehensive treatment plan. • The general recommendation for vocational placements for individuals with autism stresses the strengths of the individual and plays down the social problems.

30. Family and Lifespan • Family Issues: • Parents as teachers • Relationship focused (RF) • Sibling considerations • Family Support services • Transition