Introduction to Autism

Session One

What is Autism

Presented byMarc Tardif

Social Skills Program Co-ordinator

Learning Objectives:

After the workshop participants will be able to:

Label the disorders which fall under the PDD umbrella

Label the three Autism Spectrum Disorders

Describe impairments in social interaction, communication, & behaviour

The Latest Statistics…

1 in 165 Canadians are affected with ASD

Ratio of males to females 4:1

Possible Causes of Autism

Genetic:Current research links ASD to biological or

neurological differences in the brain

Organic:Some research suggests that environmentalfactors play a part in the expression of ASD

DSM IV Diagnostic Criteria

At least two impairments in social interaction

At least one impairment in communication

At least one impairment in restricted or repetitive behaviour

A diagnosis requires a total of 6 or more impairments

present in total

Impairment in Social Interaction

Impairment in the use of nonverbal behaviours

Failure to develop peer relationships appropriate to age level

Lack of spontaneous seeking and sharing

Lack of social or emotional reciprocity

*requires at least two impairments from this category

Impairments in Communication

Delay or total lack of the development of spoken language In individuals with adequate speech, marked impairment in ability to initiate or sustain

conversation Stereotyped, repetitive use of language or

idiosyncratic language Lack of make-believe play or social imitative play

*requires at least one impairment from this category

Restricted, Repetitive and Stereotyped Patterns of Behaviour

Preoccupation with one or more stereotyped andPreoccupation with one or more stereotyped and

restricted patterns of interest restricted patterns of interest

Apparently inflexible adherence to specific,Apparently inflexible adherence to specific,

nonfunctional routines or ritualsnonfunctional routines or rituals

Stereotyped and repetitive motor mannerisms Stereotyped and repetitive motor mannerisms

Persistent preoccupation with parts of objectsPersistent preoccupation with parts of objects

*requires at least one impairment from this category*requires at least one impairment from this category

Diagnosis

A diagnosis is reached after an assessment is completed by a pediatrician or a psychologist

Diagnosis can take place as early as 18 months

There is no proven cause or cure for autism

(Scientific American Journal, 2000)

Pervasive Developmental Disorder

CDD

Rett’s

Syndrome PDD-NOS

AspergerSyndrome

Autism

Autism Spectrum Disorders (ASDs)

Childhood Disintegrative Disorder

Extremely rare: Prevalence rate 1.7/100 000

Typical development until age two

Onset usually between 36 – 46 months

Significant loss of skills

More common in boys than girls 4:1

(Canadian Journal of Psychiatry- In Review)

Rett’s Syndrome

1 in 10,000-23,000

Have normal head size at birth and normal development

Between 5 – 48 months head growth slows

Develop stereotypic hand movements

Poor coordination and social withdrawal occurs

(Source: Canadian Journal if Psychiatry- In Review)

Pervasive Developmental Disorder –Not Otherwise Specified

(PDD-NOS) Referred to as “Atypical” autism

Do not meet criteria for full autism diagnosis

Traditionally seen as a “milder” form of autism

Is a diagnosis by exclusion of other disorders in autistic spectrum Screening and assessment is the same as for autism

Asperger Syndrome Must have both:

1. Qualitative impairment in social interaction

2. Restricted and repetitive patterns of behaviour, interests and activities

No delay in language development, though language development may be peculiar

Fail to make connection between thoughts/feelings and behaviour/actions

Symptoms may be subtle or even undetected until child is over 3 years of age

Facts about Asperger’s Syndrome (AS)

First identified by Dr. Hans Asperger in 1944

Approximately 5 out of every 10,000 people 15,000 Canadians

More common in boys than girls (4:1)

(Autism Society, 2005)

Autism Usually manifests itself during the first three

years of life

Problems with social interactions is the hallmark symptom as people with ASD have problems relating to others

The range and intensity of disability varies widely

Associated with developmental disability

High-functioning Autism (HFA) vs. Asperger’s Syndrome (AS)

DSM-IV-TR criteria:

History of language delay in HFA but not in AS

Intact cognitive functioning in AS but not in HFA

(Tsai, 2005)(Tsai, 2005)

DifferencesAutism Asperger’s

Onset 1-3 years After 3 years

Early Language Impaired proficient

Motor Skills Developmental level Below developmental level

Cognitive Level Often below chronological age

At or above chronological age

Visual Spatial Skills Strength weakness

Verbal Skills Weakness strength

Social Pragmatic Aspects of Language

Weakness weakness

Repetitive Behaviour Actions, objects/physical mannerisms

Verbal cognitive mannerisms

(Condillac, 2003)

Triad of Impairments

Language and Communication

Social Interaction

Restricted, Repetitive Behaviour

Social Deficits

Lack of reciprocal social interactions

Unusual reaction to other’s emotions

Lack of joint attention

May not seek out the company of peer

Avoidance of eye contact

Social Interaction

Communication Deficits

Idiosyncratic use of language

Literal interpretation of language

Echolalia or delayed echolalia

Use of unusual expressions

Tend to use third person

Difficulty initiating/sustaining a conversation

Communication Deficits

Thank you MGM. Rain Man Best Picture 1988

Communication Deficits

Literal Interpretation

http://www.boreme.com/boreme/funny-2007/police-helps-kid-p1.php

Temple Grandin

“During the last couple of years I have become more aware of a kind of electricity that goes on between people. I have observed that when several people are together and having a good time, their speech and language follow a rhythm. They will all laugh together and then talk quietly

until the next laughing cycle…”

“I have always had a hard time fitting in with this rhythm, and I usually interrupt

conversations without realizing my mistake. The problem is that I can’t follow

the rhythm.”

(Grandin, 1995)

Behavioural Deficits

Insistence on sameness No real fear of dangers Hand or arm flapping Spins objects Tantrums Inappropriate attachment to objects

Uneven gross or fine motor skills

Restricted and Repetitive Behaviours

Social Interactions Language and

Communication

Triad

Anxiety

Sensory

+ 2

Anxiety and PDD

Neurological differences responsible for anxiety coping

Anxiety is a subjective response to stimuli Difficulty using “buffers”

Behaviours quickly become an anxiety reduction tool

Kevin Baskerville (2005)

Sensory Issues

Children with Autism tend to overreact or under react to sensory input

Under react (hyposensitive): don’t respond to small or even moderate amounts of stimulation in the area of their sensitivity (i.e., fail to respond to ordinary speech)

Over react (hypersensitive): find small or moderate amount of stimulation overloading or irritating (i.e., speech or television)

Sensory Issues

Auditory- hearing appears to be selective

Visual- attraction or aversion to particular visual stimuli

Tactile- attachment to objects may be related to tactile qualities

Taste- non-food items are sometimes tasted

Smell- sometimes become fixated on the smell of something

Sensory OverloadActivity

Risk Markers ("Red Flags")

Social

Little or no eye contact Difficulty mixing with other children No functional play but uses objects in a

repetitive manner (lining up, stacking) Prefers to be alone May not want to be held or cuddled

Risk Markers ("Red Flags")

Communication

Inappropriate laughing or giggling Echolalia Not responsive to verbal cues Difficulty in expressing needs, failure to use

gestures or pointing in place of words

Risk Markers ("Red Flags")

Behavioural Insistence on sameness, resists change in routine No real fear of danger Toe walking Hand or arm flapping Apparent insensitivity to pain Spins objects Noticeable physical over/under activitiy Tantrums Uneven gross/fine motor skills

Autism SpeaksAutism Speaks

Video From : www.autismspeaks.org

Please fill out yourevaluation forms

Autism Society (2005). Retrieved March 12, 2005 from www.autismsocietycanada.ca

American Psychiatric Association. Quick Reference to the Diagnostic Criteria from DSM-IV-TR. Arlington, VA.

Baron-Cohen, Simon (1995). Mindblindness. MIT Press, United States.

Baskerville, Kevin (2005). Mapping your way through the ASD maze: reducing anxiety to assist individuals with ASD. Autism Inclusion Coordinator, Autism Team. Warwickshire, DISCS, England.CAIRN(2006). Canadian autism intervention research network. Retrieved May 20, 2006 from www.cairn-site.com

Collins, Paul (2004). Not even wrong; adventures in autism. Bloomsbury, New York & London.

Cutler, Eustacia. A Thorn In My Pocket.

Gaining Face www.ccoder.com/GainingFace

Gray, Carol (2005). The national autism conference presents: from kid-tastrophe to cooperation: loss, learning and students with ASD. Progress through partnership. National Autism Conference. Penn State, Pennsylvania.

Gray, Carol. (2005) From Kid-tasphrope to Cooperation: Loss, Learning and Students with ASD. The Gray Center for Social Learning and Understanding, Grand Rapids, Michigan.

Grandin, T. (June 2000) http://www.cdrcp.com/aut_teachingtips.html

Grandin, Temple. (1995) Thinking in Pictures and Other Reports From My Life With Autism. Vintage Books, New York.

Gwynne, Fred (1970). The king who rained. Windmall Books, New York.

.

References

Haddon, Mark (2003). The curious incident of the dog in the night-time. Anchor Canada.

Howlin, Patricia (2000) Geneva centre international symposium on autism. Canadian Management Centre.

Hodgdon, L. (2005) ASD ProvincialConference

Hodgdon, L., (1995). Visual Strategies for Improving Communication – Practical Supports for School and Home. Troy, Michigan, USA: QuirkRoberts Publishing

Integrated Services Division Ontario Ministry of Community, Family and Children’s Services. Intensive behavioural intervention: a manual for instructor-therapists Version 2.

Jackson, Luke (2002). Freaks, geeks and asperger syndrome. Jessica Kingsley Publishers. London & Philadeplhia

Leaf & McEachin (1999). A Work In Progress: Behavior management strategies and a curriculum for intensive behavioural treatment of autism. New York, NY: DRL Books, L.L.C.

Metro-Goldwyn-Mayer Studios Inc (1998). Rainman. Best Picture, MGM Studios Inc.

Michaels, Alex (2005). Executive functioning. Educational Consultants of New England, Inc. Waltham, MA. Retrieved May 5, 2006 from http://www.stopthatbehaviour.com/i_executive_functioning.html

References

Ministry of Education Ontario. Special Education Monographs No.4: Students with Autism. April 1990. Retrieved October 19, 2005. http://www.edu.gov.on.ca/eng/general/elemsec/monog4.html

Newport, Jerry (2005). The person is more important than the label. Progress Through Partnership. National Autism Conference. State College, Pennsylvania.

Notbohm, Ellen. (2005). Ten things Every Child With Autism Wishes You Knew. Arlington, Texas:Future Horizons

Perry A, Condillac R.L (2003). Evidence-based practices for children and adolescents with autism specturm disorders: review of the literature and practice guide. Children’s Mental Health of Ontario.

Toronto, Ontario, Retrieved September 15th 2005.

Pennsylvania, State College (2005). Progress through partnership, national autism conference. Penn State.

Robledo, S.J & Ham-Kucharski, D (2005). The autism book, answers to your most pressing questions. Penguin Group Inc. New York.

References

References

Stokes, S. (2001). Structured teaching: Strategies for supporting students with autism? Written under a contract with CESA 7 and funded by a discretionary grant from the Wisconsin Department of Public Instruction. http://www.cesa7.k12.wi.us/sped

Tidmarsh, Lee & Volkmar, Fred (2003). The canadian journal of psychiatry-in review. Vol 48, No 8, September 2003. Pg. 518, 519

Tsai, Luke. M.D. (2005). Autism spectrum disorder and co-morbid neuorpsychiartric disorders. Progress Through Partnership. National Autism Conference. State College, Pennsylvania.

Training & Inservice- Autism Module Complied by Gateway SocietyWorld Class Communication Technologies(2004). Souls, beneath and beyond autism.

Books That Touch.

Winter, Matt (2003). Asperger syndrome, what teachers need to know. Jessica Kingsley Publishers, London & Philadelphia.

References