Intro to Autism: Different Perspectives

Rizlyana Othman
DPAK B11002012 Kemahiran Berfikir DTM 201 Mdm Hashima Hashim

Autism Spectrum Disorders

What does this mean?

Autism Spectrum Disorders

Pervasive Developmental Disorders

What is Autism? (a.k.a. Autism Spectrum Disorders or ASD)

Autism is a complex neurological disorder that affects ones communication and socialization ability. Autism is typically evident by Age 3 (can now be diagnosed as early as 6 months old) 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.
A new case of autism is diagnosed every 20 minutes

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. Amygdala: Memory & Emotions.

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.

What is Autism? (Continued)

Autism impairs ones 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.

Autism Spectrum Disorders Autism impacts every individual differently

Autism Spectrum Disorders Children can move from one end of the spectrum to another with intensive Evidenced-Based intervention

What Causes Autism???

What Causes Autism?

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

Epidemic

Epidemic

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.

What to Look For

Early Signs

What to Look For(early signs)

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

Autism Characteristics

Autism Characteristics

1. Insistence on Sameness 2. Difficulty in expressing needs; uses gestures instead of words 3. Repeating words or phrases in place of normal responsive language 4. Laughing, crying, showing distress for reasons not apparent to others 5. Prefers to be alone, aloof manner 6. Tantrums

Autism Characteristics (cont.)

7. Difficulty mixing with others 8. May not want to cuddle or be cuddled 9. Little or no eye contact 10. Unresponsive to normal teaching methods 11. Sustained odd play 12. Spins objects 13. In appropriate attachment to objects 14. Apparent over-sensitivity or unsenstivity to pain

Autism Characteristics (cont.)

15. No real fear of danger 16. Noticeable physical over-activity or extreme under-activity 17. Uneven gross/fine motor skills 18. Not responsive to verbal cues; acts as if deaf although hearing tests in normal range

ASAif over half of these characteristics, then autism is possible

Myths about Autism

Myths
Children with autism dont make eye contact.
They do and can. It may look different than neurotypical 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

Working With Families through the Diagnostic Process

Work Closely with Parents/Families

Parents are your BEST RESOURCE and best source of informationthey 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

Working with Parents/Families

Grieving Process 1. Shock - What? 2. Denial - AutismNo way! You are crazy! They like to be heldthey smile, laugh, look at usthey are just late talkers! 3. Anger - How dare you? 4. Bargaining - God, please let them be wrong! 5. Acceptance - Where do we go from here?
Try not to take uncomfortable parent reactions personally!!!

The Autism Emotional Roller-Coaster

The grieving process is ONGOING Consider the emotional aspects of raising a child with autism

Medical Diagnosis vs. Educational Eligibility

Medical Diagnosis vs. Educational Criteria

Medical Consideration: Medical information, if available, should be considered as part of an education evaluationnot sole component

Medical Diagnosis vs. Educational Criteria School cannot require parents to obtain medical diagnosis during an educational diagnosis Medical terms such as Aspergers 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)

Autism vs. Aspergers

Autism vs. Aspergers

What distinguishes Autism from Aspergers is the severity of symptoms and

By definition: There is an absence of language delays with individuals with Aspergers Syndrome Individuals with Aspergers Syndrome cannot possess a clinically significant cognitive delay and must possess average to above average intelligence Individuals with Aspergers Syndrome may be only mildly affected and they frequently have good language and cognitive skills

Autism vs. Asperger's

Individuals with Aspergers Syndrome usually want to fit in and have interaction with othersthey just dont know how to do it. Individuals with Aspergers 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. Aspergers

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 Aspergers as they get older (move on the continuum)Developmental history is important for diagnosis of Autism vs. Aspergers

Is There a Cure???

Cure?
* Some claim recoveryreversing effects possible. Neuro-pathways can be changed with autism. Brain PlasticityEarly 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.

Research

Rewiring the Brain

Neuroplasticity
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
Neuroplasticity occurs in the brain under two primary

conditions:

1.

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

Brain changes can occur with

Positive or negative environments Exercise Nurturance Learning Other experiences

Research : Lovaas
Applied Behavior Analysis research basedpositive 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

This research reported that 47% of those children that had received 3040 hours of intensive therapy were mainstreamed into regular classrooms, and were classified as "indistinguishable" from their peers in followup studies. Early intervention is imperative to future outcomes

Research: Lovaas

Intensive In-home therapy and schools working togetherstrengthens generalization of skills, gets everyone on the same page. Learn from on another!

Traditional and Non-Traditional Interventions

Interventions
Traditional
Behavioral approaches (Discrete Trial TrainingABA) Relational Development Intervention Floortime Medical Interventions School Programs/Therapies/Activities Numerous Evidence-Based Interventions (i.e. Visual Supports, Peer Mediated programs, PECS, Social Skills Groups, Social Stories etc.)

Non-Traditional

Gluten/Casien Free Diet Vitamin Therapy Heavy Metal Detoxification (i.e. chelation) Sensory Integration Therapy Auditory Integration Training Vision Therapy Yoga Chiropractic Reflex Inhibition Programs (Physical Therapy) Martial Arts Music Therapy Hyperbaric Oxygen Therapy Many More Options

Interventions

1. Look at each person individually. 2. Become familiar with the major issues related to autism. 3. Believe that individuals with autism can learn and do extraordinary things!!!

4. Understand that they are not behaving inappropriately purposefullyits neurological!!!

Autism is a World
It is difficult to know what is inside of a non-verbal individual with autism. Sometimes the right piece of technology that allows them to speak may open up a whole new world

Least Restrictive Environment

Least Restrictive Environment

Individuals with autism often have a hard time generalizing information from one environment to another. May learn something very well in one environment, but not be able to do it in another. Inclusion in school and community settings is helpful to work on generalization. Adult Supportissues with dependency.

Behavior Analysis

Behavior Analysis Attention positive or negative Escape or avoidance get out of doing something hard or someplace uncomfortable, escape pain/discomfort, ask for help Power or control of environment or peoplehappens when kids feel overly controlled To get a tangible reward food, drink, toys, etc., immediate feedbacksensory needs being met Revenge or justicenot common with autism Expression of self seeking independence Acceptance or affiliation seeking social interaction, gain acceptance from peers

Behavior Analysis

ABC Analysis
Antecedent What happened immediately before the behavior Behavior What the exact behavior (in objective, observable and measureable wordsJohnny hit Joey with a closed fist on Joeys bicep) Consequence What was the consequence (Johnny was removed from the lunch line and had to stand at the back)

Functional Behavioral Assessment

Should be completed when a significant behavior is interfering with living or learning Should be completed prior to writing a Behavior Intervention Plan See examples of FBAs

Other Tips/Techniques

Tips/Techniques
Sometimes the environment is so overwhelming that the student cannot learn Distracting worksheet simulation Consider all sensestry to live through the eyes of the child to see what they are experiencing Sandpaper simulation

Consider potential medical issues (if cannot express him/herself, how do you know if not feeling well? That alone can cause behavior.

Tips/Techniques

Social Stories and Social Scripts: Carol Gray

http://www.thegraycenter.org/

Assist individuals with autism in understanding social situations Provide instructions as to how to interact in socially appropriate ways

Person First, Strength-Based Approach

Always consider the person first, then the disability (not Autistic person Person with Autism) Focus on the individuals strengths. What are they good at? (memorization, computers, working with hands etc.) Maximize strengths!!! But, do not forget about the weaknessesDisconnected Kids

Use MOTIVATORS whenever faced with difficult tasks

Its okay to give edible motivators as an instructional tool

Strength-Based Approach

Focus on their strengths while trying to address their weaknesses (Brain Balance) Believe that through new experiences with repetition, we can effectively retrain their neurological pathways

Believe that they can learn ANYTHING given the opportunityand repetition for things that dont come easily

A different perspective on AUTISM.

Questions

References
Autism Speaks, http://www.autismspeaks.org/ National Professional Development Center on Autism Spectrum Disorders, http://www.fpg.unc.edu/~autismpdC/ Autism Internet Modules, http://www.autisminternetmodules.org/ Carol Grays Social Stories, http://www.thegraycenter.org/ Melillo, Robert. (2009) Disconnected Kids. Penguin Group (USA) Inc.