Autism Spectrum Disorders

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Autism Spectrum Disorders

• An introduction to ASD including a brief history,
  profile, implications and opportunity for
  discussion

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Autism Spectrum Disorder

• Developmental disorder affecting children from
  birth or the early months of life.
• Exact cause remains unknown, but generally felt
  to be neurological in origin, although recent
  research points to possible genetic or
  chromosomal abnormalities as well as viral
  infections, pregnancy/birth complications and/or
  other causes.
• May co-exist with other medical conditions e.g.
  fragile X syndrome, tuberous sclerosis.
• Often accompanied by additional learning
  difficulties (about 75).
• No single consistent explanation at the moment.

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Autism Spectrum Disorder

• Background / History
• Leo Kanner (USA) Child Psychiatrist
• Paper published in 1943 based on study of 11
  cases. Resulted in identification of a separate
  condition Autism.
• He wandered about smiling, making stereotyped
  movements with his
• fingers, crossing them about in the air. He shook
  his head from side to
• side...humming the same three-note tune. He spun
  with great pleasure
• anything he could seize upon to spin.When taken
  into a room, he
• completely disregarded the people and instantly
  went for objects,
• preferably those that could be spun.( Kanner
  1943)

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Autism Spectrum Disorder

• Background / History
• Hans Asperger (Austria) Physician
• Identified similar group.
• 1944 published dissertation on autistic
• psychopathy in childhood.
• Published in German and in middle of Second
• World War - it took nearly 50 years before it
  was
• translated (Wing 1981)
• Many similarities with Kanner use of autistic

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Autism Spectrum Disorder

• Background / History
• Lorna Wing research with Judy Gould (1979)
• Identified threads of commonality
• amongst group of children referred for
• psychiatric help who were socially impaired.
• Wings Triad of Impairments
• 1988 The Autistic Continuum
• 1996 The Autistic Spectrum broader
  classification

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Triad of Impairments
Social Relationships
Social Communication
ASD
Rigidity of Thought, Behaviour and Play (Social
Understanding)
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Communication

• Some children may not use spoken language to
  communicate, and may use non-verbal means
  instead, e.g. pushing, biting, squealing, crying
• Even children with developmentally appropriate
  verbal skills may have problems with their use of
  language when talking to others (pragmatics).
  They may have difficulties with their non-verbal
  communication as well.
• May not understand subtle conversational clues
  e.g. facial expressions indicating surprise,
  anger etc. and may therefore not know to look
  contrite.
• May have difficulties with concepts e.g. more /
  less, time (including the need to wait)
• Inability to ask questions to establish another
  persons view point, but may ask repetitive
  questions e.g. What's your name? This may mask
  unspoken anxieties in the child or indicate that
  they have not understood.

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Communication

• Some children may use unusual intonation with
  stereotypical, stilted speech (or a sing-song
  intonation pattern)
• May have a very literal understanding of speech -
  therefore may fail to follow a lot of classroom
  language e.g. "its time to go outside" may mean
  take your apron off, get your coat and line up
  at the door" but a child with ASD may think they
  can go straight outside and may consequently
  appear disobedient. Literality can lead to
  distress e.g. go to the toilet and wash your
  hands"
• Repetition of chunks of language heard in other
  situations/videos - may sound clumsy or odd

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Social Relationships
Child may display general awkwardness in social
situations
May be unable to interact appropriately with
peers
Difficulty in making friends may initiate and
want social contact, but lack understanding
and skills to carry through
Unusual facial and/or physical gestures
(smiles, grimaces, eye-contact)
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Social Relationships
Problems with social distance
Child may have difficulties with conventional
turn-taking and sharing. May start/finish
conversations abruptly or fail to answer
appropriately.
Child may not see themselves as a part of group
Motivation may not be rewarded by success at
tasks (They are not being lazy or
obstinate!)
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Rigidity of thought, play and behaviour

• Their play may be learnt and repeated. This means
  that initially the childs play skills may appear
  appropriate, but over time it is apparent that
  the childs play sequences are not extending.
• Imaginative and symbolic play begins to emerge at
  around 2 to 2 ½ years, but for children with ASD
  their play may be repetitive and limited to
  specific actions, e.g. lining toys up, moving
  trains around a track
• May find activities difficult when imagination or
  pretend skills are needed, e.g. home corner, role
  play games
• Difficulty coping with adult direction and
  imposed routines
• Difficulties with understanding changes in
  routine and new situations

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Rigidity of thought, play and behaviour

• Some children exhibit fixed interests and may
  become obsessional about these
• Attentional problems on tasks chosen by others
• Difficulties with problem solving, e.g. finding
  an item that is not in its usual place
• Seeing 'part' rather than 'whole' - not the
  'bigger picture, e.g. focusing on a specific
  part of a picture
• Rigidity of thinking and behaviour being a
  class policeman
• Perseveration - the need to repeat words,
  actions, activities etc

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Beyond the Triad of Impairments
The Sensory World of Autism
Senses provide us with the unique experiences
which allow us to interact be involved with
others
Senses play a significant role in determining
our responses to a particular situation
Many individuals with autism experience either
an intensification or absence of sensory
integration
Hyper Hypo
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The Sensory World of Autism
The Five Senses
Touch (includes balance and body awareness)
Tactile relates to touch ,pressure, pain,
hot/cold
Hypo- Holding others tightly
High pain threshold
Self-harming (biting, gouging etc.)
Hyper- Finds touch painful/uncomfortable
(Social aspect)
Sensitivity to certain clothing/textures
Dislike of having things on hands/feet
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The Sensory World of Autism
The Five Senses
Touch (includes balance and body awareness)
Vestibular informs where body is in space

Hypo- The need for rocking, swinging,spinning Hy
per- Difficulties in activities which include
movement (sport, dance)
Difficulties in stopping quickly or during an
activity

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The Sensory World of Autism
The Five Senses
Touch (includes balance and body awareness)
Proprioception where how body is moving
Hypo- Proximity personal body space in relation
to others. Navigating rooms
avoiding obstructions.


Hyper- Fine motor difficulties, manipulating
small objects (buttons, threading, shoe
laces etc). Moves whole body to
look at something.

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The Sensory World of Autism
The Five Senses
Sight
Visual helps to define objects, colours, space
Hypo- Peripheral vision (central vision blurred)
Poor depth perception
(throwing/catching)


Hyper-Fragmentation of images (too many sources)
Focussing on particular detail
(rather than whole).

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The Sensory World of Autism
The Five Senses
Hearing
Auditory informs about sounds around us
Hypo- Partial or complete absence of hearing
Enjoys noisy places/activities (bangs
things)


Hyper- Magnification or distortion of sounds
Unable to filter out external sounds

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The Sensory World of Autism
The Five Senses
Smell
Olfactory Is the first sense we rely on
Hypo- May be oblivious to strong odours
May lick things indiscriminately


Hyper- Smells appear intensified/overpowering.
Toileting problems

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The Sensory World of Autism
The Five Senses
Taste
Gustatory Informs about various tastes
Hypo- Likes very spicy/salted foods
May eat anything (soil, grass, material etc)


Hyper- Prefers bland (white) food
Texture of food may be problematic (lumps)

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The National Picture

• Estimated population of ASD (whole spectrum) in
  the UK
• National Autistic Society estimated the
• prevalence at 1100
• No. of children with ASDs under 18 (est.) 133,500
  
• (based on 2001 census UK under-18 population
  of 13,354,297

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The Local Picture

• October 2006 Yorks Humbs ASD Regional
  Partnership Benchmarking questionnaire. Numbers
  of pupils in each regional Local Authority with
  ASDs.
• Mainstream Special School pupils from
  pre-school to Post 16
• Rotherham incidence slightly higher (approx 650
  children with diagnosed ASDs

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Discussion Points

• Implications for education
• Implications for families
• Support networks (schools)
• Support networks (families)
• Any other questions?