P1247176258cjEVO

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Understanding and Teaching Students
with Autism Spectrum
Disorders
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What is an Autism Spectrum Disorder (ASD)?

• ASD refers to a group of related disorders marked
  by
• Qualitative impairments in communication
• Qualitative impairments in socialization
• Limited and/or unusual interests/preoccupations
  

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• Statistics
• ASD is not rare
• ASD more common than childhood cancer and
• Down Syndrome
• Affects 1 in every 250 to 300 children
• More Boys than Girls

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ASD Typically Includes

• All the Pervasive Developmental Disorders (PDD)
• Autistic Disorder
• Aspergers Disorder
• Pervasive Developmental Disorder Not
• Otherwise Specified
• Retts Disorder
• Childhood Disintegrative Disorder

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Whats the Difference Between ASD and PDD?

• PDD Diagnostic Statistical Manual of
• Mental Disorders Fourth Edition, Text
• Revision (DSM-IV TR)
• DSM system used in the clinical world
• ASD Used by many educators, parents,
  professionals, and advocates. Will also see
  autistic spectrum disorders.

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Special Educations Autism Definition
Autism is a developmental disability,
generally evident before age three, that
adversely affects a student's educational
performance and significantly affects 1.
developmental rates and sequences 2.
verbal and non-verbal communication 3.
social interaction and participation
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Special Education Definition Continued

• Other characteristics often associated with
  autism are
• unusual responses to sensory experiences
• engagement in repetitive activities and
• stereotypical movements
• resistance to environmental change or
• change in daily routines

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Special Education Definition Continued

• Students with autism vary widely in their
  abilities and behavior. The term of autism may
  also include students who have been diagnosed
  with
• Pervasive Developmental Disorder
• Aspergers Disorder
• Retts Disorder
• Childhood Disintegrative Disorder

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If youve seen one child with Aspergers
Syndrome or Autism, you have seen one child
with Aspergers Syndrome or Autism.
Brenda Smith Myles 2000
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• Area One Developmental Rates and Sequences
• Delays, Arrests, and/or Inconsistencies in the
  acquisition of any 1 or more of the following
  areas
• Motor
• Sensory
• Social
• Cognitive skills

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• Area One Developmental Rates and Sequences
• Continued
• Areas of precocious or advanced skill development
  may be present, while other skills may develop at
  typical or extremely depressed rates.
• The order of skill acquisition frequently differs
  
• from typical developmental patterns.

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• Development of Children with ASD Motor Skills
• Even if delayed, development of motor skills
  typically a strength in relation to
  social/emotional skills.
• Many infants with ASD meet early motor
  milestones on-time.
• Motor problems become common in preschool and
  early elementary years. Includes problems with
  coordination or clumsiness.

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• Development of Children with ASD Language
• Language may be completely absent. Some will use
  gestures. Others use neither words nor gestures.
• Echolalia Imitating the speech of others. Two
  types
• Immediate Echolalia
• Delayed Echolalia

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• Development of Children with ASD Language
• Continued
• Those who develop past echolalia, usually
• acquire more advanced grammar and
• language skills.
• Continue to have problems with the social
• rules of conversations Pragmatics

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• Children with Aspergers and Language
  Development
• Currently the DSM-IV (Clinical) system
• requires an absence of language delay.
• Many with Aspergers do achieve language
• on-time, but idiosyncratic differences in
• language development often evident early
  on.
• These children may use an advanced expressive
• vocabulary Little Professors

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• Development of Children with ASD Sensory
• Sensory problems Neither universal with nor
  specific to ASD.
• When compared to typical children and children
  with other disabilities, the following are common
  characteristics of infants and toddlers with ASD
  
• Insensitivities to pain
• Under and overreactions to sound
• Unusual postures

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• Common characteristics of development continued
• Unusual visual behaviors
• Unusual play behaviors
• Stereotypic behaviors
• Overexcitement when tickled

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• Area Two Social Interaction and Participation
• Student must have either difficulties with
  or idiosyncratic differences in interacting with
  people and participating in events.
• Student may be unable to establish and
  maintain reciprocal relationships with people.

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• ASD and Social Deficits
• Difficulties with social relationships and
• interactions usually regarded as the
• core feature of ASD.
• ASD can be seen as a
• Social Communication Disorder

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• ASD and Social Deficits
• Myth Children with autism never initiate
• social interactions with others.

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• ASD and Social Deficits
• REALITY
• Peer interactions are characterized by
• LOW RATES of initiation and response.
• Most pronounced for
• Purpose of sharing experiences
• Joint attention

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• ASD and Social Deficits
• Myth Children with autism do not play
• with other children.

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• ASD and Social Deficits
• REALITY
• Often enjoy play. Usually differences in play
• Lack of imitation
• Problems with symbolic or dramatic play
• Preference for solitary play

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• ASD and Social Deficits Three Suggested
  Subgroups
• Aloof
• Indifferent to social interactions, particularly
  with other children
• Approach others only to get needs met
• May still enjoy physical interactions

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• ASD and Social Deficits Three Suggested
  Subgroups Continued
• Passive
• Make few social initiations
• Respond positively to the approaches of others

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• ASD and Social Deficits Three Suggested
  Subgroups Continued
• Active but Odd
• Make social initiations
• Are interested in interactions with others
• Their ways of carrying out interactions are
  problematic and often involve
• Odd language
• Obsessional topics
• Lack of understanding the feelings and intentions
  of others

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• ASD and Social Deficits Joint Attention
• What is Joint Attention?
• Definition 2 Components
• Two people actively sharing attention with
  respect to an object or event
• 2. Monitoring each others attention to that
  object or event

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• ASD and Social Deficits Joint Attention
• Purpose
• The purpose of joint attention is SOCIAL
• Reflects childs growing understanding of
• the world and motivation to interact with
• others about interesting objects.

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• ASD and Social Deficits Joint Attention
• Development of Joint Attention in Typical
  Children
• 9-18 months Responds to voice and gestures
• 12-14 months Develops Gaze Alternation
• Checks back with adult
• Begin to initiate joint attention by using
  gestures (such as pointing) coordinated with
  gaze alternation.

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• ASD and Social Deficits Joint Attention
• Deficit in joint attention one of the earliest
  symptoms of ASD
• Early to middle childhood Some with ASD
  demonstrate ability to respond to joint attention
  bids.
• May be good at using joint attention to obtain
  objects of interest but, impaired use of joint
  attention for social purposes.

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• Area Three Communication
• A student displays a basic deficit in the
  capacity to use verbal language for social
  communication, both receptively and expressively.
  May involve
• Delay
• Deviance
• Absence of verbal language
• Lack of usual communicative form
• OR
• The student may have a nonverbal
• communication impairment.

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• Social Communication Characteristics of Children
  with ASD
• Myth Children with autism do not make eye
  
  contact
• REALITY Many do make eye contact. Often problems
  using eye gaze to regulate social interactions.

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• Social Communication Characteristics of Children
  with ASD
• Fail to read verbal and nonverbal social cues
• Fail to use verbal and nonverbal social cues
  appropriately
• Fail to empathize with others and offer comfort
• Difficulty identifying and describing their own
  feelings

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• Social Communication Characteristics Continued
• Problems with topic maintenance
• Impaired ability to discuss the interests of
  others.
• May switch back to comfortable topics.
• Overuse of questions to initiate communication
  or to maintain the social interaction.

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• Social Communication Characteristics Continued
• Often have unusual language features
• May include
• Monotonic speech
• Up and down or sing-song patterns
• Volume disturbances
• May use words in stimulatory manner
• Echolalia (Immediate and/or Delayed)
• May invent idiosyncratic words or phrases

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• Area Four Sensory Processing
• Unusual, repetitive or unconventional
• responses to sensory stimuli of any
  kind.
• A student's responses may vary from low to
• high levels of activity.

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• Area Five Repertoire of Activities and Interests
• Any of the following included here
• Repetitive activities
• Distress over changes
• Insistence on following routines
• Persistent preoccupation with or attachment
• to objects
• May have difficulties displaying a range of
• interests and/or imaginative play
• Stereotypical body movements

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Typical Problems Experienced by High Functioning
Students with ASD in the School Setting

• Withdrawal
• Limited classroom participation
• Seeks solitary play or isolation
• Disorganization/Lack of Self-Direction
• These children need their routines
• Structure very important
• Use of visual schedules may be helpful

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• Typical Problems Continued
• On-Task Behavior
• May be related to
• ADHD component (especially with Aspergers)
• Poor motivation
• By nature, have restricted interests
• Can use these interests to reward task
  completion and attention
• Visual overselectivity Focus on irrelevant
  components of the task

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• On -Task Problems Continued
• Perseveration Get stuck on thoughts
• Do not know how to ask for assistance
• Sensory processing
• Deficit in planning ability to predict future
  
• Not able to plan how much time to allocate to
  each task component.
• Not able to predict or know when task will be
  over. Leads to increased anxiety.
• Need to know when something is finished.

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• Typical Problems Continued
• Aggressive Behaviors
• Can be towards self or others
• Hitting may be way of distancing self
• May be sensory related
• May increase with stress
• Odd and Disruptive Behaviors
• Stimulatory/Sensory
• Tics
• Social Deficit Dont know the behavior is weird
  or inappropriate

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• Typical Problems Continued
• Meltdowns and Shutdowns
• The social nature of school can be very
  
• stressful for these students. However, they
• lack the social-communication skills to
• seek assistance and express their feelings.

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• Typical Problems Continued
• Extreme Stress and Anxiety are Common
• Be on the look-out for increases in stereotyped
  behaviors, preoccupations, meltdowns, withdrawal
  or escaping into their own world. Problem
  behaviors typically increase during times of
  stress.
• Need to identify function of the behavior, so
  that appropriate or functional
  social-communication skills can be taught.

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• Typical Problems Continued
• Language Problems
• Difficulty following directions
• May need repetition
• Visual cues and schedules may be helpful
• May require extra time to process language

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• Language Problems Continued
• Interpret things literally Dont understand
  sarcasm, jokes, figurative language, humor
• Problems with abstract concepts or
  higher-level reading and oral language
  comprehension
• Inconsistent understanding of language

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Other Problems Often Seen with High Functioning
ASD/Aspergers

• Depression
• Especially during middle school/adolescence
• Related to lack of peer relationships
• Aspergers Extreme fear of making mistakes
• Full-Blown Obsessive-Compulsive Disorder (OCD)

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• Other Problems for those with Aspergers/High
  Functioning ASD Continued
• Socially Naïve
• Make social blunders related to their failure to
  understand nonverbal communication and social
  language.
• Easy targets for bullies
• Get set-up, used, and exploited.
• Social difficulty can be related to inflexible
  adherence to rules.

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• Prognosis for Students with ASD
• Variable
• If no language by 6-years of age, then unlikely
• to acquire it.
• Better outcomes with higher rates of functional
• language and normal to above average IQs
• In general, the more severe the deficits, the
• more likely the child is to be dependent on
• others as an adult.
• Better outcomes with early intervention!!

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• Prognosis and Aspergers/High Functioning ASD
• Most experience great improvement between
• the ages of 6-12 years.
• Common to experience regression in
• adolescence.
• In adulthood, some recover or learn to
• cope with symptoms.
• Many remain dependent on others into
• adulthood.
• Many experience extreme difficulty keeping
• jobs, having relationships, and maintaining
• daily functioning.

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REMEMBER If youve seen one child with
Aspergers Syndrome or Autism, you have seen one
child with Aspergers Syndrome or Autism.
Brenda Smith Myles
2000