Introduction to Autism

1
Introduction to Autism

• Session One

2
What is Autism

• Presented by
• Marc Tardif
• Social Skills Program Co-ordinator

3
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

4
The Latest Statistics

• 1 in 165 Canadians are affected with ASD
• Ratio of males to females 41

5
Possible Causes of Autism

• Genetic
• Current research links ASD to biological or
  neurological differences in the brain
• Organic
• Some research suggests that environmental
• factors play a part in the expression of ASD

6
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

7
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

8
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

9
Restricted, Repetitive and Stereotyped Patterns
of Behaviour

• Preoccupation with one or more stereotyped and
• restricted patterns of interest
• Apparently inflexible adherence to specific,
• nonfunctional routines or rituals
• Stereotyped and repetitive motor mannerisms
• Persistent preoccupation with parts of objects

requires at least one impairment from this
category
10
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)

11
Pervasive Developmental Disorder
CDD
Retts Syndrome
Autism
AspergerSyndrome
PDD-NOS
Autism Spectrum Disorders (ASDs)
12
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 41

(Canadian Journal of Psychiatry- In Review)
13
Retts 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)
14
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

15
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

16
Facts about Aspergers 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 (41)

(Autism Society, 2005)
17
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

18
High-functioning Autism (HFA) vs. Aspergers
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)
19
Differences
(Condillac, 2003)
20
Triad of Impairments
Social Interaction
Language and Communication
Restricted, Repetitive Behaviour
21
Social Deficits

• Lack of reciprocal social interactions
• Unusual reaction to others emotions
• Lack of joint attention
• May not seek out the company of peer
• Avoidance of eye contact

22
Social Interaction
23
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

24
Communication Deficits
Thank you MGM. Rain Man Best Picture 1988
25
Communication Deficits

• Literal Interpretation
• http//www.boreme.com/boreme/funny-2007/police-hel
  ps-kid-p1.php

26
(No Transcript)
27
(No Transcript)
28
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 cant follow
• the rhythm.
• (Grandin, 1995)

29
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

30
Triad
2
Restricted and Repetitive Behaviours
Social Interactions
Language and Communication
Sensory
Anxiety
31
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)
32
Sensory Issues

• Children with Autism tend to overreact or under
  react to sensory input
• Under react (hyposensitive) dont 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)

33
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

34
Sensory Overload Activity
35
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

36
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

37
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

38
Autism Speaks
Video From www.autismspeaks.org
39

• Please fill out your
• evaluation forms

40
References
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 Co
llins, 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 Grandi
n, 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. .
41
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 Childrens 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_funct
  ioning.html

42
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/monog
  4.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. Childrens 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
43
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 Society World
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.