Autism Spectrum Disorders

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Autism Spectrum Disorders

• A developmental disability
• Begins prior to birth or in early infancy
• Variations or subgroups exist
• May occur with other motor, cognitive, and/or
  language disabilities
• Triad of deficits
• Social reciprocity
• Communication
• Repetitive or ritualistic behaviors

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the spectrum includes

• Autism
• Childhood disintegrative disorder
• Asperger syndrome
• Atypical autism/ Pervasive developmental
  disorder-not otherwise specified (PDD-NOS)
• See Table 2.1 in Wetherby Prizant, 2000

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• At the core of autism is an inability to process
  and understand social and affective information
  in a cohesive, flexible manner.
• This decreased ability to process, understand,
  and integrate multiple types of information
  (language, social and emotional) affects ones
  ability to engage in social interactions that are
  both dynamic and unpredictable.

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Individuals with ASD have difficulty with

• processing social information.
• perceiving, understanding and integrating
  expressions, emotions, and social perspectives.
• theory of mind.
• the ability to understand the thoughts and
  feelings of others
• taking the perspective of others in social
  interaction

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• To understand the thinking patterns, social
  perspectives and socioemotional qualities of
  children with ASD, we focus on three aspects of
  cognition
• attention,
• information processing, and
• social cognition.

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Problems with Attention

• A hyperfocus on concrete information helps create
  order.
• Use repetition and rituals to make sense of
  world.
• Hypersensitivity or atypical responses to sensory
  information
• Overselectivity?difficulty attending to multiple
  features of stimuli
• Difficulty selecting the meaningful feature to
  attend to for learning
• May focus on irrelevant details or misinterpret
  meaning of information
• Difficulty shifting attention

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Problems with Information Processing

• Overselectivity leads to processing information
  one piece at a time.
• Gestalt processing-information recognized and
  stored as a whole
• Problems integrating information in a meaningful
  and flexible way
• Rely on patterns to store information
• Retrieval of information is concrete.

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• Visual thinking-process visuospatial information
  more easily
• Fixed in time and space
• Does not change rapidly
• Learning is driven by concrete physical
  experiences.
• Decreased understanding of abstract social
  concepts

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Problems with Social Cognition

• Linking emotions and behaviors
• Social referencing
• understanding the meaning of an experience by
  looking at how people react to events
• Theory of mind and social perspective taking
• understanding the intentions, thoughts, and
  feelings of others and comparing them to your own
• Anticipating, understanding, and predicting the
  social behaviors of others
• Continually monitoring and adapting to partners
  knowledge, perspective, and behaviors

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The rituals or repetitive behaviors of
individuals with ASD can be a/an

• expression of emotional state or understanding.
• regulation of sensory information.
• expression of anxiety used to create order.
• impairment in cognitive functioning.
• expression of poor inhibition.

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References

• Wetherby, A. Prizant, B. (2000). Autism
  spectrum disorders A transactional developmental
  perspective. Baltimore, MD Brookes Publishing.
• Quill, K.A. (2000). Do-Watch-Listen-Say.
  Baltimore, MD Brookes Publishing.

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Social Communication of Individuals with ASD
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Communication Development

• Reciprocal, dynamic process takes
• two people to communicate.
• initiations and responses to information.
• Requires attention to and understanding of
  rapidly changing information
• Interpretation of speakers message takes place
  in context.

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Social Development

• Interactions with environment and people provide
  the context for learning.
• Interactions and information are constantly
  changing and require flexibility to monitor and
  adjust to actions of others.

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Core Skills of Social and Communication
Development

• Nonverbal social communication
• use of eye gaze, facial expressions, and gestures
  to respond and engage in interactions
• Imitation is a means to
• learn new things.
• relate self to the world around you.
• develop symbolic thought.

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Areas of Weakness

• Joint attention
• Social-affective signaling
• Symbolic play

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Joint attention

• Pivotal skill or core feature of ASD
• Deficits distinguish ASD from other language and
  cognitive disorders.
• Evident from an early age (begins at 9-12
  months.)

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Joint attention

• Orienting to social stimuli
• looking at and attending to
• Coordinating eye gaze (attention) between objects
  and people
• Displaying affect or emotion to a person
• sharing of affective state
• Reading and interpreting the expressions of
  others
• Drawing the attention of others to objects or
  events to share an experience

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Decreased coordinated attention to social stimuli
(the objects and people you interact with) leads
to

• difficulty learning the meaning of objects,
  actions, and events.
• When looking at the same object or event, adults
  provide the language for children to learn.
• difficulty understanding the perspective of
  others? what others are thinking about the
  objects, actions, and events.
• A child must understand that the adult is
  attending to the same aspect, object, or event
  he/she is and be able to compare perspectives.
• This facilitates the development of conversation
  and social interaction.
• difficulty knowing how to draw someones
  attention to you, objects, or activities in order
  to share an experience.
• We learn from the reactions of others how to
  respond in future interactions.

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Symbol Systems

• Understanding that one thing stands for or
  represents another
• Learned in a social context while interacting
  with people and objects
• Play and language are examples of symbol systems.
• Words/gestures stand for/represent an object or
  action.
• In pretend play, an object like a banana can
  represent a phone.

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Difficulties with Symbol Use

• Fewer vocalizations to express intentions in
  younger years
• Fewer conventional, symbolic gestures? waving,
  pointing, showing
• Difficulty understanding and using the
  conventional meaning of words
• Less variety and complexity of pretend play
• More time playing with objects in a functional way

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Areas of Weakness

• Joint attention
• Less attention to objects and people
• Less coordinated attention between objects and
  people
• Social-affective signaling
• Less positive affect when interacting with others
• Less response to the affect of others
• Less sharing of affect while attending to same
  object or event as adult
• Symbolic play

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Communicative Functions

• We communicate for three main reasons or
  purposes
• Behavior regulation?to obtain or restrict a goal
• Social interaction?to attract attention to self
• Joint attention?to direct attention to an object
  or event

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• Children with ASD use communication more often to
  regulate the behavior of others?to obtain or
  restrict a goal
• Requesting an object I want that ball.
• Requesting an action Get me a drink.

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The difficulty lies in using communication (eye
gaze, gestures, sounds, words) to draw attention
in order to share an experience.

• social interaction
• To request a routine Lets play peek a boo.
• To request comfort Give me a hug.
• To call or greet someone Hi, Mom.
• To show off Look what I can do.
• To request permission Can I crawl on the
  table?
• joint attention
• To comment Look, thats a cow.
• To request information Is that a cow?
• To provide information Im going to read a
  book.

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Profile of Social Communication and Symbolic
Abilities

• Areas of weakness for children with ASD
• Communicative Functions
• Gestures
• Reciprocity
• Social-affective signaling
• Symbolic behavior
• (Wetherby Prizant, 1993)

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Strengths/Weaknesses

• Areas of weakness
• Joint attention and social-affective signaling
• Communicating for social purposes/functions
• Eye-gaze shift
• Symbolic play
• Strengths
• Communicating for behavior regulation
• Constructive/functional play

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References

• Wetherby, A. Prizant, B. (1993). Profiling
  communication and symbolic abilities in young
  children. Journal of Childhood Communication
  Disorders, 15, 23-32.
• Wetherby, A. Prizant, B. (2000). Autism
  spectrum disorders A transactional developmental
  perspective. Baltimore, MD Brookes Publishing.
• Quill, K.A. (2000). Do-Watch-Listen-Say.
  Baltimore, MD Brookes Publishing.

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Communication Terminology
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Terminology

• Communication the process of sharing thoughts,
  ideas, attitudes, feelings, and desires with
  others
• Language a shared system of symbols and rules
  a code with which people communicate
• Speech the oral expression of language

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Language

• We acquire language in order to share ideas,
  thoughts, and feelings.
• Through our interactions with people and
  experiences with the environment, we construct
  knowledge and shared meanings.
• Intentionality drives language acquisition.

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Language

• Language a shared system of symbols and rules
  a code with which people communicate
• Phonology the speech sound system of language
• Morphology word formation
• Syntax rules used in constructing and
  understanding sentences
• Semantics rules for the meaning of words and
  their combinations
• Pragmatics the use of language

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Phonology

• the study of phonemes or speech sounds and the
  rules that determine how they can be sequenced
  into syllables and words. For example, the words
  seed and seat are different only because of
  the final phoneme or sound. Phonology is not the
  same as speech. Speech is what we do when we talk
  and listen.

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Morphology

• The words and their parts as units of meaning. A
  morpheme is the smallest meaningful unit of
  language. Morphemes can be sounds or syllables
  or whole words. For example, the word dog is a
  morpheme, as is the s to make the word dogs.
  You will hear speech language pathologists (SLPs)
  talk about mean length of utterance. This is a
  marker of language maturity and complexity.

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Syntax

• the rules for how to string words together to
  form phrases and sentences, what sentences are
  acceptable, and how to transform sentences into
  other sentences
• the study of the structure of phrases, clauses,
  and sentences

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Semantics

• the study of linguistic meaning. This includes
  vocabulary and meanings associated with words and
  word combinations. Semantics deals with the
  relationships between and among words, sentences,
  and their meanings.

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Pragmatics

• the study of how language is used to communicate
  within a situational context. Pragmatics involves
  knowing how to use information from the social
  situation to determine what to say and how to
  achieve personal and social goals. Speakers must
  decide the appropriate form of a message to use
  in different contexts, make judgments about the
  capacities and needs of listeners, and set rules
  for social exchanges or conversational abilities.

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Language

• Language can also be classified by its content,
  how it is used, and the form it takes.
• Content semantics
• Use pragmatics
• Form phonology, morphology, and syntax

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Speech

• Speech the oral expression of language
• Articulation?the production of the sounds
• Resonance?the air flow associated with sound
• Phonation?the voicing of sounds
• Fluency?the smoothness with which the sounds are
  blended together

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Communication can be symbolic or nonsymbolic.

• Symbolic communication when one form represents
  or stands for something else
• The word chair stands for this object.
• Nonsymbolic communication communication that
  does not rely on symbols
• depends on how the communication partner
  interprets the message

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Features of communication

• The goal of the speaker
• The effect on the listener
• The way the person communicates
• The contextual influences on the communicative
  exchange

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Communication may be intentional or
nonintentional.

• Communicative intent goal of the speaker
• Aware of the effects on listener
• Intentionality is inferred with nonsymbolic
  communicators
• Alternating gaze between goal and listener
• Persistent signaling until goal is accomplished
  or fails
• Changing the signal quality until goal is met
• Ritualizing or conventionalizing the form within
  specific contexts
• Awaiting a response from the listener
• Terminating signal when goal is met
• Displaying satisfaction when goal is met or
  dissatisfaction when it is not

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Communicative Functions

• Communicative function effect on listener
• Behavioral regulation?to obtain or restrict a
  goal
• Requesting
• Protesting
• Joint Attention?to direct attention to an object
  or event
• Commenting
• Social Interaction?to attract attention to self
• Greeting
• Answering

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Communicative Forms

• Communicative forms/modes/means the way a
  person communicate
• Words
• Gestures
• Signs
• Writing
• Behavior
• Facial expression

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Contextual influences

• Contextual influences on communication
  environmental factors that influence
  communicative interactions

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Environmental Influences
dyadic
situational
setting
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Environmental Influences

• Setting
• Activities
• Social climate
• Characteristics of partners
• Access and familiarity with setting

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Environmental Influences

• Situational
• Routines
• Needs for assistance or objects
• Protest situations
• Opportunities for making choices

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Environmental Influences

• Dyadic
• Partner responsiveness to initiations
• Developmental level of partner utterances
• Compliance with/recognition of student
  preferences
• Familiarity with student
• Repair attempts
• Topic maintenance
• Affect and attitude