Title: Autism Spectrum Disorders ASD
1Autism Spectrum Disorders (ASD)
2Objectives
- Discuss
- definitions of ASD
- characteristics of ASD
- increase in reported prevalence rate and the
factors that might contribute to this finding - the importance of early identification and
intervention - educational intervention
3Historical Background
- Leo Kanner, a child psychiatrist, first
systematically described the autism disorder, and
pointed out the similarities in dysfunction in a
group of children, whom he was later to identify
as having early infantile autism in America,
1943.
4Historical Background, Cont.
- Kanner used the term autism to suggest the
notion of the childs living in his or her own
world. - The essential features of Kanner syndrome
(classic autism) are -
- Disturbances of social relationships
- Limited use of language to communicate
- Fixed repetitive interests and routines
51. Defining Autism
- Both children and adults with autism typically
show difficulties in verbal and non-verbal
communication, social interaction, and leisure or
play activities. - One should keep in mind however, that autism is a
spectrum disorder and it affects each individual
differently and at varying degrees - (Autism Society of America, 2007).
6What is the definition under the IDEA?
- Autism is a developmental disability
significantly affecting verbal and nonverbal
communication and social interaction, generally
evident before 3, that adversely affects a
childs educational performance. - Other characteristics often associated with
autism are engagement in repetitive activities
and stereotyped movements, resistance to
environmental change or change in daily routines,
and unusual response to sensory experiences.
7High-functioning Autism (HFA)
- Individuals with autism who do not have mental
retardation are often referred to as having high
functioning autism (HFA) (Klin, Pauls, Schultz,
Volkmar, 2005).
8Historical Background of Asperger Syndrome (AS)
- Hans Asperger
- the first person to describe AS in 1944
- Lorna Wing
- the first person to use the term Asperger
Syndrome in a paper published in 1981.
91. Definition of Asperger Syndrome (or Aspergers
Disoder)
- The essential features of AS are severe and
sustained impairment in social interaction and
the development of restricted, repetitive
patterns of behavior, interest, and activity that
cause limitations in social and other areas of
functioning. - There are no significant language or cognitive
development delay, nor lack of age-appropriate
self-help skills. - (Autism Society of America, 2007)
102. CharacteristicsThree Core Dimensions of ASD
Social interaction
Restricted, repetitive, and stereotyped patterns
of behavior, interests, and activities
Verbal and nonverbal communication
112. Characteristics
- Communication
- Echolalia repetitive vocalizations of any speech
or sounds they hear - Some do speak others have limited language.
- Difficulty with understanding abstract concepts
and pragmatic language skills - Social interaction
- Poor eye contact
- Does not often initiate play with peers
- May lack understanding of social cues
- Behavior
- Exhibits repetitive body movements
- May be extremely sensitive to some auditory
stimuli - May not respond to some auditory stimuli
- May demonstrate persistent preoccupation with
parts of objects
123. Prevalence
- About one in 150 children have been diagnosed
with autism (CDC, Stevens et al., 2007). - Boys are nearly four times more likely than girls
to be identified with autism. - Hispanics had lower autism rates, though its
possible that may be related to health-care
access problems. - (May 5, 2006, published in the U.S. Centers for
Disease Control and Preventions Morbidity and
Mortality Weekly Report). (www.cdc.gov/ncbddd/auti
sm/asd_common.htm)
13What do you think of the high rates of ASD now?
- It might be due to the expanded definition, and
greater awareness. But we do see more children
with ASD diagnosed. - Current increase has led to recommendation that
screening for ASD be routinely done by
pediatricians.
14- It can cost about 3.2 million to care for a
person with autism over a lifetime, according to
the Harvard School of Public Health.
154. Causes Genes or Environment
- Both the causes and cures of the disorder are
unknown. - Autism is currently considered a neurological
disorder that is influenced by both environmental
and genetic factors (Sigman, Spence Wang,
2006).
165. Importance of Early Identification
- Autistic disorder is typically noticed in the
first or second year of life (DiCicco-Bloom et
al. 2006). - Differences between typically developing children
and those with ASD are detectable by two years of
age (Landa, Garrett-Mayer, 2006). - ASD can be diagnosed as young as 2 years of age
and by 3 years of age, difficulties in the three
domains are typically observed - (DiCicco-Bloom et al., 2006).
- DiCicco-Bloom et al. (2006). The developmental
neurobiology of autism spectrum disorder. The
Journal of Neuroscience, 26(26), 6897-6906. - Landa, R, Garrett-Mayer, E. (2006) Development
in infants with autism spectrum disorders a
prospective study. Journal of Child Psychology
and Psychiatry and Allied Disciplines, 47(6),
629-638.
175. Early Identification Cont.
- Many children with ASDs are identified in the
elementary school year. - Asperger syndrome may not be apparent until a
child is older (DiCicco-Bloom et al. 2006). -
- Identifying developmental disruptions in infants
and very young children with ASD may allow for
earlier detection and critical intervention.
186. Early Indicators
- Developmental red flags for parents and
physicians to watch for include - poor eye contact
- reduced responsive smiling
- diminished babbling
- reduced social responsivity
- and difficulty with language development, play
and initiating or sustaining social interaction. - (Landa, 2006)
196. Early Indicators of Possible ASDs in very
young children
- No big smiles or other warm, joyful expressions
by 6 months or thereafter - No back-and-forth sharing of sounds, smiles, or
other facial expressions by nine months or
thereafter - No babbling by 12 months
- No back-and-forth gestures, such as pointing,
showing, reaching, waving, or three-pronged gaze
(e.g., child looks at adult, looks at toy to
indicate interest in it, looks back at adult to
communicate something about the toy) 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 - Does not respond consistently to his/her name
- (Rogers, 2001 Travis Sigman, 2000)
206. Early Indicators of Possible ASDs in older
children
- Failure to develop peer relationships appropriate
to developmental level - Appropriate language skills, but not using
language in a socially appropriate way (e.g.,
impairment in the ability to initiate or sustain
a conversation) - Stereotyped and repetitive use of language or
idiosyncratic language - Preoccupation with an interest that is abnormal
in its intensity or focus - Inflexibility, with a need for non-functional
routines or rituals - (Cadigan Estrem, 2006).
217. Early Intervention
- About half of children with as ASD diagnosis
overcome many of the language and social skills
deficits that limit their participation with
their families, schools, and communities by the
time they enter kindergarten or first grade
(Sallows Graupner, 2005) - Many children who start treatment earlier achieve
significant better outcomes (Mundy Neal, 2001)
227. Early Intervention, cont. What is the best
comprehensive intervention model?
- Not many studies have compared comprehensive
intervention models. - Different models have yielded similar outcomes.
- Foster speech/communication skills
- Behavioral teaching methods (DTT)
- Social skill training (high functioning
individuals with ASD)
237. Early Intervention, cont.What does NRC
recommend
- Effective programs for young children with ASD
include the following characteristics (NRC, 2001,
pp. 220-221) - A minimum of 25 hours a week, 12 months a year,
of systematically-planned educational activity - Sufficient individual attention every day so that
Individual Family Service Plan (IFSP) and
Individualized Education Program (IEP) objectives
can be addressed with adequate intensity - Ongoing assessment
- Successful interactions with typically-developing
children - Instruction in the areas of functional
spontaneous communication, social interaction,
play skills, cognitive skills taught in a manner
to facilitate generalization, proactive and
effective approaches to challenging behavior, and
functional academic skills.