Autism Spectrum Disorders and Severe Disabilities

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Autism Spectrum Disorders and Severe Disabilities

• SPED 417
• 7/15/02

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Wetherby Prizant, 2000
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Wetherby Prizant, 2000
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Autism Spectrum Disorders (ASDs) and Pervasive
Developmental Disorders (PDDs) Characteristics

• Neurodevelopmental disorders that have 3 core
  features
• Impairments in social interaction
• Impairments in verbal and nonverbal communication
• Restrictive and repetitive patterns of behavior
• Joint attention appears to be a fundamental
  component of etiology of autism
• Impairments in the capacity for symbol use
• Approximately 50 of individuals with autism do
  not develop functional speech

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Autism Spectrum Disorders (ASDs) and Pervasive
Developmental Disorders (PDDs) Characteristics

• Use of primitive presymbolic gestures lack of
  conventional gestures such as pointing.
• Period of using echolalia
• Delayed
• Immediate
• May be single word or phrase which may serve as a
  label for a situation or event. Learn meaning of
  phrases by finding out how they work.
• Gestalt processing
• For individuals with speech a disturbance of the
  pragmatics of language use is prominent
• Cognitive impairment
• About 50 of individuals with autism function in
  the same IQ range as individuals with mental
  retardation.
• 25 develop communicative language before the age
  of 5 years have less severe disabilities.
• 25 have typical intelligence function
  independently (Beukelman Mirenda, 1998).

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Services A Major Issue

• Incidence
• Incidence of autism has increased dramatically
• Initially thought occur in approximately 5-15 per
  10,000 births.
• Now thought to occur at a rate of 1 in 1000
  (Mundy Stella, 2000) possibly 1 in 500
  depending on diagnostic criteria.
• Illinois reported increase from 317 new cases in
  1991 to 2,305 in 1997 (Fienberg Vacca, 2000).

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Services A Major Issue

• No Consensus on Etiology
• Genetic predisposition
• Various combination of affected genes however
  what combinations trigger the condition is
  unknown.
• Neurobiological/chemical
• Difference in brain chemistry
• Shortened brain stem as well as other
  abnormalities in brain structures.
• MMR Vaccine
• Environmental toxins
• Diet/nutrition

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Services A Major Issue

• No Consensus on Intervention
• Lovaas
• Applied Behavior Analysis
• Discrete Trial
• TEACCH
• Treatment Education of Autistic Related
  Communication Handicapped Children
  http//www.teacch.com/
• PECS
• Picture Exchange Communication System
  http//www.pecs.com/index.html
• Greenspan
• Floor Time
• Sensory Integration
• New emphasis on integrating approaches

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Services A Major Issue

• Age of Diagnosis
• Services provided prior up to age 3 may not be
  provided with special education.
• e.g., Lovaas (40,000/year)
• Litigation
• Family -Centered Paradigm
• Access to information
• Increase in due process hearings
• Policy Implications
• How to plan programs
• IDEA ignores cost issues for specific children
  (Fienberg Vacca, 2000).
• What is appropriate?

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Severe and Multiple Disabilities

• IDEA Sec.300.7
• Multiple Disabilities
• Concomitant impairments (such as mental
  retardation-blindness, mental retardation-orthoped
  ic impairment, etc.), the combination of which
  causes such severe educational needs that they
  cannot be accommodated in special education
  programs solely for one of the impairments.
• Curriculum
• What to teach
• Goals
• OUTCOMES
• Ecological Inventory

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Severe DisabilitiesTop Down Approach
DOMAINS
ENVIRONMENTS
SUBENVIRONMENTS
ACTIVITIES
SKILLS
INSTRUCTIONAL PROGRAMS
See domestic domain handout example
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Severe Disabilities Curriculum

• Ecological Inventory Environments
• school
• home
• community
• work
• OUTCOMES Access To General Education Curriculum
• SAME
• ADAPTED/SUPPLEMENTED
• DIFFERENT
• see outcome handout
• Assessment
• Curriculum based assessment
• Illinois Alternative Assessment
• Student with severe disabilities are not likely
  to participate in ISAT
• Based on Illinois Learning Standards
• http//www.measuredprogress.org/ProductsandService
  s/SpecialEducation/Illinois/Illinois.html

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Severe Disabilities

• Instructional Program Objectives
• Selection
• needs
• priorities
• functional and meaningful outcomes
• appropriate for age
• Quality
• Observable
• Appropriate condition statements
• Appropriate criterion statements
• allow for assessing/instructing in environment
  where skill would typically be performed.
• IEP activity
• Case study activity

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Case StudyMarc

• Marc is a 14 year old student who is ambulatory
  but has physical limitations including poor
  muscle control in upper and lower extremities as
  well as poor fine motor skills. He has very
  limited speech using 3-5 words to request
  favorite snacks and enjoys watching T.V. and
  listening to music. His family would like him to
  become as independent as possible and are hoping
  for placement in a group home by age 21 however
  he is dependent on his family for all daily
  living requirements. The group home requires
  residents to maintain their rooms, have good
  mealtime and grooming and hygiene skills, and
  participate in community leisure activities.
• Identify an outcome
• Write a goal
• Write two objectives for this goal.

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Severe Disabilities Curriculum Issues

• IDEA 97 Access to the General Curriculum
• participation
• progress
• align IEP goals with general curriculum standards
• statewide assessment
• improve outcomes of students with disabilities
• Effect of district/state policy for teachers and
  students with severe disabilities
• IEP Assessment

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Severe Disabilities Transition

• IDEA 97
• Coordinated set of transition services at age 14
• Rehabilitation Act (1974)
• Students with severe disabilities entitled to
  continuing services when they leave school
• Supported employment
• Continued educational programs
• Educators Role
• work experience work related behaviors
• Work interests and preferences
• Supports to ensure success