AUTISM

Overview
What is Autism?
Is there more than one type of Autism?
What causes Autism?
How is Autism diagnosed?
What are the characteristics of Autism?
What are the most effective approaches
to treating Autism? Is there a cure?

WHAT IS AUTISM?
Very complex, often baffling
developmental disability
First described by Leo
Kanner in 1943 as early
infantile autism
Auto children are locked
within themselves.
For next 30 years,
considered to be an
emotional disturbance

WHAT IS AUTISM?
3 categories for autism in IDEA?
Today, autism is a severe form of
a broader group of disorders
These are referred to as pervasive
developmental disorders (later)
Typically appears during the first 3
years of life

WHAT IS AUTISM?
Very likely neurological in origin
not emotional, not the refrigerator
mom
Prevalence is 2-6/1000 individuals (1/2
to 1 million affected)
4 times more prevalent in boys
No known racial, ethnic, or social
boundaries
No relation to family income, lifestyle

WHAT IS AUTISM?
Autism impacts normal development
of the brain in areas of social
interaction and communication
skills.
Difficult to communicate with others
and relate to the outside world.
Occasionally, aggressive and/or selfinjurious behavior may be present.

WHAT IS AUTISM?
May exhibit repeated body
movements (hand flapping,
rocking).
Unusual responses to people
Attachment to objects
Resistance to change in routine
Sensory sensitivities

WHAT ARE THE TYPES?

Actually, the umbrella heading is
Pervasive Developmental
Disorder (PDD).
Autism is one of the 5 PDDs.
All have commonalities in
communication and social deficits
Differ in terms of severity

1. Autistic Disorder
Impairments in social
interaction, communication,
and imaginative play.
Apparent before age 3.
Also includes stereotyped
behaviors, interests, and activities

2. Aspergers Disorder
Impairments in social interactions,
and presence of restricted
interests and activities
No clinically significant general
delay in language
Average to above average
intelligence

3. Pervasive Developmental
Disorder Not Otherwise
Specified (PDD-NOS)
Often referred to as atypical
autism
Used when a child does not meet
the criteria for a specific diagnosis,
but there is severe and pervasive
impairment in specified behaviors

4. Retts Disorder
Progressive disorder which, to date,
has only occurred in girls.
Period of normal development and
then the loss of previously acquired
skills
Also loss of purposeful use of hands,
which is replaced by repetitive hand
movements
Beginning at age of 1-4 years

5. Childhood
Disintegrative Disorder
Normal development for at least
the first 2 years
Then significant loss of previously
acquired skills

Conclusions on Types
Autism is a spectrum disorder
This means that symptoms and
characteristics can present themselves
in wide variety of combinations, from
mild to severe
Autistic individuals can be very different
from each other
Autism is still commonly used to refer
to any of the 5 PDDs

What causes (and doesnt

cause) autism?
Good agreement in general that
autism is caused by abnormalities
in brain development,
neurochemistry, and genetic
factors
Bettleheims theory of
psychogenesis?

How is Autism Diagnosed?

No definitive medical test
Team uses interviews, observation, and
specific checklists developed for this
purpose.
Team might include neurologist, psychologist,
developmental pediatrician, speech/language
therapist, learning consultant, etc.
Must rule out MR, hearing impairment,
behavior disorders, or eccentric habits

CHARACTERISTICS
1. Communication/Language
2. Social Interaction
3. Behaviors
4. Sensory and movement disorders
5. Resistance to change
(predictability)
6. Intellectual functioning

1.
Communication/language
Broad range of abilities, from no
verbal communication to quite
complex skills
Two common impairments:
A. Delayed language
B. Echolalia

A. Delayed language
50% of autistic individuals will eventually
have useful speech (?)
Pronoun reversal: You want white
icing on chocolate cake.
Difficulty in conversing easily with others
Difficulty in shifting topics
Look away; poor eye contact
Facilitated communication??????

Elements of Facilitated
Communication
1.
2.
3.
4.
5.
6.

Physical Support
Initial training/introduction
Maintaining focus
Avoiding competence testing
Generalization
Fading

B. Echolalia
Common in very young children
(Age 3)
Immediate or delayed (even years)
Is there communicative intent with
echolalia?

2. Social Interaction
One of hallmarks of autism is lack of
social interaction
1. Impaired use of nonverbal behavior
2. Lack of peer relationships
3. Failure to spontaneously share
enjoyment, interests, etc. with others
4. Lack of reciprocity
Theory of mind?

3. Behaviors
Repetitive behaviors, including
obsessions, tics, and perseveration
Impeding behaviors (impede their
learning or the learning of others)
Will need positive behavior supports
A. Self-injurious behavior
B. Aggression

4. Sensory and movement

disorders
Very common
Over- or under-sensitive to sensory stimuli
Abnormal posture and movements of the
face, head, trunk, and limbs
Abnormal eye movements
Repeated gestures and mannerisms
Movement disorders can be detected very
early perhaps at birth

5. Predictability
Change in routine is very stressful
May insist on particular furniture
arrangement, food at meals, TV
shows
Symmetry is often important
Interventions need to focus on
preparing students for change if
possible

6. Intellectual functioning
Autism occurs in children of all levels of
intelligence, from those who are gifted
to those who have mental retardation
In general, majority of individuals with
autism are also identified as having
mental retardation 75% below 70
Verbal and reasoning skills are difficult
Savant syndrome

Interventions
1. Individualization and early
intervention are the keys
2. Include life skills, functional
academics, and vocational
preparation
3. Positive behavior support
4. Social stories (music therapy?)
5. Lovaas model