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Autism and Autism Spectrum Disorders (ASD)

Also called Pervasive Developmental Disorders

A Spectrum of five different disorders, ranging in level of disability from mild to severe Autistic Disorder (Autism)

Asperger Syndrome

Rett Syndrome

Childhood Disintegrative Disorder

Pervasive Developmental Disorder Not Otherwise Specified (PDD – NOS)

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A Person with Autism Spectrum Disorder May Present with the

Following Behavioral Characteristics:

• Not respond to their name by 12 months

• Not point at objects to show interest (point at an airplane flying over) by 14 months

• Not play “pretend” games (pretend to “feed” a doll) by 18 months

• Avoid eye contact and want to be alone

• Have trouble understanding other people’s feelings or talking about their own feelings

• Have delayed speech and language skills

• Repeat words or phrases over and over (echolalia)

• Give unrelated answers to questions

• Get upset by minor changes• Have obsessive interests• Flap their hands, rock their

body, or spin in circles• Have unusual reactions to

the way things sound, smell, taste, look, or feel

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Diagnosis

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• The American Psychiatric Association's Diagnostic and

Statistical Manual of Mental Disorders is the main

diagnostic reference used by mental health

professionals and insurance providers in the United

States. The diagnosis of autism requires that at least six

developmental and behavioral characteristics are

apparent, that problems are evident before age three,

and that there is no evidence for certain other conditions

that are similar.

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History •1911 – Autism formally identified and labeled by Eugen Bleuler, a psychiatrist who described the condition as “self-absorption caused by poor social relatedness”

•1911 through 1960 – Autism commonly considered a form of schizophrenia

•1943 – Leo Kanner, a psychoanalyst, publishes Autistic disturbances of affective contact, which describes 11 children who display signs of unusual development. It is one of the first documented studies of individuals displaying Autistic characteristics.

•1944 – Hans Asperger formally identifies and labels Aspergers Syndrome

•1965 – Bernard Rimland a psychologist, publishes Infantile Autism, which proposes that Autism is a neurodevelopmental condition. Rimland establishes the Autism Society of America

•1967 – Autism formally classified under schizophrenia in the International Statistical Classification of Diseases and Related Health Problems

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History, cont’d• 1980 - Autism formally identified as a unique disorder, separate from

schizophrenia, by the American Psychiatric Association

• 1990 – Autism is first considered a disability under the Individuals with Disabilities Education Act

• 1991 – Autism is officially added to the list of covered disabilities in the Individuals with Disabilities Education Act

• 2004 – The National Institute of Mental Health estimates that the prevalence of ASD range from 2 to 6 per 1,000 children

• 2007 – The Centers for Disease Control estimates the prevalence of ASDs to be 1 in 150 children

• 2010 – Autism Speaks estimates that 1 in every 110 children is diagnosed with Autism

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Causes

• There is no known cause for developing an Autism Spectrum Disorder

• There are likely many different factors that make a child more likely to have an ASD, including environmental, biologic, and genetic factors

• Much research is currently being done in an attempt to identify the causes of the disorder

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Current Research 

•Psychodynamic brain-based disorder•Onset must occur before a child’s third birthday•In 1990, the US mandated to add autism and traumatic brain injury (TBI) to the classification of children receiving special education services. In subsequent years, the number of children receiving special education services diagnosed autistic were far greater than TBI.•Children are no longer being considered in the MR category. Autistic children have gone from showing forms of mental retardation at 75% down to 40%. •Evidence shows that vaccinations are not a contributing factor to the cause of autism or the increase in the number of children being diagnosed•It appears there is a genetic component: if one identical twin has autism then the likelihood of the other twin having autism is 69-95%•Research indicates that intervention started before 3.5 years of age is more effective than intervention started after 5 years of age•Mute children who receive quality, early behavioral intervention, between 75-95% learn to talk

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Current Research, cont,d

 

•Majority of individuals with ASDs may have IQs in the cognitively disabled or mentally retarded range

•Nonverbal levels of autistic children can be over 50%. 

•Over-activity at the level of the synapse and the balance of local versus long-range connections was skewed in autism in favor of strong local connections but weak long-range connections between distant brain regions. Complex behavior, such as language and social interaction, depend upon such long range connections

•Differences in axons and their insulation may explain disrupted communication in autism

•PTCHD1 gene mutation may disrupt crucial developmental processes, contributing to the onset of autism. Identification of a male-linked genetic mutation begins to address the previously unknown basis for often reported skewed male to female ratio in autism.

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Characteristics Social Symptoms

• Difficulty learning to engage• Avoid eye contact• Prefer being alone• Fail to seek comfort• Subtle social cues have little meaning• Difficulty seeing things through another’s

perspective• Difficulty regulating emotions• Can be disruptive/physically aggressive

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CharacteristicsCommunication Difficulties

• Use language in unusual ways• Cannot form meaningful sentences• Repeat or “parrot” • Exchange of conversion is hard• Inability to understand body language, tone of

voice, or “phrases of speech • Facial expressions, movements, and gestures

may not match what they are saying • May simply grab or scream at what they want• Can appear anxious and/or depressed

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CharacteristicsRepetitive Behaviors

• Odd repetitive motions may set them apart from other children

• Might be extreme and highly apparent or more subtle • Spend hours lining up their cars and trains in a certain

way, rather than using them for pretend play• Many children with autism need, and demand, absolute

consistency in their environment • A slight change in routines can be extremely stressful• Persistent, intense preoccupation

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Medical Issues That May Accompany Autism

• Seizure Disorders– Epilepsy occurs in as many as 39% of people with autism

• Genetic Disorders– identifiable neurogenetic condition such as Fragile X Syndrome, Angelman's

Syndrome, a neurocutaneous disorder called Tuberous Sclerosis, Chromosome 15 Duplication Syndrome or another chromosomal abnormality

• Gastrointestinal Disorders– between 46 and 85% of children with autism have problems such as chronic

constipation or diarrhea.

• Sleep Dysfunction– evidence of abnormality of melatonin regulation in children with autism

• Sensory Integration Dysfunction – unusual responses to sensory stimuli, or input

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Educational Implications Social Interactions

• difficulty engaging in and maintaining normal social contact (including friendships)

• lack of empathy - insensitivity to the feelings and needs of others• inappropriate use of facial expressions and body language• little awareness of personal space• difficulty with interpreting non-verbal language (e.g. body language)• lack of or abnormal eye contact• inappropriate and naive social interactions• lack of or difficulty displaying affection.

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Educational ImplicationsCommunication Skills

• poor language comprehension as compared to expressive language

• difficulty understanding non-verbal communication• difficulty with symbolic or abstract language• delays in speech acquisition• unusual speech patterns (e.g. rhythm, pitch, intonation)• echolalia - repetition of speech• difficulties initiating and sustaining conversations• difficulty listening and following directions when given to

whole class.

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Educational ImplicationsRestricted Interests and Behavior

Implications• may find surroundings confusing and unpredictable• difficulties 'making sense' of classroom and/or learning activities• changes in routines and/or environment may cause anger, fear,

irritation and stress• obsessive behavior in relation to interest, hobbies and objects• insistence on sameness and resistance to change• ritualistic behavior e.g. taking same route to places• impaired creative and imaginative play• inappropriate attachment to objects• needing help but not knowing how to communicate need or who to

go to for help.

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Educational ImplicationsSensory Processing Implications

• variable sensitivities depending upon situation and individual stress threshold

• delayed reaction/response• anger, stress, or anxiety reactions• auditory system (hearing) e.g. makes sounds to screen out unwanted noise• visual system (sight) e.g. sensitive to pulsations in lighting• tactile system (touch) e.g. avoids touch or contact• olfactory system (taste & smell) e.g. dislike of strong smells such as perfume• vestibular system (movement, balance, gravity) e.g. oblivious to danger of

heights• proprioceptive system (movement, one's own position) e.g. exerts too much

pressure when handling objects• gustatory (taste) e.g. only eats certain food.

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Strategies

• Forget what you think you know - chances are you’re wrong anyway!

• Allow for and create order for ASD students when possible. – Visual distractions can be an issue. – Be aware of loud/harsh sounds and how they can

affect an autistic student. – “Some nonverbal children and adults cannot process

visual and auditory input at the same time. They are mono-channel.” (Grandin, 2002)

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Strategies, cont’d

• Sequence is often a challenge for students with Autism, so try not to use lenthy sets of instructions.

• Celebrate their skills: visual, concrete skills like art and computer programming are often strengths.

• Use fixations to drive success with school work. • Allow typing rather than manual note-taking. • Help ASD students to develop social skills they

lack.

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Strategies, cont’d

• Allow the way subjects are taught to be adjusted.

• Use concrete language. – Flashcards with words and pictures of what the words

represent on the card are very effective.– “Use concrete visual methods to teach number

concepts.” This is closely related to using concrete language, but adds the necessity of tying the idea to teaching mathematics: using picture problems and adding/taking away items to teach addition and subtraction is vital.

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References• Autism Resources. (2004). Autism FAQ – History. Retrieved from http://www.autism- resources.com/autismfaq-

hist.html• Autism Society of America. (2009). What is Autism? Retrieved from http://www.autism-

society.org/site/Page/server?pagename=about_whatis• Autism Speaks, Be Informed, What is Autism, Symptoms of Autism. Autism Speaks, Home Page. Retrieved

November 22, 2010, from <http://www.autismspeaks.org/whatisit/symptoms.php> • Autism Speaks Inc. (2010). What is Autism. Retrieved from http://www.autismspeaks.org/whatisit/index.php• Genetic Finding Identifies Male-Linked Mutation Associated With Autism Spectrum Disorders. (n.d.). Autism

Speaks, Home Page. Retrieved November 22, 2010, from <http://www.autismspeaks.org/press/male_linked_mutation_autism.php>

• What lies beneath: differences in brain connections « Autism Speaks Official Blog. (n.d.). Autism Speaks Official Blog. Retrieved November 22, 2010, from <http://blog.autismspeaks.org/2010/11/11/what-lies-beneath- brain-connections/?utm_source=autismspeaks.org&utm_medium=web&utm_campaign=sciencenews>

• Autism Watch: Your Scientific Guide to Autism. (2010). DSM – IV Criteria for Diagnosing Autism. Retrieved from http://www.autism-watch.org/general/dsm/shtml

• Baker, J.P. (2008). Public Health Then and Now. Mercury, Vaccines, & Autism: One Controversy, Three Histories. American Journal of Public Health. Retrieved from http://ajph.alphapublications.org/cgi/content/full/98/2/244

• Betts, S. W., Betts, D. E. and Gerber-Eckard, L. N. (2007) Asperger syndrome in the inclusive classroom. London: Jessica Kingsley.

• Booth, T. & Ainscow, M. (2000) Index for Inclusion. Bristol: Centre for Studies in Inclusive Education.• Butler, L. (2010, October). Autism. Foundations of Special Education. Lecture conducted at Manhattanville College

School of Education. Purchase, NY, USA.• Centers for Disease Control and Prevention. (2010). Autism Spectrum Disorders (ASDs): Facts About ASDs.

Retrieved from http:www.cdc/gov/ncbddd/autism/facts/html

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References, cont’d• "What are the educational implications?." Education Queensland. N.p., n.d. Web. 22 Nov. 2010.

<http://education.qld.gov.au/studentservices/learning/disability/generalinfo/asd/asd1.html>• Grandin, T. (2002, December). Teaching Tips for Children and Adults with Autism. Retrieved from

http://www.autism.com/ind_teaching_tips.asp• Gray, C. (2007). What Are Social Stories? Retrieved November 19, 2010 from

http://www.thegraycenter.org/social-stories/what-are-social-stories• Humphrey, N. (2008, February). Including pupils with autistic spectrum disorders in mainstream schools. Support

for Learning, 23(1), 41-47.• "NIMH · What Are the Autism Spectrum Disorders?." NIMH · Home. N.p., n.d. Web. 22 Nov. 2010.

<http://www.nimh.nih.gov/health/publications/autism/what-are-the-autism-spectrum-disorders.shtml>.• Schizophrenia.Com. (2010). History of Schizophrenia. Retrieved from http://www.schizophrenia.com/history• Shaw, Evelyn, and Brian A Boyd. "Autism in the Classroom: A Group of Students Changing in Population and

Presentation." Preventing School Failure 54.4 (2010): 211-219. Print. • Taylor, R.L., Smiley, L.R., and Richards, S.B. (2009) Exceptional Students: Preparing Teachers for the 21st

Century. New York, NY: McGraw Hill• Temple Grandin. (n.d.). In Wikipedia. Retrieved November 19, 2010 from

http://en.wikipedia.org/wiki/Temple_Grandin • http://www.txautism.net/docs/Guide/Introduction/EducationalImplications.pdf• The Washington Post. (2008). Some Key Dates in Autism History. Retrieved from

http://www.washingtonpost.com/wp-dyn/content/article/2008/06/27/AR2008062703062.html

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