Autism 101

Presented by Kara BrattonLutheran Special Education Ministries

kbratton@luthsped.org

Autism: Definition

• Autism is a bio-neurological developmental disability that generally appears before the age of 3

• These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors

• “With the May 2013 publication of the DSM-5 diagnostic manual, all autism disorders were merged into one umbrella diagnosis of ASD. Previously, they were recognized as distinct subtypes, including autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome. ”(http://www.dsm5.org/Documents/Autism%20Spectrum%20Disorder%20Fact%20Sheet.pdf)

Autism: Definition

• “People with ASD tend to have communication deficits, such as responding inappropriately in conversations, misreading nonverbal interactions, or having difficulty building friendships appropriate to their age. In addition, people with ASD may be overly dependent on routines, highly sensitive to changes in their environment, or intensely focused on inappropriate items. Again, the symptoms of people with ASD will fall on a continuum, with some individuals showing mild symptoms and others having much more severe symptoms. This spectrum will allow clinicians to account for the variations in symptoms and behaviors from person to person.”

Autism: Characteristics

• Difficulty relating to peers/social skills• Unusual play with toys and other objects• “Obsessive” about area of interest (trains, vacuums,

etc.)• Difficulty with changes in routine or surroundings• Repetitive body movements, behaviors and language• Difficulty using and understanding

language/communication

Autism: Characteristics

• About 40 percent of individuals with ASD have average to above average intellectual abilities.

• About 25 percent of individuals with ASD are nonverbal but can learn to communicate using other means.

Autism: Early Signs

• The characteristic behaviors of autism spectrum disorder may be apparent in infancy (18 to 24 months), but they usually become clearer during early childhood (24 months to 6 years)

• Most obvious signs of autism and symptoms of autism tend to emerge between 2 and 3 years of age

• Any of these “red flags” does not mean a child has autism. But because the disorder’s symptoms vary so widely, a child showing these behaviors should be evaluated by a multidisciplinary team

• Under the DSM-5 criteria, individuals with ASD must show symptoms from early childhood, even if those symptoms are not recognized until later

Autism: Early Signs

• No big smiles or other warm, joyful expressions by six 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 gesturing (pointing, waving bye-bye) 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

Autism: Early Signs

• Doesn’t make eye contact (e.g. look at you when being fed).

• Doesn’t smile when smiled at.• Doesn’t respond to his or her name or to the sound of a

familiar voice.• Doesn’t follow objects visually.• Doesn’t point or wave goodbye or use other gestures to

communicate.• Doesn’t follow the gesture when you point things out.

Autism: Early Signs

• Doesn’t make noises to get your attention.• Doesn’t initiate or respond to cuddling.• Doesn’t imitate your movements and facial expressions.• Doesn’t reach out to be picked up.• Doesn’t play with other people or share interest and

enjoyment.• Doesn’t ask for help or make other basic requests

Autism: Asperger Syndrome

• Major differences • No speech delay in Asperger’s • Children with Asperger Syndrome frequently have good

language skills, just use language in different ways• Speech patterns may be unusual, lack inflection or have a

rhythmic nature, or may be formal, but too loud or high-pitched

• Children with Asperger Syndrome may not understand the subtleties of language, such as irony and humor, or they may not understand the give-and-take nature of a conversation

Autism: Asperger Syndrome

• Difference in cognitive ability• Some individuals with autism have intellectual

disabilities, by definition, a person with Asperger Syndrome cannot have a “clinically significant” cognitive delay, and most possess average to above-average intelligence.

• While motor difficulties are not a specific criterion for Asperger’s, children with Asperger Syndrome frequently have motor skill delays and may appear clumsy or awkward.

Autism: Diagnosis

• Needs to be done by professionals and multidisciplinary team

• Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R)• Online screening tool for toddlers 16-30

months, assesses risk for ASD• http://www.autismspeaks.org/what-autism/

diagnosis/screen-your-child

Autism: Prevalence

http://www.autismspeaks.org/science/science-news/can-rise-autism-be-explained-broadened-diagnosis

Autism: Prevalence

• U.S. Centers for Disease Control and Prevention (CDC) identify around 1 in 68 American children as on the autism spectrum–a ten-fold increase in prevalence in 40 years

• Estimated 1 out of 42 boys and 1 in 189 girls are diagnosed with autism in the United States

• Research shows increase is only partly explained by improved diagnosis and awareness

• No established explanation for this continuing increase, although improved diagnosis and environmental influences are two reasons often considered

http://www.autismspeaks.org/what-autism

Autism: Causes

• No one cause of autism• Most cases of autism appear to be caused

by a combination of autism risk genes and environmental factors influencing early brain development

http://www.autismspeaks.org/what-autism

Autism: Causes

• “In the presence of a genetic predisposition to autism, a number of nongenetic, or “environmental,” stresses appear to further increase a child’s risk. The clearest evidence of these autism risk factors involves events before and during birth. They include advanced parental age at time of conception (both mom and dad), maternal illness during pregnancy and certain difficulties during birth, particularly those involving periods of oxygen deprivation to the baby’s brain. It is important to keep in mind that these factors, by themselves, do not cause autism. Rather, in combination with genetic risk factors, they appear to modestly increase risk.” (http://www.autismspeaks.org/what-autism)

Autism: Strategies

• Provide highly structured and predictable routines and procedures• Prepare for new routines and places

• Understand any behavior “triggers”• Practice transitions• Practice social skills and interacting with peers

(http://www.nationalautismresources.com/autism-social-skills.html)

Autism: Strategies

• Use visual schedules (note changes to schedule visually also)• Autismschedules.com

Autism: Strategies

• Find quiet place for student to go to when needed

• Use sensory items (velcro, fabric books, box with pillows, weighted vests and blankets)• http://www.nationalautismresources.com/

sensory-integration.html

Autism: Strategies

• Visual Timer available through discountschoolsupply.com or

Time Timer App ($2.99)• Transition Box

Autism: Resources

• Autism Resources, search by state:

http://www.autismspeaks.org/family-services/resource-guide• Autism Speaks ToolKits

http://www.autismspeaks.org/family-services/tool-kits• Autism App Finder

http://www.autismspeaks.org/autism-apps

Autism: Resources

• National Autism Resources

http://www.nationalautismresources.com• Autism Now

http://autismnow.org• Little Friends Center for Autism (Chicago)

http://littlefriendsinc.org/LFCA.cfm

• “Not Different Enough” by Gloria Doty • Writingbygloria.com• Book can be purchased at: http://www.amazon.com/Not-

Different-Enough-Intellectual-Disabilities/dp/1491855096/ref=sr_1_1?ie=UTF8&qid=1421196259&sr=8-1&keywords=Not+Different+Enough+Gloria+Doty

Autism: Resources

Kara Bratton, LSEM Resource Center Directorkbratton@luthsped.org 260-385-4033Sign up for our FREE e-newsletters at www.luthsped.org