Autism TLSE 240

History of Autism Leo Kanner of John Hopkins University Observed 11 students and their “tendencies” 1923-1934 Became the first person to formulate an idea that lead to the studies of the prevalence of autism.

Kanner’s Observation Results *A lack of affect or emotional contact with others. *An intense wish for sameness in routines *Muteness or abnormalities in speech *Fascination with manipulating objects *High levels of visuo-spatial skills, but major learning difficulties in other areas *Attractive, alert and intelligence appearance

5 Types of Autism Asperger Syndrome Autistic Disorder Pervasive Developmental Disorder Rett’s Disorder Childhood Disintegrative Disorder

Asperger Syndrome Coined after Dr. Hans Asperger Usually average intelligence Literal language Not due to delay in speech or language development Issues with social skills and unusual behaviors or interests

Pervasive Developmental Disorder Mild problems or problems not occurring in all 3 of these areas: Communication Social skills Unusual behaviors such as restricted range of interests Sometimes used as label for young children

Rett’s Disorders Genetic disorder Coined by Dr. Andreas Rett More common in girls Usually mental retardation Repeated stereotypic hand wringing Loss of muscle control Communication and social deficits

Childhood Disintegrative Disorder Very rare Begin developing normal until age 5 or 6 The, begin regressing Regress in language and social skills Long term outcomes are poor

Incidence/Prevalence U.S., 4-5 individuals per 10,000 World-wide 5-15 per 10,000 Boys outnumber girls 4 to 1. A family with 1 child with autism has a 9% risk of having a second child with autism

Approximations of Autism Prevalence (Feinburg, 2000).

CHARACTERISTICS

Basic Information Spectrum Pervasive Developmental Disorder Mild to severe Any combination in any degree Pervasive Developmental Disorder Not an emotional disturbance Lifelong Seen before the age of three

Additional basic information Senses are over or under-active Aggressive or self-injurious Developmental Delays Cognitive Social Motor

TRAITS Insistence on sameness; resistance to change Difficulty expressing needs; uses gestures or points instead of words Repeats words in phrases in place of normal language Laughs, cry, shows distress for reasons not apparent to others Prefers to be alone, withdrawn

Unresponsive to normal teaching methods Sustained odd play Spins objects/ repetitive actions Inappropriate attachments to objects Difficulty relating with others and situations May not want to cuddle or be cuddled Tantrums

MORE TRAITS Resists learning Resists change in routine Apparent over-sensitivity or under-sensitivity to pain No real fears of danger

Noticeable physical over-activity or extreme under-activity Uneven gross/ fine motor skills Not responsive to verbal cues; acts as if deaf although tests in normal range Little or no eye contact

EXAMPLES Repetitive motions Resistance to change Language Senses

DIAGNOSTIC CRITERIA (I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C) A) Social interaction Marked impairment in the use of multiple non verbal behaviors such as eye to eye gaze, facial expression, body postures, and gestures to regulate social interaction Failure to develop peer relationships appropriate to developmental level Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest) Lack of social or emotional reciprocity

B) Communication Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime) In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others Stereotyped and repetitive use of language or idiosyncratic language Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level C) Restricted repetitive and stereotyped patterns of behavior, interests and activities Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus Apparently inflexible adherence to specific, nonfunctional routines or rituals Stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements) Persistent preoccupation with parts of objects

III) The disturbance is not better accounted for by: II) Prior to age 3 years: Social interaction Language as used in social communication Symbolic or imaginative play III) The disturbance is not better accounted for by: Rett’s Disorder Childhood Disintegrative Disorder

75% have MR 25% have average intelligence 5% Savant – unusual gift or trait 50% never develop functional speech 40% have self-injurious behavior 33% develop seizures

Causes of Autism

No-one knows for sure what causes autism. It is a complex biological disorder, and no two people with autism are the same. Although there is no known unique cause of autism, there is growing evidence that autism can be caused by a variety of problems including: Genetic Influences A Virus The Environment

GENETIC CAUSES There is some indication of a genetic influence on autism There is a greater likelihood that two identical twins will have autism than two fraternal twins. That is because in identical twins there is a 100% overlap in genes, but in fraternal twins there is only a 50% overlap (the same as in non-twin siblings)

Genetic causes continued A great deal of research has focused on locating the “autism gene” however, many researchers speculate that 3 to 5 genes will likely be associated with autism. There is growing evidence that the genetic link to autism may be a weakened immune system. Other research has shown that depression and/or dyslexia are quite common in one or both sides of the family when autism is present.

VIRAL CAUSES There is also evidence that a virus can cause autism. There is an increased risk in having a child with autism, after exposure to rubella during the first trimester. Cytolomegalo virus has also been associated with autism. There is also a growing concern that viruses associated with vaccinations, such as the measles component of the MMR vaccine and the pertussis component of the DPT shot, may cause autism.

ENVIRONMENTAL CAUSES There is growing concern that toxins and pollution in the environment can also lead to autism. There is a high prevalence of autism in the small town of Leomenster, Massachusetts, where a factory manufacturing sunglasses was once located. The highest proportion of autism cases were found in the homes down-wind from the factory smokestacks.

Things the teacher needs to understand Students with autism rarely make eye contact, as a teacher one must understand that this doesn’t mean that they are not paying attention. Communication skills are also poor among children with autism. Keeping that in mind, students with this disability may need other ways of expressing ideas and opinions Students with Autism have a hard time adjusting to new activities and any other thing that disrupts their normal routine. These students often times will repeat certain motor activities such as body rocking and finger flapping. These activities are not done with the intentions of disrupting the classroom.

Ways to insure good communication. Be sure student is paying attention. Use language appropriate for that child and be sure that gestures are paired with verbal commands. All directions must be clear and concise. Is the presentation, as well as the materials, well organized? Are the tasks designed to allow the student to perform at his/her best ability? Next is an example of what a schedual my look like for the students.

8:30 Arrive, put belongings away, and greet others. 8:45 Work session 1 9:30 Work session 2 10:15 Art / P.E. 11:00 Work session 3 11:45 Finish any work and prepare for lunch 12:00 Lunch 12:30 Recess 1:00 Story time 1:35 Work session 4 2:20 Finish any work and prepare to go home 2:30 Dismissal

Ways to make transitions easier: Inform the student ahead of time that “in ten minutes we are going to start a new activity.” Write the time of which one activity will end and the new one will begin on the board. This gives the student a visual. Have the student initiate the changing of subject matter, that way the student is not surprised by the on coming tasks. Provide a list of all planned activities for that day and follow your plan.

Questions you need to ask yourself about your classroom: Is there space available for individual AND group work? Are the work areas in the least distractible settings? Are all visuals able to be seen in each area? Are the work areas always consistent? Can I always see what my students are doing? Are the students materials easily accessible and clearly marked for him or her?