1 What is ASD? Parent Information Session

2 Aim for today…. To learn about and increase understanding of ASD and how it manifests itself in everyday life

3 Autism Spectrum Disorder ‘ASD is a complex developmental disability that essentially affects the way a person communicates and relates to people’ ‘Autism is a lifelong developmental disability that affects how a person communicates with and Relates to other people. It also affects how they make sense of the world around them’

4 Autism? Asperger’s Syndrome? High Functioning Autism? Autism Spectrum Disorder

5 Is ASD new? Leo Kanner first identified Autism in 1943 Hans Asperger 1944 Lorna Wing and Judith Gould 1978 – ‘Triad of Impairment’

6 What causes ASD? At the minute – exact causes are unknown Neurological and developmental condition

7 What we do know…….. It is not due to poor parenting It is not a learning difficulty It is not a mental health difficulty ASD is hidden – there are no physical characteristics

8 Prevalence (how common is ASD) For every 100 children approximately 1 will have a diagnosis of ASD Average age of diagnosis (age group 2-18) is 9 Years 2 Months ( Gillian Gamble, 2010) Ratio Boys : Girls 1:5 (Gillian Gamble, 2010)

9 Co-existing difficulties ADHD Dyspraxia Semantic Pragmatic Disorder Anxieties, phobias and obsessive compulsive tendencies Depression Fragile X

10 Triad Of Impairment Social Communication Imagination & Flexibility of Thought Social Interaction ASD

11 Social Communication

12 Social Communication Understanding of language Expressive language – saying words and sentences How we say words and sentences – speech sounds, tone of voice, intonation, volume, rate Communication without words – eye contact, gesture, facial expression, body posture

13 In ASD…… Understanding of Language Focusing attention and listening, can be easily distracted by environmental noises Abstract phrases are ‘learned’ (idioms) Understanding of questions Literal understanding – process meaning of words, not speakers intention

14 ‘I say what I mean but I don’t always mean what I say’ Alice in Wonderland, Lewis Carrol

15 In ASD…… Expressive language Immediate and delayed echolalia Uses words and phrases in an unusual way or out of context Expressive language may be more advanced than receptive language Vocabulary Difficulties Struggles to offer social information spontaneously

16 Non-Verbal Communication Over 50% of our communication is non –verbal Children and young people with ASD have difficulties understanding and using non-verbal communication It is just as important for a child to learn to understand and use non-verbal communication as it is to understand and use words.

17 In ASD….. Non verbal communication Intonation used inconsistently and contradicts the meaning of words and phrases Incorrect volume to setting Unusual / lack of rhythm to speech Struggles to use voice skilfully to communicate enthusiasm, boredom, worry etc

18 Non-Verbal Communication continued…. Avoids eye contact with others or stares too much at others Facial expression may be flat / unchanging or overly animated Gesture may be absent from communication

19 Social Interaction

20 Social Interaction Style of interaction Getting others attention and starting interaction Sharing interests and enjoyment Reciprocal two way conversation Making and keeping friendships How to respond in different settings with different people – reading the ‘social cues’ Empathy

21 Styles of interaction in ASD The aloof groupThe passive group The ‘active but odd group’ The over-formal ‘stilted’ group

22 In ASD, getting others attention and starting interaction Younger children May not establish attention Rely on adults to ‘figure out’ what they want Physically give objects Be overly physical ATTENDING to others Do not respond to name Unaware that others are attending to them

23 Older children with ASD……… Aloof group may be very direct when wanting needs met Passive group may not attempt to get others attention or make undirected comments and struggle to establish others attention Active but odd group Some attempts appear slightly unusual but may be trying to get others attention Over formal-stilted group May use adult like phrases to establish others attention

24 Sharing interests and enjoyment Interests can be intense and not typical Can be a barrier but can also be used to engage Enjoyment often not shared (verbally or non- verbally)

25 Reciprocal (two way) conversations Difficulties starting a conversation Struggle to be flexible in responding to the person they talk to Miss the subtle rules of conversations (taking turns) Struggle to use conversation to share, negotiate and compromise

26 Making and keeping Friendships Friendships can be difficult for children with ASD ‘The child with Asperger’s Syndrome usually has a concept of friendships that is immature and at least two years behind that of his/her age peers’ (Attwood 2003) Consider child’s friendship needs, they may not be similar to yours

27 Reading the Social Cues Social Responses in ASD Treat adults and peers similarly Struggle to adjust interaction to setting State the obvious (often factually accurate but socially insensitive) May learn social niceties but struggle to use spontaneously Maybe described as ‘socially awkward’ or ‘socially clumsy’

28 Emotions & Empathy Children and young people with ASD experience emotions but their ‘emotional maturity is usually behind their peers’ (Attwood) Expressing emotions is often difficult for children & young people with ASD – both verbally and non-verbally Children & young people with ASD struggle to interpret others facial expressions They may appear insensitive to others feelings but it’s rarely an intentional insensitivity – it’s due to lack of skill and awareness

29 Life tends to be either ‘happy’ or ‘not happy’, ‘angry’ or ‘not angry’. All the in between emotions on the continuum get missed. I jump from being calm to panic in one major step. Lawson 2001

30 Until recently I always believed that if someone close to me was ‘angry’ then it must be because of me. Lawson 2001

31 Imagination & Flexibility of Thought

32 Imagination & Flexibility of thought Play Interests Creativity Flexibility Rule bound Routines

33 Play in ASD Play skills are often delayed and may often be ‘stereotyped’ Children with ASD are often drawn to objects in environment in a non-play way (e.g. doors, light switches) Often need to ‘learn’ how to play and may rely on imitation

34 Creativity Play sequences maybe highly repetitive or sensory based Role play may be present but often imitation from TV or other settings. Often have difficulty creating ideas in play (or response to questions) that are not related to own personal experience

35 Flexibility & Rules Play skills may be evident but lack flexibility to take on others ideas in play or repeat play across environments. Winning is OK, loosing is not… Strong sense of injustice Need to finish activities

36 Routines Strong liking for routine but often due to lack of flexibility, creativity and ability to figure out social cues that inform what will happen next. Problems coping with unexpected events Some routines and rituals are developed over time to ease anxiety and regain control

37 Mannerisms

38 ASD and Sensory Processing Research indicates that sensory difficulties are a salient part of ASD A greater understanding of the sensory world of individuals on the spectrum allows us to help them develop in a more comfortable environment.

39 the problems arise not so much from Asperger’s syndrome itself, as from a SOCIAL world which is not designed for people with Asperger’s syndrome but for people who think and perceive the world in very different ways’ (Claire Sainsbury)

40 Autism is not just a label but a signpost