~ Autistic Spectrum Disorders ~ Martin Galvin Training and Development Officer Behaviour Support Specialist 15 th November 2006 Gheel Autism Services Caring for adults with an Autistic Spectrum Disorder

The terms ‘ autistic ’ and ‘ autism ’ are derived from the Greek word ‘ autos ’, which means self (McKernan and Mortlock, 1995).

LEO KANNER (1943) ‘early infantile autism’ HANS ASPERGER (1944) “ ‘Autistic Psychopathy’ in Childhood” Lorna Wing and Judith Gould (1979) ‘The Triad of Impairments of Social Interaction'

Kanner’s Autism An inability to develop relationships Delay in acquisition of language Non-communicative use of spoken language Delayed echolalia Pronoun reversal

Repetitive and stereotype behaviour Maintenance of sameness Good rote memory Normal physical appearance

Asperger’s Syndrome ( Gillberg and Gillberg, 1989) Social impairment Narrow interest Repetitive routines Speech and language peculiarities Non-verbal communication problems Motor clumsiness

Autistic Spectrum Disorders ‘The continuum’ ____________________________________________ Learning Kanner’s/Classic Able/High Asperger’s Disability Autism Functioning Syndrome Autism 2:1 4:1 8:1 10/13:1

Prevalence National Autistic Society U.K. (1997) 56 per 10,000 Herbert (1998) 4 –13.8 per 10,000 Mental Health Foundation U.K. (2000) 31 – 47 per 10,000

Intellectual Disability Intelligence Quotient __________________________________

Autistic Spectrum Disorder (ASD) Autism Kanner’s or Classic Autism Able or High functioning autism Asperger’s Syndrome (AS) Autistic continuum or Autistic Spectrum Savant

Diagnosing Autism DSM – IV Rev. Diagnostic and Statistical Manual of Mental Disorder, American Psychiatric Association. ICD – 10. W.H.O.,1993. International Classification of Diseases. Gillberg and Gillberg (1989), Gillberg (1991): diagnostic criteria for Asperger’s Syndrome.

Checklist for autism in toddlers (CHAT) Childhood autism rating scale (CARS) Autism diagnostic interview (ADI) Diagnostic interview for social and communication disorders (DISCO)

Triad of impairments (Wing and Gould, 1979) The autistic spectrum disorder is recognised by a combination of three impairments, with varying degrees of severity.

Triad of impairments (Wing and Gould, 1979) Impairment of social interaction Impairment of social communication Impairment of social imagination and play

Impairment of social communication Verbal difficulties: Delay in the development of language Comprehension difficulties Literalness Echolalia Repetitive use of language Language not used for communication, used to meet their needs, make statements and ask questions Talk at others, not with

Non-Verbal difficulties: Failure to convey or comprehend gesture, mime, facial expression, body posture, verbal intonation Failure to read body language e.g. facial expression Gestures that are stiff and stilted or too dramatic or exaggerated

Impairment of social interaction The lack of the inbuilt ability to recognise that other people have thoughts and feelings The Aloof The Passive The active but odd The ‘over formal’ stilted

Impairment of social imagination and play Inability to play imaginatively with objects or toys Resistance to change a likeness for sameness and predictability Ritualistic behaviours – obsessive interests Inability to understand abstract concepts Absence of empathy

Older theories about the causes of autism Psychological explanations: Social class and autism Parenting style (Bettelheim 1903 –1990) Refrigerated mother syndrome

Sensory impairments Hearing Sight Smell Taste Touch Vestibular Proprioceptive

Sensory overload You just get this whole load of sensory impressions … you are going to run full tilt into a wall or into the traffic or harm yourself …… anything to stop the sensory overload happening because I would much rather have pain ….. Its one overriding sensation rather than getting a whole lot of confused jumbles. (Lindsay Weeks)

Theories about the causes of autism Pre-natal factors Peri-natal factors Post- natal factors

Autistic Spectrum Disorders Epilepsy 20% - 35% (Trevarthen et al.,1998)

National Autistic Society U.K. (1997) 56 per 10,000 Herbert (1998) 4 –13.8 per 10,000 Mental Health Foundation U.K. (2000) 31 – 47 per 10,000 Gheel Autism Services Caring for adults with an Autistic Spectrum Disorder Philosophy “If you would help me, don’t try to change me to fit your world. Don’t try to confine me to some tiny part of the world that you can change to fit me. Grant me the dignity of meeting me on my own terms – recognise that we are equally alien to each other, and that my ways of being are not merely damaged versions of yours. Question your assumptions. Define your terms. Work with me to build more bridges between us.” (J. Sinclair : Personal Essay – High Functioning individuals with autism E. Schopler, G. Mesibov, 1992).