Students with Autism Spectrum Disorder Chapter 10 This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of any image over a network; preparation of any derivative work, including the extraction, in whole or in part, of any images; any rental, lease, or lending of the program.

Development of the Field Early belief in “refrigerator mothers” 1981 –distinguished autism and Asperger syndrome 1990 – Autism category added to IDEA 1994 – Autism added to the DSM IV 2013 – DSM only Autism Spectrum Disorder. Dimensional system.

IDEA Definition of Autism Spectrum Disorder …a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects a child’s educational performance.

Autism Spectrum Disorder Persistent deficits in social communication and social interaction across multiple contexts ◦Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions. ◦Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication. ◦Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

Autism Spectrum Disorder Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following: ◦Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases). ◦Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day). ◦Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). ◦Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement). With or without accompanying intellectual impairment With or without accompanying language impairment

Characteristics  Language Development  Ranging from no verbal communication to complex communication  Delayed Language  Receptive vs Expressive Skills  Echolalia  Social Development  Delays in social interaction and social skills  Lack of peer relationships  Failure to spontaneously share enjoyment, interests, and achievements  Lack of reciprocity  Lack of Proxemics

Common characteristics  Repetitive behavior  Fixations, tics, and perseverations. Self stimulatory.  Problem behavior  Self-injurious behavior  Studies indicate the less communication needs are met, the more self-injurious behavior  Aggression  Need for environmental predictability/sameness  Sensory and movement disorders  Intellectual functioning  Approx. 75% have intellectual disabilities

Prevalence of Autism Spectrum Disorder Much controversy about prevalence. No consensus exists. Some organizations say 1 : 166 children; others 1:100 IDEA estimates ~5% of students DSM-V reported rate of 1% of population  Males outnumber females 4 to 1  Increased prevalence in last decade  Greater public awareness  More refined diagnostic procedures

Causes of ASD BiologicalBrain-BasedEnvironmental May be inheritedAbnormalities in cerebellum Controversy over immunization Higher frequency of siblings with autism Abnormalities in frontal and temporal lobes NOTHING has been established! No single gene responsible

Autistic Savant ◦About 10% of the population with autism have splintering skills in areas such as  Mathematical calculations  Memory feats  Artistic and musical abilities  Reading ◦ Hyperlexia– ability to read without formal instruction

Cognitive and Academic Characteristics  Cognitive abilities vary widely  Over-reliance on rote memory  Lacking a theory of mind  Problem solving challenges

Behavior Characteristics Stimulus overselectivity Generalization difficulties

Assessment Intellectual ◦75 % of individuals with autism have mental retardation; IQ norms between Behavioral ◦Behavior screening examples  Childhood Autism Rating Scale; Autism Diagnostic Interview (ADI) ◦Functional behavior assessment  Required by IDEA Functional Assessment ◦Measures skills needed for independent living

Early Childhood Education Typical programs often include:  Intervention prior to age 3  20 – 45 hours of intervention weekly  Active family involvement  Focus on communication and development  Individualized interventions

Educational Placements of Students Ages Six to Twenty-One Who Have Autism Spectrum Disorders (in percentages)

Planning for the Transition to Adulthood Teach work skills Teach self-help skills Teach play, leisure and recreation skills Teach social skills Teach home management skills

Recommended Educational Practices Environmental supports ◦Visual supports Assistive technology Instructional practices ◦Priming - familiarize students with academic material ahead of time ◦Discrete trial training (DDT) - highly specialized approach to teaching skills ◦Prompting - providing physical or verbal cues to specific behaviors

Interventions Applied Behavior Analysis (Lovaas) Discrete Trial Training (DTT) (1) Discriminative Stimulus - the trainer's command (2) the child's response (3) the consequence (reward) (4) a short pause between the consequence and the next instruction (between interval trials). “Copyright© Allyn & Bacon 2006”

Interventions Psychological and Medical Services Sensory Perception Programs address issues of tactile defensiveness or extreme reaction to auditory stimulus Medications used to alleviate symptoms such as aggression, anxiety, or obsessive compulsive disorder, ADHD

Technology ◦Apps for tablets ◦Manual sign language ◦PECS: Picture Exchange Communication System

Social Skills Supports Instruction in social skills Social stories SOCCSS ◦Situation ◦Options ◦Consequences ◦Choices ◦Strategies ◦Simulation

Perspectives of Parents and Families Parents need information and support ◦Need for intensive, early intervention for child ◦Role of parent is very demanding Siblings also need support ◦Siblings play an important role ◦Need resources appropriate to age

Current Needs in the Field of Autism Spectrum Disorder Better techniques for early diagnosis and assessment Evidence-based interventions More programs to train professionals