1. 1 Autism and Autism Spectrum Disorder November 12, 2007

2. 2 Definition Complex developmental disability Impairment in: –social reciprocity & communication –behavioral rigidity Usually diagnosed before 30 months –some symptoms evident in infancy

3. 3 Prevalence of Autism 2-6 cases per 1,000 boy:girl, 4:1 No racial or socioeconomic differences –but linked with paternal age growing at a rate of 10-17% / year –but “rate” of mental retardation decreasing proportionately – better diagnosis?

4. 4 Causes Physical symptoms: –Abnormality of brain patterning (Owens, 1999), most often in cerebellum –Abnormal (ERP) response to auditory stimuli (Rapin & Dunn, 2003) Likely genetic component (Pericak-Vance, 2003) Can be caused by congenital rubella & other neurological conditions (Lauritsen & Ewald, 2001)

5. 5 Autistic Spectrum Disorders –Autistic Disorder –Asperger's Disorder (hard to distinguish from high-functioning autism) –Childhood Disintegrative Disorder (CDD) –Rett's Disorder –PDD-Not Otherwise Specified (PDD- NOS)

6. 6 Characteristics of Autism –Insistence on sameness; resists change –Difficulty in expressing needs –Repetitive, not communicative language –Little or no eye contact –Prefers to be alone –Tantrums –May not want to cuddle or be touched –Laughing, crying, showing distress for reasons not apparent to others –Inappropriate attachments to objects –Don’t succumb to visual illusions

7. 7 The Ebbinghaus Illusion (from Frith, 2003)

8. 8 Intellectual ability May perform above average on memory or spatial tasks May be talented in music or drawing 1/3 have IQ>70 Savants –ten times more common in people with autism than in others with mental handicap –occurring in approximately one in ten individuals with autism

9. 9 Language-related development Joint attention, eye gaze –At 1 st birthday, children later diagnosed with ASD lacked: (Osterling & Dawson, 1994) pointing & showing activity looking at faces of others normal response to hearing name called Symbol use –Fail to develop symbolic play –Difficulty learning verbal labels for concepts –Trouble with waving & pointing

10. 10 Language-Related Development Theory of Mind: –Understanding intentions and mental states of others Impairments –don’t produce/understand mental state words (Tager-Flusberg, 1992, Baron-Cohen et al., 1994) –fail to make accidental-intentional distinction (Phillips, 1993) –unable to deceive (Baron-Cohen, 1992) –don’t understand intentionally non-literal statements (Happé, 1994) –Causes impairment in vocabulary development! don’t follow speaker’s eye gaze when hear new word – scan own visual field

11. 11 Language development Delayed & deviant Don’t engage in prelinguistic conversation Only half of autistic population develops expressive language at all (Bailey, Phillips, & Rutter, 1996) –Language success closely associated with IQ Narrow range of grammatical constructions –little use of questions, mental state verbs Impaired in nonsense word repetition

12. 12 Language development Echolalia –immediate vs. delayed –often “mitigated” – not exact, with minor changes in structure –indicates difficulty in comprehension Pronominal reversal –e.g. 'do you want a drink' instead of ‘I want a drink' Use of '-ing' –'daddy piping', 'boy bubbling' (boy blowing bubbles) - 9 yr old autistic girl (Wing, 1976)

13. 13 Diagnosing Autism The NICHD lists these five behaviors that signal further evaluation is warranted: –Does not babble or coo by 12 months –Does not gesture (point, wave, grasp) by 12 months –Does not say single words by 16 months –Does not say two-word phrases on his or her own by 24 months –Has any loss of any language or social skill at any age.

14. 14 Language outcomes strongly related to the amount of speech-language intervention a child receives (Stone & Yoder, 2001) Applied behavior analysis (ABA) –Child’s interests guide selection of targets & activities –Effective in changing IQ, adaptive behavior, & language –Improved communication  reduced aggressive & socially inappropriate behaviors –Most effective if administered by clinicians (Bibby et al., 2001) Treatment

15. 15 Prognosis Best predictors of success in language acquisition: (Toth et al., 2006) –3 - 4 y.o. joint attention immediate imitation of motor movements –4.5 - 6 y.o. pretend play deferred imitation of motor movements Intervention studies show preliminary success (Kasari et al., 2004)