1. DrRoNovick@aol.com Summer 2012

2. Bright, academically accomplished middle school student. Referred in 7 th grade for severe social difficulties – doesn’t get along, doesn’t seem interested in socializing, says unusual things, speaks in professorial voice, difficulty working on cooperative learning tasks. More difficult with parents, not listening, argumentative, highly opinionated. Often discusses science facts.

3. Reluctant to work in counseling. Sees no difficulties, feels everyone else has the problem. Seven years later – in college – returns to counseling at his request. Accused of stalking. Doesn’t understand jokes in cafeteria. Wants help being socially appropriate, despite enormous success academically.

4.  Mental Retardation  Intermittent  Limited  Extensive  Pervasive  Rule-out Traumatic Brain Injury  Autism  Asperger’s Disorder

5.  300,000 children in US affected  Was assumed to be rare – 1/10,000  Current incidence – as high as 1/150  Reasons for increased incidence  Better diagnosis  Including Aspergers  Genetic factors  Environmental

6.  Kanner- refrigerator parents – totally debunked  Genetics - Selective breeding  Vaccines – thimerasol controversy  Brain pathology  Limbic (emotion), hippocampal (memory) abnormalities  Cerebellar abnormalities (purkinje cells) –abnormal growth of brain – too many connections

7.  Qualitative impairment in social interaction with at least 2  Impaired use of nonverbal cues, failure to develop peer relationships,lack of spontaneous seeking to share with others, lack of social/emotional reciprocity  Qualitative impairments in communication with at least 2  Delay or lack of language, impaired conversation, stereotyped or repetitive language, lack of play on developmental level  Restricted repetitive and stereotyped patterns of behavior, with at least 1  Preoccupation with one or more restricted pattern of interest, inflexible adherence to routines/rituals, stereotyped motor mannerisms, preoccupation with parts of objects

8.  Qualitative impairment in social interaction with at least 2  Impairment in use of nonverbal behaviors, failure to devel peer relationships, lack of spontaneous seeking to share interests, lack of social reciprocity  Restricted repetitive and stereotyped patterns of behavior, interests, with at least 1  Encompassing preoccupation with stereotyped interests, inflexible adherence to specific routines, stereotyped, repetitive movements, preoccupation with parts of objects  Disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning

9.  Intelligence deficits – ¾ classically autistic children will score 2 s.d. below mean  Impaired language  Need for sameness  Social difficulties/poor relatedness

10.  Delayed language  Echolalia – immediate or delayed  Pronoun reversals  Concrete language (raining cats and dogs)  Tone and inflection difficulties

11.  Infants do not cry to get attention  Not easily cuddled  Poor eye contact  In own world  Poor play skills

12.  Self-stimulation  Self injurious behavior

13.  Milder?  Geek syndrome?  Appear more interested in social interaction

14.  Speech and Language critical – prognosis much bleaker if no speech by age 5  Lovaas work – ABA and related approaches  Social skills – social scripting

15.  http://www.youtube.com/watch?v=JnylM1hI2jc