• In its purest form the definition of autism is a mental
condition, present from early childhood, characterized
by great difficulty in communicating and forming
relationships with other people and in using language
and abstract concepts. Special usage: a mental
condition in which fantasy dominates over reality, as a
symptom of schizophrenia and other disorders.
• Autism Spectrum Disorders is a group of 5 childhood
developmental disorders characterized by varying
degrees fo impairment in communication skills, social
interactions, and restricted, repetitive and stereotyped
patterns of behavior.
• The disorders can often be accurately detected by 3
years of age and sometimes earlier to 1 year of age.
Warning signs of ASD is reason enough to not wait
and have a child evaluated by a professional
specializing in these disorders.
• There are three main types of autism spectrum disorder, and
two rare, severe autistic-like conditions:
• Asperger's syndrome
• Pervasive developmental disorder, not otherwise specified
(PDD-NOS)
• Autistic disorder
• Rett's syndrome
• Childhood disintegrative disorder
• Asperger's Syndrome
• The mildest form of autism, Asperger's syndrome affects boys
three times more often than girls. Children with Asperger's
syndrome become obsessively interested in a single object or
topic. They often learn all about their preferred subject, and
discuss it nonstop. Their social skills are markedly impaired,
though. They are often awkward and uncoordinated physically.
• Because Asperger's syndrome is mild compared to other autism
spectrum disorders, some doctors call it "high-functioning
autism." As children with Asperger's syndrome enter young
adulthood, though, they are at high risk for anxiety and
depression.
• This mouthful of a diagnosis applies to most children with autistic spectrum
disorder. Children whose autism is more severe than Asperger's syndrome but
not as severe as autistic disorder are diagnosed with PDD-NOS.
• Autism symptoms in kids with PDD-NOS vary widely, making it hard to
generalize. Overall, compared to children with other autistic spectrum
disorders, children with PDD-NOS have:
• impaired social interaction -- like all children with autistic spectrum disorder
• better language skills than kids with autistic disorder, but not as good as
those with Asperger's syndrome
• fewer repetitive behaviors than children with Asperger's syndrome or autistic
disorder
• a later age of onset
• However, no two children with PDD-NOS are exactly alike in their symptoms.
In fact, there are no agreed-upon criteria for diagnosing PDD-NOS. In
effect, if a child seems autistic to professional evaluators but doesn't meet all
the criteria for autistic disorder, he or she has PDD-NOS.
• Children who meet more rigid criteria for a diagnosis of autism
have autistic disorder. They have more severe impairments
involving social and language functioning, as well as repetitive
behaviors. Often, they have mental retardation and seizures as
well.
• There are two rare, severe forms of autistic spectrum disorder
that are considered separately from the others: Rett's syndrome
and childhood disintegrative disorder.
• Almost exclusively affecting girls, Rett's syndrome is rare. About
one in 10,000 to 15,000 girls develop this severe form of
autism. Between 6 and 18 months of age, a little girl stops
responding socially, wrings her hands habitually, and loses
language skills. Coordination problems appear and can
become severe.
• Rett's syndrome is usually caused by a genetic mutation. The
mutation usually occurs randomly, rather than being inherited.
Treatment focuses on physical therapy and speech therapy to
improve function.
• The most severe autistic spectrum disorder, childhood
disintegrative disorder (CDD), is also the least common.
• After a period of normal development, usually between age 2
and 4, a child with CDD rapidly loses multiple areas of function.
Social and language skills are lost, as well as intellectual
abilities. Often, the child develops a seizure disorder. Children
with childhood disintegrative disorder are severely impaired
and don't recover their lost function.
• Fewer than two children per 100,000 with an autistic spectrum
disorder meet criteria for childhood disintegrative disorder.
Boys are affected by CDD more often than girls.
• Changes in criteria for diagnosis, along with increased
recognition by professsionals and the public has
increase the number of children diagnosed with ASD.
• Risk is 3-4 times higher in males than females.
• 3.4/1000 children between ages 3-10 years are
affected.
• Because of its relative inaccessibility, scientists have only recently
been able to study the brain systematically. But with the emergence
of new brain imaging tools—computerized tomography (CT), positron
emission tomography (PET), single photon emission computed
tomography (SPECT), and magnetic resonance imaging (MRI), study of
the structure and the functioning of the brain can be done. With the
aid of modern technology and the new availability of both normal
and autism tissue samples to do postmortem studies, researchers will
be able to learn much through comparative studies.
• Postmortem and MRI studies have shown that many major brain
structures are implicated in autism. This includes the cerebellum,
cerebral cortex, limbic system, corpus callosum, basal ganglia, and
brain stem. Other research is focusing on the role of neurotransmitters
such as serotonin, dopamine, and epinephrine and genetic
rearrangements.
• Higher than normal levels of serotonin may contribute to the
development of autism spectrum disorders. According to The National
Autistic Society in the U.K., between 30 percent and 50 percent of
children with autism have higher than normal blood serotonin levels.
• It appears that children with autism produce an overabundance of
serotonin and their brains aren't able to utilize it effectively.
• Serotonin is a neurotransmitter that contributes to the healthy development of the central nervous system. At healthy levels, it is best
known for its enhancement of well-being and improvement of mood.
• Serotonin has significant effects on sensory perception, in the functions
of sensation, sight, sound, smell and taste.
• Serotonin also affects regulation of body temperature and energy
levels. It influences aggression, sleep and social behavior.
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• Serotonin is manufactured by the body from an amino acid
called tryptophan. Foods high in tryptophan are bananas,
pecans, pineapples, plums and tomatoes as well as breads,
pastas, some cheeses, nuts and seeds. Avoiding these foods can
help to reduce serotonin levels.
• Children may seem different right from birth or may develop
normally then will withdraw. Research has shown that parents
are usually correct about noticing some developmental problem
even though they may not understand the specific nature of
what is different or not right about the child.
• A young child may become withdrawn or unresponsive to social
situations and one-on-one contacts. autism may be
accompanied by sensory disturbances, seizures and mental
retardation.
• All children with ASD have difficulty with social interactions,
verbal and non-verbal communications, and repetitive behaviors
or interests. Additionally, they may have unusual responses to
sensory experiences. The symptoms can be mild or severe and
present in each child differently. Presentation of the symptoms
can be seen at birth but more often between 12 and 36 months.
• Possible Indicators of ASD in infants and toddlers:
• Does not babble, point, or makes meaningful gestures by 1
year of age.
• Does not speak one word by 16 months.
• Does not combine two or more words by 2 years.
• Does not respond to name.
• Loses language or social skills.
• Poor eye contact.
• Does not seem to know how to play with toys.
• Excessively lines up toys or other objects.
• Is attached to one particular toy or object.
• Does not smile.
• At times seems to be hearing impaired.
• Difficulty learning to engage in give and take every day human
interactions.
• Seem indifferent to people. Seldom see comfort or resists attention
or cuddling.
• Miss subtle social clues such as a wink or a smile. Common phrases
have no emotional context. For example: Come here whether said
with upbeat excitement or with frustration/anger is the same to the
child.
• Cannot understand another person's viewpoint, leaving them without
the ability to interpret someone's intentions.
• May have difficulty regulating their own emotions. Labeled as
immature.
• The earlier the diagnosis the better. Research over the last 15
years indicates that intense early intervention for at least 2
years during preschool age improved outcomes in most young
children with ASD.
• As part of a child’s well child checkup, a developmental
screening should be done. There are several tools that are
available for toddlers and preschoolers to evaluate for
potential or actual developmental problems. If a problem is
noted the next step is to have a full evaluation by experts in the
field.
• There is no specific treatment. Experts agree that the earlier
the start in a well structured special program the better. The
child should have an IEP or Individual Educational Plan which is
tailored to the specific strengths and weaknesses of the child.
• Be consistent. Children with autism have a hard time adapting
what they’ve learned in one setting (such as the therapist’s
office or school) to others, including the home. Creating
consistency in the child’s environment is the best way to reinforce
learning. Find out what the child’s therapists/parents/teachers
are doing and continue their techniques as closely as possible.
• Stick to a schedule. Children with autism tend to do best when
they have a highly-structured schedule or routine. If there is an
unavoidable schedule change, prepare your child for it in
advance.
• Reward good behavior. Positive reinforcement can go a long
way with children with autism, so make an effort to “catch them
doing something good.
• Create a home safety zone. Carve out a private space where
the child can relax, feel secure, and be safe. This will involve
organizing and setting boundaries in ways the child can
understand. Visual cues can be helpful (colored tape marking
areas that are off limits, labeling items with pictures). May also
need to safety proof the environment, particularly if the child is
prone to tantrums or other self-injurious behaviors.
• Look for nonverbal cues. Pay attention to the kinds of sounds
they make, their facial expressions, and the gestures they use
when they’re tired, hungry, or want something.
• Figure out the need behind the tantrum. When children with
autism act out, it’s often because the caretaker is not picking up
on their nonverbal cues. Throwing a tantrum is their way
communicating their frustration and getting your attention.
• Make time for fun. A child coping with autism is still a kid. For
both children with autism and their parents, there needs to be
more to life than therapy. Figure out ways to have fun together
by thinking about/listing the things that make the child smile,
laugh, and come out of their shell.
• Pay attention to the child’s sensory sensitivities. Many
children with autism are hypersensitive to light, sound, touch,
taste, and smell. Other children with autism are “under-sensitive”
to sensory stimuli. Figure out what sights, sounds, smells,
movements, and tactile sensations trigger “bad” or disruptive
behaviors and what elicits a positive response. What does the
child find stressful? Calming? Uncomfortable? Enjoyable? Adjust
the environment as needed.
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A good treatment/teaching plan will:
Build on the child's interests.
Offer a predictable schedule.
Teach tasks as a series of simple steps.
Actively engage the child's attention in highly structured
activities.
• Provide regular reinforcement of behavior.
Involve the parents.
• Source: National Institute of Mental Health
• http://www.specialed.us/autism/index2.htm
Autism: Interventions and Strategies for Success
• TEACCH (Information on practices and other ideas)
www.unc.edu/depts/teacch
• Carol Gray (Information on Social Stories)
www.thegraycenter.org
• Visual Supports and other free supplies
www.do2learn.com
www.usevisualstrategies.com
http://card.ufl.edu/visuals
• Free online reading books/following directions for students and
beginning sounds
www.starfall.com
• Free Resources from the Net for (Special) Education
http://paulhami.edublogs.org/
This is an example of making a visual boundary on a table/area that
many students share.
This is an example of a matching activity with functional signs.
This is an example for a student who needs to ask for help, the adult wears
this “bracelet” and the student matches their help card to the bracelet and
help is then given.
This is an example of a transition stage so the student can visually see when
it is time to change activities or areas.
This is an example of a “choice” board for break/play time.
This is an example of a schedule where a student is able to use
first/then, a finished envelope, and also carry needed supplies in the
binder.
• The basic tenet of Montessori education is that a child learns best in
an enriched, supportive environment through exploration, discovery
Children are encouraged to pursue their interests, make responsible
choices for themselves and direct themselves to constructive activities.
• In Indianapolis, the public schools have a Montessori Magnet-Option
schools for grades K-8. Parents in the Indianapolis Public School
district with children that have Asperger's or ASD are encouraged to
apply to these schools. They have shown incredible success with both
the children that are profoundly autistic (they are in a separate
program within the school) and those with high-functioning ASD are
mainstreamed in the classrooms, with pull-out assistance for special
areas.
• Montessori principles and applications can work for autistic
children with some modifications. Testimonies from parents and
teachers are generally positive.
• It is similar in terms of the curriculum and classroom layout. It
uses the same materials with the same task analysis techniques.
The difference is how it is taught. The child is taught working
one-to-one, with prompting and reinforcement schedules based
on each step of the task analysis. In addition there are set
programs/activities that the child must do each day. This is
different to a typical Montessori approach which allows the
child to have choice and to be shown a presentation before
using the activity.
• Call the National Dissemination Center for Children with
Disabilities at 1-800-695-0285
• http://www.nichcy.org/Pages/StateSpecificInfo.aspx?State=MA
Listings of state agencies for the state of Massachusetts
• http://www.nectac.org/default.asp
Search the Early Intervention State Contact List from the National
Early Childhood Technical Assistance Center.
• http://idea.ed.gov/explore/home
U.S. Department of Education’s IDEA web site. Provides
background on goals and regulations from DOE.
• http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002494/
PubMed/ National Center for Biotechnology Information, U.S.
National Library of Medicine, 8600 Rockville Pike, Bethesda
MD, 20894 USA
• http://www.nimh.nih.gov/health/topics/autism-spectrumdisorders-pervasive-developmental-disorders/index.shtml
The National Institute of Mental Health (NIMH) is part of the
National Institutes of Health (NIH)
• http://www.empowher.com/autism/content/autism-and-effectsserotonin?page=0,1
Autism and The Effects of Serotonin by Jody Smith
• http://www.helpguide.org/mental/autism_help.htm
Helping Children with Autism, Autism Treatment Strategies and Parenting Tips
• http://www.ninds.nih.gov/disorders/autism/detail_autism.htm
National Institute of Neurological Disorders and Stroke: Autism Fact Sheet
National Institute of Neurological Disorders and Stroke: "Asperger Syndrome
Fact Sheet.“
• http://www.nimh.nih.gov/health/topics/child-and-adolescent-mentalhealth/index.shtml
National Institute of Mental Health: "Autism Spectrum Disorders.“
• http://www.blog.montessoriforeveryone.com/the-underlying-organizationof-a-montessori-classroom.html
Montessori for Everyone