Chapter 5
Children with Autism
Spectrum Disorders
Historical Overview
• History
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Kanner (1943)
Asperger (1944)
Rutter (1966)
Bettelheim (1974)
Neurological Disorders (Current)
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• Leo Kanner (1943) first described children who
had significant impairments in their social
functioning and language skills.
• In 1944, Viennese physician Hans Asperger
described another type of autism within the
autism spectrum disorder. One of the
distinguishing characteristics of students with
Asperger’s syndrome (AS) is an observable
developmental imbalance. On the one hand,
they can be of average or superior intelligence;
on the other, they are years behind in social
development.
• .
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• England, Michael Rutter (1996) reported a study
that compared children diagnosed as autistic
with children who displayed other emotional
disorders. He found three characteristics that
almost always were present in the children with
autism, but only occasionally in children with
emotional disorders: (1) failure to develop social
relationships, (2) language retardation with
impaired comprehension, and (3) ritualistic or
compulsive behaviors.
• Bettelheim and others believed during the 1960s
and 1970s that autism was caused by cold and
unfeeling mothers. Currently there is widespread
acceptance that autism is a neurophysiological
condition
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Federal Definition
A developmental disability significantly affecting
verbal and non-verbal communication and
social interaction, usually evident before age 3,
that adversely affects a child’s educational
performance. Other characteristics often
associated with autism are engagement in
repetitive activities and stereotyped movement,
resistance to environmental change or change in
daily routines, and unusual sensory experiences.
Source: http://idea.ed.gov/explore/search/p/,root,regs,300,A,300%252E8
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Federal Definition
A developmental disability significantly affecting
verbal and non-verbal communication and
social interaction, usually evident before age 3,
that adversely affects a child’s educational
performance. Other characteristics often
associated with autism are engagement in
repetitive activities and stereotyped movement,
resistance to environmental change or change in
daily routines, and unusual sensory experiences.
http://www.youtube.com/watch?v=lbXjW-cX9kQ&feature=related
http://www.youtube.com/watch?v=w9N0_7D_Re8&feature=related
Source: http://idea.ed.gov/explore/search/p/,root,regs,300,A,300%252E8
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Federal Definition
A developmental disability significantly affecting
verbal and non-verbal communication and
social interaction, usually evident before age 3,
that adversely affects a child’s educational
performance. Other characteristics often
associated with autism are engagement in
repetitive activities and stereotyped movement,
resistance to environmental change or change in
daily routines, and unusual sensory experiences.
Source: http://idea.ed.gov/explore/search/p/,root,regs,300,A,300%252E8
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Autism spectrum
disorders
• Autism spectrum disorders is a term that refers
to a variety of neurological disorders affecting
the child’s social development and ability to
communicate. Included in this group are
pervasive developmental disorder not otherwise
specified (PDDNOS), Asperger’s syndrome,
Rett’s syndrome, and childhood disintegrative
disorders. One of the subgroups of special
interest is Asperger’s syndrome. Children with
Asperger’s syndrome may be high-functioning
with respect to their cognitive abilities but have
impairments in their social and language skills.
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Autism & PDD Prevalence
• Occurs between 2 to 6 per 1000 children.
• Autism & PDD 4 times more common in boys
than in girls.
From NICHCY, 2008.
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Etiological Factors
• Genetic factors
• Environmental factors
• Mirror neurons system
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• Genetic factors—Evidence is accumulating for a
strong genetic linkage for autism. The advances
in our genetic knowledge through the Human
Genome Project and other research have even
identified two of the chromosomes (7 and 15) as
the possible sites for the disorder in many
children with autism.
• Environmental factors—During the 1970s and
1980s, it became popular in the social sciences
to emphasize the effects of environment on
children and adults. Now, with the growing
capabilities of genetic research, it seems clear
that many conditions that produced special
needs in children are linked to an intertwining of
genetics and environment.
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• Mirror neurons system—Mirror neurons are
brain cells that respond equally whether we
perform an action or someone else performs
the same action. This capability of mirror
neurons allows us to imitate others’ actions
or speech or even emotions (Winerman,
2005). Children with autism appear to have
problems in the mirror neuron system. This
could explain several common behaviors,
such as the lack of eye contact, limited
social interaction, communication delays,
and even some repetitive motor movements,
such as rocking. Scientists are working to
see if stimulating this system would allow
these children to experience what children
with normal systems can experience.
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Identifying Autism
• Early screening conducted by pediatricians can
help to identify children who may be at risk. The
Checklist for Autism (CHAT) measures the
presence or absence of three key factors, which,
if absent, indicate an 80 percent risk of autism.
Those factors are protodeclarative pointing,
gaze monitoring, and pretend play.
• Also refer to www.firstsigns.org for more
information and video regarding identifying
autism.
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Early Identification and Intervention
• Language and social skills develop rapidly
during the critical developmental ages of 18
months to 3 years. Therefore, early
identification of children with autism is one of the
key elements of treatment. In addition, imitation
of motor behaviors and using eye gaze to
communicate need to be fostered at that time.
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Characteristics
• Lack of Theory of Mind: The ability of human
beings to understand the thinking and
feelings of other people. A theory of mind is
necessary for understanding, predicting, and
shaping the behavior of others. Typical 4year-old children have a developing theory of
mind (Twachtman-Cullen, 2000). The Sally
and Anne Test (see Figure 8.2) can evaluate
the concept of theory of mind.
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• Hypersensitivity to Sensory Stimuli: Many children
with autism also have a hypersensitivity to noises in the
environment. In addition to sound sensitivity, sensitivity
to stimuli can extend to the tactile—some children with
autism are sensitive to touch. This sensitivity is part of a
larger condition called sensory integration dysfunction
(or sensory processing disorder).
• Social and Communication Difficulties—This is a
major area of limitations and delays for child with autism.
• Motor Skills Difficulties—Difficulty with a range of
motor skills—such as gross motor skills (examples are
running and jumping), fine motor skills, and motor
planning (moving one’s body in space.) Although
children with ASD may meet motor milestones on time,
the quality of the child’s movements can appear stiff or
clumsy.
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Programs for Children with ASD
• During the preschool years, intervention
programs for children with autism spectrum
disorders should focus on the development of a
functional communication system and basic
social skills such as attending to a speaker.
An applied behavior analysis approach is the
most effective method for teaching initial basic
skills
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• As children master the basic skills for developing
language and social competence, many
educators shift to a child-centered approach
where the teacher responds to the child’s natural
communicative needs. If a child is unable to
respond, augmentative and alternative
communication may be used and can serve to
avoid the development of behaviors such as
head banging, which may stem from the child’s
frustration at not being able to communicate her
needs
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•
•
•
•
UCLA Young Autism Project
TEACCH : North Carolina
LEAP program at the University of Colorado
Pivotal Response Model at the University of
California at Santa Barbara.
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Commonalities Among
Treatment Program
• Common curriculum content
• Highly supportive and structured teaching
environment
• Predictability and routine
• Functional approach to problem behaviors
• Transition between preschool and kindergarten
Source (Dawson and Osterling, 1997)
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• As the child with autism progresses through school, a
multidisciplinary team, including a specialist in the
education of children with autism, should plan the
child’s IEP and a comprehensive set of activities and
experiences to meet his or her individual needs.
• Assignments should be short. Tiered assignments
that are adjusted to the developmental level of the child
can be designed to accommodate the child in an
inclusive classroom, and inappropriate behaviors should
be addressed in the context of a functional behavioral
analysis. The use of functional analysis of behavior
can be an effective means of identifying the motivation
behind maladaptive behavior and identifying a more
acceptable way for the child to achieve his goals.
• As children get older, classroom teachers should have
teaching assistants and easy access to consultation from
specialists.
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• An adaptive strategy for assisting children with
autism is called structured teaching (Mesibov,
1999). The child is presented with an individual
daily schedule that describes what will happen
at each time in the school day. Providing a
consistent physical environment, providing
assignments in a clear and predictable fashion,
and using direct instruction to teach both social
and cognitive concepts are all effective teaching
strategies for children with autism spectrum
disorders.
• .
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• Technological supports can be addressed in
many ways. The use of communication
devices such as the Picture Exchange
Communication System (PECS) and VoiceOutput Communication Aids (VOCA) can also
reduce challenging behaviors by reducing the
frustration associated with not being able to
communicate.
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School-Age Programs
for Children with ASD
•
•
•
•
•
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Inclusion-based
IEP - clear goals and objectives
Tiered assignments
Functional behavior assessments
Structured teaching
Technological supports
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Social Skills Approaches
•
•
•
•
•
Ecological Variations
Collateral skills interventions
Child-specific interventions
Peer-mediated intervention procedures
Comprehensive interventions
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• A wide variety of approaches have been used to
enhance the social abilities of children with
autism spectrum disorders. McConnell (2000)
identified five major categories of these
approaches and assessed the research efficacy
of each.
• Ecological approaches modify the physical
environment to enhance social functioning and
produce weak to moderate effects
• Collateral skills interventions may increase
social interactions of children with autims by
bringing them into contact with typically
developing peers
• .
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• Child-specific interventions have limited potential
because they focus on social initiations rather
than sustained interactions, peer-mediated
intervention procedures have demonstrated
powerful treatment effects, and comprehensive
interventions that contain two or more of the
previously mentioned components can be very
effective
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• Parents of children with autism need specialized
training in teaching strategies that will enable
them to help their child acquire new skills,
manage challenging behaviors, and thus reduce
family stress. For some families, having a child
with autism creates considerable stress, and
professionals should be prepared to coordinate
support services for family members. In
particular, siblings should be considered part of
a comprehensive treatment plan.
• The general recommendation for vocational
placements for individuals with autism stresses
the strengths of the individual and plays down
the social problems.
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Family and Lifespan
• Family Issues:
– Parents as teachers
• Relationship focused (RF)
– Sibling considerations
– Family Support services
• Transition
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