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KASHVI SHIRUDKAR
GRADE 10
0610
THE AUTISM
SPECTRUM DISORDER
-Kashvi. Shirudkar
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KASHVI SHIRUDKAR
Contents:
The Autism Spectrum Disorder
Acknowledgements
Purpose of Research
Introduction
Properties
Signs and Symptoms
Diagnosis
1.2a Diagnosis in young children
1.2b Diagnosis in older children
1.2c Diagnosis in adults
2. Treatments
2.1 What really works?
GRADE 10
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KASHVI SHIRUDKAR
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INTRODUCTION
Autism or the correct diagnostical term – autism spectrum
disorder, can be defined as a developmental disorder in social
communication skills appearing at an early age (usually in the
first 2 years of life). The ‘spectrum’ refers to the different and
varying levels of severity with which it can affect someone. In
layman’s terms, every patient with autism will have different
symptoms and challenges.
Between 1995 to 2011, autism was grouped with Asperger’s
syndrome and Pervasive developmental disorder in the
DSM-4; Asperger’s syndrome was said to be on the low
severity scale of the ‘spectrum’ of autism. However, DSM-5
no longer follows this.
The definition of the autism spectrum disorder in the DSM-5
states that an autism diagnosis requires persistent deficits in
social communication and social interaction across multiple
contexts.
In this report we will explore the various causes, effects and
properties of autism. We will also study the reason behind
why the autism spectrum disorder confounds doctors to this
day and remains one of medicine’s greatest mysteries.
DSM: DIAGNOSTIC AND STATISTICAL MANUAL OF
MENTAL DISORDERS
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Signs and Symptoms
There are a range of possible symptoms in autism which
appear differently in every patient.
Communication:
Does not respond to his/her
name by 12 months of age.
Cannot explain what he/she
wants.
Doesn’t follow directions.
Doesn't follow directions
Seems to hear sometimes,
but not other times
Seems to prefer to play
alone
Gets things for him/herself
only
Is very independent for
his/her age
Seems to be in his/her "own
world"
Seems to tune people out
Doesn't point or wave "byebye"
Is not interested in other
children
Used to say a few words or
babble, but now does not
Doesn't point out
interesting objects by 14
months of age
Social behavior:
Doesn't smile when smiled
at
Has poor eye contact
Doesn't like to play "peek-aboo"
Doesn't try to attract
his/her parent's attention
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KASHVI SHIRUDKAR
Stereotyped Behavior:
Gets "stuck" doing the same
things over and over and
can't move on to other
things
GRADE 10
Doesn't know how to play
with toys
Does things "early"
compared to other children
Walks on his/her toes
Shows unusual attachments
to toys, objects, or routines
(for example, always
holding a string or
Doesn't like to climb on
things such as stairs
having to put on socks
before pants)
Seems to stare at nothing or
wander around with no
purpose
Spends a lot of time lining
things up or putting things
in a certain order
Doesn't imitate silly faces
Throws intense or violent
tantrums
Repeats words or phrases
(sometimes called echolalia
Is overly active,
uncooperative, or resistant
Other behavior:
Seems overly sensitive to
noise
Doesn't play "make believe"
or pretend by 18 months of
age
Has odd movement patterns
Doesn't like to be swung or
bounced on his/her parent's
knee, etc.
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Diagnosis
1.2.a Diagnosis In Young Children
STAGE 1: GENERAL DEVELOPMENTAL SCREENINGS
During regular check-ups with a child’s pediatrician, they
should have autism – specific screenings which evaluate the
child’s development and assess his/her behavior for any
irregularities or developmental disorders. If the child shows
any symptoms of developmental differences, they are
referred to a specialist in child development.
STAGE 2: ADDITIONAL DIAGNOSTIC EVALUATION
Ideally a team including child neurologists, developmental
pediatricians, speech-language pathologists, child
psychologists and psychiatrists, educational specialists, and
occupational therapists should conduct the additional
diagnostic evaluation. They will assess the child’s behavior,
development, performance in age-appropriate abilities,
cognitive and language abilities (recognition-comprehension).
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1.2.b Diagnosis In Older Children
Caregivers and teachers often identify signs of Autism
Spectrum Disorder (ASD) in older children and adolescents at
school. The school’s special education team may conduct an
initial assessment and then suggest further evaluation by the
child’s primary health care provider or a specialist in ASD.
Caregivers may discuss their child’s social challenges with
these health care providers, such as difficulties in
understanding subtle forms of communication. For instance,
some children struggle with interpreting tone of voice, facial
expressions, and body language. Older children and teens
might find it hard to grasp figures of speech, humor, or
sarcasm, and they may struggle to form friendships with
peers.
In essence, caregivers and educators play a crucial role in
identifying ASD symptoms, leading to comprehensive
evaluations and support strategies.
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1.2.c Diagnosis In Adults
Diagnosing Autism Spectrum Disorder (ASD) in adults poses
greater challenges compared to diagnosing children.
Symptoms of ASD in adults can overlap with those of other
mental health conditions like anxiety or ADHD.
Adults who recognize potential signs of ASD should consult a
healthcare provider and seek a referral for a thorough
evaluation. This process typically involves specialists such as
neuropsychologists, psychologists, or psychiatrists who are
experienced in ASD. They assess various aspects including
difficulties in social interaction, communication, sensory
sensitivities, repetitive behaviors, and specific interests.
Additionally, the evaluation may incorporate insights from
caregivers or family members about the individual's early
developmental history, crucial for achieving an accurate
diagnosis. Despite ongoing refinements in diagnostic
methods for adults, obtaining a comprehensive assessment
from qualified professionals remains essential to
understanding and addressing potential ASD concerns
effectively.
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What really works?
Applied Behaviour Anaylisis – Applied behaviour
anaylisis(ABA) is based on the simple reasoning that beaviour
can be studied and changed, that a human’s behaviour is
dependent on its environment. ABA can be used to develop
interventions that teach skills, increase behavior that
contributes to
learning,
independence,
and happiness,
and decrease
behavior that
interferes with
the acquisition
of skills, is
dangerous to
self or others,
or limits
opportunities. ABA is not a treatment methond in itself but it
is the science behind how succesful and effective
interventions and treatmant plans are created for autism
patients. When ABA is applied intensively and early in life, it
produces magnificent results and reduces the need for
special care later on in life by a humongous margin.
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DIRECT INSTRUCTION - Direct Instruction (DI) is a
structured teaching method designed by Bereiter and
Engelmann in 1966 to ensure students master material
through active participation and systematic procedures. DI
features scripted lessons, where teachers follow detailed
instructions to present content, model responses, and allow
student practice. Correct answers are praised, and mistakes
are corrected on the spot. This method progresses to
independent student demonstrations, ensuring they’ve truly
learned the material.
DI curricula, like Language for Learning and Reading Mastery,
cover various subjects such as reading, math, and writing.
Placement tests help teachers start each student at the right
level, and post-tests indicate if further practice is needed or if
the student is ready to move on. This data-driven approach
allows teachers to tailor instruction to each student's needs.
Research highlights DI's effectiveness, with an average effect
size of .59 across over 300 studies, making it one of the most
impactful instructional methods. It's been shown to boost
academic skills from preschool to high school, across different
socioeconomic backgrounds, and among students with
various disabilities, including those with autism spectrum
disorders (ASD).
Initial studies on DI for children with ASD focused on specific
skills within broader curricula, while later research evaluated
entire lessons over longer periods. For example, a study with
25 ASD children using the Language for Learning program
showed significant language improvements, maintained over
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months. Another large-scale study with 83 children found
that 3 hours of DI per week for 6 months significantly
benefited over half the participants.
To successfully implement DI, proper training is crucial,
despite its straightforward, scripted nature. Providers should
choose curricula that match individual educational goals and
consider modifications for ASD students, such as one-on-one
instruction or additional reinforcements.
Overall, DI is a proven, versatile teaching method that
enhances learning outcomes across various populations,
including those with ASD. It requires matching the curriculum
to the student's needs and ensuring instructional staff are
well-prepared through training.
EARLY INTENSIVE BEHAVIORAL INTERVENTION - Early
Intensive Behavioral Intervention (EIBI) provides 20-40 hours
weekly of individualized instruction for children with autism
starting before age four, typically continuing for 2-3 years.
The UCLA Model focuses on home instruction using discrete
trial training, while other models use classroom settings and
different teaching methods. Research shows EIBI can
significantly improve development and reduce the need for
special services, though larger, well-designed studies are
needed. EIBI is highly promising, warranting further
investigation and information for professionals and families.
PICTURE EXCHANGE COMMUNICATION SYSTEM (PECS)The Picture Exchange Communication System (PECS) is an
augmentative communication system developed in 1985 by
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Andy Bondy, Ph.D., and Lori Frost, MS, CCC-SLP. Originally
designed for preschool children with autism spectrum
disorder (ASD) who have limited vocal communication, PECS
has expanded to other age groups and disabilities. PECS relies
on Applied Behavior Analysis and Verbal Behavior principles,
involving a systematic progression of communication skills
across six phases. Using pictures stored in a communication
book, children learn to exchange images for desired items,
facilitating functional communication.
PECS is structured into phases: initiating communication,
generalizing it across environments, picture discrimination,
sentence structure, using attributes, and answering questions
or commenting. It emphasizes the importance of what is
being communicated over the method of communication.
The PECS protocol was updated in 2002, ensuring it remains a
comprehensive and distinct system.
Research supports PECS as an effective tool for teaching
functional communication to individuals with ASD. The
National Standards Project (2015) classified PECS as an
emerging intervention, and subsequent studies have
bolstered its status as an established method. PECS not only
improves communication but also increases vocal requests
and reduces challenging behaviors. Studies have shown that
children using PECS may transition to vocal communication
over time.
Generalization and maintenance of PECS skills across settings
are essential, with family involvement playing a crucial role.
Research shows that PECS is effective in various environments
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and maintains high social validity among parents and
teachers. Proper training for those implementing PECS is
critical, with behavioral skills training being particularly
effective.
PECS is recommended as an evidence-based practice for
teaching communication skills to individuals with ASD.
Continued research is needed to evaluate long-term effects
and optimize transitions to other communication methods.
Overall, PECS has proven to be a robust, effective intervention
for enhancing communication in individuals with ASD.
SELF MANAGEMENT INTERVENTIONS Self-management interventions, integral to applied behavior
analysis, aim to improve socially significant behaviors by
teaching individuals to alter their environments in ways that
lead to beneficial changes in their own behavior. These
interventions help individuals exercise self-control, making
them more successful in various aspects of life. Particularly
for individuals with autism spectrum disorder (ASD), selfmanagement interventions foster independence and reduce
reliance on external prompts. Traditional prompting, if not
gradually removed, can lead to dependency, whereas selfmanagement encourages individuals to self-cue, thereby
promoting autonomy.
For example, a child with autism might use a visual cue chart
to respond to peer questions independently, rather than
relying on adult prompts. Self-management strategies are
effective across multiple domains, including academic, social,
and vocational skills, and can both increase appropriate
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behaviors and decrease challenging ones. These interventions
typically involve components such as goal setting, selfmonitoring, self-evaluation, self-reinforcement, and selfinstruction.
Goal setting involves selecting a performance standard to
achieve desired behavior changes. Self-monitoring includes
tracking one's behavior, while self-evaluation involves
comparing recorded behavior with set goals or another
observer’s records. Self-reinforcement allows individuals to
reward themselves upon meeting goals, and self-instruction
involves giving oneself reminders or instructions to promote
target behaviors. While everyone uses self-management
strategies to some extent, individuals with ASD may need
more explicit instruction to use them effectively.
Research has shown that self-management interventions
improve social skills, academic performance, and daily living
skills for individuals with ASD. For instance, interventions can
teach responsiveness to social cues, enhance academic skills
like writing and following directions, and support
independent living tasks. Reviews and reports affirm selfmanagement as an evidence-based practice for ASD,
highlighting its benefits in fostering behavior awareness,
accountability, and reducing social stigma.
Despite the strong support for self-management
interventions, further research is needed to understand their
long-term effects and how well they maintain improvements
across different settings and age groups. There is also a need
for more studies on self-management's impact on vocational
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and daily living skills specifically for individuals with autism.
Nonetheless, substantial evidence supports the use of selfmanagement interventions as effective tools for enhancing
the lives of individuals with autism, making them a
recommended approach for skill development and behavior
improvement.
BEHAVIORAL SIBLING TRAINING –
Children with autism spectrum disorder (ASD) often face
challenges in social interactions, making even minimal
engagement difficult. Including siblings in their treatment can
be beneficial, helping to build crucial interaction skills.
Behavioral Sibling Training involves neurotypical siblings in
interventions for their ASD siblings, aiming to foster positive
interactions and improved social and play skills. For example,
neurotypical siblings can be taught to target play-based
language, reinforce positive behaviors, and prompt their
siblings with autism to respond appropriately.
Siblings can be effective agents of change, extending the
benefits of peer-mediated interventions, which have long
been proven effective. Besides direct intervention roles,
siblings can be supported through educational programs,
social opportunities, and sibling support groups, which help
them communicate their needs, cope with stress, and
address peer questions about autism.
Extensive research has shown that engaging siblings in
interventions leads to mutual benefits. Children with ASD
gain in social-communication and play skills, while
neurotypical siblings experience increased confidence and
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satisfaction in interactions with their autistic siblings. These
interventions also help reduce problematic behaviors in
children with ASD and sibling frustration.
Despite these benefits, the literature also highlights
limitations. The roles of neurotypical siblings vary, and more
research is needed to understand how the extent of their
involvement impacts outcomes. Factors such as age, gender,
and sibling closeness should also be studied. Additionally,
most studies lack long-term follow-up, making it difficult to
draw definitive conclusions about the long-term impacts of
sibling involvement.
Further research with better experimental designs is needed
to fully understand the benefits of sibling training. Providers
should practice within their competence scope and consider
family, cultural, linguistic, and socioeconomic factors. Parents
should discuss with providers their prior experiences with
sibling interventions and be open about their family values
and limitations. Mindfulness of the knowledge differential
surrounding autism between the autistic child and their
sibling is crucial for effective intervention.
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