Utah AHEAD Conference
University of Utah
May 21, 2010

Michael Brooks

Accessibility Center
Brigham Young University

Edward Martinelli
Accessibility Services
Utah Valley University

Ronald Chapman
Student Life
Brigham Young University

Norman Roberts
Campus Life
Brigham Young University
Julie Preece
Academic Support
Brigham Young University
J
• What has been your experience
working with students with autism
spectrum disorders?
• What are your concerns when working
with students with these disorders?
J

Presentation purpose—Setting Limits

Disability Law and Autism Spectrum Disorders

Looking at the numbers

Cases, discussions, and recommendations:
 Autism Spectrum Disorders
 Autism
 Asperger’s Disorder
 Nonverbal Learning Disorders

Concluding comments
J

Enhance awareness of best advisement practices; not prepare
psychological service providers.

Autism spectrum disorders are complex; a thorough review of all
disorders is beyond the scope of one workshop.

Disorders may vary in their signs and symptoms from person-to-person.

Recognition, Reconnaissance, Respect, and Referral (4R’s) help a
majority of students experiencing psychological concerns.
J



Any condition can be a qualifying condition as
long as it is a physical or mental impairment that
substantially limits a major life activity
Substantially limits is to be considered liberally
ADA Amendments Act has provided a nonexhaustive list of major life activities, including:
 Communicating &
 Concentrating
Two problems seen in PDDs
M
Psychological Disorders among
Higher Education Students
N
National College Health Assessment
American College Health Association
Fall 2009
N=34,208
N
Proportion of College Students
Reporting Following Conditions:
ADD
Chronic Illness
Psychiatric Condition
Learning Disability
Partially Sighted/Blind
Deaf/Hard of Hearing
Mobility/Dexterity Disability
Speech or Language Disorder
Other Disability
5.1%
4.1%
3.7%
3.5%
1.7%
1.6%
1.0%
0.9%
2.1%
N
Proportion of College Students
Reporting Following Conditions:
ADD
Chronic Illness
Psychiatric Condition
Learning Disability
Partially Sighted/Blind
Deaf/Hard of Hearing
Mobility/Dexterity Disability
Speech or Language Disorder
Other Disability
5.1%
4.1%
3.7%
3.5%
1.7%
1.6%
1.0%
0.9%
2.1%
N
Within the last 12 months, diagnosed or
treated by professional for :
Anxiety
ADD/HD
Bipolar
Depression
OCD
Panic attacks
Phobia
Schizophrenia
9.4%
3.4%
1.3%
9.2%
2.1%
4.6%
1.0%
0.4%
N
 Prevalence varies quite widely from study to
study due to “divergent diagnostic criteria”
 Tends to be about:
 2 per 10,000 for Asperger’s disorder
 10 per 10,000 for Autism
 Male-to-female ratio is estimated to be 4:1
E
The Ripple from the 1990s
E




Life-long developmental disability.
Symptoms usually apparent within the first
36 months of life.
However, for high-functioning individuals,
symptoms may not be apparent until later
in life.
Syndrome, i.e., a condition defined by the
existence of a collection of characteristics.
Susan J. Moreno, MAAP Services for the Autism Spectrum
http://www.aspergersyndrome.org/Articles/What-is-autism-.aspx
E
Video 1
Student with
High Functioning Autism
E
E
Range of difficulties in verbal/nonverbal communication:
not speaking at all
unable to interpret body language
Unable to participate comfortably in two-way conversation
Rigidity in thought processes, including difficulty with:
learning abstract concepts
generalizing information
tolerating changes in routines and/or environments
Difficulty with reciprocal social interaction.
appearing to want social isolation
experiencing social awkwardness in attaining and
maintaining ongoing relationships

Susan J. Moreno, MAAP Services for the Autism Spectrum
http://www.aspergersyndrome.org/Articles/What-is-autism-.aspx
E
A. A total of 6 (or more) items from (1), (2), & (3), with
at least two from (1), and one each from (2) & (3):
(1) qualitative impairment in social interaction, as manifested
by at least two of the following:
(a) marked impairment in the use of multiple nonverbal
behaviors such as eye-to-eye gaze, facial expression,
body postures, and gestures to regulate social interaction
(b) failure to develop peer relationships appropriate to
developmental level
(c) a lack of spontaneous seeking to share enjoyment,
interests, or achievements with other people (e.g., by a
lack of showing, bringing, or pointing out objects of
interest)
(d) lack of social or emotional reciprocity
E
(2) qualitative impairments in communication as manifested by
at least one of the following:
(a) delay in, or total lack of, the development of spoken
language (not accompanied by an attempt to compensate
through alternative modes of communication such as
gesture or mime)
(b)in individuals with adequate speech, marked impairment
in the ability to initiate or sustain a conversation with
others
(c) stereotyped and repetitive use of language or
idiosyncratic language
(d)lack of varied, spontaneous make-believe play or social
imitative play appropriate to developmental level
E
(3) restricted repetitive and stereotyped patterns of behavior,
interests, and activities, as manifested by at least one of the
following:
(a) encompassing preoccupation with one or more
stereotyped and restricted patterns of interest that is
abnormal either in intensity or focus
(b) apparently inflexible adherence to specific, nonfunctional
routines or rituals
(c) stereotyped and repetitive motor mannerisms (e.g., hand
or finger flapping or twisting, or complex whole body
movements)
(d) persistent preoccupation with parts of objects
E
B. Delays or abnormal functioning in at least one of
the following areas, with onset prior to age 3
years:
(1) social interaction,
(2) language as used in social communication, or
(3) symbolic or imaginative play.
C. The disturbance is not better accounted for by
Rett’s Disorder or Childhood Disintegrative
Disorder.
E
Must Meet criteria 1, 2, & 3:
1. Clinically significant, persistent deficits in social
communication and interactions
2. Restricted, repetitive patterns of behavior,
interests, and activities
3. Symptoms must be present in early childhood
E
Must Meet criteria 1, 2, & 3:
1.
Clinically significant, persistent deficits in social
communication and interactions, as manifest by
all of the following:
a. Marked deficits in nonverbal and verbal communication
used for social interaction:
b. Lack of social reciprocity;
c. Failure to develop and maintain peer relationships
appropriate to developmental level
E
Must Meet criteria 1, 2, & 3:
2. Restricted, repetitive patterns of behavior,
interests, and activities, as manifested by at least
TWO of the following:
a. Stereotyped motor or verbal behaviors, or unusual sensory
behaviors
b. Excessive adherence to routines and ritualized patterns of
behavior
c. Restricted, fixated interests
3. Symptoms must be present in early childhood (but
may not become fully manifest until social demands
exceed limited capacities)
E
Continuing Along
the Autism Spectrum
J
 Social
interaction impairment
 Repetitive
patterns
 No
or stereotyped behavior
significant general delay in language
 No
significant delay in cognitive or selfhelp skills
J
Video 2
Asperger’s Disorder
J
J
 Qualitative
impairment in social interaction
 Restricted
repetitive and stereotyped patterns
 eye-to-eye gaze, facial expression, body
of behavior,
interests, and activities
posture, and gestures to regulate social
 No significant
general
language
 interaction
preoccupation
with onedelay
or morein
restricted
 peer
relationships
patterns
of interest
 No significant
inadherence
cognitive
development
 spontaneous
seeking
to
share enjoyment,
apparentlydelay
inflexible
to specific,
or in thenonfunctional
development
age-appropriate
interest
or achievements
other people
routinesof
or with
rituals
self-help
skills,
adaptive
 repetitive
lack
of social
or mannerisms
emotionalbehavior
reciprocity
motor
(e.g. hand or
finger flapping or twisting, or complex wholebody movements)
 persistent preoccupation with parts of objects
J
Meal plans
2. Laundry
3. Budgeting
4. Campus ID
5. Dorm rules
6. Fire drills
7. Communal bathrooms
8. Transportation
9. Campus maps
10. Security personnel
1.
Finding restrooms
12. Using alarm clock
13. Mail
14. Library usage
15. Lecture halls
16. Dorm activities
17. Health services
18. Emergencies
19. Illness self-care
20. Physical exercise
11.
http://ezinearticles.com/?College-and-the-Autistic-Student&id=523157
J
Private dorm room
2. 1-on-1 help with time
management & budget
3. Note-taker
4. “Daily Life Coach”
5. Distraction-free testing
6. Modified presentation
assignments
7. Preferential seating
1.
8.
9.
10.
11.
12.
13.
On-line courses
Learning specialist
support
Emotional support
Tutoring
Proctors for reading
and transcribing
Photocopies of
class materials
J
Comparisons & Contrasts:
Drawing Distinctions
M

What is it?
 AS and NVLD may describe the same “type” of
disorder but at differing levels of severity—
with AS describing more severe symptoms.
 Deficits are thought to be due to right cerebral
hemisphere involvement
“It may be that the diagnoses of Asperger syndrome (AS)
and NLD simply “provide different perspectives on a
heterogeneous, yet overlapping, group of individuals…”
– Klin and Volkmar
M

No!
◦ Not in the Diagnostic and Statistical Manual –
Fourth Edition – Text Revision (DSM-IV-TR)


But, often referenced in neuropsychological
evaluations
Disability resource coordinators need to
consider whether to recognize it as a
disorder worthy of accommodation.
M

IQ tests:
 Usually at least a 10-point difference between verbal
and performance scores (with verbal higher).
 Difference is often 40 points or higher.

Well developed:
 Rote memory & auditory memory,
 May have poor memory for essences, emotional
experiences, and visual data.

Elaborated, but often odd, verbal expression
(e.g., define “umbrella”) with strong vocabulary
M

Reading ability:
 generally excellent reading skills
 with poor comprehension

Math skills:
 Poor
 May affect later understanding of science concepts

Poor visual-spatial organization skills

Distorted sense of time

Tactile:
 perceptual and motor deficits, generally left side
 physical awkwardness and poor coordination

Messy or laborious handwriting
M
Probable Major Deficits of NVLD
 Hyper-attention to detail
 Missing ‘big picture’
 Concrete thinking
 Literal thinking
 Problems reading facial expressions, gestures,
social cues, and tones of voice (low ‘social IQ’)
 Difficulty using social feedback
 Difficulty adjusting to new situations
M

Naïvete or lack of common sense

Rote reactions to situations


Dependence on language to gather
information and anxiety relief - doesn’t
always work (hearing “nice going” with
dropped football pass – what does this
mean?)
Problems developing and maintaining
friendships, leading to : anxiety, depression,
social withdrawal.
M


Strikes others as very intelligent
Strong early academic record:
◦
◦
◦
◦

Abstractions become important from 6th grade on
Grades plummet
Abstractions for sequencing in math, science & writing
Coordination skills for physical activities
Spend more time with adults:
◦ Plays to verbal strengths
◦ adults tolerate eccentricities


“Inattentive and hyperactive” early in life
Socially withdrawn and isolated later in life
M


Problems seen in organization as each detail is
taken one-at-a-time, not integrated.
Appears smart but unmotivated, which can be
internalized secondary to adults’ feedback
 display internalizing behaviors
 nail biting, stomach aches, etc.

Later, when learning is lecture-based, problems
with hearing and transcribing concurrently.
M

Outlines to provide the “forest”

Schedule of the day’s events (primary)


Meet with professor to discuss how the
syllabus will play out (postsecondary)
Sequencing tips to break down complex
tasks

Interactive discussion rather than lectures

Play to strengths in rote learning

Point out social rules and articulate events
M

Joey – active boy

Infant physical development:
 Walked at 12 months
 Could not drink from cup until 15 months

Age 4
 Teacher concerned with his fine motor skills
 “Engaging” with “advanced expressive language”
 Language “confusing and circuitous”

Age 7
 VIQ 136/PIQ 92
 Socially one-on-one “OK”, but not so in groups
M
Questions and Answers
J

Michael Brooks:
michael_brooks@byu.edu

Edward Martinelli:
edward.martinelli@uvu.edu

Julie Preece:
julie_preece@byu.edu

Ronald Chapman:
ronald_chapman@byu.edu

Norman Roberts:
norman.roberts@byu.edu