INTRO TO AUTISM:
DIFFERENT PERSPECTIVES
Marion Staff Training 2009
Lisa Anderson
M.S. Education, Autism Consultant, CESA 8
VIDEO: “J-MAC”

http://video.google.com/videoplay?docid=7057999856625517002&q=Jason+McElwain&ei=PAMMSIKPD6PsrAK
kjrG6BA&hl=en
Autism Spectrum Disorders…
WHAT DOES THIS MEAN?
AUTISM SPECTRUM DISORDERS
Pervasive Developmental Disorders
WHAT IS AUTISM?
(A.K.A. AUTISM SPECTRUM DISORDERS OR ASD)

Autism is a complex neurological disorder that affects one’s
communication and socialization ability.

Autism is typically evident by Age 3 (can now be diagnosed as early
as 6 months old)

1 in 150 children (1 in 94 boys) are now diagnosed with autism in
the U.S. In the United Kingdom, 1 in 58 children has some form of
autism.

The rate of autism is highest in California of those born after 1980.

Just over a decade ago, the prevalence rate was 1 in 10,000.

Current research suggests that it is caused by the lack of
coordination and proper connectivity within the brain.

Common: Rapid Brain Growth in 1st year of life (Journal of the
American Medical Association, 2003) .
WHAT IS AUTISM?
(CONTINUED)

A new case of autism is diagnosed every 20
minutes

Autism currently affects more than 1.5
million people in the U.S. alone

http://dpi.wi.gov/sped/autdata.html
NEUROLOGICAL DISORDER
Cerebral Cortex: Most
highly developed area
of the brain which
includes gray matter
in right & left
hemispheres.
Activities within this
area of the brain
include: Thinking,
Perceiving, Producing
Language , Sensing &
Interpreting input
from various sources.
Amygdala: Memory
& Emotions.
Temporal Lobe:
Auditory Processing,
visual input, semantics
of language, verbal
memory.
Cerebellum:
Coordinated, smooth
movements of the
skeletal muscular
system including
abilities to walk, talk,
eat, and to perform
other self care tasks.
WHAT IS AUTISM?
(CONTINUED)
Autism impairs one’s ability to Communicate;
affecting Receptive Language, Expressive
Language and Pragmatic or Social Language
abilities.
 Autism affects socialization.
 Autism affects the sensory system.
 Autism can impact cognitive skills where brain
is wired differently.

AUTISM SPECTRUM DISORDERS
Autism impacts every individual differently…
AUTISM SPECTRUM DISORDERS
Children can move from one end of the spectrum
to another with intensive Evidenced-Based
intervention…
Wisconsin is currently a part of
the project that is being done to
“Promote optimal development
and learning of infants, children,
and youth with ASD and provide
support to their families through
the use of evidence-based
practices .”
NATIONAL PROFESSIONAL DEVELOPMENT CENTER FOR AUTISM SPECTRUM DISORDERS
EVIDENCE BASED PRACTICE BRIEFS
A-F
•Computer-Aided Instruction
•Differential Reinforcement
•Discrete Trial Training
•Extinction
•Functional Behavior Assessment
•Functional Communication Training
M-R
•Naturalistic Interventions
•Parent-Implemented Interventions
•Peer-Mediated Instruction And Intervention
•Picture Exchange Communication System (PECS)
•Pivotal Response Training
•Prompting
•Reinforcement
•Response Interruption/Redirection
S-Z
•Self-Management
•Social Narratives
•Social Skills Training Groups
•Stimulus Control
•Structured Work Systems
•Task Analysis
•Time Delay
•Video Modeling
•Visual Supports
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Picture Exchange Communication System
(PECS)
According to the developers of PECS, it is a
behaviorally based intervention that teaches
the learner to use visual-graphic symbols to
communicate with others (Bondy & Frost,
1994; Frost & Bondy, 2002). This module will
provide information on this augmentative and
alternative communication system.
WWW.AUTISMINTERNETMODULES.ORG
WHAT IS AUTISM?

Autism is now the most common childhood
disability with more cases than pediatric
cancer, childhood diabetes, and AIDS
combined!

It is estimated that lifetime individual costs
for raising a child with autism ranges from
$3.5 to $5 million dollars.
FUTURE AUTISM EXPENDITURES

The Department of Health and Human Services
Projections over the next 15 years as the current wave of
individuals with autism become adults…

27 Billion annually will be spent on living costs alone for
the autism population by 2023; more than 1/3 of this
year’s budget and larger than the entire current budget of
the U.S. Energy Department.

More than 380,000 individuals expected to need
extensive services, often requiring 1:1 care in many
cases
The Washington Post, April 07, 2009
WHAT CAUSES AUTISM???
WHAT CAUSES AUTISM?

Nobody knows for sure!

There is no medical detection or cure for autism.

Abnormalities in the shape and structure of the brain
(brain imaging)

Theories:



Genetic Predisposition
Environmental toxins (i.e. heavy metals)
Controversy:


Immunizations
Mitochondria? (Hannah Poling)
EPIDEMIC
EPIDEMIC

“Autism in the U.S. has reached epidemic levels, 1 in
150 children. Dr. Julie Gerberding, Director of the
Center of Disease Control and Prevention has
recently upgraded autism to “an urgent health
threat.”

“The most contentious issue of the autism debate is
the link to routine childhood vaccinations.”

“Hannah Poling v. U.S. Dept. of Health and Human
Services, has changed this debate forever.
What to Look For…
EARLY SIGNS
WHAT TO LOOK FOR…(EARLY SIGNS)

No big smiles or warm, joyful expressions by six months or
thereafter

No back and forth sharing of sounds, smiles, or other facial
expression by 9 months or thereafter

No babbling by 12 months

No back and forth gestures such as pointing, showing, reaching,
or waving by 12 months

No words by 16 months

No two-word meaningful phrases (without imitating or repeating)
by 24 months

Any loss of speech or babbling or social skills at any age
Autism Society of America
AUTISM CHARACTERISTICS
AUTISM CHARACTERISTICS…
1.
2.
3.
4.
5.
6.
Insistence on Sameness
Difficulty in expressing needs; uses gestures
instead of words
Repeating words or phrases in place of normal
responsive language
Laughing, crying, showing distress for reasons
not apparent to others
Prefers to be alone, aloof manner
Tantrums
AUTISM CHARACTERISTICS (CONT.)
7.
8.
9.
10.
11.
12.
13.
14.
Difficulty mixing with others
May not want to cuddle or be cuddled
Little or no eye contact
Unresponsive to normal teaching methods
Sustained odd play
Spins objects
In appropriate attachment to objects
Apparent over-sensitivity or unsenstivity to pain
AUTISM CHARACTERISTICS (CONT.)
15.
16.
17.
18.
No real fear of danger
Noticeable physical over-activity or extreme
under-activity
Uneven gross/fine motor skills
Not responsive to verbal cues; acts as if deaf
although hearing tests in normal range
ASA…if over half of these characteristics, then
autism is possible
PARENTS’ PERSPECTIVE

http://www.talkaboutcuringautism.org/video/h
ope-video.htm
MYTHS ABOUT AUTISM
MYTHS

Children with autism don’t make eye contact.


Children with autism do not show affection.


They do and can. It may look different than neurotypical children
Children with autism do show affection and may be
extremely loving of others
Children with autism cannot communicate
effectively

They may develop good, functional language skills
where it may be difficult to distinguish them from
others
WORKING WITH FAMILIES THROUGH
THE DIAGNOSTIC PROCESS…
WORK CLOSELY WITH PARENTS/FAMILIES

Parents are your BEST RESOURCE and best
source of information…they know their child
better than anyone else. But, they go through a
grieving process when informed that something
may be wrong with their child.

Help parents feel comfortable and assist them
through the diagnostic process
WORKING WITH PARENTS/FAMILIES
Grieving Process…
1. Shock - What?
2. Denial - Autism…No way! You are crazy!
They like to be held…they smile, laugh, look
at us…they are just late talkers!
3. Anger - How dare you…?
4. Bargaining - God, please let them be
wrong!
5. Acceptance - Where do we go from here?

Try not to take uncomfortable parent reactions personally!!!
THE AUTISM EMOTIONAL ROLLER-COASTER…

The grieving process is ONGOING…

Consider the emotional aspects of raising a
child with autism

Autism Everyday…
http://www.youtube.com/watch?v=FDMMwG7
RrFQ&feature=related
-
MEDICAL DIAGNOSIS VS. EDUCATIONAL
ELIGIBILITY
MEDICAL DIAGNOSIS VS. EDUCATIONAL CRITERIA

Medical Consideration:
 Medical Diagnosis NOT REQUIRED in
Wisconsin to determine educational
disability of autism
 Medical
information, if available, should
be considered as part of an education
evaluation…not sole component
MEDICAL DIAGNOSIS VS. EDUCATIONAL CRITERIA
 School
cannot require parents to obtain medical
diagnosis during an educational diagnosis
 Medical
terms such as Asperger’s Disorder, PDD,
and others do not automatically qualify students
under the educational disability category of autism.
 Labels
do not transfer between systems (i.e.
education and medical)
AUTISM VS. ASPERGER’S
AUTISM VS. ASPERGER’S

What distinguishes Autism from Asperger’s is
the severity of symptoms and…
By definition: There is an absence of language delays
with individuals with Asperger’s Syndrome
 Individuals with Asperger’s Syndrome cannot
possess a “clinically significant” cognitive delay and
must possess average to above average intelligence
 Individuals with Asperger’s Syndrome may be only
mildly affected and they frequently have good
language and cognitive skills
AUTISM VS. ASPERGER'S

Individuals with Asperger’s Syndrome usually
want to “fit in” and have interaction with
others…they just don’t know how to do it.

Individuals with Asperger’s Syndrome may
appear to be socially awkward and clumsy.
They may lack empathy, may display limited
eye contact, may talk about interests
excessively and may not understand
gestures
AUTISM VS. ASPERGER’S

Autism

Children with Autism are frequently seen as aloof
and uninterested in others

Many individuals with autism display cognitive
delays (though it is difficult to obtain accurate IQ
scores as they experience significant difficulties with
language ability

Children can receive a diagnosis of autism when
young and make substantial progress. They appear
to look more like individuals with Asperger’s as they
get older (move on the continuum)…Developmental
history is important for diagnosis of Autism vs.
Asperger’s
IS THERE A CURE???
CURE?
* Some claim recovery…reversing effects possible.
 Neuro-pathways can be changed with autism.
 Brain Plasticity…Early intervention can strongly
impact progress.
 Cure??? Not so Sure!!!
 Improve and live a relatively “normal” life is VERY
Possible!
 Several reports of children “overcoming” autism.
 Not “Gloom and Doom” as once thought.
RESEARCH
REWIRING THE BRAIN
NEUROPLASTICITY

Neuroplasticity, a.k.a. “plasticity” is the lifelong
ability of the brain to reorganize neural pathways
based on new experiences.

The Brain in NOT Hardwired from Birth

We all have a lifelong power to change

As we learn, we acquire new knowledge and skills
through instruction or experience.

The ability of the brain to change with learning is
what is known as neuroplasticity.
NEUROPLASTICITY

1.
Neuroplasticity occurs in the brain under two
primary conditions:
During normal brain development when the immature brain
first begins to process sensory information through
adulthood (developmental plasticity and plasticity of learning
and memory).
2. As an adaptive mechanism to compensate for lost function
and/or to maximize remaining functions in the event of brain
injury.

The environment plays a key role in influencing plasticity.
NEUROPLASTICITY

Brain changes can occur with…
 Positive
or negative environments
 Exercise
 Nurturance
 Learning
 Other
experiences…
RESEARCH : LOVAAS

Applied Behavior Analysis – research based…positive
results for nearly half of children who received intensive
therapy at a young age (between ages 3-8)

Original research in peer-reviewed journals indicating
that 90% of children substantially improved when
utilizing the Lovaas Model of Applied Behavior Analysis,
compared to the control group.

Close to half attained a normal IQ and tested within the
normal range on adaptive and social skills.
RESEARCH: LOVAAS

This research reported that 47% of those
children that had received 30–40 hours of
intensive therapy were mainstreamed into
regular classrooms, and were classified as
"indistinguishable" from their peers in follow-up
studies.

Wisconsin Waiver Program supports this

Early intervention is imperative to future
outcomes
RESEARCH: LOVAAS

Intensive In-home therapy and schools working
together…strengthens generalization of skills,
gets everyone on the same page.

Learn from on another!
TRADITIONAL AND NON-TRADITIONAL
INTERVENTIONS…
INTERVENTIONS

Traditional







Behavioral approaches (Discrete Trial Training…ABA)
Relational Development Intervention
Floortime
Medical Interventions
School Programs/Therapies/Activities
Numerous Evidence-Based Interventions (i.e. Visual Supports, Peer Mediated programs,
PECS, Social Skills Groups, Social Stories etc.)
Non-Traditional













Gluten/Casien Free Diet
Vitamin Therapy
Heavy Metal Detoxification (i.e. chelation)
Sensory Integration Therapy
Auditory Integration Training
Vision Therapy
Yoga
Chiropractic
Reflex Inhibition Programs (Physical Therapy)
Martial Arts
Music Therapy
Hyperbaric Oxygen Therapy
Many More Options…
INTERVENTIONS…
1.
2.
3.
4.
Look at each person individually.
Become familiar with the major issues related
to autism.
Believe that individuals with autism can learn
and do extraordinary things!!!
Understand that they are not
behaving inappropriately
purposefully…it’s neurological!!!
AUTISM IS A WORLD…
http://www.youtube.com/watch?v=U1wsiVYCq
n0
It is difficult to know what is inside of a
non-verbal individual with autism.
Sometimes the right piece of technology
that allows them to speak may open up a
whole new world…
LEAST RESTRICTIVE ENVIRONMENT
LEAST RESTRICTIVE ENVIRONMENT

Individuals with autism often have a hard time
generalizing information from one environment
to another.

May learn something very well in one
environment, but not be able to do it in another.

Inclusion in school and community settings is
helpful to work on generalization.

Adult Support…issues with dependency.
BEHAVIOR ANALYSIS
BEHAVIOR ANALYSIS







Attention – positive or negative
Escape or avoidance – get out of doing something hard or
someplace uncomfortable, escape pain/discomfort, ask for
help
Power or control – of environment or people…happens when
kids feel overly controlled
To get a tangible reward – food, drink, toys, etc., immediate
feedback…sensory needs being met
Revenge or justice…not common with autism
Expression of self – seeking independence
Acceptance or affiliation – seeking social interaction, gain
acceptance from peers
BEHAVIOR ANALYSIS

ABC Analysis
 Antecedent
– What happened immediately before
the behavior
 Behavior – What the exact behavior (in objective,
observable and measureable words…Johnny hit
Joey with a closed fist on Joey’s bicep)
 Consequence – What was the consequence
(Johnny was removed from the lunch line and had
to stand at the back)
FUNCTIONAL BEHAVIORAL ASSESSMENT
Should be completed when a significant
behavior is interfering with living or learning
 Should be completed prior to writing a Behavior
Intervention Plan
 See examples of FBA’s

OTHER TIPS/TECHNIQUES
TIPS/TECHNIQUES

Sometimes the environment is so overwhelming that the
student cannot learn


Distracting worksheet simulation
Consider all senses…try to live through the eyes of the child
to see what they are experiencing

Sandpaper simulation

Consider potential medical issues (if cannot express
him/herself, how do you know if not feeling well? That alone
can cause behavior.
TIPS/TECHNIQUES

Social Stories and Social Scripts: Carol Gray

http://www.thegraycenter.org/

NPDC-ASD: Social Narratives

Assist individuals with autism in understanding
social situations

Provide instructions as to how to interact in
socially appropriate ways
PERSON FIRST, STRENGTH-BASED APPROACH

Always consider the person first, then the disability
(not “Autistic person”…” Person with Autism”)

Focus on the individual’s strengths. What are they
good at? (memorization, computers, working with
hands etc.) Maximize strengths!!! But, do not forget
about the weaknesses…Disconnected Kids

Use MOTIVATORS whenever faced with difficult tasks

It’s okay to give edible motivators as an instructional
tool
STRENGTH-BASED APPROACH

Focus on their strengths while trying to
address their weaknesses (Brain Balance)

Believe that through new experiences with
repetition, we can effectively retrain their
neurological pathways

Believe that they can learn ANYTHING given
the opportunity…and repetition for things
that don’t come easily
GOAL: INDEPENDENCE
A different perspective on
AUTISM.
HTTP://WWW.SPLENDAD.COM/ADS/SHOW/2863-GATORADE-WHATS-G-II
QUESTIONS/DISCUSSION
REFERENCES
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

Autism Society of America, http://www.autismsociety.org/site/PageServer
Autism Speaks, http://www.autismspeaks.org/
Wisconsin Department of Public Instruction: Educational Evaluation
Guide for Autism, Fall 2007
Journal of Consulting and Clinical Psychology,
55, 3-9. Lovaas, O. I. (1987).
National Professional Development Center on Autism Spectrum
Disorders, http://www.fpg.unc.edu/~autismpdC/
Autism Internet Modules, http://www.autisminternetmodules.org/
Carol Gray’s Social Stories, http://www.thegraycenter.org/
Melillo, Robert. (2009) Disconnected Kids. Penguin Group (USA)
Inc.