Transcript Autism Spectrum Disorders

Autism Spectrum Disorders
An introduction to ASD including a
brief history, profile, implications
and opportunity for discussion
Autism Spectrum Disorder
• Developmental disorder affecting children from birth or
the early months of life.
• Exact cause remains unknown, but generally felt to be
neurological in origin, although recent research points to
possible genetic or chromosomal abnormalities as well
as viral infections, pregnancy/birth complications and/or
other causes.
• May co-exist with other medical conditions e.g. fragile X
syndrome, tuberous sclerosis.
• Often accompanied by additional learning difficulties
(about 75%).
• No single consistent explanation at the moment.
Autism Spectrum Disorder
Background / History
Leo Kanner (USA) Child Psychiatrist
Paper published in 1943 based on study of 11 cases.
Resulted in identification of a separate condition –
Autism.
He wandered about smiling, making stereotyped movements with his
fingers, crossing them about in the air. He shook his head from side to
side...humming the same three-note tune. He spun with great pleasure
anything he could seize upon to spin….When taken into a room, he
completely disregarded the people and instantly went for objects,
preferably those that could be spun….( Kanner 1943)
Autism Spectrum Disorder
Background / History
Hans Asperger (Austria) Physician
Identified similar group.
1944 – published dissertation on ‘autistic
psychopathy’ in childhood.
Published in German and in middle of Second
World War - it took nearly 50 years before it was
translated (Wing 1981)
Many similarities with Kanner – use of ‘autistic’
Autism Spectrum Disorder
Background / History
Lorna Wing – research with Judy Gould (1979)
Identified ‘threads of commonality’
amongst group of children referred for
psychiatric help who were socially impaired.
Wing’s ‘Triad of Impairments’
1988 ‘The Autistic Continuum’
1996 ‘The Autistic Spectrum’ – broader classification
Triad of Impairments
Social
Relationships
Social
Communication
ASD
Rigidity of Thought,
Behaviour and Play
(Social Understanding)
Communication
• Some children may not use spoken language to
communicate, and may use non-verbal means instead,
e.g. pushing, biting, squealing, crying
• Even children with developmentally appropriate verbal
skills may have problems with their use of language
when talking to others (pragmatics). They may have
difficulties with their non-verbal communication as well.
• May not understand subtle conversational clues e.g.
facial expressions indicating surprise, anger etc. and
may therefore not know to look contrite.
• May have difficulties with concepts e.g. more / less, time
(including the need to wait)
• Inability to ask questions to establish another persons
view point, but may ask repetitive questions e.g. What's
your name? This may mask unspoken anxieties in the
child or indicate that they have not understood.
Communication
• Some children may use unusual intonation with
stereotypical, stilted speech (or a sing-song intonation
pattern)
• May have a very literal understanding of speech therefore may fail to follow a lot of classroom language
e.g. "its time to go outside" may mean “take your apron
off, get your coat and line up at the door" but a child with
ASD may think they can go straight outside and may
consequently appear disobedient. Literality can lead to
distress e.g. “go to the toilet and wash your hands"
• Repetition of chunks of language heard in other
situations/videos - may sound clumsy or odd
Social Relationships
• Child may display general awkwardness in social
situations
• May be unable to interact appropriately with peers
• Difficulty in making friends – may initiate and want
social contact, but lack understanding and skills to
carry through
• Unusual facial and/or physical gestures (smiles,
grimaces, eye-contact)
Social Relationships
• Problems with social “distance”
• Child may have difficulties with conventional
turn-taking and sharing. May start/finish
conversations abruptly or fail to answer
appropriately.
• Child may not see themselves as a part of group
• Motivation – may not be rewarded by success at
tasks
(They are not being lazy or obstinate!)
Rigidity of thought, play and behaviour
• Their play may be learnt and repeated. This means that
initially the child’s play skills may appear appropriate, but
over time it is apparent that the child’s play sequences
are not extending.
• Imaginative and symbolic play begins to emerge at
around 2 to 2 ½ years, but for children with ASD their
play may be repetitive and limited to specific actions, e.g.
lining toys up, moving trains around a track
• May find activities difficult when imagination or pretend
skills are needed, e.g. home corner, role play games
• Difficulty coping with adult direction and imposed
routines
• Difficulties with understanding changes in routine and
new situations
Rigidity of thought, play and behaviour
• Some children exhibit fixed interests and may
become obsessional about these
• Attentional problems on tasks chosen by others
• Difficulties with problem solving, e.g. finding an
item that is not in its usual place
• Seeing 'part' rather than 'whole' - not the 'bigger
picture‘, e.g. focusing on a specific part of a
picture
• Rigidity of thinking and behaviour – being a
‘class policeman’
• Perseveration - the need to repeat words,
actions, activities etc
Beyond the Triad of Impairments
The Sensory World of Autism
• Senses provide us with the unique experiences which
allow us to interact & be involved with others
• Senses play a significant role in determining our
responses to a particular situation
• Many individuals with autism experience either an
intensification or absence of sensory integration
Hyper—
Hypo—
The Sensory World of Autism
The Five Senses
• Touch (includes balance and body awareness)
Tactile: relates to touch ,pressure, pain, hot/cold
HypoHyper-
Holding others tightly
High pain threshold
Self-harming (biting, gouging etc.)
Finds touch painful/uncomfortable
(Social aspect)
Sensitivity to certain clothing/textures
Dislike of having things on hands/feet
The Sensory World of Autism
The Five Senses
• Touch (includes balance and body awareness)
Vestibular: informs where body is in space
Hypo- The need for rocking, swinging,spinning
Hyper- Difficulties in activities which include
movement (sport, dance)
activity
Difficulties in stopping quickly or during an
The Sensory World of Autism
The Five Senses
• Touch (includes balance and body awareness)
Proprioception: where & how body is moving
Hypo- Proximity – personal body space in relation to
others.
Navigating rooms – avoiding obstructions.
Hyper- Fine motor difficulties, manipulating small
objects (buttons, threading, shoe laces etc).
Moves whole body to look at something.
The Sensory World of Autism
The Five Senses
• Sight
Visual: helps to define objects, colours, space
Hypo- Peripheral vision (central vision blurred)
Poor depth perception (throwing/catching)
Hyper-Fragmentation of images (too many sources)
whole).
Focussing on particular detail (rather than
The Sensory World of Autism
The Five Senses
• Hearing
Auditory: informs about sounds around us
Hypo- Partial or complete absence of hearing
Enjoys noisy places/activities (bangs things)
Hyper- Magnification or distortion of sounds
Unable to filter out external sounds
The Sensory World of Autism
The Five Senses
• Smell
Olfactory: Is the first sense we rely on
Hypo- May be oblivious to strong odours
May lick things indiscriminately
Hyper- Smells appear intensified/overpowering.
Toileting problems
The Sensory World of Autism
The Five Senses
• Taste
Gustatory: Informs about various tastes
Hypo- Likes very spicy/salted foods
May eat anything (soil, grass, material etc)
Hyper- Prefers bland (white) food
Texture of food may be problematic (lumps)
The National Picture
Estimated population of ASD (whole
spectrum) in the UK
National Autistic Society estimated the
prevalence at 1:100
No. of children with ASDs under 18 (est.)
133,500
(based on 2001 census – UK under-18
population of 13,354,297
The Local Picture
October 2006 – Yorks & Humbs ASD
Regional Partnership Benchmarking
questionnaire. Numbers of pupils in each
regional Local Authority with ASDs.
Mainstream & Special School pupils from
pre-school to Post 16
Rotherham incidence: slightly higher
(approx 650 children with diagnosed ASDs
Discussion Points
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Implications for education
Implications for families
Support networks (schools)
Support networks (families)
• Any other questions?