Transcript Introduction to Autism Session One What is Autism Presented by Marc Tardif Social Skills Program Co-ordinator.

Introduction to Autism
Session One
What is Autism
Presented by
Marc Tardif
Social Skills Program Co-ordinator
Learning Objectives:
After the workshop participants will be able to:

Label the disorders which fall under the PDD umbrella
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Label the three Autism Spectrum Disorders

Describe impairments in social interaction,
communication, & behaviour
The Latest Statistics…
1 in 165 Canadians are affected with ASD
Ratio of males to females 4:1
Possible Causes of Autism
Genetic:
Current research links ASD to biological or neurological
differences in the brain
Organic:
Some research suggests that environmental
factors play a part in the expression of ASD
DSM IV Diagnostic Criteria

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At least two impairments in social interaction
At least one impairment in communication
At least one impairment in restricted or repetitive
behaviour
A diagnosis requires a total of 6 or more impairments
present in total
Impairment in Social Interaction

Impairment in the use of nonverbal behaviours

Failure to develop peer relationships appropriate to age
level
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Lack of spontaneous seeking and sharing

Lack of social or emotional reciprocity
*requires at least two impairments from this category
Impairments in Communication
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Delay or total lack of the development of spoken
language
In individuals with adequate speech, marked
impairment in ability to initiate or sustain conversation
Stereotyped, repetitive use of language or idiosyncratic
language
Lack of make-believe play or social imitative play
*requires at least one impairment from this category
Restricted, Repetitive and Stereotyped
Patterns of Behaviour

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Preoccupation with one or more stereotyped and
restricted patterns of interest
Apparently inflexible adherence to specific,
nonfunctional routines or rituals
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Stereotyped and repetitive motor mannerisms
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Persistent preoccupation with parts of objects
*requires at least one impairment from this category
Diagnosis

A diagnosis is reached after an assessment is
completed by a pediatrician or a psychologist

Diagnosis can take place as early as 18 months

There is no proven cause or cure for autism
(Scientific American Journal, 2000)
Pervasive Developmental Disorder
CDD
Rett’s
Syndrome
Autism
Asperger
Syndrome
PDDNOS
Autism Spectrum
Disorders (ASDs)
Childhood Disintegrative Disorder

Extremely rare: Prevalence rate 1.7/100 000

Typical development until age two

Onset usually between 36 – 46 months

Significant loss of skills

More common in boys than girls 4:1
(Canadian Journal of Psychiatry- In Review)
Rett’s Syndrome

1 in 10,000-23,000

Have normal head size at birth and normal
development

Between 5 – 48 months head growth slows

Develop stereotypic hand movements

Poor coordination and social withdrawal occurs
(Source: Canadian Journal if Psychiatry- In Review)
Pervasive Developmental Disorder –Not
Otherwise Specified
(PDD-NOS)

Referred to as “Atypical” autism

Do not meet criteria for full autism diagnosis

Traditionally seen as a “milder” form of autism

Is a diagnosis by exclusion of other disorders in
autistic spectrum
Screening and assessment is the same as for
autism

Asperger Syndrome

Must have both:
1. Qualitative impairment in social interaction
2. Restricted and repetitive patterns of behaviour, interests and
activities
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No delay in language development, though language development
may be peculiar
Fail to make connection between thoughts/feelings and
behaviour/actions
Symptoms may be subtle or even undetected until child is over 3
years of age
Facts about Asperger’s
Syndrome (AS)
 First identified by Dr. Hans Asperger
in 1944
 Approximately 5 out of every 10,000
people 15,000 Canadians
 More common in boys than girls (4:1)
(Autism Society, 2005)
Autism

Usually manifests itself during the first three years of life

Problems with social interactions is the hallmark
symptom as people with ASD have problems relating to
others

The range and intensity of disability varies widely

Associated with developmental disability
High-functioning Autism (HFA) vs.
Asperger’s Syndrome (AS)
DSM-IV-TR criteria:

History of language delay in HFA but not in AS

Intact cognitive functioning in AS but not in HFA
(Tsai, 2005)
Differences
Autism
Asperger’s
Onset
1-3 years
After 3 years
Early Language
Impaired
proficient
Motor Skills
Developmental level
Below developmental level
Cognitive Level
Often below chronological
age
At or above chronological
age
Visual Spatial Skills
Strength
weakness
Verbal Skills
Weakness
strength
Social Pragmatic Aspects of
Language
Weakness
weakness
Repetitive Behaviour
Actions, objects/physical
mannerisms
Verbal cognitive
mannerisms
(Condillac, 2003)
Triad of Impairments
Social Interaction
Language and Communication
Restricted, Repetitive Behaviour
Social Deficits

Lack of reciprocal social interactions

Unusual reaction to other’s emotions

Lack of joint attention

May not seek out the company of peer

Avoidance of eye contact
Social Interaction
Communication Deficits
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Idiosyncratic use of language
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Literal interpretation of language

Echolalia or delayed echolalia

Use of unusual expressions

Tend to use third person
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Difficulty initiating/sustaining a conversation
Communication Deficits
Thank you MGM. Rain Man Best Picture 1988
Communication Deficits
Literal Interpretation
http://www.boreme.com/boreme/funny2007/police-helps-kid-p1.php
Temple Grandin
“During the last couple of years I have become more aware of a kind of
electricity that goes on between people. I have observed that when
several people are together and having a good time, their speech and
language follow a rhythm. They will all laugh together and then talk quietly until
the next laughing cycle…”
“I have always had a hard time fitting in with this rhythm, and I usually interrupt
conversations without realizing my mistake. The problem is that I can’t follow
the rhythm.”
(Grandin, 1995)
Behavioural Deficits

Insistence on sameness
No real fear of dangers
Hand or arm flapping
Spins objects
Tantrums
Inappropriate attachment to objects

Uneven gross or fine motor skills
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Triad + 2
Restricted and Repetitive
Behaviours
Social Interactions
Language and
Communication
Sensory
Anxiety
Anxiety and PDD

Neurological differences responsible for anxiety
coping
Anxiety is a subjective response to stimuli

Difficulty using “buffers”

Behaviours quickly become an anxiety reduction tool

Kevin Baskerville (2005)
Sensory Issues
Children with Autism tend to overreact or under react to
sensory input

Under react (hyposensitive): don’t respond to small or
even moderate amounts of stimulation in the area of
their sensitivity (i.e., fail to respond to ordinary speech)

Over react (hypersensitive): find small or moderate
amount of stimulation overloading or irritating (i.e.,
speech or television)
Sensory Issues

Auditory- hearing appears to be selective

Visual- attraction or aversion to particular visual
stimuli

Tactile- attachment to objects may be related to
tactile qualities

Taste- non-food items are sometimes tasted

Smell- sometimes become fixated on the smell of
something
Sensory Overload
Activity
Risk Markers ("Red Flags")
Social
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Little or no eye contact
Difficulty mixing with other children
No functional play but uses objects in a
repetitive manner (lining up, stacking)
Prefers to be alone
May not want to be held or cuddled
Risk Markers ("Red Flags")
Communication
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Inappropriate laughing or giggling
Echolalia
Not responsive to verbal cues
Difficulty in expressing needs, failure to use
gestures or pointing in place of words
Risk Markers ("Red Flags")
Behavioural
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Insistence on sameness, resists change in routine
No real fear of danger
Toe walking
Hand or arm flapping
Apparent insensitivity to pain
Spins objects
Noticeable physical over/under activitiy
Tantrums
Uneven gross/fine motor skills
Autism Speaks
Video From : www.autismspeaks.org
Please fill out your
evaluation forms
References
Autism Society (2005). Retrieved March 12, 2005 from www.autismsocietycanada.ca
American Psychiatric Association. Quick Reference to the Diagnostic Criteria from DSM-IV-TR. Arlington, VA.
Baron-Cohen, Simon (1995). Mindblindness. MIT Press, United States.
Baskerville, Kevin (2005). Mapping your way through the ASD maze: reducing anxiety to assist individuals with
ASD. Autism Inclusion Coordinator, Autism Team. Warwickshire, DISCS, England.
CAIRN(2006). Canadian autism intervention research network. Retrieved May 20, 2006 from www.cairn-site.com
Collins, Paul (2004). Not even wrong; adventures in autism. Bloomsbury, New York & London.
Cutler, Eustacia. A Thorn In My Pocket.
Gaining Face www.ccoder.com/GainingFace
Gray, Carol (2005). The national autism conference presents: from kid-tastrophe to cooperation: loss, learning and
students with ASD. Progress through partnership. National Autism Conference. Penn
State, Pennsylvania.
Gray, Carol. (2005) From Kid-tasphrope to Cooperation: Loss, Learning and Students with ASD. The Gray Center
for Social Learning and Understanding, Grand Rapids, Michigan.
Grandin, T. (June 2000) http://www.cdrcp.com/aut_teachingtips.html
Grandin, Temple. (1995) Thinking in Pictures and Other Reports From My Life With Autism. Vintage Books, New
York.
Gwynne, Fred (1970). The king who rained. Windmall Books, New York.
References
Haddon, Mark (2003). The curious incident of the dog in the night-time. Anchor Canada.
Howlin, Patricia (2000) Geneva centre international symposium on autism. Canadian Management
Centre.
Hodgdon, L. (2005) ASD ProvincialConference
Hodgdon, L., (1995). Visual Strategies for Improving Communication – Practical Supports for School
and Home. Troy, Michigan, USA: QuirkRoberts Publishing
Integrated Services Division Ontario Ministry of Community, Family and Children’s Services. Intensive
behavioural intervention: a manual for instructor-therapists Version 2.
Jackson, Luke (2002). Freaks, geeks and asperger syndrome. Jessica Kingsley Publishers. London &
Philadeplhia
Leaf & McEachin (1999). A Work In Progress: Behavior management strategies and a curriculum for
intensive behavioural treatment of autism. New York, NY: DRL Books, L.L.C.
Metro-Goldwyn-Mayer Studios Inc (1998). Rainman. Best Picture, MGM Studios Inc.
Michaels, Alex (2005). Executive functioning. Educational Consultants of New England, Inc. Waltham,
MA. Retrieved May 5, 2006 from
http://www.stopthatbehaviour.com/i_executive_functioning.html
References
Ministry of Education Ontario. Special Education Monographs No.4: Students with Autism. April 1990.
Retrieved October 19, 2005. http://www.edu.gov.on.ca/eng/general/elemsec/monog4.html
Newport, Jerry (2005). The person is more important than the label. Progress Through Partnership. National
Autism Conference. State College, Pennsylvania.
Notbohm, Ellen. (2005). Ten things Every Child With
Autism Wishes You Knew. Arlington, Texas:
References
Future Horizons
Perry A, Condillac R.L (2003). Evidence-based practices for children and adolescents with autism specturm
disorders: review of the literature and practice guide. Children’s Mental Health of Ontario.
Toronto,
Ontario, Retrieved September 15th 2005.
Pennsylvania, State College (2005). Progress through partnership, national autism conference. Penn State.
Robledo, S.J & Ham-Kucharski, D (2005). The autism book, answers to your most pressing questions.
Group Inc. New York.
Penguin
References
Stokes, S. (2001). Structured teaching: Strategies for supporting students with autism? Written under a contract
with CESA 7 and funded by a discretionary grant from the Wisconsin Department of Public Instruction.
http://www.cesa7.k12.wi.us/sped
Tidmarsh, Lee & Volkmar, Fred (2003). The canadian journal of psychiatry-in review. Vol 48, No 8,
September 2003. Pg. 518, 519
Tsai, Luke. M.D. (2005). Autism spectrum disorder and co-morbid neuorpsychiartric disorders. Progress Through
Partnership. National Autism Conference. State College, Pennsylvania.
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Touch.
Winter, Matt (2003). Asperger syndrome, what teachers need to know. Jessica Kingsley Publishers, London
& Philadelphia.