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AUTISM
 WHAT IS AUTISM?

 Very complex, often baffling

developmental disability
 First described by Leo Kanner in
1943 as early infantile autism
 “Auto” – children are “locked
within themselves.”
 For next 30 years, considered to
be an emotional disturbance
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 WHAT IS AUTISM?

 3 categories for autism in IDEA?

 Today, autism is a severe form of a
broader group of disorders
 These are referred to as pervasive
developmental disorders (later)
 Typically appears during the first 3
years of life
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 WHAT IS AUTISM?

 Very likely neurological in origin –

not emotional, not the refrigerator
mom
 Prevalence is 2-6/1000 individuals
(1/2 to 1 ½ million affected)
 4 times more prevalent in boys
 No known racial, ethnic, or social
boundaries
 No relation to family income, lifestyle
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 WHAT IS AUTISM?

 Autism impacts normal development

of the brain in areas of social
interaction and communication skills.
 Difficult to communicate with others
and relate to the outside world.
 Occasionally, aggressive and/or self-
injurious behavior may be present.
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 WHAT IS AUTISM?

 May exhibit repeated body

movements (hand flapping, rocking).
 Unusual responses to people
 Attachment to objects
 Resistance to change in routine
 Sensory sensitivities
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 WHAT ARE THE TYPES?

 Actually, the “umbrella” heading is

Pervasive Developmental Disorder
(PDD).
 Autism is one of the 5 PDDs.
 All have commonalities in
communication and social deficits
 Differ in terms of severity
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 1. Autistic Disorder

 Impairments in social interaction,

communication, and imaginative
play.
 Apparent before age 3.
 Also includes stereotyped behaviors,
interests, and activities
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 2. Asperger’s Disorder

 Impairments in social interactions,

and presence of restricted interests
and activities
 No clinically significant general delay
in language
 Average to above average
intelligence
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 3. Pervasive Developmental
Disorder – Not Otherwise Specified
(PDD-NOS)

 Often referred to as atypical autism

 Used when a child does not meet the
criteria for a specific diagnosis, but
there is severe and pervasive
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impairment in specified behaviors

 4. Rett’s Disorder

 Progressive disorder which, to date,

has only occurred in girls.
 Period of normal development and
then the loss of previously acquired
skills
 Also loss of purposeful use of hands,
which is replaced by repetitive hand
movements
 Beginning at age of 1-4 years
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 5. Childhood Disintegrative
Disorder
 Normal development for at least the
first 2 years
 Then significant loss of previously
acquired skills
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 Conclusions on Types

 Autism is a spectrum disorder

 This means that symptoms and
characteristics can present
themselves in wide variety of
combinations, from mild to severe
 Autistic individuals can be very
different from each other
 “Autism” is still commonly used to
refer to any of the 5 PDDs
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 What causes (and doesn’t cause)
autism?
 Good agreement in general that
autism is caused by abnormalities in
brain development, neurochemistry,
and genetic factors
 Bettleheim’s theory of
psychogenesis?
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 How is Autism Diagnosed?

 No definitive medical test

 Team uses interviews, observation,
and specific checklists developed for
this purpose.
 Team might include neurologist,
psychologist, developmental
pediatrician, speech/language
therapist, learning consultant, etc.
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 Must rule out MR, hearing

impairment, behavior disorders, or
eccentric habits
 CHARACTERISTICS

 1. Communication/Language
 2. Social Interaction
 3. Behaviors
 4. Sensory and movement disorders
 5. Resistance to change
(predictability)
 6. Intellectual functioning
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 1. Communication/language

 Broad range of abilities, from no

verbal communication to quite
complex skills
 Two common impairments:
 A. Delayed language
 B. Echolalia
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 A. Delayed language

 50% of autistic individuals will

eventually have useful speech (?)
 Pronoun reversal: “You want white
icing on chocolate cake.”
 Difficulty in conversing easily with
others
 Difficulty in shifting topics
 Look away; poor eye contact
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 Facilitated communication??????
 Elements of Facilitated
Communication
 1. Physical Support
 2. Initial training/introduction
 3. Maintaining focus
 4. Avoiding competence testing
 5. Generalization
 6. Fading
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 B. Echolalia

 Common in very young children (Age

3)
 Immediate or delayed (even years)
 Is there communicative intent with
echolalia?
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 2. Social Interaction

 One of hallmarks of autism is lack of

social interaction
 1. Impaired use of nonverbal
behavior
 2. Lack of peer relationships
 3. Failure to spontaneously share
enjoyment, interests, etc. with others
 4. Lack of reciprocity
 Theory of mind?
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 3. Behaviors

 Repetitive behaviors, including

obsessions, tics, and perseveration
 Impeding behaviors (impede their
learning or the learning of others)
 Will need positive behavior supports
 A. Self-injurious behavior
 B. Aggression
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 4. Sensory and movement
disorders
 Very common
 Over- or under-sensitive to sensory
stimuli
 Abnormal posture and movements of
the face, head, trunk, and limbs
 Abnormal eye movements
 Repeated gestures and mannerisms
 Movement disorders can be detected
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very early – perhaps at birth

 5. Predictability

 Change in routine is very stressful

 May insist on particular furniture
arrangement, food at meals, TV
shows
 Symmetry is often important
 Interventions need to focus on
preparing students for change if
possible
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 6. Intellectual functioning

 Autism occurs in children of all levels

of intelligence, from those who are
gifted to those who have mental
retardation
 In general, majority of individuals
with autism are also identified as
having mental retardation – 75%
below 70
 Verbal and reasoning skills are
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difficult
 Savant syndrome
 Interventions

 1. Individualization and early

intervention are the keys
 2. Include life skills, functional
academics, and vocational
preparation
 3. Positive behavior support
 4. Social stories (music therapy?)
 5. Lovaas model
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