SPED 542 Introduction to Autism PP

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Power point on autism and communication issues related to ASD

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Introduction to Autism:

Presented by Valentin Sanchez Introduction to Autism

Introduction:

Autism was first described in 1943 by Leo Kanner , a child psychiatrist at Johns Hopkins University in Baltimore, Maryland. Dr. Kanner used the word “autism, from the Greek word autos, meaning self. He observed that the children became upset when other changes to routines occurred, and often engaged in repetitive behavior, such as hand-flapping. The symptoms described by Dr. Kanner more than 60 years ago still represent the core symptoms that define autism: social isolation, repetitive behaviors, and restricted interests, and communication and language impairments. Introduction

Diagnostic Criteria for Autistic Disorder:

Qualitative impairment in social interaction, as manifested by at least two of the following: 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. Failure to develop peer relationships appropriate to developmental level. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people. Lack of social or emotional interest. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, (Copyright 2000). American Psychiatric Association Diagnostic Criteria for Autistic Disorder

Diagnostic Criteria for Autistic Disorder (cont.):

Restricted repetitive and stereotyped patterns of behavior, interest, and activities, as manifested by at least one of the following: Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus. Apparently inflexible adherence to specific, nonfunctional routines or rituals. Stereotyped and repetitive motor manners (hand or finger flapping). Persistent preoccupation with parts of objects. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, (Copyright 2000). American Psychiatric Association Diagnostic Criteria for Autistic Disorder (cont.)

Diagnostic Criteria for Autistic Disorder (cont.):

Qualitative impairments in communication as manifested by at least one of the following. Delay in, or total lack of, the development of spoken language. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others. Stereotyped and repetitive use of language or idiosyncratic language. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, (Copyright 2000). American Psychiatric Association Diagnostic Criteria for Autistic Disorder (cont.)

Characteristics of Individuals with Autism Spectrum Disorders:

Autism S pectrum D isorder (ASD) is characterized by a core triad of diagnostic features: Impairments in social interaction. Young children with autism often are delayed in their use of eye gaze. Impairments in communication. Many experience delayed communication and language development, while others never learn to talk at all ( Sturmey & Sevin , 1994). Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. Rocking or spinning, hand or arm flapping. Interests in narrowly focused topics. Other interests may be more unusual. Characteristics of Individuals with Autism Spectrum Disorders

Commonly Used Screening Measures for ASD:

INSTRUMENT AGE RANGE FORMAT MOST APPROPRIATE USE AUTHOR(S) Asperger Syndrome Diagnostic Scale 5-18 years Parent or professional Questionnaire Targeted Screening Myles, Bock & Simpson (2001) Autism Spectrum Screening Questionnaire (ASSQ) 6-17 years Parent Questionnaire Targeted Screening Ehlers, Gillberg , Wing (1999) Gilliam Autism Rating Scale (GARS)-2 nd Ed. 3-22 years Questionnaire completed by parent, teacher or clinician. Targeted Screening Gilliam 2006 Modified Checklist for Autism in Toddlers (M-CHAT) 16-30 months Parent Questionnaire Targeted Screening Robins, Fein, Barton, (2001) Screening Tool for Autism in Two Year-Olds (STAT) 24-36 months Interactive Play-based Targeted Screening Stone & Ousley (1997) Social Communication Questionnaire (SCQ) 4 years and up Parent Questionnaire Targeted Screening Bailey, Berument , Lord, Pickles, Rutter (2003) Commonly Used Screening Measures for ASD

Communication difficulties and ASD :

Difficulties in using language: Problems with pace, volume, quality of speech, tone and inflection of voice. Echolalia – repetitive echoing of the speech of others. Incessant talking, with no regard to the interest or attention of the listener. Constant questioning, often expecting the same response. Making irrelevant comments out of context. Distortion of language rules e.g. answering a question with a question. Making tactless remarks and/or using inappropriate language. Communication difficulties and ASD

Communication issues related to students with ASD:

Communicative intent is defined as a desire or necessity to affect the receiver’s behavior , emotions, ideas , etc . Research has shown that very often autistic children do not lack communicative intent, but rather show a limited ability to use verbal or non-verbal communication for different purposes, and often use unconventional means of communication (their own means of communication, i.e. their language we do not share .) Olga Bogdashina Communication Issues in Autism and Asperger Syndrome: Do we speak the same language ? (2004) Jessica Kingsley Publishers. Communication issues related to students with ASD

PowerPoint Presentation:

Difficulties with expressive language: Social timing – may interrupt conversation. Poor concentration. Lack of joint attention and shared interest. Letting people know s/he has something to communicate. Starting , ending and keeping a conversation going. Taking turns in conversation. Knowing if the listener is interested, understands and is paying attention. No sense of ‘register’ – recognizing suitability of when and where certain topics can be talked about , who to, for how long and the appropriateness of language to be used. Following ‘give and take’ of conversation flow, especially in group situations. Olga Bogdashina : ‘Communication Issues in Autism and Asperger Syndrome’ Jude Welton : ‘What Did You Say, What did You Mean?’ Stuart Hamilton: ‘An Asperger Dictionary of everyday Expressions’

PowerPoint Presentation:

Difficulties with receptive communication: Use and understanding of body language – facial expression, gesture, proximity, body position, eye contact. Literal understanding – problems with irony, idiom and metaphor, jokes and teasing, judging the sincerity of other people’s words. Processing delay. Understanding abstract concepts. Following instructions. Expressing and understanding emotions. Olga Bogdashina : ‘Communication Issues in Autism and Asperger Syndrome’ Jude Welton : ‘What Did You Say, What did You Mean?’ Stuart Hamilton: ‘An Asperger Dictionary of everyday Expressions’

Research based interventions for ASD.:

Goals of Pivotal Response Training- Teach learners to respond to the many learning opportunities and social interactions that occur in the natural environment. Decrease learners' needs for constant supervision and support from adults. Promote family involvement and improve the quality of life for all family members. Decrease the number of services delivered in separate settings that remove learners from the natural environment. It is very similar to the Naturalistic teaching method. Research based interventions for ASD.

PowerPoint Presentation:

An example of Pivotal Response Training would be… If you observe your students while they play, you will notice that there is a great deal of diversity in the toys they use, the complexity of their play behaviors, and how creative they are during their play activities. Students with ASD often have difficulty with symbolic play. For instance, students on the autism spectrum are less likely to pretend that a plastic plate is a hat, or that a play stove is hot. Instead , if they engage in appropriate play, they are more likely to use a toy exactly as it was designed to be used. PRT has been used to target symbolic play skills for students on the autism spectrum . In this example, the adult interacting with the child used the following strategies : following the child’s interest, modeling how to play with the toys ( including symbolic play), reinforcing attempts, using natural and direct re- inforcers , and taking turns . The National Autism Center’s (NAC)

Research based interventions for ASD. (cont.):

Modeling- The best and clearest way to teach someone what to do is to show him what to do. When we are children, we learn from observing the modeling provided by our parents, siblings, peers, and teachers. Even as adults, we continue to benefit from modeling. Modeling is most effective with ASD children when exposed at an early age (3-18 years) and when the following skills and behaviors are targeted: Communication skills Higher cognitive functioning Interpersonal skills Personal responsibility Play skills Problem behaviors Sensory and emotional regulation Research based interventions for ASD . ( cont.)

PowerPoint Presentation:

An example of Modeling would be… If a speech-language pathologist needs to target conversational skills for a student, he could design a treatment using video modeling. The video might show adults having conversations (i.e., how to initiate and maintain conversation by asking and answering questions). The next step is to decide how often the student should watch the video. Typically, the video is shown to the student immediately before the student practices holding the same conversation. Keep in mind that students should be reinforced for acceptable deviations from the videotaped conversation. The National Autism Center’s (NAC)

Research based interventions for ASD. (cont.):

Naturalistic Teaching Strategies: it is important for a child with ASD to perform skills in all environments where they naturally occur. The first principle shows us to use direct and natural consequences. The natural consequence that directly relates to our actions is what motivates us in everyday life. Naturalistic teaching strategies… Have been shown to be effective for children aged 0-9 years Have produced favorable outcomes for children with autism. Have been shown to be effective with target skills and behaviors, including: Communication skills Interpersonal skills Play skills Research based interventions for ASD. (cont.)

PowerPoint Presentation:

An example of a Naturalistic Teaching Strategy would be… A teacher wants to teach her student, Jorge, to tie his shoes. She observes Jorge’s day and assesses when naturally occurring opportunities to tie his shoelaces occur (e.g., after coming back from the playground to take sand out of his shoes , after a swimming session, etc.). We know that children with ASD often need many , many teaching trials before they will fully develop a skill. There may be limited naturally occurring opportunities to practice a skill like tying shoelaces. The teacher decides to create more such opportunities for Jorge in a natural setting. She develops a daily activity of doing relaxation training for the entire class. This relaxation activity involves removing the shoes and wiggling the toes. She has just created five additional teaching opportunities per week ! The National Autism Center’s (NAC)

In conclusion…:

“The committee recommends that educational services begin as soon as a child is suspected of having an autistic spectrum disorder. Those services should include a minimum of 25 hours a week, 12 months a year, in which the child is engaged in systematically planned, and developmentally appropriate educational activity toward identified objectives. What constitutes these hours, however, will vary according to a child’s chronological age, developmental level, specific strengths and weaknesses, and family needs . Each child must receive sufficient individualized attention on a daily basis so that adequate implementation of objectives can be carried out effectively. The priorities of focus include functional spontaneous communication, social instruction delivered throughout the day in various settings, cognitive development and play skills, and proactive approaches to behavior problems. To the extent that it leads to the acquisition of children’s educational goals, young children with an autistic spectrum disorder should receive specialized instruction in a setting in which ongoing interactions occur with typically developing children .” The National Autism Center’s (NAC) In conclusion…

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