Autism Spectrum Disorders

1. Autism Spectrum Disorders Consulting Project Spring 2012 Mary Moats

2. Autism Spectrum Disorders • Autism Spectrum Disorders, or ASD, are a group of developmental disabilities that cause social, behavioral, and communication deficiencies. • ASD is a spectrum disorder meaning that the symptoms appear different in each individual case. • The range for ASDs can be from very mild to severe.

3. Example of Range Symptoms There are three main symptoms that children with ASD exhibit: Social Interaction Verbal or nonverbal communication Repetitive behaviors or interests Other indicators are: Child does not babble, point, or make meaningful gestures by age 1 Does not speak in appropriate time Does not react to name Does not know how to play with toys Is attached to one particular toy Avoids eye contact Has poor language or social skills Rarely smiles Seems to be hearing impaired

4. Symptoms Cont. Social Skills Communication • Avoids Eye Contact • Prefers to play alone • Only interacts to achieve desired goal • Has flat or inappropriate facial expressions • Does not understand personal space boundaries • Avoids and resists physical contact • Is not comforted by others during stress • Delayed speech and language skills • Repeats words or phrases over and over (echolalia) • Reverses pronouns • Gives unrelated answers to questions • Does not point or respond to pointing • Talks in a flat, robot like voice • Does not pretend in play • Does not understand jokes, sarcasm, or teasing

5. Symptoms Cont. Unusual Interests or Behavior Sensory and Mental Issues • Lines up toys or other objects • Likes parts of objects • Is very organized • Gets upset by minor changes • Has obsessive interests • Has to follow certain routines • Flaps hands, rocks body, or spins self in circles • Plays with toys the same way every time • Highly attuned or even painfully sensitive to certain sounds, textures, tastes, and smells • Greater difficulty recalling verbal information compared to typically developing children

6. Diagnosis of ASD • There is a two stage process to diagnose children with ASD • 1. A screening process using parental questionnaires and clinical observations to gather information about the child’s social and communicative development. • A comprehensive evaluation by a multidisciplinary team that has a psychologist, a neurologists, a psychiatrist, and a speech therapist to examine language and social behavior.

7. Causes of ASD While the exact causes of ASD are unknown, there are many current studies trying to understand the differences in ASD children and non-ASD children. The following slides will highlight a few of these studies.

8. Brain Structure Studies • By using MRIs, researchers have been able to see major brain structures and how they look within ASD children. The major parts of the brain concerned are the cerebellum, the cerebral cortex, limbic area, corpus callosum, basal ganglia, and the brainstem.

9. Genetic Studies • Gaze avoidance is one of the earliest symptoms of ASD. Researchers now compare children with ASD to their non-ASD family members. MRI scans of the amygdala, where the brain houses emotion, showed a spike of negative feelings when eye contact is made. Purposeful avoidance of eye contact may help prevent some of the stress ASD children feel. • Assortative mating theory claims that parents of children with ASD could have a tendency of gravitating towards a mate with similar issues such as depression, drug use, or mood changes. Because this theory brings together those who might not have “mated” before, the prevalence of ASD has dramatically increased.

10. The Theory of Mind Hypothesis • Theory of Mind refers to ASD children’s inability to make connections to other peoples’ “states of mind”, such as predicting and explaining their behavior. • This theory connects the low amount of Von Economo neurons (responsible for social bonds and intuitive responses) to those with ASD.

11. Causes of ASD cont. Extreme Male Brain Theory Mercury Toxicity • Due to men only receiving one X chromosome, the chance to have defects is substantially higher. • Four out of five people with ASD are male • Simon Baron-Cohen believes in to mental domains: systemizing and empathizing. Men are able to systemize far better than women. Those with ASD lack in empathy and usually excel in the systemizing area of the brain. • Many scientists have seen the connection between the rise of ASD cases in children with the introduction of the measles, mumps, and rubella vaccine. The vaccine in the 90’s contained thimerosal, which contains mercury, and related the mercury poisoning symptoms to those with ASD. This is still being explored and nothing is solidly proven.

12. Asperger Syndrome • Discovered by Hans Asperger in 1944, Asperger syndrome patients have similar symptoms as those on the autism spectrum. • Usually referred to as a mild or high functioning form of autism. Asperger patients tend to have better communication skills. • While Asperger’s syndrome is currently its own disorder, many believe that these children should just be clarified as high functioning autism due to the difficulty in determining between the two.

13. Treatment of ASDs • There is no cure for ASD. This is a life long disorder. There are, however, effective ways to help manage the disorder such as • 1. Medication • 2. Applied Behavior analysis

14. Treatments • Applied Behavior analysis helps to reduce inappropriate behavior and helps alleviate common struggles in areas like communication, learning, and appropriate social behaviors. • Applied Behavior analysis is very complicated and time consuming. If started at an early age, experts believe it can help rewire some parts of the brain for better results. • Medicines used to treat the behavior problems in children with ASD tend to come from other disorders. • The key areas treated are aggression, self-injurious behavior, and severe tantrums. • Some of these medications treat things like: • Depression • Anxiety • Obsessive-compulsive disorders

15. Strategies for Teachers The following slides contain information for teachers regarding strategies, modifications, and adaptations that can be made in the classroom to better provide for children with ASD.

16. Below is an example of a graphic organizer used in the classroom. Learning Different Learning styles: help keep students organized by using visual aids to guide work throughout the day. Need for structure: Organize materials Give clear instructions Provide stability Establish patterns Provide consistency and predictability Increase independence Social Interactions: Lots of repetition Planned conversational scripts to use in difficult situations Speech and visual cues given at the same time A set order of interactions Messages linked to that the student is doing.

17. Parental Involvement • Parents are key to making progress in students with ASD. Because parents are around throughout the child’s life and in hours outside of school, those trained to help intercede with their child will improve their children’s behavior. • It is extremely stressful on the support systems of children with ASD. It has been stated that by being trained, it can help eliminate some of the feelings of stress and depression.

18. Parents Cont. • Parents can do the following to help their children: • Help initiate a language and speech intervention to help modify behavior. • Teach language, imitation, and preacademic skills through the use of visual aids and a strict structure • Being knowledgeable on behavior management skills • Being knowledgeable in areas such as language, social development, and problem solving helped their children do better with language skills over time.

19. Other Interventions Intensive behavioral interventions Multicomponent early intervention Language and speech treatments Setting Touch therapy Use of computers

20. In The Classroom • Teachers can provide educational structure and classroom management by: • Providing a predictable environment and routine • Prepare children for upcoming changes • Be consistent • Avoid doing for the student what they can do for themselves • Give clear, precise, concrete instruction • State expectations clearly and allow each student time to process information • Break up tasks into manageable parts

21. Instructional Approaches • Support Verbal information with visual aids • Incorporate manipulative and models • Record lessons and instructions so students can listen again and take notes later either at home or during a different hour of the day • Model the action and behavior you want students to use • Use cooperative learning and help create appropriate social responses to use in group settings • Minimize similar repetitive activities to keep students engaged • Avoid abstract language • Assign activities related to topics students enjoy to help create a fun learning experience and gain knowledge as to how facts and data are collected

22. Support and Discipline Strategies • Have a strategy ready in case students cannot cope due to overstimulation • Create a time-out or downtime area to help students refocus and gather themselves • Try to eliminate stressors in the classroom environment • Explicitly teach the rules of social conduct • Inform parents on a regular basis of the students’ good and bad days. This can be done through a journal • Protect them from teasing and bullying

23. Questions • How can a classroom teacher make sure the parents are getting the appropriate support they need to provide the best learning environment for a child with ASD? • How can teachers benefit from understanding the theories behind the causes of ASD? • How can understanding the science behind the brain workings help both teachers and parents provide the best care for children with ASD?

24. Activity • Divide up into pairs. • One student will be asked to complete a task of drawing a picture. The other student will become the teacher. • The purpose of this activity is to understand how lacking social norms and concepts can create a difficult learning environment.