Gheel Autism ServicesCaring for adults with an Autistic Spectrum Disorder ~ Autistic Spectrum Disorders ~ Martin Galvin Training and Development Officer Behaviour Support Specialist 15th November 2006
The terms ‘autistic’ and ‘autism’ are derived from the Greek word ‘autos’, which means self (McKernan and Mortlock, 1995).
LEO KANNER (1943) ‘early infantile autism’ HANS ASPERGER (1944) “ ‘Autistic Psychopathy’ in Childhood” Lorna Wing and Judith Gould (1979) ‘The Triad of Impairments of Social Interaction'
Kanner’s Autism • An inability to develop relationships • Delay in acquisition of language • Non-communicative use of spoken language • Delayed echolalia • Pronoun reversal
Repetitive and stereotype behaviour • Maintenance of sameness • Good rote memory • Normal physical appearance
Asperger’s Syndrome(Gillberg and Gillberg, 1989) • Social impairment • Narrow interest • Repetitive routines • Speech and language peculiarities • Non-verbal communication problems • Motor clumsiness
Autistic Spectrum Disorders ‘The continuum’ ____________________________________________ Learning Kanner’s/Classic Able/High Asperger’s Disability Autism Functioning Syndrome Autism • 2:1 4:1 8:1 10/13:1
Prevalence • National Autistic Society U.K. (1997) 56 per 10,000 • Herbert (1998) 4 –13.8 per 10,000 • Mental Health Foundation U.K. (2000) 31 – 47 per 10,000
Intellectual Disability Intelligence Quotient __________________________________ 0 20 40 60 80 100 120 170
Autistic Spectrum Disorder (ASD) • Autism • Kanner’s or Classic Autism • Able or High functioning autism • Asperger’s Syndrome (AS) • Autistic continuum or Autistic Spectrum • Savant
Diagnosing Autism • DSM – IV Rev. Diagnostic and Statistical Manual of Mental Disorder, American Psychiatric Association. • ICD – 10. W.H.O.,1993. International Classification of Diseases. • Gillberg and Gillberg (1989), Gillberg (1991): diagnostic criteria for Asperger’s Syndrome.
Checklist for autism in toddlers (CHAT) • Childhood autism rating scale (CARS) • Autism diagnostic interview (ADI) • Diagnostic interview for social and communication disorders (DISCO)
Triad of impairments(Wing and Gould, 1979) • The autistic spectrum disorder is recognised by a combination of three impairments, with varying degrees of severity.
Triad of impairments(Wing and Gould, 1979) • Impairment of social interaction • Impairment of social communication • Impairment of social imagination and play
Impairment of social communication Verbal difficulties: • Delay in the development of language • Comprehension difficulties • Literalness • Echolalia • Repetitive use of language • Language not used for communication, used to meet their needs, make statements and ask questions • Talk at others, not with
Non-Verbal difficulties: • Failure to convey or comprehend gesture, mime, facial expression, body posture, verbal intonation • Failure to read body language e.g. facial expression • Gestures that are stiff and stilted or too dramatic or exaggerated
Impairment of social interaction • The lack of the inbuilt ability to recognise that other people have thoughts and feelings • The Aloof • The Passive • The active but odd • The ‘over formal’ stilted
Impairment of social imagination and play • Inability to play imaginatively with objects or toys • Resistance to change a likeness for sameness and predictability • Ritualistic behaviours – obsessive interests • Inability to understand abstract concepts • Absence of empathy
Older theories about the causes of autism Psychological explanations: • Social class and autism • Parenting style (Bettelheim 1903 –1990) • Refrigerated mother syndrome
Sensory impairments • Hearing • Sight • Smell • Taste • Touch • Vestibular • Proprioceptive
Sensory overload You just get this whole load of sensory impressions… you are going to run full tilt into a wall or into the traffic or harm yourself…… anything to stop the sensory overload happening because I would much rather have pain ….. Its one overriding sensation rather than getting a whole lot of confused jumbles. (Lindsay Weeks)
Theories about the causes of autism • Pre-natal factors • Peri-natal factors • Post- natal factors
Autistic Spectrum Disorders • Epilepsy 20% - 35% (Trevarthen et al.,1998)
National Autistic Society U.K. (1997) 56 per 10,000Herbert (1998) 4 –13.8 per 10,000Mental Health Foundation U.K. (2000) 31 – 47 per 10,000Gheel Autism ServicesCaring for adults with an Autistic Spectrum Disorder Philosophy “If you would help me, don’t try to change me to fit your world. Don’t try to confine me to some tiny part of the world that you can change to fit me. Grant me the dignity of meeting me on my own terms – recognise that we are equally alien to each other, and that my ways of being are not merely damaged versions of yours. Question your assumptions. Define your terms. Work with me to build more bridges between us.” (J. Sinclair : Personal Essay – High Functioning individuals with autism E. Schopler, G. Mesibov, 1992).