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AUTISM. What it is, is not, and how we treat it effectively Marisa R. Leyden, M.A., BCBA. Autism: Facts. At present, 1 in 88 children in the United States are diagnosed with an autism spectrum disorder. This number is similar throughout the world.

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Autism

AUTISM

What it is, is not, and how we treat it effectively

Marisa R. Leyden, M.A., BCBA


Autism facts
Autism: Facts

  • At present, 1 in 88 children in the United States are diagnosed with an autism spectrum disorder. This number is similar throughout the world.

  • It is 4 to 5 times more likely to be diagnosed in boys than girls.

  • Most cases manifest by age 3 with reliable diagnosis possible as early as age 2.

  • 1 in 49 children in New Jersey are diagnosed with an autism spectrum disorder.

  • Currently 80 children in the Perth Amboy school district carry an autism classification


Autism myths
Autism: Myths

  • All people with autism have mental retardation

  • People with autism can’t speak

  • Autism and schizophrenia are the same

  • People with autism are savants

  • Autism is caused by “refrigerator mothers”

  • Autism is caused by the MMR vaccine

  • People with autism rock back and forth all the time


What is autism
What is Autism?

  • According to the DSM IV the essential features of autistic disorder are;

  • Markedly abnormal or impaired development in social interaction and communication

  • A markedly restricted repertoire of activities and interests

    (DSM – IV – TR, 2000)


What is autism1
What is Autism?

  • Autism is considered a spectrum disorder, meaning that a wide range of symptoms are expressed by those people diagnosed “on the spectrum”.

  • The 5 disorders which make up the autism spectrum are;

    - Autism (aka; classic autism, early infantile autism,

    childhood autism, etc.)

    - Asperger’s Disorder

    - Pervasive Developmental Disorder – Not Otherwise Specified (PDD – NOS)

    - Rett’s Disorder

    - Childhood Disintegrative Disorder


What is autism2
What is Autism?

  • The core features of the autism spectrum disorders are;

    - Impairment in social interaction

    - Impairment in communication

    - Restricted, repetitive, stereotyped patterns of behavior, interests and activities


Autism social impairment
Autism: Social Impairment

  • Marked impairment in non-verbal behavior

  • Failure to develop peer relationships

  • Lack of joint attention

  • Lack of social or emotional reciprocity


Autism communication
Autism: Communication

  • Delay or lack of speech, with no non-verbal compensation

  • Where there is speech, lack of ability to initiate or sustain conversation

  • Stereotyped, repetitive and idiosyncratic language

  • Lack of varied, spontaneous, make-believe or social imitative play


Autism behavior
Autism: Behavior

  • Preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal or intense

  • Rigid adherence to specific non-functional routines

  • Stereotyped and repetitive motor mannerisms

  • Preoccupation with parts of objects


What is autism3
What is Autism?

  • REMEMBER – Just becoming familiar with the diagnostic criteria and a list of symptoms will not help us to truly understand autism.

  • “When you have met an individual with autism you have met one individual with autism.” (Stephen Shore, Ed.D., a person on the spectrum)


What is autism4
What is Autism?

  • What causes autism?

  • Is autism treatable?

  • If so, how do we treat it effectively?


Autism research
Autism: Research

  • Much of today’s research focuses on a genetic link to autism. The most convincing finding in this line of research is the number of monozygotic (identical) twins that are both diagnosed with autism. There is a 60% concordance rate for classic autism and a 92% concordance rate when a broader autism phenotype is studied (Muhle, Trentacoste & Rapin, 2004)


Autism research1
Autism: Research

  • Current research suggests that there are multiple abnormalities that are spread out over several different genes that vary from one individual to another.

  • Less than a quarter of cases can be accounted for by a single genetic defect (i.e., Fragile X syndrome) or environmental insult (i.e., congenital rubella)


Autism treatment
Autism: Treatment

  • 1987 – O. Ivar Lovaas publishes his study “Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children”

  • Compared two groups of “similarly constituted” young, autistic children. One group received behavioral treatment and the other did not.


Autism treatment1
Autism: Treatment

  • Of the group that received behavioral treatment,47% achieved normal range IQ scores and were successfully placed in 1st grade classrooms in public schools.

  • Only 2% of the non-treatment group achieved normal educational and intellectual functioning


Autism treatment2
Autism: Treatment

  • The 11 Established Treatments listed by The National Standards Project are:

    - Antecedent Package

    - Behavioral Package

    - Comprehensive Behavioral Treatment for Young Children

    - Joint Attention Intervention

    - Modeling

    - Naturalistic Teaching Strategies

    - Peer Training Package

    - Pivotal Response Treatment

    - Schedules

    -Self-management

    -Story-based Intervention Package


Autism treatment3
Autism: Treatment

  • All of these established treatments have at least some basis in the behavioral literature and/or make use of strategies described in the behavioral literature

  • They all employ the following:

    - Use of positive reinforcement (R+)

    - Individualized instruction

    -Data based decision making


Teaching language to students with autism

Teaching Language to Students with Autism

The Theory of Verbal Behavior


Autism verbal behavior
Autism: Verbal Behavior

  • Developed by Skinner in his 1957 book “Verbal Behavior” and described extensively by Dr. Mark Sundberg in his publications.

  • Differs from traditional linguistics in that it treats speech and language as a behavior under the control of antecedents and consequences


Autism verbal behavior1
Autism: Verbal Behavior

  • Four of the verbal operants in the behavioral classification of language are:

    - Mand – asking for reinforcers i.e., Asking for “water” when you are thirsty.

    - Tact – Naming or identifying objects, actions, events, etc. i.e., Saying “water” because you see it.

    - Echoic – Repeating what is heard i.e., Saying “water” after someone else says “water”.

    - Intraverbal – Answering questions or having conversations where your words are controlled by other words i.e., Saying “Patten school” after someone says “Where do you work?”


Autism verbal behavior2
Autism: Verbal Behavior

  • The mand is an especially important verbal operant for individuals on the autism spectrum.

    - Those individuals with language may have an extensive list of tacts (labels) but no ability to ask for what they want.

    - For those individuals who develop a mand repertoire, they may only be able to ask for desired items/activities when they are present.

    - For many who have no communicative behaviors, the only “mand” they have is to engage in maladaptive behaviors.


Autism verbal behavior3
Autism: Verbal Behavior

  • There are various types of mands:

    -Items

    -Activities/Termination of an Activity

    -Missing Items

    -Information

    -Changes in the Environment

    -etc.


Autism treatment4
Autism: Treatment

  • How can we teach individuals on the autism spectrum to mand?

    - Observe their behavior in the natural environment to determine what items/activities they like best and/or do a formal preference assessment

    - Assess the individuals best modality for communication

    - Capture and contrive motivation

    - Provide reinforcement immediately following the desired behavior and on an appropriate schedule

    - Set up the environment for learning

    - Practice in a variety of settings and situations to promote generalization


Questions

Questions?

Thanks everyone


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