AUTISM

1. AUTISM

2. 1. Autistic Disorder • Impairments in social interaction, communication, and imaginative play. • Apparent before age 3. • Also includes stereotyped behaviors, interests, and activities

3. 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

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

5. 1. Communication/language • Broad range of abilities, from no verbal communication to quite complex skills • Two common impairments: • A. Delayed language • B. Echolalia

6. 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

7. B. Echolalia • Common in very young children (Age 3) • Immediate or delayed (even years) • Is there communicative intent with echolalia?

8. 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?

9. 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

10. 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 very early – perhaps at birth

11. 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

12. 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 difficult • Savant syndrome

13. Baron-Cohen, Leslie & Frith (1985) Does the Autistic child have a Theory of Mind?

14. The Sally-Anne Test A tool to diagnose Autism?

16. The Baron Cohen et al conclusion • That autistic children do not have a • THEORY OF MIND • are unable to recognise that other people may have ‘their own’ representation of the world in their heads

17. Another Advanced Test of Theory of Mind: Evidence from Very High Functioning Adults with Autism or Asperger Syndrome. Simon Baron-Cohen and Therese Jolliffe (University of Cambridge) Catherine Mortimore and Mary Robertson (University of London). 1997

18. SubjectsGroup 1 • 4 high functioning autistic adults with IQ > 85 (WAIS-R) diagnosed using DSM-IV with language delay. • 12 Asperger Syndrome adults diagnosed using ICD-10 with no language delay. • All together 13 males and 3 females. • All within normal intelligence range.

19. SubjectsGroup 1 • Sampling – clinical sources plus advert in National Autistic Society magazine ‘Communication’.

20. Group 2 • 50 normal age matched adults (25 males and 25 females). They were Cambridge (non-university) residents. No psychiatric illness (self-report). A random selection from the subject panel. Their IQ was not measured but was considered to be within the normal range.

21. Group 3 • 10 Adult Tourette Syndrome (TS) sufferers. Age matched with groups 1 and 2. (8 males and 2 females). Diagnosed using DSM-IV. Sampling frame was a tertiary referral centre in London.

22. Group 3 • IQ greater than 85 (short form WAIS-R using block design, object assembly and vocabulary comprehension). Short form used owing to limited time available for testing. Short form correlates with full scale 0.91.

23. Subjects • Groups 1 and 3 had to pass 2 1st order false belief tasks and a second-order task (all passed). A first-order task requires the subject to infer the thoughts of another person. A second-order task involves the subject reasoning about what one person thinks about another person’s thoughts.

25. Method and Design • · Eyes Task • · Strange Stories task • · 2 control tasks • Presented in random order.

26. The Eyes Task • Magazine photos • 15cm X 10cm • Black and White • Midway along nose to just above eyebrow. • 3 second exposure and then a forced choice between 2 mental states.

27. The Eyes Task • “Which word best describes what the person is feeling or thinking?” • 25 pictures

28. 1 Serious or Fantasising

29. 2 Anticipation or Despairing

30. 3 Certain or Doubtful

31. 4 Submissive or Defiant

32. 5 Uncertain or Confident

33. 6 Concerned or unconcerned

34. 7 Distrustful or Trustful

35. 8 Suspicious or Trusting

36. 9 Unfriendly or Friendly

37. Answers

38. 1 Fantasising

39. 2 Anticipation

40. 3 Doubtful

41. 4 Defiant

42. 5 Confident

43. 6 Concerned

44. 7 Distrustful

45. 8 Suspicious

46. 9 Friendly

48. The Eyes Task • Four judges 2 male and 2 female picked the labels and opposites in open discussion. • Eight judges 4 males and four females independently agreed the labels unanimously. • They were blind to the hypothesis. • Task validated by Happes (1994) strange stories.

49. Control tasks. • Gender recognition task – the same eyes were used but participants were required to recognise gender. • Basic emotion recognition task (emotion task) – participants are required to judge the emotion of the whole face. • Six faces were used – happy, sad, angry, afraid, disgusted and surprised. These are considered to be basic emotions.