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Autism Spectrum Disorders. An introduction to ASD including a brief history, profile, implications and opportunity for discussion. Autism Spectrum Disorder. Developmental disorder affecting children from birth or the early months of life.

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Autism Spectrum Disorders

An introduction to ASD including a brief history, profile, implications and opportunity for discussion


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Autism Spectrum Disorder

  • Developmental disorder affecting children from birth or the early months of life.

  • Exact cause remains unknown, but generally felt to be neurological in origin, although recent research points to possible genetic or chromosomal abnormalities as well as viral infections, pregnancy/birth complications and/or other causes.

  • May co-exist with other medical conditions e.g. fragile X syndrome, tuberous sclerosis.

  • Often accompanied by additional learning difficulties (about 75%).

  • No single consistent explanation at the moment.


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Autism Spectrum Disorder

Background / History

Leo Kanner (USA) Child Psychiatrist

Paper published in 1943 based on study of 11 cases. Resulted in identification of a separate condition – Autism.

He wandered about smiling, making stereotyped movements with his

fingers, crossing them about in the air. He shook his head from side to

side...humming the same three-note tune. He spun with great pleasure

anything he could seize upon to spin….When taken into a room, he

completely disregarded the people and instantly went for objects,

preferably those that could be spun….( Kanner 1943)


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Autism Spectrum Disorder

Background / History

Hans Asperger (Austria) Physician

Identified similar group.

1944 – published dissertation on ‘autistic

psychopathy’ in childhood.

Published in German and in middle of Second

World War - it took nearly 50 years before it was

translated (Wing 1981)

Many similarities with Kanner – use of ‘autistic’


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Autism Spectrum Disorder

Background / History

Lorna Wing – research with Judy Gould (1979)

Identified ‘threads of commonality’

amongst group of children referred for

psychiatric help who were socially impaired.

Wing’s ‘Triad of Impairments’

1988 ‘The Autistic Continuum’

1996 ‘The Autistic Spectrum’ – broader classification


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Triad of Impairments

Social Relationships

Social Communication

ASD

Rigidity of Thought, Behaviour and Play

(Social Understanding)


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Communication

  • Some children may not use spoken language to communicate, and may use non-verbal means instead, e.g. pushing, biting, squealing, crying

  • Even children with developmentally appropriate verbal skills may have problems with their use of language when talking to others (pragmatics). They may have difficulties with their non-verbal communication as well.

  • May not understand subtle conversational clues e.g. facial expressions indicating surprise, anger etc. and may therefore not know to look contrite.

  • May have difficulties with concepts e.g. more / less, time (including the need to wait)

  • Inability to ask questions to establish another persons view point, but may ask repetitive questions e.g. What's your name? This may mask unspoken anxieties in the child or indicate that they have not understood.


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Communication

  • Some children may use unusual intonation with stereotypical, stilted speech (or a sing-song intonation pattern)

  • May have a very literal understanding of speech - therefore may fail to follow a lot of classroom language e.g. "its time to go outside" may mean “take your apron off, get your coat and line up at the door" but a child with ASD may think they can go straight outside and may consequently appear disobedient. Literality can lead to distress e.g. “go to the toilet and wash your hands"

  • Repetition of chunks of language heard in other situations/videos - may sound clumsy or odd


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Social Relationships

• Child may display general awkwardness in social

situations

• May be unable to interact appropriately with peers

• Difficulty in making friends – may initiate and want

social contact, but lack understanding and skills to

carry through

• Unusual facial and/or physical gestures (smiles,

grimaces, eye-contact)


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Social Relationships

• Problems with social “distance”

• Child may have difficulties with conventional

turn-taking and sharing. May start/finish

conversations abruptly or fail to answer

appropriately.

• Child may not see themselves as a part of group

• Motivation – may not be rewarded by success at

tasks

(They are not being lazy or obstinate!)


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Rigidity of thought, play and behaviour

  • Their play may be learnt and repeated. This means that initially the child’s play skills may appear appropriate, but over time it is apparent that the child’s play sequences are not extending.

  • Imaginative and symbolic play begins to emerge at around 2 to 2 ½ years, but for children with ASD their play may be repetitive and limited to specific actions, e.g. lining toys up, moving trains around a track

  • May find activities difficult when imagination or pretend skills are needed, e.g. home corner, role play games

  • Difficulty coping with adult direction and imposed routines

  • Difficulties with understanding changes in routine and new situations


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Rigidity of thought, play and behaviour

  • Some children exhibit fixed interests and may become obsessional about these

  • Attentional problems on tasks chosen by others

  • Difficulties with problem solving, e.g. finding an item that is not in its usual place

  • Seeing 'part' rather than 'whole' - not the 'bigger picture‘, e.g. focusing on a specific part of a picture

  • Rigidity of thinking and behaviour – being a ‘class policeman’

  • Perseveration - the need to repeat words, actions, activities etc


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Beyond the Triad of Impairments

The Sensory World of Autism

• Senses provide us with the unique experiences which allow us to interact & be involved with others

• Senses play a significant role in determining our responses to a particular situation

• Many individuals with autism experience either an intensification or absence of sensory integration

  • Hyper— Hypo—


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The Sensory World of Autism

The Five Senses

• Touch (includes balance and body awareness)

Tactile: relates to touch ,pressure, pain, hot/cold

Hypo- Holding others tightly

High pain threshold

Self-harming (biting, gouging etc.)

Hyper- Finds touch painful/uncomfortable

(Social aspect)

Sensitivity to certain clothing/textures

  • Dislike of having things on hands/feet


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The Sensory World of Autism

The Five Senses

• Touch (includes balance and body awareness)

Vestibular: informs where body is in space

Hypo- The need for rocking, swinging,spinning

Hyper- Difficulties in activities which include movement (sport, dance)

Difficulties in stopping quickly or during an activity


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The Sensory World of Autism

The Five Senses

• Touch (includes balance and body awareness)

Proprioception: where & how body is moving

Hypo- Proximity – personal body space in relation to others.

Navigating rooms – avoiding obstructions.

Hyper- Fine motor difficulties, manipulating small objects (buttons, threading, shoe laces etc).

Moves whole body to look at something.


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The Sensory World of Autism

The Five Senses

• Sight

Visual: helps to define objects, colours, space

Hypo- Peripheral vision (central vision blurred)

Poor depth perception (throwing/catching)

Hyper-Fragmentation of images (too many sources)

Focussing on particular detail (rather than whole).


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The Sensory World of Autism

The Five Senses

• Hearing

Auditory: informs about sounds around us

Hypo- Partial or complete absence of hearing

Enjoys noisy places/activities (bangs things)

Hyper- Magnification or distortion of sounds

Unable to filter out external sounds


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The Sensory World of Autism

The Five Senses

• Smell

Olfactory: Is the first sense we rely on

Hypo- May be oblivious to strong odours

May lick things indiscriminately

Hyper- Smells appear intensified/overpowering.

Toileting problems


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The Sensory World of Autism

The Five Senses

• Taste

Gustatory: Informs about various tastes

Hypo- Likes very spicy/salted foods

May eat anything (soil, grass, material etc)

Hyper- Prefers bland (white) food

Texture of food may be problematic (lumps)


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The National Picture

Estimated population of ASD (whole spectrum) in the UK

National Autistic Society estimated the

prevalence at 1:100

No. of children with ASDs under 18 (est.) 133,500

(based on 2001 census – UK under-18 population of 13,354,297


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The Local Picture

October 2006 – Yorks & Humbs ASD Regional Partnership Benchmarking questionnaire. Numbers of pupils in each regional Local Authority with ASDs.

Mainstream & Special School pupils from pre-school to Post 16

Rotherham incidence: slightly higher (approx 650 children with diagnosed ASDs


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Discussion Points

  • Implications for education

  • Implications for families

  • Support networks (schools)

  • Support networks (families)

  • Any other questions?


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