Autism 101

Lisa Kunelius
School Psychologist
Prepared for AVW
October 31, 2012

Goals for today..

This workshop will provide a good start to understanding

the challenges that persons with Autism Spectrum Disorder
(ASD) encounter. Because children with autism are on a
broad spectrum, we will learn about children along the
spectrum, their skills and unique needs. We will look at the
research by leaders in the field of autism (Stanley
Greenspan, Kathleen Quill, Tony Attwood and others),
discuss the key concepts we need to know and consider
when working with students with ASD, and how to apply
them when working with students. This workshop is
appropriate for general education and special education
teachers who want a foundation from which to build their
knowledge and skills about ASD. Paraprofessionals are
especially welcome to attend

History of Autism
Autism was first described in US literature
by Leo Kanner in 1943
He called the syndrome early infantile
autism
Autism was also often misdiagnosed as
early childhood schizophrenia
Early psychologists hypothesized that
children became autistic due to cold and
unnurturing mothers. This theory was
proven false in 1979.

CDC census data

Facts on Autism-From CDC 2010

Autism:
Between 1 in 80 and 1 in 240 with an average
of 1 in 110 children in the United States have
an ASD
Autism prevalence figures are growing (the
current annual growth rate is 10-17%)
More children will be diagnosed with autism
this year than with AIDS, diabetes & cancer
combined
Autism is the fastest-growing serious
developmental disability in the U.S.

FACTS: Continued
Autism costs the nation over $35 billion per year, a
figure expected to significantly increase in the
next decade
Recent studies have estimated that the lifetime
cost to care for an individual with an ASD is $3.2
million
Autism receives less than 5% of the research
funding of many less prevalent childhood diseases
Boys are four times more likely than girls to have
autism
There is no medical detection or cure for autism

Facts: Continued
Typically manifests around the ages of 18 months to
3 years
Is found throughout the world in families of all
racial, ethnic and social backgrounds
There is no cure, but lots of research is currently
being done.
There are lots of treatments, and from researched
based evidence, educational treatment is the most
effective.
Autism remains throughout a persons lifetime,
although with proper intervention symptoms can
lesson.

Facts: Continued
Genetics are a factor in the cause
Environmental triggers are also a factor
Dr Wakefield discredited for his research
linking autism and vaccinations.also can
no longer practice medicine in the UK
Probability of 2nd twin being diagnosed after
1st diagnosed

Screening and Diagnosis

Diagnosing autism spectrum disorders (ASDs) can be

difficult, since there is no medical test, like a blood
test, to diagnose the disorders. Doctors look at the
childs behavior and development to make a diagnosis
ASDs can sometimes be detected at 18 months or
younger. By age 2, a diagnosis by an experienced
professional can be considered very reliable.[1]
However, many children do not receive a final
diagnosis until much older. This delay means that
children with an ASD might not get the help they
need.
Diagnosing an ASD takes two steps:

Developmental Screening
All children should be screened for
developmental delays and disabilities during
regular well-child doctor visits at:
9 months
18 months
24 or 30 months
Additional screening might be needed if a
child is at high risk for developmental
problems due to preterm birth, low birth
weight or other reasons.

In addition, all children should be screened

specifically for ASDs during regular well-child
doctor visits at:
18 months
24 months
Additional screening might be needed if a
child is at high risk for ASDs (e.g., having a
sister, brother or other family member with
an ASD) or if behaviors sometimes associated
with ASDs are present

Comprehensive Diagnostic
Evaluation
The second step of diagnosis is a
comprehensive evaluation. This thorough
review may include looking at the childs
behavior and development and interviewing
the parents. It may also include a hearing
and vision screening, genetic testing,
neurological testing, and other medical
testing.

Developmental Milestones
What developmental milestone is this child
displaying?

Developmental Milestones
What developmental milestone is this child
displaying?

Developmental Milestones
What developmental milestone is this child
displaying?

Developmental Milestones
What developmental milestone is this child
displaying?

Developmental Milestones
What developmental milestone is this child
displaying?

Developmental Milestones
http://
www.cdc.gov/CDCTV/BabySteps/index.html
Open hyperlink

Developmental Milestones @ 2
months

Begin to smile at people

Can briefly calm self
Tries to look at parent
Coos, makes gurgling sounds
Turns head towards sounds
Pays attention to faces
Begins to follow things with eyes and can
recognize people at a distance
Begins to act bored (fussy) if activity does
not change

Developmental Milestones @ 6
months
Knows familiar faces and begins to know if someone
is a stranger
Likes to play with others, especially parents
Responds to others emotions and often seems happy
Likes to look at self in the mirror
Responds to sounds by making sounds
Strings vowels together
Responds to own name
Makes sounds to show joy and displeasure
Shows curiosity about things and tries to get things
out of reach

Developmental Milestones @ 1
year
Shy or nervous w/ strangers
Cries when mom or dad leave
Has favorite things and people
Shows fear in some situations
Hands you a book when he wants to hear a
story
Repeats sounds or actions to get attention
Plays simple games such as peek a boo
Cooperates w/ dressing

Milestones @ 1 year: Cont

Responds to simple spoken requests
Uses simple gestures like bye bye
Makes sounds with change in tone
Says mama or da da or Uh oh!
Tries to imitate words heard
Explores things in different ways
Finds hidden things easily
Looks at the right picture when its named
Follows simple directions

Developmental Milestones @ 2
years
Copies others especially adults and older
children
Gets excited when with other children
Plays beside other children, but is beginning
to include other children such as chase
games
Points to things/pictures when named
Repeats words overheard in conversation
Points to objects in books
Names items in book such as cat, bird or
dog

Autism is a Spectrum
Disorder
Autistic Disorder
Aspergers
Disorder
Childhood
Disintegrative
Disorder
Rhetts Disorder
PDD:NOS

Early Symptoms Birth to 18

Months
Feeding problems, such as poor nursing ability.
Apathetic and unresponsive showing little or
no desire to be held or cuddled.
Constant crying or unusual absence of crying.
Disinterested in people and surroundings.
Repetitive movements, such as hand shaking,
prolonged rocking and spinning, head banging.
Sleeping problems.
Insistence on being left alone.

Early Symptoms 18 Months

to 3 Years

Difficulties in toilet training.

Odd eating habits and preferences.
Late speech, no speech, or loss of
previously acquired speech.
Sleeping problems, such as requiring only a
few hours of sleep each night.

Early Symptoms Other

Indications

Does not have anticipatory response to be

picked up.
Seems to tune out a lot.
Prolonged tantrums.
Doesnt play appropriately with toys.
Seems to have a good memory.
Fails to respond to the affection of others.

Early Symptoms Other

Indications
May use an adults hand like a tool for
accomplishing tasks.
Does not spontaneously imitate the play of
other children.
Tendency to spend inordinate amounts of time
doing nothing or pursuing ritualistic behaviors.
Difficulty with changes in environment and
routine.
Does not seek opportunities for interaction
with others.

Autism Spectrum Disorder

Must meet criteria A, B, C, and D:
A. Persistent deficits in social communication and social interaction across
contexts, not accounted for by general developmental delays, and manifest by all 3
of the following:
1.
Deficits in social-emotional reciprocity; ranging from abnormal social approach
and failure of normal back and forth conversation through reduced sharing of
interests, emotions, and affect and response to total lack of initiation of social
interaction,
2.
Deficits in nonverbal communicative behaviors used for social interaction;
ranging from poorly integrated- verbal and nonverbal communication, through
abnormalities in eye contact and body-language, or deficits in understanding and use
of nonverbal communication, to total lack of facial expression or gestures.
3.
Deficits in developing and maintaining relationships, appropriate to
developmental level (beyond those with caregivers); ranging from difficulties
adjusting behavior to suit different social contexts through difficulties in sharing
imaginative play and in making friends to an apparent absence of interest in people

Autism Spectrum Disorder

Must meet criteria A, B, C, and D:
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by
at least two of the following:
1.
Stereotyped or repetitive speech, motor movements, or use of objects; (such as
simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic
phrases).
2.
Excessive adherence to routines, ritualized patterns of verbal or nonverbal
behavior, or excessive resistance to change; (such as motoric rituals, insistence on
same route or food, repetitive questioning or extreme distress at small changes).
3.
Highly restricted, fixated interests that are abnormal in intensity or focus; (such
as strong attachment to or preoccupation with unusual objects, excessively
circumscribed or perseverative interests).
4.
Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects
of environment; (such as apparent indifference to pain/heat/cold, adverse response to
specific sounds or textures, excessive smelling or touching of objects, fascination with
lights or spinning objects).

Autism Spectrum Disorder

Must meet criteria A, B, C, and D:
C. Symptoms must be present in early
childhood (but may not become fully
manifest until social demands exceed limited
capacities)
D.
Symptoms together limit and impair
everyday functioning. (See chart)

Rationale for changes:

New name for category, autism spectrum disorder, which includes autistic
disorder (autism), Aspergers disorder, childhood disintegrative disorder, and
pervasive developmental disorder not otherwise specified.
Differentiation of autism spectrum disorder from typical development and
other "nonspectrum" disorders is done reliably and with validity; while
distinctions among disorders have been found to be inconsistent over time,
variable across sites and often associated with severity, language level or
intelligence rather than features of the disorder.
Because autism is defined by a common set of behaviors, it is best
represented as a single diagnostic category that is adapted to the individuals
clinical presentation by inclusion of clinical specifiers (e.g., severity, verbal
abilities and others) and associated features (e.g., known genetic disorders,
epilepsy, intellectual disability and others.) A single spectrum disorder is a
better reflection of the state of knowledge about pathology and clinical
presentation; previously, the criteria were equivalent to trying to cleave
meatloaf at the joints.

Common Characteristics of
Autism
Three common Characteristics of autism
include:
Deficits or differences in socials skills
Deficits or differences in communication skills
Deficits or differences in
routines/behaviors/sensory

Social skill challenges

http://www.5min.com/Video/Early-Signs-of-Autism6777

Lack of awareness of the existence or feelings of others

Severe impairment in the ability to relate to others
Aloof and distant from others
Appears to not listen when spoken to

Social skill challenges: Cont.

Challenges in producing appropriate facial
affect to specific occasions
Avoid or fleeting eye contact
Challenges with changes in environment
and routine
Challenges in seeking
opportunities to interact with
others
Unwillingness and/or inability
to engage in cooperative play

Communication skills
challenges
Challenges in using and understanding both
verbal and non-verbal language
Failure to initiate or sustain conversational
interchange
Abnormalities in the pitch,
stress, rate, rhythm and
intonation of speech

Communication skills:
Cont.
Poor receptive and expressive skills
May echo words (echolalia) either
immediate or delayed
May use screaming, crying, tantrums,
aggression or self abuse as ways to
communicate
Repeating words or phrases in place of
normal, responsive language (TV talk)

Behavioral/Sensory Challenges

Unusual and repetitive movements of the

body that interfere with the ability to attend
to tasks or activities, such as hand flapping,
finger flicking, rocking, hand clapping,
grimacing or eye gazing.

Behavioral/Sensory
Challenges
Marked distress over changes in seemingly
trivial aspects of the environment
Laughing, crying, or showing distress for
reasons not apparent to others
Unreasonable insistence on following
routines in precise detail

Behavioral/Sensory Challenges
Unresponsive to normal teaching methods
Acts as if deaf
Apparent over or under sensitive to pain
No fear of real danger
Uneven gross and fine
motor skills

Other characteristics:
Cont.
May have difficulties cuddling
Inappropriate attachment with objects
Inappropriate play
Noticeable physical over or under activity

The Many Faces of Autism

http://
www.youtube.com/watch?v=rXgUl1qPdMg

Classroom strategies
Communication: pictures and picture
schedule; simple sign language; assigment
notebook; teach the meaning of idioms; use
short verbal phrases; allow wait time (just
how long is a minute?); alert students to key
phrases (This is important!)
Social: use mixed grouping; use social stories
or social scripts; use pictures with words to
present choices; allow students to work in
pairs; integrate team building; teach
awareness early

Classroom strategies
Behavioral: use seating charts; classwide and
school wide behavioral plan; develop each
personalized behavioral plan; teach self
monitoring (5 point scale); review schedule often;
model positive behavior; be generous with specific
praise; provide direct feedback
Environmental: post daily activities; use
preferential seating; allow dedicated space for
student; avoid sudden changes in routine; label
desks; maintain consistent routine; provide
movement breaks; use study carrols; keep
unnecessary material away

Classroom strategies
Visual: write information on board or desk;
provide notes; give written information for
assignments/projects; use pictures in
support of verbal and written directions;
make artifacts so child can copy
Sensory: assess students sensitivity (Get
the OT!!); allow stress balls or fidget items;
use inflatable seat cushions; provide regular
breaks; make chewies available; have a
relaxation room

Want more ???!!!

Dec 6, 2012: Strategies to Support Persons

with Autism Spectrum Disorders and Other
Kids Who Have Social Cognitive Disorders

Check out: Friday, October 12, 2012:

Smartboards, Boardmaker and iPads...Oh My!
#126-13 with Marcia Obukowicz!!!!!!!!

Thank you for coming!

Resources
http://www.udel.edu/bkirby/asperger/
http://www.firstsigns.org/
http://www.autism-society.org/
http://www.autismspeaks.org/
http://icdl.com/