Autism Overview

Kelly Wight, November 2008

Definition of Autism

Autism is defined under IDEA as a developmental disability significantly affecting verbal and nonverbal communication and social interaction usually evident before age 3 that adversely affects a child’s educational

performance.

Other characteristics

engagement in repetitive activities and stereotyped movements

resistance to environmental change or change in daily routines

unusual responses to sensory experiences.

Autism Spectrum Disorders

(1)Autistic Disorder also referred to as Classic Autism

(2) Pervasive Developmental Disorder—Not Otherwise Specified (PDD-NOS), which refers to a collection of features that resemble autism but may not be as severe or extensive

(3) Rett's syndrome, which affects girls and is a genetic disorder with hard neurological signs, including seizures, that become more apparent with age

Autism Spectrum Disorders

(4) Asperger syndrome, which refers to individuals with autistic characteristics but relatively intact language abilities

(5) Childhood Disintegrative Disorder, which refers to children whose development appears normal for the first few years, but then regresses with the loss of speech and other skills until the characteristics of autism are conspicuous

Autism Spectrum Disorder

Autism exists on a continuum from mild to moderate to severe.

Autism can and does exist with and without mental retardation.

Today, the Centers for Disease Control believe that the incidence may be as great as 1 in 166 for those diagnosed with autism, Asperger’s syndrome, and other pervasive developmental disorders.

Communication Impairments

Delayed onset of speech Lack of spoken language Stereotypic/repetitive use of language:

echolalia, odd vocalizations Difficulties with language for social

communication purposes (such as social niceties, “How are you today?” as well as conversational rules like turn taking)

Social Interaction Impairments

Poor eye contact Failure to respond to name Difficulty with emotional reciprocity

(understanding how someone else feels) Limited facial expressions Little interest in others Poor imitation Lack of gesturing or pointing

Restricted Interests and Stereotypical Behaviors Repetitive stereotyped movements:

hand-flapping, rocking, spinning Excessive interest with a particular

object, activity, or topic: i.e.. Trains, presidents

Pre-occupation with details of information

Upset by changes in routine – strong desire for sameness

Related Symptoms

Distractibility Impulsivity Inflexibility/rigidity Transition difficulty Deficits in mental planning Deficits in organizational skills Deficits in self-monitoring

Sensory Hyper-Sensitivity

Sensory Avoidance: intolerant of certain sounds, smells, lights; will only wear certain clothes or eat certain foods

Sensory Seeking: finding ways to create intense sensory experiences, such as spinning, visual stimming, rocking

Sensory Numbness: less reactive to sensory input, high tolerance for pain

Auditory Sensitivity

Students with autism may hear all sorts of sounds that we don’t notice; faraway cars, birds in the trees, refrigerator's hum

Sounds that to us seem soft may all seem equally loud to people with autism

They may try to block out sounds by covering their ears, or saying words to themselves so the sounds don’t seem so loud.

Visual Attention

Students with autism pay attention to details; see the parts but not the whole

Upon entering a room may see many small things other don’t notice; the color of every item in the room, the arrangement of the desks, an unfamiliar object on their desk

Are most comfortable when in an uncluttered environment where things are put in their usual place

Tactile perception/Other

May cry, wince or withdraw from what seems like very little touch

May play too rough as they don’t have the same sensation of physical contact

May find certain smells noxious

Distress

Changes in routine can be cause of great distress Avoid any unnecessary changes Prepare for any planned changes

Over or under stimulation can also be sources of distress

When distressed students may engage in repetitive actions and/or self-stimulation to calm themselves

Self-Stimulation

Verbal stimulation – repetition of words or phrases, regardless of meaning; repeating songs, movies, TV shows, data

Physical stimulation – hand/arm flapping, repeated grimacing, rocking, finger flicking, blinking, head-banging, twirling, preoccupation with moving parts of objects (spinning wheels)

Self-Stimulation

Occurs because of internal need of the student, regardless of the social context

Increases during times of over and under stimulation

Should be interrupted by redirecting student to another activity that is high interest and/or incompatible with the self-stimming behavior

Learning Characteristics

Will be good at tasks that require memorization of facts

Will struggle with tasks that require flexibility, reasoning, planning and problem solving

May develop fluent reading, but will struggle with comprehension

Likely to do well with math facts, but poorly with word problems

Communication and Language

Interpret language literally; can not understand “pulling my leg”, “lend me a hand”,

Don’t read non-verbal body language, may misinterpret situational cues

Don’t read facial expressions, often don’t even look at your face

Cognitive Characteristics

Visual skills are stronger than verbal skills

Use of visual cues is critical to success Visuals are concrete Visuals are clear and specific Visuals decrease verbal overload Visuals facilitate independence Visuals are permanent – students need

time to process information

Examples of Visual Cues/Aids

Visual timers with sound Provides a concrete start and finish

Daily schedules (pictures, words or both) Do/Done lists Activity choice cards

“What are you working for?” Venn Diagrams Task cards

Visual Strategies

Highlight and/or color code information Use graphic organizers (story web) to

represent verbal ideas Provide a model/example of what a

completed product will look like (you will know you are done when yours looks like this)

Provide pictures that go along with class discussion/lecture

Benefits of Visual Cues/Aids

Establishes attention Helps students remember what they

were told Reduces anxiety, frustration and

confusion Provides a vehicle to prepare students

for upcoming changes

Social Emotional Strategies

Social Stories Time and place to “take a break” Provide a visual tool to identify emotions

(picture cards of faces like the pain scale in the hospital)

Offer access to calming item or activity during times that require higher levels of coping (hold this picture of a monster truck while we wait for our school picture)

Application for working with students with autism Limit verbal directions – use the fewest words Limit presentation of visual information to avoid

overwhelming student (don’t let them see a stack of work…)

Do what you say i.e.. “Office then bathroom.” Do that, do not change your mind and go to the bathroom on the way to the office.

No open ended questions i.e.. “What do you want to do next?”

Provide specific choices

Application for working with students with autism

Pay attention to ‘triggers’ Be responsive to signs of distress, even

if the child can not tell you what is wrong Be organized and well prepared Know what is next Be concrete Use positive approach i.e.. ‘Do this’ not

‘don’t do that’

Application for working with students with autism

Use clear expectations, “The rule is…” Explain to the student when they have

inadvertently and unintentionally been insulting, rude, insensitive or inappropriate and teach them the correct response to the situation.

Build in expectations of unavoidable changes, a “zinger” or “zig-zagger”

Application for working with students with autism

Offer menu of self-soothing activities for prevention and recovery from emotional overload

Prime student for newness by pre-exposure (meet maternity leave teacher before current teacher leaves)

Seek out OT/PT/Speech input Be consistent