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Autism Spectrum Disorders
Autism Spectrum Disorders
• Autism is a general term used to describe a
group of developmental brain disorders
known as Pervasive Developmental Disorders
(PDD).
• PDD-NOS (Pervasive Developmental Disorder
– Not Otherwise Specified), Asperger's
Syndrome, Rett Syndrome and Childhood
Disintegrative Disorder are referred to as
Autism Spectrum Disorders.
Classic Symptoms of Autism
• Cognitive difficulties, poor eye contact,
trouble reading people's faces and gestures.
Many kids flap their hands, speak without
much emotion (or have otherwise unusual
speech patterns); need to follow schedules
rigidly or else the world feels out of control,
and are intensely, even obsessively, interested
in one specific subject. Students with classic
autism also exhibit sensitivities to various
stimuli, from sounds to clothing to food items.
Overview of Autism
• It is estimated that one in every 150 children
have Autism.
• Boys are more likely than girls to develop
autism and receive the diagnosis.
• The definitive cause (or causes) of autism is
not yet clear.
• There is not a medical test for autism; a
diagnosis is based on observed behavior and
educational and psychological testing.
PDD vs. PDD-NOS
• PDD-NOS is often incorrectly referred to as
simply "PDD."
• The term PDD refers to the class of conditions
to which autism belongs. PDD is NOT itself a
diagnosis, while PDD-NOS IS a diagnosis. The
term Pervasive Developmental Disorder - Not
Otherwise Specified is when full features for
autism or another explicitly defined PDD are
not met.
PDD-NOS
• PDD-NOS, is a condition on the Autism
spectrum that has some, but not all, of the
symptoms associated with classic autism.
• The symptoms can include difficulty socializing
with others, repetitive behaviors, and
heightened sensitivities to certain stimuli.
• They may appear unemotional, have trouble
holding eye contact, or trouble transitioning
quickly from one activity to the next.
PDD-NOS (continued)
• Those with PDD-NOS are different from others
on the spectrum.
• Perhaps they started having difficulties at a
much later age than others on the spectrum.
• Or they may have the same challenges — for
example, they may be oversensitive to their
surroundings — but not to the extreme that
others on the spectrum do.
Treatments for PDD-NOS
• Various behavioral regimens, including play
therapy, Applied Behavior Analysis (ABA),
sensory integration therapy,
• Medications, including anti-depressants
• Social skills training and Alternative therapies
wherein they flex their muscles literally and
figuratively (they get stronger and learn how
to function in a group setting); music therapy
(kids learning how to communicate with the
help of songs)
Asperger's Syndrome
• A neurological disorder where children have
classic autism except:
• IQ falls in the normal or even superior range.
• Exhibit few, if any, delays in speaking.
• They also generally hit most of their
milestones within reasonable time periods.
Because of this, some describe children with
this condition as “high-functioning” autism.
Rett Syndrome
• Rett Syndrome is a debilitating, sometimes
fatal, developmental disorder.
• Classic autism except students with Rett
Syndrome have problems walking and
speaking. Have disproportionately small
heads. The condition presents itself in four
stages, from "early onset," which could begin
when children are as young as six months, to
"late motor deterioration," which can render
them nearly immobilized.
Rett (continued)
• Rett Syndrome, sufferers are almost always
girls.
• Children with Rett often appear to develop
typically until they simply don't any longer and
begin regressing progressively.
• Often move their hands in a manner distinct
only to them: fidget, wring, clasp, squeeze or
tap them, seemingly unable to stop.
• Loss the ability to open their mouths and
walk.
Treatment for Rett’s
• Physical therapy, Occupational therapy,
Speech therapy.
• Medical interventions that address health
issues associated with Rett Syndrome,
including seizures and gait problems.
• Splints and braces to assist with coordination
and balance.
• Sensory integration therapy, which helps them
process what they see, hear, taste, smell and
touch.
Childhood Disintegrative Disorder
(CDD)
• The cause of childhood disintegrative disorder
is unknown, but it has been linked to
neurological problems.
• An affected child shows a loss of
communication skills, has regression in
nonverbal behaviors, and significant loss of
previously acquired skills.
CDD (continued)
• Over several months, a child with this disorder
will deteriorate in intellectual, social, and
language functioning from previously normal
behavior.
• Symptoms include classic autism except:
Loss of social skills
Loss of bowel and bladder control
Loss of expressive or receptive language
Loss of motor skills
Overview
• The most common characteristics in students
with pervasive development disorders(PDD) is
difficulty communicating with others.
• Autism appears during the first three years of
life.
• Some students with Autism often repeat what
they hear verbatim, rather than providing an
answer. This condition is referred to as
echolalia.
Facts about Autism
• According to the Centers for Disease Control
and Prevention (2005), the number of
individuals diagnosed with Autism Spectrum
Disorders has increased six-fold over the last
ten years.
• One of the most effective classroom strategies
for individuals with Autism Spectrum
Disorders or PDD is to establish a predictable
classroom routine.
Strategies for Teaching Social Skills
• A Social Story is a non-coercive approach that
presents social concepts and rules to children
in the form of a brief story. This strategy could
be used to teach a number of social and
behavioral concepts, such as making
transitions, playing a game, and going on a
field trip.
• There are four components of a successful
social story.
Social Story (continued)
• (i) The story should be written in response to
the child’s personal need; (ii) the story should
be something the child wants to read on her
own (depending upon ability level); (iii) the
story should be commensurate with ability
and comprehension level; and (iv) the story
should use less directive terms such “can,” or
“could,” instead of “will” or “must.”
Role Playing
I have found that children with ASD learn best
when Social Stories are used in conjunction
with Role-Playing.
• Role-playing consists of acting out various
social interactions that the child would
typically encounter. During the role-play
scenarios, the child could be required to
initiate a conversation with another person as
the other person is engaged in a separate task.
Role Playing (continued)
• He would then have to ask to join in, or ask
the other person to join him in another
activity. The latter typically proves to be most
difficult for children with ASD. During the first
few sessions, it is not uncommon for the child
to get “stuck” in conversations and
interactions, often for minutes without
knowing what to say or how to proceed.
Role Playing (continued,
continued)
• During the early sessions, the child should be
given ample time to process and respond to
the role-play scenarios. As the sessions
progress, speed and proficiency should
gradually increase.
Managing Problematic Autistic
Behavior
(i) The first step in managing problem behavior
is to understand why the behaviors are
occurring. A functional behavioral
assessment (FBA) will help answer the
aforementioned question.
(ii) Be consistent when implementing
interventions.
(iii) Behavior intervention plan (BIP)
(iv) Monitor challenging behavior directly and
indirectly.
Functional Behavioral Assessment
• The logic behind an FBA is that behavior
occurs within a particular context and serves a
specific purpose. Students learn to behave (or
misbehave) in ways that satisfy a need or
results in a desired outcome. Students will
change their behavior only when it is clear
that a different response will more effectively
and efficiently result in the same outcome.
Functional Behavioral Assessment
(continued)
• Identifying the purpose of problem behaviors
or more specifically, what the student "gets"
or "avoids" through those behaviors) can
provide information that is essential to
developing instructional strategies and
supports to reduce or eliminate behaviors that
interfere with successful classroom
performance or participation.
Behavior Intervention Plan (BIP)
• A Behavior Intervention Plan (BIP) takes the
observations made in an FBA and turns them
into a concrete plan of action for managing a
student's behavior. A BIP may include:
(i) Ways to change the environment to keep
behavior from starting in the first place.
(ii) Provide positive reinforcement to promote
good behavior, employ planned ignoring to
avoid reinforcing bad behavior.
BIP (continued)
(iii) Provide supports needed so that the student
will not be driven to act out due to frustration
or fatigue.
Note:
When a behavior plan is agreed to, the school
and staff are legally obligated to follow it, and
consequences of not following it should not
be inflicted on the student.
Indirect and Direct Monitoring of
Problem Behaviors
• Indirect assessments include interviews with
parents and previous teachers, as well as the
completion of rating scales.
• Direct assessments involve observing and
documenting the sequence of behaviors
around the challenging behavior.
– Direct assessments should be conducted for five
school days.
Positive Behavior Supports (PBS)
• PBS refers to interventions being implemented
in a proactive manner rather than a traditional
reactive manner.
• The goal of PBS is to focus on teaching new
skills rather than implementing a consequence
after the challenging behavior has occurred.