L8: Autism Spectrum Disorder

1. Level 1 - High-Functioning Autism

2. Level 2 - Autism

3. Level 3 - Severe Autism

Spectrum of Autism Disorder

Spectrum

Depict categories or levels to classify

Level 1 - High-functioning Autism

Needs support; Patient’s social and communication skills and repetitive behaviors are only noticeable without support (hindi agad napapansin)

Level 2 - Autism

Needs substantial support; Patient’s social and communication skills and repetitive behaviors are still obvious to the casual observer, even with support in place.

Level 3 - Severe Autism

Needs very substantial support; Patient’s social and communication skills and repetitive behaviors severely impair daily life

Autism Spectrum Disorder (ASD)

Characterized by persistent deficits in social communication and interaction across multiple contexts, including deficits in social reciprocity, nonverbal communicative behaviors used for social interaction, and skills in developing, maintaining, and understanding relationships.

1. Deficits in social-emotional reciprocity

2. Deficits in nonverbal communicative behaviors used for social interaction

3. Deficits in developing, maintaining, and understanding relationships

Diagnostic Criteria:

A. Persistent deficits in social communication and interaction across multiple contexts, as manifested by all the following, currently or by history:

1. Stereotyped or repetitive motor movements, use of objects, or speech.

2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior.

3. Highly restricted, fixated interests that are abnormal in intensity or focus.

4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment.

Diagnostic Criteria:

B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history:

C. Symptoms must be present in the early developmental period

D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

E. These disturbances are not better explained by intellectual developmental disorder or global developmental delay

Diagnostic Criteria C to E of ASD

6 Months

Early signs:

• No big smiles or other warm, joyful expressions

9 Months

Early signs:

• No back-and-forth sharing of sounds, smiles, or other facial expressions

12 Months

Early signs:

• No consistent response to own name

• No babbling

• No back-and-forth gestures, such as pointing, showing, reaching, waving, or three-pronged gaze

16 Months

Early signs:

• No words

24 Months

Early signs:

• No two-word meaningful phrases (without imitating or repeating)

Any loss of speech or babbling or social skills at any age

Early signs of Autism

• Requiring support

• Requiring substantial support

• Requiring very substantial support

• With or without accompanying intellectual impairment

• With or without accompanying language impairment

• Associated with a known genetic or other medical condition or environmental factor

• Associated with a neurodevelopmental, mental, or bahavioral problem

• With catatonia

Specifies for ASD

1. Generic factors

2. Neurological causes

Causes of ASD

TRUE

T or F: NO single “autism gene” exists; multiple genes are involved

15%

If a child has ASD, the chance of their sibling having ASD is about ___

Much greater

When a monozygotic twin has autism, the chances are ___ than the other twin will also have autism than is the case with dizygotic twins

TRUE

T or F: Family member of those with autism are more likely to exhibit autistic-like characteristics at a subclinical level, such as a lack of close friends, a preoccupation with narrow interests, and a preference for routines

Brain cells

The ___ of individuals with autism exhibit deficient connectivity that disrupts the cells’ ability to communicate with each other

Brains and heads

The ___ of young children with autism tend to grow suddenly and excessively then followed by a deceleration

Androgen

High levels of ___ in their mothers’ amniotic fluid are more likely to exhibit autistic traits as children (extreme male brain)

Cerebral Cortex

Thin layer of gray matter on the surface of the cerebral hemispheres. For higher mental functions, general movement, perception, and behavioral reactions

Amygdala

Responsible for emotional responses, including aggressive behavior

Hippocampus

Makes it possible to remember new information and recent events

Basal Ganglia

Gray masses deep in the cerebral hemisphere that serve as a connection between the cerebrum and cerebellum. Helps regulate automatic movement

Brainstem

Relay station, passing messages between various parts of the body and cerebral cortex. Primitive functions essential to survival (breathing and heart control)

Corpus Callosum

Closely packed bundles of fibers that connect the right and left hemisphere. For communication between hemispheres

Cerebellum

Fine tunes motor activity. Regulates balance, body movements, coordination, and muscles used in speaking

1. Applied Behavior Analysis (ABA)

2. Instruction in natural settings

3. Functional Behavioral Assessment (FBA)

4. Positive Behavioral Interventio and Support (PBIS)

5. Picture Exchange Communication System (PECS)

6. Social Stories

7. Pivotal Response Teaching (PRT)

8. Service Delivery Models

Educational Considerations

Applied behavior analysis (ABA)

Focuses on teaching functional skills and continuous assessment of progress. Emphasizes positive reinforcement or rewarding of desired behaviors.

Instruction in natural settings

Use of the natural interactions by which children normally learn language and other social skills (play stage)

Functional behavioral assessment (FBA)

Involves determining the consequences, antecedents, and setting events that maintain such behaviors

Positive behavioral intervention and support (PBIS)

Finding ways to support positive behaviors of students rather than punishing negative behaviors.

Picture Exchange Communication System (PECS)

Involves the use of pictures to help students initiate and maintain functional communication.

Social Stories

For students who are more verbal but who have problems with interpreting social cues and interaction.

Pivotal response teaching (PRT)

Some skills are critical, or pivotal, for function in other areas such as motivation, self-management, initiations and responding to multiple cues

Service Delivery Models

• self-contained classroom

• general education classroom

• resource rooms

• residential facilities

1. MacArthur-Bates Communicative Development Inventory Second Edition

2. Clinical Evaluation Fundamentals-4 of Language

3. PDD Behavior Inventory (PDDBI)

4. The Social Responsiveness Scale (SRS)

5. Autism Social Skills Profile (ASSP)

6. The Childhood Autism Rating Scale

Assessment of Progress

MacArthur-Bates Communicative Development Inventory Second Edition

Monitor the progress of language development of very young children

Clinical Evaluation of Language Fundamentals-4

Measures receptive, expressive, grammatical, and semantic skills for individuals ages 5-21

PDD Behavior Inventor (PDDBI)

Designed to measure progress in social/adaptive behavior of students 2-12 years old

Social Responsiveness Scales

Evaluates the severity of soccial impairment of individual with autism spectrum disorders, between 4-18.

Autism Social Skills Profile

Social skills of children and adolescents with autism spectrum disorder (6-17 years old)

Childhood Autism Rating Scale

Focuses on behaviors that deviate from children developing typically and is appropriate for children over 2 years old.

Early Intensive Behavioral Interventions (EIBI) Program

Help young children with developmental delay to acquire adaptive and functional skills in the areas of communication, play, and social, emotional, cognitive, and self-help skills.

1. Person-centered Planning

2. Community residential facilities

3. Supported living settings

4. Supported competitive employment

Transition to Adulthood

Person-centered Planning

Person with the disability is encouraged to make their own decisions as much as possible.

Community Residential Facilities

People with autism are being integrated into the community

Supported living settings

Own homes or apartments