wk 1: intro to social communication disorders

what the spectrum is really like: (what are the differences or behaviors?)

• sensory differences

• language differences

• repetitive behaviors

• social differences

this is not an accurate portrayal of the autistic experience

Autism is NOT linear

what does a more realistic depiction of the autism spectrum?

person first vs identity first language

person first: a child with autism

identity first: autistic child

we now use identity-first language in the Autistic community, unless the person says otherwise

symbols (puzzle piece vs infinity symbol)

we are moving away from the puzzle piece (they have something missing) and towards the infinity symbol

Who Can Diagnose Autism? (depends on the state)

• Developmental Pediatricians

• Child Psychologists

• Child Psychiatrists

• Pediatric Neurologists

• Pediatricians- TX (any)

• Neurologists- TX

• Other Physicians- TX

• School Psychologists- TX

• SLPs can in their scope of practice but insurance does not recognize our dx

what is DSM-5?

The Diagnostic and Statistical Manual of Mental Disorders

A reference book on mental health and brain-related conditions and disorders

• DSM-I (1952) –

• DSM-II (1968) –

• DSM-III (1980) –

• DSM-IV (1994) –

• DSM-V (2013) --

• no autism classification

• autism classified under schizophrenia

• “infantile autism” listed as a separate diagnosis from schizophrenia

• revised diagnostic criteria with 5 subtypes of autism

• autism spectrum disorder (ASD) redefined as a single disorder with 3 levels; added social communication disorder (SCD)

DSM-IV-TR Possible Diagnosis vs DSM 5

DSM-IV: Autism spectrum disorders with pervasive developmental disorder-not otherwise specified (PDD-NOS), autistic disorder, Asperger disorder, childhood disintegrative disorder

DSM 5- Autism spectrum is the sole diagnosis

DSM-IV-TR vs DSM 5 Diagnostic criteria for ASD

DSM-IV: must meet two of the social and one of the communication criteria

DSM 5: Deficits in social communication/interaction (must meet all three of the social criteria)

Restricted and repetitive interests (must meet two of the four behavior criteria)

DSM-5 Possible co-occurring diagnosis

Attention-deficit/hyperactivity disorder; speech sound disorder, language disorder, childhood-onset fluency disorder; social (pragmatic) communication disorder NOT social (pragmatic) communication disorder

shows how ASD is NOT the same as social communication disorder

DSM-5 severity levels

Level 3: Requiring very substantial support

Level 2: Requiring substantial support

Level 1: Requiring support

*this is very subjective

Persistent deficits in each of the __ areas (name these areas) of social communication plus at least __ types of restricted, repetitive behaviors

3; 2-4

1. Social-emotional reprocitiy: Trouble with social back-and-forth, not knowing how to start or keep a conversation going, not sharing interests or feelings, or not responding to others in social situations.

2. Problems with nonverbal communication: This can include using words and body language that don’t match, avoiding eye contact, not understanding gestures, or not using facial expressions or other nonverbal cues.

3. Difficulty with relationships: This includes struggling to change behavior depending on the social situation, having trouble playing or making friends, or showing little interest in other people

all three have to be present

what are the 2-4 types of restricted, repetitive behaviors

1. Repetitive motor actions, use of objects, or speech: This includes repeated body movements (like hand-flapping), lining up toys, repeating words or phrases (echolalia), or using unusual expressions.

2. Strong need for routines: This means getting very upset with small changes, having a hard time with transitions, insisting on doing things the same way (like always taking the same route or eating the same food), or using set ways to greet people.

3. Intense or unusual interests: This refers to being extremely focused on specific topics or objects, often in a way that seems unusual or overly intense.

4. Unusual (hyper or hypo) responses to sensory input: This includes being very sensitive or not sensitive enough to things like sounds, textures, or temperature, or showing strong interest in sensory details (like staring at lights or touching objects often).

Here’s a short list for Autistic traits, redefined from a deficit/symptomatic mindset:

Deficit: Autistics have abnormal social approaches

Redefined: We socialize differently and often find socializing with one another easier than socializing with non-autistics

Here’s a short list for Autistic traits, redefined from a deficit/symptomatic mindset:

Deficit: Autistics take part in restrictive, repetitive movements

Redefined: We take part in stimming in order to self-regulate, communicate our needs, and express emotions

Here’s a short list for Autistic traits, redefined from a deficit/symptomatic mindset:

Deficit: Autistics insist on sameness and have strict routines

Redefined: In order to cope with the chaos of unsupportive environments, we ground ourselves in comforting routines

Here’s a short list for Autistic traits, redefined from a deficit/symptomatic mindset:

Deficit: Autistics engage in highly restrictive interests with abnormal intensity.

Redefined: We are drawn to specific passions that bring us joy, help us self-regulate, foster connections with others, and allow us to process the world around us.

Here’s a short list for Autistic traits, redefined from a deficit/symptomatic mindset:

Deficit: Autistics are aversive to sensory input or have excessive interest in sensory input.

Redefined: We perceive our world through details instead of the big picture, and as such we are affected by the impact of sensory details – some of which we are sensitive to or attracted to

neurodiversity movement

• Individual brain differences are part of the expected variation

• Neurotypical brains are not “normal”

• Neurodivergent brains are not “broken”

• Focuses on inclusion, accommodations and support

• Not trying to find a cure

Social Pragmatic/Communication Disorder (SCD)

• Recent addition to the DSM-5

• Rule out ASD first

• Persistent difficulties using verbal and nonverbal communication cues across several contexts

• Communication difficulties

• Delayed milestones at an early age

• Challenges unrelated to other medical or language difficulty (i.e., not intellectual disability)

• NOT have the repetitive/restricted behaviors (MAIN DIFFERENCE)