Intro to Autism and ID

What are the DSM-5 criteria for autism?

• Restricted and repetitive patterns of behaviour, interests, or activities

• sensory processing issues

• differences in social communication.

What three areas must be impacted to diagnose ID?

• Conceptual (e.g. language, memory)

• Social (e.g. judgement, empathy)

• Practical functioning (e.g. personal care, money management)

What IQ score is associated with ID?

An IQ score below approximately 70

What genetic factors are linked to autism?

• Many genes are involved (some inherited, some mutate), can run in families

• it may be inherited or related to a syndrome like Down syndrome or Fragile X

What environmental factors are linked to autism?

up to 50% of variance

toxins, drugs, air pollutants, older parents, prematurity, delivery complications, maternal obesity/diabetes

What prenatal, perinatal, and postnatal factors are linked to ID?

Prenatal: Alcohol, toxins, infections

Perinatal: Birth trauma, low birth weight, prematurity

Postnatal: Infections, traumatic brain injury, severe neglect

What genetic factors are linked to ID?

• 10 variants of genes associated with ID

• may be associated with a syndrome e.g. Down syndrome, William syndrome, Fragile X syndrome

Are most cases of ID and autism explained by a known cause?

No – most are idiopathic

Characteristics of autism at preschool age

• Inflexibility of behaviour (e.g. each same food each day)

• Difficulty coping with change (e.g. meltdowns when routine changes)

• Restricted/repetitive behaviours which interfere with functioning (e.g. preference for sensory exploration over functional use of an object)

• Social communication differences

• Sensory input differences

• Difficulty with organisation and planning

What are common restricted/repetitive behaviours in preschoolers with autism?

Lining up toys, flicking lights, spinning, flapping, insisting on routines, echolalia, preference for sensory play

How might social communication be affected in preschoolers with autism?

• Less joint attention

• less turn taking

• less topic maintenance

• fewer responses/initiation

• reduced imitation of social actions/ gestures/ play

• more parallel play than interactive

• echolalia

• prosody differences (pitch, intonation, volume and rate)

What sensory traits are common in autism?

Hyper- or hypo-reactivity to sounds, lights, textures, smells, etc.

What is the te ao Māori term for autism and what does it mean?

Takiwātanga – “in their own time and space.”

How does the te ao Māori view of autism differ from medical views?

It is strengths-based and non-medicalised, focusing on each child’s uniqueness and capabilities

What kind of support do children with autism and ID typically need?

Long-term, structured support in learning

• daily routines - toileting, dressing, eating etc

• social skills - playing

• planning/organisation and managing self

• pre-literacy, pre-maths etc

• behaviour

• sensory needs

• language disorder - same characteristics as DLD

Who is typically involved in the support team for children with autism or ID?

SLTs, psychologists, early intervention teachers, OTs, and whānau

How is language disorder in autism similar to DLD?

It often includes difficulties with morphology, syntax, and vocabulary.

Children don’t always fit neatly into diagnostic categories

True

Children can vary a lot within diagnosis and be similar across diagnoses

True

Diagnostic terms and requirements change over time

True

Many children with severe diagnostic labels, there is often crossover with Autism, DLD, AHDH and ID etc

True

In language therapy for neurodevelopmental conditions, a diagnosis doesn’t tell you exactly what you need to do to help the child, but may give a signpost

True

You still need to assess the child, to describe the child’s level across various skills/work on weaker areas,

True

Because of this, if the family doesn’t want a diagnosis (yet), you can still work out what to do in therapy from the assessment

Can speech therapy cure autism or ID?

NO but

• can accelerate the language development and social communication development of children with ID and autism

• can help them learn, succeed, compensate, adapt etc

• can help those around them adapt and support the child better

Language disorder associated with autism

• young children with autism by definition have pragmatic differences

• may also have a language disorder in form or content

• approximately 30% of autistics remain minimally verbal

• but a difficulty with language isn’t required for an autism diagnosis, only with social communication