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AUTISM:
AN OVERVIEW

A PRESENTATION BY ZACHARY CARR

DECEMBER 12, 1999
for Kind Tree Productions, Inc.
 



 Autism Overview
Diagnosis
 General Etiology
 Key Points
 Strengths
 Implications for Treatment - (Examples)
 Treatments (1)
 What Can Help?
 Autism - a definition
 More Etiology
 Treatments (2)

OVER VIEW OF AUTISM


 AUTISM IS A LIFE-LONG DEVELOPMENTAL DISABILITY.

 AUTISM 15 A PHYSICAL DISORDER AFFECTING THE
BRAIN THAT PREVENTS INDIVIDUALS FROM PROPERLY
PROCESSING AND INTEGRATING INFORMATION FROM
THEIR SENSES AND SURROUNDINGS.

 THE BRAIN DISORDER MAY CAUSE SEVERE
PROBLEMS IN LEARNING, COMMUNICATION, SOCIAL
RELATIONSHIPS, COGNITIVE FUNCTIONING, SENSORY
PROCESSING AND BEHAVIOR.

 AUTISM IS A SPECTRUM DISORDER. THE SYMPTOMS
RANGE FROM VERY MILD TO SEVERE AND CAN OCCUR
IN DIFFERENT COMBINATIONS FROM ONE INDIVIDUAL
TO THE NEXT.

 AUTISM USUALLY BECOMES APPARENT IN TUE FIRST THREE
YEARS OF LIFE BUT CAN BE IDENTIFIED AT ANY POINT IN LIFE.

 AUTISM CAN OCCUR WITH OTHER DISABILITIES. A
SIGNIFICANT PERCENTAGE OF PEOPLE WITH AUTISM HAVE
MENTAL RETARDATION.

 AUTISM DOES NOT PREVENT LEARNING. PEOPLE WITH
AUTISM GROW, CHANGE, LEARN AND ACQUIRE NEW SKILLS
THROUGHOUT THEIR LIVES.



DIAGNOSIS FOR AUTISM

MEDICAL (DSM-IV)


 LANGUAGE AND COMMUNICATION DIFFICULTIES.

 SOCIAL JUDGMENT AND RELATING ISSUES.

 RESTRICTED REPERTOIRE OF BEHAVIOR/NEED FOR SAMENESS.

 SENSORY AND PERCEPTION ISSUES.

 UNEVEN PATTERNS OF DEVELOPMENT.
 

 ORGANIZATION AND SEQUENCING DIFFlCULTIES

COGNITIVE AND ABSTRACT THINKING DIFFICULTIES


EDUCATIONAL

(FOR DETERMINING ELIGIBILITY
FOR SPECIAL EDUCATION SERVICES ONLY)

 IMPAIRED VERBAL/NONVERBAL LANGUAGE OR SOCIAL
COMMUNICATION SKlLLS.

 IMPAIRED ABILITY TO RELATE TO PEOPLE OR THE
ENVIRONMENT.

 EXHIBITS OR PREVIOUSLY EXHIBITED UNUSUAL
RESPONSES TO SENSORY INFORMATION

 EXHIBITS OR PREVIOUSLY EXHIBITED
INCONSISTENCIES OR DISCREPANCIES IN THE
DEVELOPMENT OF PHYSICAL, LANGUAGE, SOCIAL OR
COGNITIVE SKILLS.
 


ETIOLOGY

 
 
 

THERE ARE SEVERAL KNOWN CAUSES FOR
AUTISM BUT NO KNOWN SINGLE CAUSE.

 GENETIC-TWIN STUDIES HAVE SHOWN A
CONCORDANCE RATE FOR AUTISM TO BE
GREATER THAN 50%.

 INFECTIOUS DISEASES- RUBELLA HAS BEEN LINKED TO THE
DIAGNOSIS OF AUTISM.

 METABOLIC DISORDERS- PKU AND CELIACS
DISEASE HAVE BEEN IMPLICATED AS THE CAUSE
FOR SOME PEOPLE WITH AUTISM.

 STRUCTURAL ABNORMALITIES- HYDROCEPHALUS HAS
BEEN DETERMINED AS A CAUSE. UNDER DEVELOPMENT OF
THE CEREBELLUM MAY BE ANOTHER.


KEY POINTS


 AUTISM EFFECTS APPROXIMATELY 1 IN 1000 LIVE BIRTHS.

 IT OCCURS IN A RATIO OF APPROXIMATELY 3.5 BOYS
TO EVERY 1 GIRL.

 AS HIGH AS 70% OF PEOPLE WITH AUTISM ALSO HAVE
MENTAL RETARDATION.

 20-65% OF PEOPLE WITH AUTISM SHOW
ABNORMALITIES ON EEGs.

 25-33% OF PEOPLE WITH AUTISM DEVELOP SEIZURE
DISORDERS BEFORE OR DURING ADOLESCENCE.

 AUTISM IS EQUALLY DISTRIBUTED OF THE SOCIAL CLASSES,
CULTURAL AND NATIONALITIES.



COMMON STRENGTHS OF PEOPLE WITH AUTISM

 
 
 

 EXCELLENT MEMORY, ESPECIALLY FOR DETAIL

ABILITY TO FOLLOW ROUTINES

 APPRECIATION FOR PRECISION AND ACCURACY

 STRONG VISUAL SKILLS

 ABILITY TO MAKE ASSOCIATIONS QUICKLY

 MANY PEOPLE WITH AUTISM ALSO DISPLAY
SPECIALIZED TALENTS (E.G., SIGHT READING
MUSIC, SELF TAUGHT READERS, DRAWING, AND
ABILITY TO CALCULATE NUMBERS)




 

IMPLICATIONS FOR TREATMENT

Example 1
 

Teaching strategies of verbal and imitation not effective
Learn best through visual structure and routine
Need to learn power of communication
 

SYMPTOMS

Problems understanding commands
Limited topics
Does not communicate own needs
Delayed processing or refuse things does not want
Understanding based on context
Concrete
Asks lots of questions
 
 
 

COMMUNICATION AND LANGUAGE PROBLEMS



 

IMPLICATIONS FOR TREATMENT
Example 2

Extreme problems with generalization - need to teach in each new
situation, new people, new materials

Utilize strategies to minimize problems with judgement

Give extra time

Highlight important information

Symptoms

Concrete, literal

Focus on detail

Can't tell relevant from irrelevant

Can't tell clean from dirty

Slow to process information

Slow pace

Trouble with choices

Indecision
 
 

COGNITIVE PROBLEMS
DIFFICULTY WITH MEANING
PROBLEMS WITH ABSTRACT THINKING,
JUDGMENT AND INTEGRATING IDEAS
 



 
 

IMPLICATIONS FOR TREATMENT
Example 3
 

Main motivation of social reinforcement or timeout does not work
Does not learn from watching

SYMPTOMS

Poor eye contact
Difficulty modulating behavior to setting
Peculiar affect
Lack of response to others emotions
Difficulty taking another person's perspective
Affect not consistent with contact
Problems with imitation
Limited play and social interactions
 
 

SOCIAL JUDGMENT

SOCIAL RELATING
 


IMPLICATIONS FOR TREATMENT
Example 4
 

Individualized approach

Must assess full range of skills and strategies

Can't assume skills in one area based on another area
 
 

SYMPTOMS
 

Often good at numbers, rote memory tasks and music

Problems with language and abstract reasoning

Some can read but can't talk
 
 

UNEVEN PATTERNS
OF DEVELOPMENT



 
 
 
 

IMPLICATIONS FOR TREATMENT
Example 5

Work easier than play

Can learn things positive

Need predictability

Routines that we develop
 

SYMPTOMS

Upset easily by changes in environment -
holidays, new clothes, new foods, moving, staff changes
Free time difficult
Memorize the world
Easily upset and confused
Elaborate rituals
 
 

RESTRICTED REPERTOIRE
OF BEHAVIORS
FOCUS ON SAMENESS
AND RITUALISTIC BEHAVIORS


IMPLICATIONS FOR TREATMENT
Example 6

Emphasize visual clarity and systematic
or routine ways of doing things
 
 
 

SYMPTOMS
 

Do not know where to start,

what's next,

and when to finish

ORGANIZATION
AND SEQUENCING PROBLEMS


IMPLICATIONS FOR TREATMENT
Example 7

Minimize distractions

Highlight important elements of environment
 

SYMPTOMS

Inconsistent response to sounds
Distractable
Over or under reactive
Dislikes certain textures
Stares at lights
No pain response
Licks and smells things
 
 

SENSORY AND
PERCEPTION PROBLEMS
 




 

TREATMENTS FOR AUTISM

 
 
 

 THE PLAN OF TREATMENT NEEDS TO BE INDIVIDUALIZED.

 LEARNING STYLES SHOULD ALWAYS BE ASSESSED.

 ANY PAST HISTORY OF ISSUES OR EXPERIENCES THAT
THE INDIVIDUAL HAS AN AVERSION TO NEEDS TO BE
AVOIDED.

 USING DIFFERENT APPROACHES TO TEACH DIFFERENT
SKILLS MAY BE NECESSARY.

 IT IS ALWAYS BEST TO HAVE AN UNDERSTANDING OF
THE VARIETY OF THEORIES FOR TEACHING PEOPLE WITH
AUTISM. (SUGGESTED READING THE AUTISM TREATMENT
GUIDE BY ELIZABETH GERLACH.)

 EVALUATE OPINIONS FROM MULTIPLE PROFESSIONALS
AND THEN DECIDE ON THE GOODNESS OF FIT FOR YOUR CHILD.


WHAT CAN HELP FAMILIES COPING WITH

AUTISM?


Although each family is different, the supports many families need include:

 INFORMATION AND KNOWLEDGE ABOUT AUTISM.

 SKILLED RESPITE CARE: ALL PARENTS NEED A BREAK.

 PRACTICAL, EXPERT HELP TO ORGANIZE DAILY LIVING
FOR THE CHILD WITH AUTISM AND TEACH SELF CARE
SKILLS IN THE HONIE.

 EFFECTIVE STRATEGIES FOR DEALING WITH DIFFICULT
BEHAVIORS.

 HELP IN FINDING AND ACCESSING SERVICES AND
RESOURCES IN THE COMMUNITY.

 SUPPORT AND UNDERSTANDING FROM FAMILY, FRIENDS,
AND NEIGHBORS.

 CONTACTS AND FRIENDSHIPS WITH OTHER FAMILIES WHO
HAVE CHILDREN WITH AUTISM.
 



AUTISM


Autism is a developmental disability caused by a neurological dysfunction and characterized by
difficulties and abnormalities in several areas. These areas include communlcation skills, social
relationships, cognitive functioning, sensory processing, and behavior. Autism prevents people from
properly processing and integrating information from their senses and environment. Autism effect
approximately I per 1000 live births. It occurs in males more frequently than in females. The ratio is approximately 3.5 to 1. That does correlate with other commonly diagnosed disabilities. Symptoms range from very mild to severe and can often be paired with mental retardation. Approximately 25-35% of people with autism function in the range of borderline to mild mental retardation, 50-65% are moderately to profoundly mentally retarded and 10-15% have average to above average intelligence. Autism is a life long disability and no cure has been found date. Autism is commonly diagnosed before the third year of life. Autism can be diagnosed both medically or educationally. The medical diagnosis for autism, as listed in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-IV), typically includes these characteristics:

 Language and Communication Difficulties

 Social Judgment and Relating Issues

 Restricted Repertoire of Behavior- Need for Sameness

 Sensory and Perception Issues

 Uneven Patterns of Development

Organization and Sequencing Difficulties

 Cognitive and Abstract Thinking Difficulties.

The educational diagnosis is used to determine eligibility for special education services and can be
performed by an autism specialist or school psychologist with input from the educational team, which
includes the guardians. The disability must have a negative impact on student's educational performance
and the individual must be determined to dispIay these four characteristics:

 Impaired verbal/nonverbal language or social communication skills

 Impaired ability to relate to people or the environment

 Exhibits or previously exhibited unusual responses to sensory information

 Exhibits or previously exhibited inconsistencies or discrepancies in the development
of physical, language, social or cognitive skills.

Ii has been determined that approximately 50% of people with autism never develop meaningful
communicative language and most people have difficulties with other forms
of communication as well. Although many people with autism display ecolalic speech, repetitive or
stereotypic language based on past auditory experiences, it often does not become a functional option.
Language for people with autism is often based on gestures, sign language or picture systems. As long as the form of communication used meets the needs for both receptive, what one understands, and
expressive, what one can communicate to others, then it is a functional means of communication.

Leo Kanner first used the word "Autism" when he described the syndrome in 1943. He also pointed out
certain bio-behavioral patterns in addition to the multiple cognitive deficits:

 Strong Impulses
 Excessive Anxiety
Sensory and Perceptual Abnormalities


ETIOLOGY


It is generally understood that autism has several known causes. The most common is genetic although the exact transmission is not known It has been shown through twin studies that if one twin displays the
characteristics of autism, the other twin is likely to display them also by greater than 50%. other causes of autism include infectious diseases, metabolic disorders and structural abnormalities Examples include
Rubella, PKU, Celiacs Disease and hydrocephalus. Experts have determined that autism is a brain
disorder, but they haven't determined exactly how and why the brain doesn't work properly.

People with autism typicaily display strengths as well as deficits. . Most people with autism display superior strengths. Often in aspects of memory, visual perception, or specialized talents (e.g., sight reading music, self taught reader, drawing.) Some of the more common strengths include:

 excellent memory, especially for detail

 ability to follow routines

 appreciation for precision and accuracy

 strong visual skills

ability to make associations quickly


TREATMENTS


There are a variety of treatments that are available to people with autism. These include behavioral
interventions (based on learning theory), therapies, dietary treatments and medications. Because autism
effects each individual in a unique way, it is strongly suggested that whatever treatment or treatments
chosen be individualized to the person and their environment Their learning styles should always be considered in the decision as well as their past experiences and anxieties. For the family or professional seeking a general overview of treatment options, The Autism Treatment Guide by Elizabeth (Gerlach is not only a great resource. She's an Oregon parent of a child with autism.)

link to Elizabeth's page


autism@kindtree.org
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