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Autism: the Brain, Thinking and Behavior Mary Joann Lang, Ph.D., A.B.P.N. Beacon Day School Orange, California.

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Presentation on theme: "Autism: the Brain, Thinking and Behavior Mary Joann Lang, Ph.D., A.B.P.N. Beacon Day School Orange, California."— Presentation transcript:

1 Autism: the Brain, Thinking and Behavior Mary Joann Lang, Ph.D., A.B.P.N. Beacon Day School Orange, California

2 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California2 Course Objective: To understand basic concepts related to the brain, thinking and behavior and how to make appropriate interventions for children with ASDs, which help each individual reach his or her maximum potentials.

3 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California3 Autism Defined According to the NIH Autism is characterized by three distinctive behaviors: 1.difficulties with social interaction 2.problems with verbal and nonverbal communication 3.repetitive behaviors or narrow, obsessive interests. 3.repetitive behaviors or narrow, obsessive interests. These behaviors can range in impact from mild to disabling. Autism varies widely in its severity and symptoms and may go unrecognized, especially in mildly affected children or when more debilitating handicaps mask it. These behaviors can range in impact from mild to disabling. Autism varies widely in its severity and symptoms and may go unrecognized, especially in mildly affected children or when more debilitating handicaps mask it.

4 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California4 Systems Theory A system is greater than the sum of its parts.

5 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California5 Systems Theory Common Elements: input-signal going into a system output-the act of turning out throughput (or process)-raw material processed within a given time feedback-response to a particular process control-ability to manage or direct environment-the entire set of conditions under which one operates goal-the result toward which effort is directed

6 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California6 Systems Theory Open Systemcapable of growth, development & adaptation. Interaction occurs within the environment. (i.e.: The Rules of a Classroom)Open Systemcapable of growth, development & adaptation. Interaction occurs within the environment. (i.e.: The Rules of a Classroom) Closed Systemrelationships among system components are set and inflexible; no interaction with the environment (i.e.: The Laws of Physics)Closed Systemrelationships among system components are set and inflexible; no interaction with the environment (i.e.: The Laws of Physics)

7 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California7 Systemic Approach to Understanding the Brain In order to understand an individual with Autism, it is necessary to understand him or her as an individual from a systems approach: How do mind and body function?How do mind and body function? How does the individual fit into theHow does the individual fit into the community and society? What interventions can be providedWhat interventions can be provided to help an individual reach his or her potential?

8 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California8 Systemic Approach to Understanding the Brain Functions of the OrchestraPerceptionAttention Language Processes Visual-spatial Processes Memory Sensory Inputs Motor Outputs Knowledge and Skills Functions of the Conductor Inhibit Shift Flexibility Modulate Emotions Initiate Working Memory Planning Organizing Self-monitoring and Evaluating Ref.: Peter Isquith, Executive Function: Concepts and Assessments

9 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California9 Systems Theory Systems Theory Medical Issues: Human Body Systems System Location Nervous SystemBrain and Nerves Skeletal SystemBones and Skull Muscular SystemSkeletal, Cardiac and Smooth Muscles Endocrine SystemGlands and Hormones Cardiovascular SystemHeart and Blood Lymphatic and Immune SystemsLymphocytes and Macrophages Respiratory SystemLungs and Airways Digestive SystemMouth and Gastrointestinal Tract Urinary SystemKidneys and Bladder Reproductive SystemMale and Female Organs Integumenary System Hair, Skin and Nails A person with Autism will experience System Interruptions with many of the above.

10 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California10 Systems Theory Breaks in the System It is becoming clear that the normal trajectory of neurodevelopment is altered in autism. Abnormalities in brain growth, neuronal patterning and cortical connectivity are often seen.It is becoming clear that the normal trajectory of neurodevelopment is altered in autism. Abnormalities in brain growth, neuronal patterning and cortical connectivity are often seen. Changes to the structure and function of synapses and dendrites have also been strongly suggested in the pathology of autism.Changes to the structure and function of synapses and dendrites have also been strongly suggested in the pathology of autism. Finally, environmental factors are likely to interact with the underlying genetic profile, and foster the clinical heterogeneity seen in autism spectrum disorders.Finally, environmental factors are likely to interact with the underlying genetic profile, and foster the clinical heterogeneity seen in autism spectrum disorders. *reference: Pardo CA, Eberhart CG, The neurobiology of autism, Brain Pathol Oct;17 (4): Department of Neurology, Johns Hopkins University School of Medicine*reference: Pardo CA, Eberhart CG, The neurobiology of autism, Brain Pathol Oct;17 (4): Department of Neurology, Johns Hopkins University School of MedicinePardo CAEberhart CGPardo CAEberhart CG

11 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California11 System Theory The Beacon Model Supports: Physical Emotional Cognitive Behavioral Individual Functioning Cognition Educational Achievement Adaptive Behavior Participation/Social Roles Health Context

12 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California12 Cognition/Thinking

13 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California13 Exploring Brain Behavior with Respect to: AttentionAttention MemoryMemory LanguageLanguage Visual-Spatial FunctioningVisual-Spatial Functioning Executive Function, andExecutive Function, and Emotional FunctioningEmotional Functioning Cognition/Thinking

14 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California14 Social, Emotional, Cultural, Environmental and Situational Factors Overall Cognitive Functioning and Academic Achievement Speed and Efficiency of Cognitive Processing School Neuropsychological Assessment Model

15 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California15 Cognition/Thinking Cognition/Thinking Attention What happens when an individual interacts with environment? – – Always assimilating and accommodating info – – Take in, process and act – – In order to thinkone must pay attention

16 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California16 Cognition/Thinking Attention Why do children with ASDWhy do children with ASD have trouble with attention? Theyre not able to determine whats important creating a system overload! Sensory input is too muchSensory input is too much Frequently dont have organizational strategies….Frequently dont have organizational strategies…. Dont see relationships in environmentDont see relationships in environment Rate of info is provided in too much volume Rate of info is provided in too much volume Information is too complexInformation is too complex

17 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California17 Cognition/Thinking Memory We are required to process information, store it and retrieve it as needed. Some people are simply unable to keep pace with the demands of society. They suffer from one or more forms of memory dysfunction.

18 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California18 Cognition/Thinking Memory Memory requires systematic handling of information, including:Memory requires systematic handling of information, including: –Receiving new information and holding it in short-term memory –Temporary storage of information as active working memory –Processing information and knowledge in long-term memory –Recalling information from long-term memory

19 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California19 Cognition/Thinking Visual/Spatial Processing Visualizing Words (Spelling) Drawing Music Crafts Household Tasks Visualizing Details Related to Past Experiences Visualizing Academic Concepts (Science, Math, Social Studies) Visualizing Story Concepts while Reading or Listening Visualizing Directions/ Mobility The ability to visualize and process information is needed for school success and for practical use. Interpretation of relationships involves spatial processing knowing how objects relate to each other (size, order, etc.)

20 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California20 Cognition/Thinking Visual/Spatial Processing QualityDescription Saliency Recognition Problems discriminating important information from unimportant Lacks ability to prioritize Easily brought off task by sounds or images Unusual recall of irrelevant facts Surface SkimmingSees big picture but fails to recognize details Needs repeated instructions Demonstrates memory inefficiencies Concentration Weaknesses Lacks focus Lacks listening abilities Focuses on details for too long or too short of time Engagement Problems Takes excessive time to join activity Daydreams Relates unrelated materials to lessons Creative Tendencies Seeks Constant and Immediate Gratification Concentration Weaknesses Restless, hyperactive Needs exciting stimuli to hold attention Never satisfied, demanding

21 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California21 Cognition/Thinking Language Aphasiainability to produce or understand language caused by brain damage or dysfunctionAphasiainability to produce or understand language caused by brain damage or dysfunction Speech Production (Oral Expression)Speech Production (Oral Expression) Speech Comprehension (Receptive Language or Listening Comprehension)Speech Comprehension (Receptive Language or Listening Comprehension)

22 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California22 Cognition/Thinking Language Problems Can be Associated with Weak Processing when Deficiencies involve:Problems Can be Associated with Weak Processing when Deficiencies involve: –Phonological Abilities (sound) –Morphology (root words and adaptations) –Semantics (word meanings) –Syntactic (word groupings/sentences) –Discourse (larger word groupings/paragraphs) –Metalinguistics (how language works) –Pragmatics (understanding in context)

23 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California23 Cognition/Thinking LanguageImpairments Brocas aphasia Brocas aphasia non-fluent aphasia with effortful, often agrammatic speech production. Conduction aphasia fluent aphasia with severely impaired repetition, but relatively preserved language comprehension Expressive aphasia non-fluent output Global aphasia complete loss of all linguistic function Mixed aphasia displays both receptive and expressive deficits Receptive aphasia impaired comprehension Transcortical motor aphasia impaired expressive aphasia Transcortical sensory aphasia language comprehension is impaired, but repetition is preserved Wernickes aphasia receptive language and repetitions are severely impaired.

24 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California24 Cognition/Thinking Language Wernicke-Geshwind Model of Language Brocas Area Primary Auditory Cortex Primary Motor Cortex Arcuate Faciculaus Angular Gyrus Primary Visual Cortex Wernickes Area

25 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California25 Cognition/Thinking Executive Function Neuroanatomy: Frontal Lobe Involvement is associated with is associated with Executive Function. Identification of problem areas allows us to develop adaptive behavior skills for individuals with ASD.

26 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California26 Cognition/Thinking Executive Function Executive Functions include those behaviors that include:Executive Functions include those behaviors that include: –Abstract and Critical Thinking –Choosing to Take Action –Voluntary Response to Stimulation –Planning and Organizing

27 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California27 Cognition/Thinking Executive Functioning Terms Associated with Executive Functions* Abstract ReasoningAbstract Reasoning AnticipationAnticipation Attention ControlAttention Control Behavioral Initiation/Behavioral Initiation/ Productivity Productivity Behavioral RegulationBehavioral Regulation Common SenseCommon Sense Concept FormationConcept Formation CreativityCreativity EstimationEstimation FluencyFluency Goal SettingGoal Setting Hypothesis Generating Inhibition of Impulsiveness Mental Flexibility Organization Planning Problem Solving Rule Learning Self-control Self-monitoring Set Formation and Maintenance Set Shifting Working Memory *Source: Miller, Dan; Essentials of School Neuropsychological Assessment; Wiley, 2007, p. 235.

28 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California28 Cognition/Thinking Executive Functioning Development Plan/Organize/Monitor 3-32 years Emotional Modulation 3-?? years Verbal Working Memory 2-13 years Nonverbal Working Memory 3-24 months Inhibit0-?

29 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California29 Cognition/Thinking Emotional Function Emotions are the feelings that color our lives and allow us to experience all of the joys and sorrows of life. Core emotions that are universally experienced and recognized: – –fear – –anger – –sadness – –enjoyment Enjoyment can enhance learning; but fear, anger and sadness interfere with learning. People with ASD experience all of the same emotions as other peoplebut they cant always communicate their feelings. Reference: Center for Development and Learning

30 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California30 Cognition/Thinking Summary NeuroFunctionPsych/MedEd FrontalPosteriorLeftRightCorticalSub-corticalCognitiveExecutiveLanguageVisual/NVLearningMemoryMotorSensorySocial/EmotionalBehaviorAcademicADHD-IADHD-CTS/OCDRADASD(NLD)MREpilepsyTBILDSLDOHIOrthoSLPDeaf Vis Imp PDDLI/IDTBIEBD Ref: Peter Isquith, PhD, Executive Function: Concepts and Assessment

31 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California31 Breaks in the System Stored Energy Autistic children dont know how to manage information overloads. Energy builds uplooking for a release. Eventually, the child discharges energy in any available manner.

32 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California32 Cognition/Thinking Visual/Spatial Processing Overload the body responds by seeking a situation to reduce the overload….Overload the body responds by seeking a situation to reduce the overload….

33 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California33 Cognition/Thinking Visual/Spatial Processing Reactions to System Overload Include Sensory-Seeking Behaviors, such as: Screaming, Aggression, Rocking Etc…

34 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California34 System Theory The Beacon Model Supports: Physical Emotional Cognitive Behavioral Individual Functioning Cognition Educational Achievement Adaptive Behavior Participation/Social Roles Health Context


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