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Autism: the Brain, Thinking and Behavior

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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, California
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. Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

3 Autism Defined According to the NIH
Autism is characterized by three distinctive behaviors: difficulties with social interaction problems with verbal and nonverbal communication 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.  Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

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

5 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 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

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

7 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 does the individual fit into the community and society? What interventions can be provided to help an individual reach his or her potential? Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

8 Systemic Approach to Understanding the Brain
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” Functions of the “Orchestra” Perception Attention Language Processes Visual-spatial Processes Memory Sensory Inputs Motor Outputs Knowledge and Skills Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

9 Systems Theory Medical Issues: Human Body Systems
System Location Nervous System Brain and Nerves Skeletal System Bones and Skull Muscular System Skeletal, Cardiac and Smooth Muscles Endocrine System Glands and Hormones Cardiovascular System Heart and Blood Lymphatic and Immune Systems Lymphocytes and Macrophages Respiratory System Lungs and Airways Digestive System Mouth and Gastrointestinal Tract Urinary System Kidneys and Bladder Reproductive System Male and Female Organs Integumenary System Hair, Skin and Nails Speak to ASD System Interruptions A person with Autism will experience System Interruptions with many of the above. Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

10 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. 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. *reference: Pardo CA, Eberhart CG, “The neurobiology of autism,” Brain Pathol Oct;17 (4): Department of Neurology, Johns Hopkins University School of Medicine 1: Brain Pathol Oct;17(4): Links The neurobiology of autism. Pardo CA, Eberhart CG. Department of Neurology, Johns Hopkins University School of Medicine Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

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

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

13 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California
Cognition/Thinking Exploring Brain Behavior with Respect to: Attention Memory Language Visual-Spatial Functioning Executive Function, and Emotional Functioning Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

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

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

16 Cognition/Thinking Attention
Why do children with ASD have trouble with attention? They’re not able to determine what’s important—creating a system overload! Sensory input is too much Frequently don’t have organizational strategies…. Don’t see relationships in environment  Rate of info is provided in too much volume Information is too complex Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

17 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. Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

18 Cognition/Thinking Memory
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 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

19 Cognition/Thinking Visual/Spatial Processing
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.) Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

20 Cognition/Thinking Visual/Spatial Processing
Quality Description 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 Skimming Sees “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 Restless, hyperactive Needs exciting stimuli to hold attention Never satisfied, demanding p. 59 green Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

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

22 Cognition/Thinking Language
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) Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

23 Cognition/Thinking Language—Impairments
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 Wernicke’s aphasia —receptive language and repetitions are severely impaired. Broca’s 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 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

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

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

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

27 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California
Cognition/Thinking Executive Functioning Terms Associated with Executive Functions* Abstract Reasoning Anticipation Attention Control Behavioral Initiation/ Productivity Behavioral Regulation Common Sense Concept Formation Creativity Estimation Fluency Goal 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. Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

28 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 Inhibit 0-? Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

29 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 people—but they can’t always communicate their feelings. Reference: Center for Development and Learning Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

30 Cognition/Thinking Summary
Neuro Function Psych/Med Ed Frontal Posterior Left Right Cortical Sub-cortical Cognitive Executive Language Visual/NV Learning Memory Motor Sensory Social/Emotional Behavior Academic ADHD-I ADHD-C TS/OCD RAD ASD (NLD) MR Epilepsy TBI LD SLD OHI Ortho SLP Deaf Vis Imp PDD LI/ID EBD Ref: Peter Isquith, PhD, “Executive Function: Concepts and Assessment” Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

31 Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California
Breaks in the System Stored Energy Autistic children don’t know how to manage information overloads. Energy builds up—looking for a release. Eventually, the child discharges energy in any available manner. Mary Jo Lang, Ph.D., A.B.P.N.-Beacon Day School-Orange, California

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

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

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


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