Chapter 7 Autism Spectrum Disorders

IDEA Definition Autism is a developmental disability affecting verbal and nonverbal communication and social interaction, generally before age 3, that adversely affects a child’s performance.

DSM-IV Definitions Autistic Disorder - marked by three defining features, with onset before age 3: 1) impaired social interaction, 2) impaired communication, and 3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities Asperger Syndrome - impairments in all social areas, particularly an inability to understand how to interact socially Rhett’s Syndrome - a distinct neurological condition that begins between 5 and 30 months of age, marked by a slowing of head growth, stereotypic hand movements, and severe impairments in language and cognitive abilities Childhood disintegrative disorder - shares characteristics with autistic disorder, but doesn’t begin until after the age of 2 and sometimes not until age 10 Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS) - diagnosis given to children who meet some, but not all, of the criteria for autistic disorder

Characteristics Impaired social relationships Communication and Language deficits - Many children with autism do not speak; echolalia is common among those who do talk Varying levels of intellectual functioning, uneven skill development Unusual responsiveness to sensory stimuli Insistence on sameness and perseveration Ritualistic and stereotypic behavior Aggressive or self-injurious behavior

Prevalence and Causes Prevalence Causes Recent estimates - Autism occurs in as many as 30–121 in 10,000 people Boys are affected about 4 times more often than girls Autism is the fastest-growing category in special education Causes The cause of autism is unknown There is a clear biological origin of autism in the form of abnormal brain development, structure, and/or neurochemistry No evidence of childhood vaccinations causing autism

Screening Early diagnosis is highly correlated with dramatically better outcomes Autism can be reliably diagnosed at 18 months of age Checklist for Autism in Toddlers (CHAT) Modified Checklist for Autism in Toddlers (M-CHAT) Social Communication Questionnaire (SCQ) Autism Spectrum Screening Questionnaire (ASSQ)

Diagnosis Childhood Autism Rating Scale (CARS) Autism Diagnostic Interview—Revised Autism Diagnostic Observation Scale—Generic Asperger Syndrome Diagnostic Scale (ASDS)

Educational Approaches Early Intensive Behavioral Intervention Applied Behavior Analysis (ABA) Discrete Trial Training Picture Exchange Communication System (PECS) Peer-mediated interventions Errorless discrimination learning Self-management strategies Functional assessment of challenging behavior Functional Communication Training Naturalistic language strategies

Educational Approaches (continued) Picture activity schedules Social Stories Educational Placement Alternatives Regular Classroom Resource Room and Special Classes

Unproven Interventions and Fads for ASD Facilitated Communication Secretic Therapy