Where in the brain is autism? At least four biological variants of autism? –Early brainstem/cerebellar associated with severe secondary problems –Midtrimester bitemporal lobe damage –Uni- or bilateral frontotemporal dysfunction in high-functioning cases –Multi-damage autism

Patricia Rakovic MA CCC/SLP

Where in the brain is autism? Frontotemporal brain dysfunction suggested by –Autopsy studies –Functional imaging studies –Neuropsychological studies –Combined neuropsychological-neuroimaging studies –Clinical picture

Where in the brain is autism? Neuropsychological studies show –Metarepresentation problems –Central coherence problems –Non-verbal learning disability in AS –Verbal learning disability in AD –Executive function deficits –Procedural (complex) learning deficits –Superior fact learning –Aberrant reading of facial expression

Where in the brain is autism? Likely that several functional neural loops are implicated and that all impinge on neurocognitive/social cognitive functions that are crucially (but possibly not specifically) impaired in autism –(Gillberg 1999, Gillberg & Coleman 2000)

Biological Implications Limbic System Memory Learning Emotion Behavior Patricia Rakovic MA CCC/SLP

Biological Implications  Cerebellum involves Modulating Sensory Input The Coordination of Muscles The Maintenance of Balance

Communication Characteristics in Children with ASD Echolalic Disorganized processing of information Atypical interactions Spontaneous vs. elicited imitation Limited use of non verbal behavior – Gestures – Eye-gaze – Point 8

The Role of Language Development in ASD Communication deficits are a primary characteristic of ASD (APA, 1994) Until recently, 50% of children with ASD did not develop spoken language (Tager-Flusberg et al., 2005) –Do not use gestures or other forms of communication to compensate Achievement of spoken language by age 6, along with IQ, is the strongest predictor of good outcome (e.g., Howlin, 2005).

Oral Motor Problems Some children with ASD have such significant oral motor problems that verbal language is extremely delayed Their oral motor problems are further complicated by their sensitivity to touch Patricia Rakovic MA CCC/SLP

Sensitivity  Children with As may have sensitivities to –Auditory stimulus –Tactile stimulus –Olfactory stimulus –Visual stimulus –Taste stimulus

Communication Problems A child may mostly repeat what he hears (echolalia). Others develop advanced speech, but have problems that effect their ability to express feelings or ideas, or in knowing the right way or time to say things. Patricia Rakovic MA CCC/SLP

Thinking in pictures People with Autism Spectrum Disorder think in pictures

Patricia Rakovic MA CCC/SLP One Channel Processing  Children with ASD may process one channel at a time  It is often difficult for them to look at you and listen to you at the same time

Difficulty Reading Social Cues The actions of others are confusing to these children and they may withdraw from social interactions. Many have difficulty with interactive play. Patricia Rakovic MA CCC/SLP

Difficulty Reading Social Cues Children with ASD have difficulty picking up nonverbal cues Yale studies point to the fact that they are not looking at some of the cues that need to be processed Patricia Rakovic MA CCC/SLP