autism and pervasive developmental disorders
TRANSCRIPT
Presented by: Emily Childress, M.A. & Amanda Gilmore,
M.S.
Pervasive Developmental
Disorders
Barclay and Associates, P.C.1525 Airport Road, Suite 101
Ames, Iowa 50010515-292-3023
What are PDDs?AKA Autism Spectrum Disorders(ASDs)Impairment in development; reciprocal
social interaction skills, communication skills, or presence of stereotyped behavior, interests and activities
Evident in first years of lifeAssociated with some degree of Mental
RetardationRange from a severe form called Autistic
Disorder, through Pervasive Development Disorder Not Otherwise Specified), to a milder form, Asperger’s Disorder
Includes Rett’s and Childhood Disintegrative Disorder
Autistic DisorderSix or more from 1, 2, and 3, with two from 1,
and one each from 2 and 31. One impairment in social interaction
marked impairment in the use of multiple nonverbal behaviorseye-to-eye gaze, facial expression, body
postures, and gestures to regulate social interaction
failure to develop peer relationships appropriate
to developmental levellack of spontaneous seeking to share
enjoyment,interests, or achievements with other
people No showing, bringing, or pointing out objects of interest
lack of social or emotional reciprocity
Autistic Disorder 2. One impairment in communication Delay or lack of development of spoken languageno attempt to compensate through alternative modes of communication (gestures, mimes)in individuals with adequate speech, impairment in ability to initiate or sustain a conversation
Stereotyped and repetitive use of language or idiosyncratic language
lack of varied, spontaneous make-believe play or social imitative play
Autistic Disorder3. One restricted repetitive and
stereotyped pattern of behavior, interests, or activities preoccupation with stereotyped and restricted patterns of interest that is abnormal in intensity or focus
inflexible adherence to specific nonfunctional routines or rituals
stereotyped and repetitive motor mannerisms
hand/finger flapping or twistingcomplex whole-body movements
persistent preoccupation with parts of objects
Rett’s DisorderNormal development for the first 5 months of life followed by a deceleration of head growth between 5 and 48 months
Loss of previously acquired purposeful hand movement
between 5 and 30 monthsLoss of social engagement, development of poorly coordinated gait or trunk movements
Severely impaired expressive and receptive language development with severe psychomotor retardation
Childhood Disintegrative Disorder
Normal development for the first 2 years
Significant loss of 2 previously acquired skills:Expressive or receptive languageSocial skillsBowel or bladder controlPlayMotor skills
Two abnormalities of functioning:Social interactionCommunicationRestricted, repetitive and stereotyped
patterns of behavior, interests and activities
Asperger’s DisorderNo significant delay in language or
cognitive developmentTwo social interaction impairments
including: use of multiple nonverbal behaviors
eye-to-eye gaze, facial expression, body postures, and gesturesFailure to develop peer relationshipsLack of spontaneous seeking to share
enjoyment, interests or achievements with other people
no showing, bringing or pointing out objects of interest
Lack of social or emotional reciprocity
Asperger’s DisorderOne restricted repetitive
and stereotyped behavior, interests, and activities including:Preoccupation with stereotyped and restricted patterns of interest that is abnormal in either intensity or focus
• Inflexible adherence to specific, nonfunctional routines or rituals•Stereotyped and repetitive motor mannerisms • Hand/finger flapping or twisting, or complex whole body movements
• Persistent preoccupation with parts of objects
Signs of Autism:Characteristic behaviors of Autism
Spectrum Disorders may or may not be apparent in infancy (18-24 months) but usually become obvious during early childhood (2-6 years)
•5 red flag behaviors:•Does not babble or coo by 12 months•Does not gesture (point, wave, or grasp) by 12 months•Does not say single words by 16 months•Does not 2 word phrases on his/her own by 24 months•Has any loss of any language or social skill at any age
Symptoms of Autism: SocialDifficulty interacting with others and avoid eye contact
Prefer being alone and resist attention
Passively may accept hugs and cuddling
May fail to seek comfort or respond to a parent’s display of anger or affection in a typical way
Unusual and difficult attachment-lack of expected showing of affection
Slow to interpret what people are thinking/feeling
Poor judgment or miss of social cues
Difficulty seeing things from another person’s perspective
Unable to predict or understand other people’s actions
Symptoms of Autism: Social..
Difficulty regulating emotions (may cry,
get angry, be disruptive)
Tendency to lose control and can show self destructive behavior
Symptoms of Autism: Communication
Some may remain mute throughout lifetimeMost develop spoken language and
all learn to communicate in some way using pictures or sign language
May repeat or parrot words (normally passes by age 3)
Slight delays in language Precocious language or seemingly advanced
vocabularyDon’t understand body language/tone of
voice/phrases of speech Their tone of voice may not reflect real
feelingsLess able to let others know what they needDo whatever they can to get through to othersAt a greater risk for becoming depressed or
anxious
Symptoms of Autism: Repetitive Behaviors
Odd repetitive motions set them apart from other children
Behavior can be extreme (arm flapping, walking on toes, freezing in position)
May spend hours lining up toys in a specific way
Need/demand absolute consistency in environment
Slight change in routines can be extremely stressful
Intense preoccupation with certain things trains, lighthouses, fire hydrants, symbols
Signs and Symptoms of Asperger’sInappropriate or minimal social interactionsConversations revolving around self versus
others“Scripted”, “robotic” or repetitive speech Lack of common senseProblems with reading, math, or writing skillsObsession with complex topics such
as patterns or music Average to below average nonverbal
cognitive abilities though verbal cognitive abilities are usually average to above average
Awkward movementsOff behaviors or mannerisms
Causes of Pervasive Developmental Disorders
Scientists are finding surprising new information about genetics, brain structure, and environmental impacts •Currently no
agreement exists on causes
Causes of PDDsSpeculations include:
VaccinationsGenetic vulnerabilityAbnormal brain development
Larger brain sizeIncreased white matter volume
Environmental factorsToxins/ Infectious agents
Lead and cadmium poisoning (in Iowa)
Prenatal exposure to chemicals• Thalidomide and valproic acid
Strategies: Physical Environment
Structure physical environment to facilitate learning and minimize frustration –visual/physical order assists in focusing
Watch for peers who obviously/subtly annoy her
Watch for peers who feed off and feedback inappropriate behaviors –she may like these peers but the relationships are not necessarily the best for either student
Ensure that she is in a position of least distraction up front and away from visual and auditory “clutter”
Consider isolating her for short periods to teach new concepts or build on pre-existing knowledge
She may be defensive of personal space
Strategies: In Class Structure
Create a predictable environment with routine and prepare student for changesSet behavioral limits and monitor to implement consequences or provide
coping strategiesGive brief and precise instructions that
she understandsState clearly what is expected-be
concrete and allow time for her to process the information
Break tasks up into manageable segments and train her to schedule and plan
Teach her to ask for help and methods of doing so
Video Clip from Parenthood
Strategies: Presentational Issues
Know and use the student’s strengths
Present new concepts in a concrete manner
Use activity based learning where possible
Use visual prompts as appropriateBreak work into small stepsHave written instructions for students,
include visual cues and mark clearly the
things that need to be completedShow examples of what is requiredKeep chalk/whiteboard neat
Strategies: Teaching IssuesDo not do for him what he can do for selfDo not expect the him to automatically generalize instructions
Use language to tie new situations to old learning
Do not rely on emotional appeals or presume that he will want to please you
Concentrate on changing unacceptable behaviors and do not worry about those that are “simply” odd
Use the obsessive or preferred activity as a reward
Use opportunities which arise to teach him about how other students feel and react when they are hurt or upset
Be consistent and do not give options if there are no options
Strategies: Child Focused for Development
Provide “peer support network/buddy system” for safety
Teach safety phrases such as “are you pretending?” or “what do you mean?” or “why should I do that?” to help her gain information (this does not come naturally) so she can determine the situation’s nature and respond accordingly
Teach rules of social conduct so she does not constantly interrupt
Explain metaphors and avoid where possible (frog in your throat)
Have a time out area for discipline (enforce consequences & ensure ‘time out’ isn’t more attractive than the activity)
Have a strategy to employ when she cannot cope due to overstimulation or confusion
Written timetables can help primary aged children stay on task
Strategies: Parent FocusedIf abnormal behaviors surface, touch base with parents to see if they are seeing these behaviors (parents prefer more information than less and often something minor points to a serious issue)
Provide parents with a timetable to ensure rehearsal of what will be required the following day (equipment, activities)
Have a daily planner to inform parents of successes and failures, ask for parental advice/information from parents
It is vital that parents know what is happening at school so they can inform doctors and therapists of issues for future collaboration
Give parents options regarding classroom modifications and the possibility of seeking outside help as an additional resource
Working with Professionals
Barclay and Associates, P.C.1525 Airport Road, Suite 101Ames, Iowa 50010515-292-3023
•Parents and professionals should work together for the child’s benefit•While professionals do have experience, remember that parents posses unique knowledge about their child•When a treatment plan is in place, parents and professionals need to have good communication in order to monitor a child’s progress•Guidelines for working with professionals:• Be informed• Be prepared, ask for clarification• Be organized• Communicate
Additional ResourcesArticle
Jackel, S (2006). “Asperger’s Syndrome-Educational Management Issues”
Asperger’s Syndrome Survival Guide: www.aspergerssociety.org
Autism Society of America: www.autism-society.orgAutism Speaks: www.autismspeaks.orgDiagnostic and Statistical Manual of Mental Disorders
Fourth Edition Text RevisionKid’s Health: http://kidshealth.orgThe Mayo Clinic: www.mayoclinic.comNational Institute of Mental Health
http://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-pervasive-developmental-disorders/index.shtml
Organization for Autism Research: www.researchautism.org
Questions?