Autism

Diagnosis and symptomsTheories of autism

Instructional strategies

Diagnosis and prevalence

Affects 1/165 Canadians DSM-IV-TR Criteria

At least 2 impairments in social interaction Impairment in communication Engage in restricted and repetitive

behaviour, interests, and activities Non-triad impairments

Restricted interests, obsessive desire for sameness, preoccupation with parts of objects, exceptional proficiency in very specific skills

Academic profile Strengths

Visual reasoning Vocabulary knowledge Word reading Math

Weaknesses Working memory Processing speed Reading comprehension Written expression Graphomotor abilities

Theories of autism

Theory of mind Weak central coherence Executive dysfunction Hyper-systemizing Excess neural excitation

Evaluation of theories

Explanatory Power: how well does it account for the FULL pattern of symptoms?

Universality: Is this deficit evidenced in ALL individuals with autism?

Specificity: Is the proposed deficit evidenced ONLY in individuals with autism

Impairments in theory of mind

Baron Cohen (1985)

Theory of mind

Theory of mind: the ability to attribute independent mental states to oneself or to others in order to explain or predict behaviour.

In the Sally Anne test, 80%of children with autism failed to demonstrate theory of mind.

Explanatory power

• Triad of impairments

Impairments in social interaction

Impairments in communication

Restrictive, repetitive, and stereotyped patterns of behaviour

Explanatory power

Non-triad Impairments

X Restricted interests

X Obsessive desire for sameness

X Islets of ability, idiot savant abilities

X Excellent rote memory

X Preoccupation with parts of objects

Universality and specificity

X Universality

X Specificity

Impairments in central coherence

Frith (1989)

Impairments in central coherence

Central coherence theory asserts that autism is characterized by an imbalance in the integration of information at different levels; individuals with autism see the parts rather than the wholes, and lack the cognitive capacity to integrate the parts into the wholes.

Explanatory power

• Triad of impairments

Impairments in social interaction

Impairments in communication

Restrictive, repetitive, and stereotyped patterns of behaviour

Explanatory power

• Non-triad Impairments

Restricted interests Obsessive desire for sameness Islets of ability, idiot savant abilities Excellent rote memory Preoccupation with parts of objects

Universality and Specificity

Universality

Specificity

Impairments in executive function

Ozonoff (1991) Tower of Hanoi Test

Impairments in executive function

Executive function is defined as the ability to maintain an appropriate problem solving set for attainment of a future goal. It includes:

planning impulse control inhibition of irrelevant responses set maintenance organized search flexibility of thought and action

Explanatory power

• Triad of impairments

Impairments in social interaction

Impairments in communication

Restrictive, repetitive, and stereotyped patterns of behaviour

Explanatory power

• Non-triad Impairments

Restricted interests Obsessive desire for sameness Islets of ability, idiot savant abilities Excellent rote memory Preoccupation with parts of objects

Universality and specificity

Universality

Specificity

Hyper-systemizing

Baron-Cohen (2006) According to this theory all individuals fall

on a continuum in their ability to process systemizable (law-governed) information.

1 8

process information that is systemized and unsystemized

process highly-systemized information

Hyper-systemizing

Baron-Cohen (2006) According to this theory all individuals fall

on a continuum in their ability to process systemizable (law-governed) information.

1 8

process information that is systemized and unsystemized

process highly-systemized information

Explanatory power

• Triad of impairments

Impairments in social interaction

Impairments in communication

Restrictive, repetitive, and stereotyped patterns of behaviour

Universality and specificity

? Universality

? Specificity

Neurological explanations

Courchesne (2010) – Excess neural excitation

My thesis

Word level decoding summary Very poor phonological processing Word reading/spelling performance

ranges from 10th-12th percentile Uses a visual route more than

phonological route Does not use semantic knowledge

to help identify words

My thesis

Reading comprehension summary Ranges from 12th to 14th percentile Strengths

Literal and vocabulary based comprehension

Weaknesses Inferential comprehension when

implicit Evaluative comprehension when a

feeling

My thesis

Explanation of findings CG performed better

when the task was law governed Ease with literal and

vocabulary-based comprehension

Difficulty with understanding feelings and inferences

Ease with whole words Difficulty with reading

phonetically Theory of hyper-

systemizing (Baron Cohen, 2006)

CG was only able to engage one processing center at a time In word reading she

engaged visual system and neglected phonological and semantic

In reading comprehension she had difficulty integrating knowledge from different areas

Theory of excess neural excitation (Courchesne et al., 2007)

Importance of theory

Intervention

Early intensive behavioural intervention (EIBI)

Most widely recognized approach McEachin, Smith, & Lovaas (1993)

found that after 4.5 years of EIBI treatment, 9 of the 19 participants were indistinguishable from their peers

Involves discrete trial training (breaking down teaching steps and systematically, repetitively teaching each step).

Exercise

Follow the program procedure on your handout and teach a classmate the skill using discrete trial training.

Discuss which theory/theories of autism could account for the success of EIBI

Discuss what elements are involved in EIBI that could translate to teaching practice.

Intervention in schools

Once children are school, EIBI often ceases

Teachers are not trained in EIBI Philosophical differences Requires one-on-one instruction, which

is largely not available

Interventions based on excess neural excitation theory

Education needs to be Law-governed, explicit instruction Provide more support for abstract tasks Ensure automaticity of each distinct task

prior to requiring integration across tasks

Explicitly require integration when several processes are required to complete one task

Reading example....

Instructional strategies

Language Anchor instruction in visual cues Video-modelling Take advantage of echolalia

echolalia, delayed non-functional echolalia, delayed functional echolalia

Modeling Explicitly teach pragmatic language skills

(i.e., respond to the intended message rather than correcting grammar, practice asking questions, etc...)

Have students practice noticing non-verbal signals

Instructional strategies

Social behaviour Social stories Video modelling Explicit practice in social situations Preparation (visual schedules, practice

for situations, etc...) Modelling emotion recognition in social

situations

Instructional strategies

Restricted, repetitive, stereotyped behaviours, interests, and activities

Reducing 'stimming' Redirect attention (incompatible behaviour) Replace with socially acceptable alternative Provide safe space for stimming

Limit perseveration on particular interest and activity.

Encourage development of new interests and activities

May use those interests and activities to motivate learning in difficult areas

Differentiated instruction

Visual supports

Video-modelling

Explicit teaching

i.e, teaching theme identification

Task analysis

Could use graphic organizers to help work on each part and then draw together

Reinforcement for motivation

Pre-teaching

Predictable classroom environment (schedules, transition preparation)

Cognitive credit cards (with visuals)

Exercise

Imagine that you have a student with autism in your class and for your lesson plan:

Task analysis – determine all of the steps needed to complete the task

Plan how you will ensure understanding of each step of each task and how you will support your student with autism in integrating all the steps involved.

Identify which steps might be more difficult and suggest ideas to support your student.

Reflection

In one short paragraph outline: The concepts from the readings/course

notes that you were hoping to apply Your contribution How your contribution successfully

applied those concept