autism spectrum disorders gill capaldi
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Autism Spectrum Disorders
An introduction to ASD including a
brief history, profile, implicationsand opportunity for discussion
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Autism Spectrum Disorder
Developmental disorder affecting children from birth orthe early months of life.
Exact cause remains unknown, but generally felt to beneurological in origin, although recent research points topossible genetic or chromosomal abnormalities as wellas viral infections, pregnancy/birth complications and/orother causes.
May co-exist with other medical conditions e.g. fragile Xsyndrome, tuberous sclerosis.
Often accompanied by additional learning difficulties(about 75%).
No single consistent explanation at the moment.
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Autism Spectrum Disorder
Background / History
Leo Kanner (USA) Child Psychiatrist
Paper published in 1943 based on study of 11 cases.
Resulted in identification of a separate condition
Autism.
He wandered about smiling, making stereotyped movements with his
fingers, crossing them about in the air. He shook his head from side to
side...humming the same three-note tune. He spun with great pleasure
anything he could seize upon to spin.When taken into a room, he
completely disregarded the people and instantly went for objects,
preferably those that could be spun.( Kanner 1943)
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Autism Spectrum Disorder
Background / History
Hans Asperger (Austria) Physician
Identified similar group.
1944 published dissertation on autistic
psychopathy in childhood
Published in German and in middle of Second
World War - it took nearly 50 years before it was
translated (Wing 1981)
Many similarities with Kanner use of autistic
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Autism Spectrum Disorder
Background / History
Lorna Wing research with Judy Gould (1979)
Identified threads of commonality
amongst group of children referred for
psychiatric help who were socially impaired.
Wings Triad of Impairments
1988 The Autistic Continuum
1996 The Autistic Spectrum broader classification
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Triad of Impairments
Social
Relationships
Social
Communication
Rigidity of Thought,Behaviour and Play
(Social Understanding)
ASD
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Communication
Some children may not use spoken language to
communicate, and may use non-verbal means instead,e.g. pushing, biting, squealing, crying
Even children with developmentally appropriate verbalskills may have problems with their useof languagewhen talking to others (pragmatics). They may have
difficulties with their non-verbal communication as well. May not understand subtle conversational clues e.g.
facial expressions indicating surprise, anger etc. andmay therefore not know to look contrite.
May have difficulties with concepts e.g. more / less, time
(including the need to wait) Inability to ask questions to establish another persons
view point, but may ask repetitive questions e.g. What'syour name? This may mask unspoken anxieties in thechild or indicate that they have not understood.
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Communication
Some children may use unusual intonation withstereotypical, stilted speech (or a sing-song intonationpattern)
May have a very literal understanding of speech -therefore may fail to follow a lot of classroom languagee.g. "its time to go outside" may mean take your apronoff, get your coat and line up at the door" but a child with
ASD may think they can go straight outside and mayconsequently appear disobedient. Literality can lead to
distress e.g. go to the toilet and wash your hands" Repetition of chunks of language heard in other
situations/videos - may sound clumsy or odd
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Social Relationships Child may display general awkwardness in social
situations
May be unable to interact appropriately with peers
Difficulty in making friends may initiate and want
social contact, but lack understanding and skills to
carry through
Unusual facial and/or physical gestures (smiles,
grimaces, eye-contact)
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Social Relationships Problems with social distance
Child may have difficulties with conventional
turn-taking and sharing. May start/finish
conversations abruptly or fail to answerappropriately.
Child may not see themselves as a part of group
Motivation may not be rewarded by success at
tasks(They are not being lazy or obstinate!)
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Rigidity of thought, play and behaviour
Their play may be learnt and repeated. This means thatinitially the childs play skills may appear appropriate, butover time it is apparent that the childs play sequencesare not extending.
Imaginative and symbolic play begins to emerge at
around 2 to 2 years, but for children with ASD theirplay may be repetitive and limited to specific actions, e.g.lining toys up, moving trains around a track
May find activities difficult when imagination or pretendskills are needed, e.g. home corner, role play games
Difficulty coping with adult direction and imposedroutines
Difficulties with understanding changes in routine andnew situations
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Rigidity of thought, play and behaviour
Some children exhibit fixed interests and maybecome obsessional about these
Attentional problems on tasks chosen by others
Difficulties with problem solving, e.g. finding an
item that is not in its usual place Seeing 'part' rather than 'whole' - not the 'bigger
picture, e.g. focusing on a specific part of apicture
Rigidity of thinking and behaviourbeing aclass policeman
Perseveration - the need to repeat words,actions, activities etc
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Beyond the Triad of Impairments
The Sensory World of Autism
Senses provide us with the unique experiences which
allow us to interact & be involved with others
Senses play a significant role in determining ourresponses to a particular situation
Many individuals with autism experience either an
intensification or absence of sensory integration
Hyper Hypo
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The Sensory World of utism
The Five Senses
Touch (includes balance and body awareness)
Tactile: relates to touch ,pressure, pain, hot/cold
Hypo- Holding others tightly
(Social aspect)Sensitivity to certain clothing/textures
High pain threshold
Self-harming (biting, gouging etc.)
Hyper- Finds touch painful/uncomfortable
Dislike of having things on hands/feet
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The Sensory World of utism
The Five Senses
Touch (includes balanceand body awareness)
Vestibular: informs where body is in space
Hypo- The need for rocking, swinging,spinning
Hyper- Difficulties in activities which include
movement (sport, dance)Difficulties in stopping quickly or during an
activity
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The Sensory World of utism
The Five Senses
Touch (includes balance and body awareness)
Proprioception: where how body is moving
Hypo- Proximitypersonal body space in relation toothers.
Navigating roomsavoiding obstructions.
Hyper- Fine motor difficulties, manipulating smallobjects (buttons, threading, shoe laces etc).
Moves whole body to look at something.
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The Sensory World of utism
The Five Senses
Sight
Visual: helps to define objects, colours, space
Hypo- Peripheral vision (central vision blurred)Poor depth perception (throwing/catching)
Hyper-Fragmentation of images (too many sources)Focussing on particular detail (rather than
whole).
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The Sensory World of utism
The Five Senses
Hearing
Auditory: informs about sounds around us
Hypo- Partial or complete absence of hearingEnjoys noisy places/activities (bangs things)
Hyper- Magnification or distortion of sounds
Unable to filter out external sounds
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The Sensory World of utism
The Five Senses
Smell
Olfactory: Is the first sense we rely on
Hypo- May be oblivious to strong odoursMay lick things indiscriminately
Hyper- Smells appear intensified/overpowering.
Toileting problems
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The Sensory World of utism
The Five Senses
Taste
Gustatory: Informs about various tastes
Hypo- Likes very spicy/salted foodsMay eat anything (soil, grass, material etc)
Hyper- Prefers bland (white) food
Texture of food may be problematic (lumps)
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The National Picture
Estimated population of ASD (whole
spectrum) in the UK
National Autistic Society estimated the
prevalence at 1:100
No. of children with ASDs under 18 (est.)
133,500(based on 2001 censusUK under-18
population of 13,354,297
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The Local Picture
October 2006Yorks & Humbs ASD
Regional Partnership Benchmarking
questionnaire. Numbers of pupils in each
regional Local Authority with ASDs.
Mainstream & Special School pupils from
pre-school to Post 16
Rotherham incidence: slightly higher
(approx 650 children with diagnosed ASDs
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Discussion Points
Implications for education
Implications for families
Support networks (schools) Support networks (families)
Any other questions?