DrRoNovick@aol.com

Summer 2012

Bright, academically accomplished middle school student. Referred in 7th grade for severe social difficulties – doesn’t get along, doesn’t seem interested in socializing, says unusual things, speaks in professorial voice, difficulty working on cooperative learning tasks. More difficult with parents, not listening, argumentative, highly opinionated. Often discusses science facts.

Reluctant to work in counseling. Sees no difficulties, feels everyone else has the problem.

Seven years later – in college – returns to counseling at his request. Accused of stalking. Doesn’t understand jokes in cafeteria. Wants help being socially appropriate, despite enormous success academically.

Mental Retardation Intermittent Limited Extensive Pervasive

Rule-out Traumatic Brain Injury Autism

Asperger’s Disorder

300,000 children in US affected Was assumed to be rare – 1/10,000 Current incidence – as high as 1/150 Reasons for increased incidence

Better diagnosis Including Aspergers Genetic factors Environmental

Kanner- refrigerator parents – totally debunked

Genetics - Selective breeding Vaccines – thimerasol controversy Brain pathology

Limbic (emotion), hippocampal (memory) abnormalities

Cerebellar abnormalities (purkinje cells) –abnormal growth of brain – too many connections

Qualitative impairment in social interaction with at least 2 Impaired use of nonverbal cues, failure to develop peer

relationships,lack of spontaneous seeking to share with others, lack of social/emotional reciprocity

Qualitative impairments in communication with at least 2 Delay or lack of language, impaired conversation,

stereotyped or repetitive language, lack of play on developmental level

Restricted repetitive and stereotyped patterns of behavior, with at least 1 Preoccupation with one or more restricted pattern of

interest, inflexible adherence to routines/rituals, stereotyped motor mannerisms, preoccupation with parts of objects

Qualitative impairment in social interaction with at least 2 Impairment in use of nonverbal behaviors, failure

to devel peer relationships, lack of spontaneous seeking to share interests, lack of social reciprocity

Restricted repetitive and stereotyped patterns of behavior, interests, with at least 1 Encompassing preoccupation with stereotyped

interests, inflexible adherence to specific routines, stereotyped, repetitive movements, preoccupation with parts of objects

Disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning

Intelligence deficits – ¾ classically autistic children will score 2 s.d. below mean

Impaired language Need for sameness Social difficulties/poor relatedness

Delayed language Echolalia – immediate or delayed Pronoun reversals Concrete language (raining cats and

dogs) Tone and inflection difficulties

Infants do not cry to get attention Not easily cuddled Poor eye contact In own world Poor play skills

Self-stimulation Self injurious behavior

Milder? Geek syndrome? Appear more interested in social

interaction

Speech and Language critical – prognosis much bleaker if no speech by age 5

Lovaas work – ABA and related approaches

Social skills – social scripting

http://www.youtube.com/watch?v=JnylM1hI2jc