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AUTISM Outline A Brief History of Autism Leo Kanner (1943) published an article describing 11 children he had seen in his psychiatric practice. Prior to this article, people with autism were labeled insane or retarded or both. Hans Asperger (1944) described a similar syndrome now called "Aspergers" syndrome. Once thought related to schizophrenia; presumed to worsen with time. Autism or Aspergers? DSM-IV: Two separate and distinct disorders with the primary difference being perceived cognitive ability DSM-IV: Autism and Aspergers are Pervasive Developmental Disorders Some people believe Autism is a "continuum" of symptoms which affects each individual differently Diagnoses of Autism DSM-IV Autism Checklists Some behavioral characteristics you may see when someone has autism Lack of eye contact Unfocused vision Ignores people Cares greatly for certain objects Upper body rocking Finger or hand flapping Spinning--self or objects Head banging Scratching Screaming Repeating phrases or vocalizations Walking on tip toes Avoidance of human touch Putting hands over ears Repeated jumping Lack of startle response Distractible Indistractible Stilted speech Ritualistic Failure to initiate Unusual or placid facial expression A Few Important Facts Autism is not a "thing" people "have" like a heart condition. Symptoms result from various factors, which are not yet fully understood or known. Generally, autism may be considered as a developmental disability that typically occurs during the first three years of life, in 1/500 individuals across all populations, but four times more often for boys than girls. Possible Causes of Autism Neurological Genetic Environmental Chemical Biological Autoimmune Cognitive Neurological findings Midbrain, frontal lobe, and brainstem differences Cerebellum of children with autism different-Smaller More densely packed cells Genetics: Familial patterns
Identical twins Fraternal twins Siblings Other Family members Other things which may be correlated with autism Congenital issues like maternal rubella Food allergies-Especially wheat and dairy Environmental factors such as pollution-Highly speculative Sensory Sensitivities Unusually high sensory sensitivities which may affect behavior "Normal" individuals subjected to sensory overload may exhibit same behaviors. We cannot assume people with autism are motivated by the same intentions as typically developing individuals--they may or may not be. Sensory Sensitivities Tactile sensitivity Hearing sensitivity Deep pressure Olfactory Sensitivity Emotional sensitivity Visual sensitivity Interventions: Categories of Interventions Used to Treat the Symptoms of Autism Aversives Medical Behavioral Communication Sensory Approaches Movement Differences Approach Aversives: No research support The use of pain to control behavior: Electric shock helmets Ammonia squirts White noise "Bad" tastes (pepper) Rubber band snaps Pinches Cold showers Medical Secretin--a medication used for a test on the pancreas, now touted as a medical intervention for autism--still being researched Tricyclic antidepressants and anti-anxiety meds Major tranquilizers-Haldol, Thorazine Vitamin therapy-Bernard Rimland is the leading advocate Medication Cautions Temple Grandin: medications should have a dramatic effect use with extreme caution with children Always consult a pharmacist for drug interactions and ALL effects Behavioral Behavioral interventions are applied to visible manifestations called behaviors. Behavioral interventions grew out of the behavioral theory of psychology which said that all human action is a reaction to a prior action. Changes in the stimulus/response to a behavior should change the behavior. If behavioral interventions do not work, says behavior theory, it is because of poor application, not bad theory. ABAAdvantagesProvides consistency Widely implemented Systematic Addresses what is "seen" LimitationsMay reinforce rigidity of behavior Addresses what is "seen" Maintains myth of cause and effect relationship between inner intention and visible action Discrete Trial Training Under the umbrella of ABA May be useful to teach some concrete tasks such as setting the table Some experts believe exclusive use of DTT is emotionally hard on the child Like other ABA applications, may increase or maintain perseverance and rigidity Lovaas Lovaas therapy uses the DTT model Practitioners directly affiliated with Ivor Lovaas "do" Lovaas A method for very early intervention which builds on child's strengths in visual processing and memory for routines. Lovaas emphasizes child's need to feel successful Some skills which may be taught with ABA: Attending Imitation Receptive and Expressive language Pre-Academic Self-help Social Abstract Language Academic School Readiness Communication Signing Alternative/Augmentative Communication Picture Exchange Word/Picture Boards Facilitated Communication Writing/Reading Computers Sensory ApproachesIrlen lenses Auditory Integration Training Sensory Integration Training Sensory Integration Training Movement Differences Approach
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