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Lecture 7

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University of Toronto Mississauga
Stuart Kamenetsky

Chapter 13: Autism - Few cases of autism are diagnosed after age 5 - Characterized by: o deficiencies in language o interpersonal skills o emotional or affective behaviour o intellectual functioning o impairs normal dev’t of many areas of functioning - IDEA’s definition: o affecting verbal & nonverbal communication and social interaction o generally evident before age 3 o irregularities and impairments in communication o engagement in repetitive activities o stereotyped movements o resistance to environmental change or change in daily routines o unusual responses to sensory experiences - autism: childhood disorder with onset prior to 36 mths of age; characterized by extreme withdrawal, self-stimulation, intellectual deficits, and language disorders - autism spectrum disorders: reflects range of functioning found, among those who exhibit symptoms of autism, in the multiple skill areas of communication and language, intelligence, and social interaction - asperger syndrome: shares certain unusual social interactions and behaviours w/ autism but typically includes no general language delay - some argue that Asperger disorder is distinct, others think it is a higher- functioning version of autism spectrum disorders Prevalence - relatively rare: 5/10 000 (APA, 2000); 60/10 000 (according to some research, 2002) - unclear if prevalence has changed or if it’s because of definitional changes - males outnumber females (4:1 to 8:1) Characteristics - as babies, unresponsive to physical contact or affection, avoid eye contact - children w/ autism rely on peripheral vision rather than direct face-to-face visual contact - social impairments, social unresponsiveness, extreme difficulty relating to others, difficulty understanding or expressing emotion, appear to be insensitive to feelings of others - prefer to interact w/ inanimate objects & form attachments to them rather than ppl - treat ppl as objects Impaired or Delayed Language - half do not develop speech, if they do they often have strange language & speaking behaviour - echolalia: a meaningless repetition or imitation of words that have been spoken o often mechanical with no sign they attach meaning to what they said - limited speaking repertoire - uneven level of dev’t with btw language skill areas - fail to use pronouns in speech directed at other ppl - fail to grasp grammatical complexity and little use of semantics in sentence structure - unusual or flat tonal quality of speech and appears to serve self-stimulation rather than communication Self-Stimulation - self-stimulation: repetitive behaviour that has no apparent purpose other than providing the person with some type of stimulation - e.g. flicking their hands in front of face, manipulating objects repetitively - some self-stimulation may worsen and create potential injury to the child e.g. face slapping, biting, head banging (usually found in low-functioning children with autism) Resistance to Change in Routine - intense resistance to change or rigidity - familiar routines are obsessively important to them and any deviation may upset them greatly - challenges may be presented in transitions from one activity to another - structured verbal and visual cues facilitating communication may smooth transitions from one activity to another Intelligence - 75% have IQs <70 - specific deficits in info processing or cognition - high-functioning individuals may test at a normal or near-normal level in IQ - 10-15% of those with autism exhibit splinter skills (areas of ability in which levels of performance are unexpectedly high compared to those of other domains of functioning) Learning Characteristics - may perseverate on a specific item to be learned and have difficulties in turning their attention to the next topic or problem - abilities of children with autism develop unevenly - may or may not generalize already-learned skills to other settings - impulsive and inconsistency in answers - difficulty with info processing and abstract ideas - may focus on one or more select stimuli while failing to understand the general concept - some qualities they possess may be educational strengths (e.g. enjoying routine, specific long-term memory skills – splinter skills) - highly variable - their behaviour patterns may limit inclusion for some individuals – depends heavily on general ed classmates Causation - Two broad theoretical views: psychodynamic and biological perspectives - Psychodynamic perspective: approach to psychological disorders that views unconscious conflict and anxieties as the cause of such disorders o Family interactions o Child withdrawing from rejection and defending a/g psychological pain by retreating to inner world and not interacting with the outside env’t (ppl) o No longer in favour due to lack of research - Fragile X syndrome: condition involving damage to the chromosome structure which appears as a breaking or splitting at the end of the X chromosome; found in some males with autism o not a cause, just an associated factor - genetic causation in autism est’d by research but we don’t know how the causation occurs due to relative infrequency with which autism appears - abnormal vermis in some ppl with autism may be related to cognitive malfunctions - vermis: portion of the cerebellum that appears to be underdeveloped in children with autism - neurological damage to the CNS may be caused during prenatal dev’t and early infancy e.g. maternal infections, alcohol abuse, unusual haemorrhaging, difficult deliveries, anoxia - no single specific factor that causes autism; appears to be assortment of symptoms instead of a specific disease (syndrome) Interventions Educational Interventions - emphasis on integration for educational purposes to the greatest degree possible and placement depends on age and functioning level of student - early interventions important for promoting growth - IEP must have central component of functional communication and social skills focusing on individual strengths and skills required for maximum independence (e.g. heavy use of language training, augementative communication, and social, self-help, and self-protection skills) - Important to have creative, innovative and positive teachers - Parental participation can be of great assistance Psychological and Medical Treatments - repairing emotional damage and resolving inner conflict – aimed at remedying faulty relationship btw child and parents - specific symptoms addressed with specific medication - some antipsychotic drugs may reduce unusual speech patterns and self- injurious behaviours Behavioural Interventions - focuses on enhancing appropriate behaviours and reducing inappropriate or maladaptive behaviours - accurate and reliable data collection is a cornerstone - effective in reducing problem behaviours and deficiencies in fundamental social skills and language dev’t - facilitative communication: treatment for autism that emphasizes use of typing as a means of communicating and therapist-facilitator provides physical support by touching and putting light pressure on the student’s arm or sho
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