Autism Spectrum Disorders

Dr. Leo Kanner
1943-Johns Hopkins University-studied 11 institutionalized individuals with similar behavioral characteristics:-profound lack of affect or emotional contact with others-intense wish for sameness in routines-muteness or abnormality of speech-fascination with manipulating objects-high levels of visuo-spatial skills, but major learning difficulties in other areas-attractive, alert, and intelligent appearance
Dr. Asperger
1944-Austrian Psychiatrist/Physician-Autism-A pattern that included a “lack of empathy, little ability to form friendships, one-sided conversations, intense absorption in a special interest, and clumsy movements.”-called children with AS “little professors” because of their ability to talk about their favorite subject in great detail
Ivar Lovaas
UCLA, 1970’s-disproved Bruno Bettlheim’s idea that autism is undifferentiated from mental retardation.

-autism is a behavioral syndrome

Primary and differentiating autistic characteristic
inability to socialize
Neurobiological research base for autism
Yale Child Study Center-Face perception abnormality study-visual perception problems
Genetic research base for autism
Cold Springs Harbor Laboratory: Discovered deletion of 27-gene cluster on chromosome 16 (using mouse models)Prenatal associations: fragile X, Cornelia de Lang, Angelman’s, Tuberous Sclerosis, RubellaPostnatal Associations-Phynylketonuria, Herpes Simplex Encephalitis
Current medical research conclusions (abnormalities in autism)
-abnormalities in amygdala and hippocampus-abnormalities in brain stem-epilepsy
Autism Historical Prevalence
1970- 1/10,0001980- 1/1,0001990- 1/1662000- 1/110-more boys than girls
Affected Skill Areas
Communication-echolalic-communicative intent-pragmatics (knowing what to say and when)Social/Emotional-flat affect-concrete play skills-distorted self-awarenessUnusual Behavior Patterns-restricted-fixed/reptitive-ritualistic-obsessive-compulsive
Secondary Problems
-anxiety-rigidity-inattention-poor generalization-rude-appearing or odd-restricted interests
3 Disorders of Autism Spectrum Disorders
-Classical Autism-Asperger’s Syndrome-PDD-NOS (pervasive developmental disorder-not otherwise specified)
Autism Diagnosis Criteria
Six or more items from (1), (2), or (3), with at least two from (1), and one each from (2) and (3)
Difference between Asperger’s and Autism
In Aspergers:-there is no clinically significant general delay in language (e.g. single words used by age 2 years, communicative phrases used by age 3 years)-There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior, and curiosity about the environment in childhood
PDD-NOS
severe and pervasive impairment in the development of:-reciprocal social language-verbal/non-verbal communication-stereotypic behavior-does not meet specific diagnostic criteria for other disorders
Applied Behavior Analysis
A science in which procedures are derived from the principles of behavior are systematically applied to change socially significant behavior to a meaningful degree
Characteristics Of ABA
-analytic-applied-conceptually systematic-efficient-generality-behavioral-technological
6 ways in which ABA will help
1) teach new skills2) maintain behaviors3) increase behaviors4) generalize or transfer behavior from one situation or response to another5) restrict or narrow conditions under which interfering behaviors occur6) reduce interfering behaviors
Picture Exchange Communication System
relies on structural and instructional elements
TEACCH
UNC-treats the whole child-heavy emphasis on structure and visuals-behavioral
Facilitated Communication
Crossley-AustraliaBilken-Syracuse-intact intelligence-assisted communication
Miller Method
1965-MillersSystem forming disorderssystem closing disordersonly one outcome study
Developmental Individual Difference Model
DID-Stanley Greenspan, MD”floortime”-child directed-low stimulus environment-motivation to relate to the world-no peer reviews
Relationship Development Intervention
RDI-Dr. Steven Gutstein-addresses core deficits of autism based on dynamic intelligence-emphasis on quality of life-specific and detailed-1 peer review