An Introduction

to

Autistic Spectrum Disorder

Knowledge and Understanding

Aims and Objectives

To gain a basic understanding of autism

To think about how people with autism behave and see the world

To consider strategies for working with people with autism

To know who to contact for advice

What is Autism?

‘Autism is a lifelong developmental

disability that affects the way a person

communicates and relates to people

around them’

National Autistic Society

Autism Spectrum Conditions/Disability

Asperger Syndrome

Autism Spectrum Disorder

Autism

Childhood Autism Pervasive Development Disorder

Autistic Spectrum Disorders Means …

Difficulties with social interactions

Difficulties communicating

Difficulties with imagination and flexible thinking

Triad of Impairments

Communication

Imagination and Flexible thinking

Social Interaction

Communication difficulties

Difficulties in understanding what other people say or mean, instructions

take things v literally, e.g. pull your socks up, dying for the toilet

May not understand sarcasm, verbal jokes, irony, exaggeration, turns of phrase

Difficulties reading – especially comprehension

Spoken language difficulties

Mixing up he/she and I/me

Calling self by own name/he or she rather than I

Flat/odd intonation/pitch

Unusual accents e.g. American

Jerky, problems with rhythm and stress

Difficulty finding words, made up words,

Unusual choice of words,

Precise/formal speech – “little professor” “little old man”

Echoing others words (Echolalia) – immediately or later

Repetitive words/phrases learned from others/TV/DVD’s

Repetitive questions even though know answer

Problems with the social use of language

May not speak in certain situations – Elective Mutism Problems requesting things

Or may only speak to request/get needs met/gather information – not to be social

Difficulties with 2 way conversation:

Talk at you rather than to you Turn taking – Interrupt, talk over, don’t listen Conversation doesn’t build to and fro - 1 sided Only on particular subject they are interested in Lack sense of what you need to know - give too much or too little

information things out of context Don’t show interest in your views/experiences

Difficulties with Non-verbal

communication May not understand gestures and body language, facial

expressions etc.

May not use gestures or struggle to do them appropriately – pointing, waving, beckoning, nodding/shaking head, shrugging, showing, giving, descriptive gestures

SOCIAL DIFFICULTIES

Difficulties understanding what others are thinking or feeling

Difficulties picking up on social cues

Difficulties knowing what is expected of them/how to behave socially

Lack social interest in others – solitary or socially interested but don’t know how to do it

Unusual social approaches to others

Lack of or unusual responses to others

Don’t know how to keep interactions going in a to and fro manner

Difficulties with eye contact – reduced and unusual quality

Lack of or unusual facial expressions

Difficulties with friendships/relationships with others

Difficulties with social rules and conventions – taking turns, sharing, listening, instructions, joining in, asking for help

Difficulties seeking help or comfort from others

Difficulties sharing enjoyment or interest

INFLEXIBILITY/DIFFICULTIES WITH IMAGINATION

Don’t use toys imaginatively or as expected

Play/activity is repetitive and lacks variation - spinning objects/patterns, lining up/sorting, running up and down, spinning, opening/closing doors, banging, switching on/off Interests may be more complex but still very narrow, very intense and possibly unusual e.g. vehicles, computers, washing machine, street signs, traffic lights, vacuum cleaners, birth dates, numbers, alarm systems, facts and figures etc

Play alone/solitary interests Lack of pretend play with others (social imaginative play) Seemingly imaginative play may be re-enactments of TV Need for sameness

same exact daily routines, same routes, Can’t tolerate even minor changes in suroundings, insisting things be done in very particular ways, difficulties trying new foods, clothing, meeting new people, going to new places, overwhelmed by choices

Focus attention on one thing only

Difficulties moving on/changing activity

Difficulties generalizing skills

Difficulties seeing the bigger picture, detail

Rigid opinions – difficulty being able to see another’s point of view or that there may be more than one way of looking at something

Sensory sensitivities

The majority of children with ASD have sensory sensitivities

Can impact on any of the five senses

Can make it very hard for the child or young person to function in certain environments

Children may be hyposensitive to pain

Cognitive Processing

Autism means a different style of thinking – monotropic (Wendy Lawson)

Filtering out environmental information can be difficult

Generalising skills can be difficult – there can be a lack of ‘connectivity’

Non social rpiorities

Associated difficulties

Developmental Coordination Disorder (DCD)

Attention Deficit Hyperactivity Disorder (ADHD)

Learning Disabilities

Bowel problems

Eating and drinking difficulties

Sleeping difficulties

The Autistic Spectrum

Everyone with autism:

will have problems with social interaction, communication and imagination / flexible thinking

But:

not everyone with autism looks the same or behaves the same e.g. some people with autism will be able to make eye contact better than others

Individual differences…

Age

Gender

Temperament/Personality

Environment

Reactions of others

Previous interventions

Life experience

How common is ASD?

Recent national studies show a prevalence of 1 in 100 people are on the autistic spectrum

There are far more boys than girls

In Manchester (2009) recent figures suggest approximately 180 children per year receive a diagnosis of ASD

This means that there are likely to be several children with ASD in every Manchester primary school

Numbers are rising – possibly due to increased awareness?

What causes autism?

We don’t know

It is not caused by: MMR

Parenting

Autism is not anyone’s fault

There is a genetic component but it is not straight forward and there is no genetic test

SCAIT (Social Communication

Assessment and Intervention Teams)

In Manchester there are 3 SCAIT teams that assess for ASD. They are based within CAMHS

SCAITs consist of a child psychiatrist, clinical psychologist, educational psychologist, mental health practitioner, specialist speech and language therapist and consultant community paediatrician

SCAIT Assessment process

Information from parents/carers Observation of child in different settings –

e.g. school, clinic, home Individual assessment – ADOS SLT assessment There is no blood test Assessment may take number of months Following diagnosis a comprehensive SCAIT

report is sent to parents and professionals including school

A Multiagency meeting is held in school to consider needs