The First Half of the 20th Century Essay

Autism Spectrum Disorder Notes Federal Law first recognized autism as a disability category for IDEA in 1990, although, autism was in the research literature in the first half of the 20th century. Symptoms of autism spectrum disorders can emerge very early in a child’s life. •Most cases become evident before the age of 2 ? and few are diagnosed after the age of 5 Autism spectrum disorders can be one of the most seriously disruptive of all childhood disabilities. •It is characterized by combinations of deficiencies in language, interpersonal skills, emotional or affective behavior, and intellectual functioning

Definition Autism: From Greek autos meaning “self” to reflect a sense of isolation and detachment from the world that characterizes some individuals with the disorders IDEA: autism: a disorder with onset prior to age 3, characterized by extreme withdrawal, self-stimulation, intellectual deficits, and language disorders •Diagnosis should not be used in cases of children with characteristics of extreme emotional disturbance •People with autism spectrum disorder are not all alike

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Autism Spectrum Disorder: the range of functioning in multiple skill areas found among those with autism disorders Asperger Syndrome: a condition that shares unusual social interactions and behaviors with autism, but includes no general language delay •Some researchers argue that it is a high functioning version of Autism, but some believe the disorder is distinct Rett Syndrome: a neurological condition primarily affecting girls, who develop normally until about 5 to 30 months of age when their skills development slows, and in many cases, regresses •Language, cognition, and urposefully hand movements often regresses •It is part of autism spectrum disorders but a distinct neurological condition Prevalence Compared to other conditions, autism is relatively rare •About 5 cases per 10,000, although some believe it is much higher (2000) •Total prevalence of autism spectrum disorder is estimated at over 116 per 10,000 (2005) •The variation in prevalence could be the result of definitional changes or to an increase in incidence Gender Differences Males out number females (4 to 1 and as high as 8 to 1) •Gender differences could be the result of females with autism being less socially aberrant than males, making them difficult to identify Characteristics Unusual behavior often appears very early •They may exhibit significant impairment in interpersonal interaction as babies: unresponsive to physical contact or affection, avoid eye contact, avert their gaze These behavior often continue in older children Children with autism are often described in terms of social impairments, unresponsiveness, extreme difficulty relating to others, difficulty understanding or expressing emotion, and lowered ability to regulate affect •Prefer interacting with inanimate objects, forming attachments to such objects rather than people •Insensitive to the feelings of others and treat other people as objects Impaired or Delayed Language

Approximately half do not develop speech, and those who do often engage in strange language and speaking behavior, such as echolalia •Echolalia: a meaningless repetition or imitation of words that have been spoken •Do not attach meaning to what they say •Reduced ability to imitate language Children who develop language often have a limited speaking repertoire, exhibit an uneven level of development between language skills areas, and fail to use pronouns in speech directed at other people •Fail to grasp grammatical competencies and make little use of semantics in sentence structure •The tonal quality of speech is unusual or flat Their speech appears to serve the purpose of self-stimulation rather than communication Stereotypic Behavior Self-stimulatory behavior is associated with Autism Spectrum Disorder •Stereotypic behavior: behavior or stereotypy involving repetitive movements such as rocking, hand-flicking, or object manipulation: (self-stimulation) Purposes and origins of stereotypic behavior are not well understood •May provide sensory input or a sense of organization Autobiographical material written by high-functioning individual may provide insight to better understand Behavior may continue for hours •Some behavior may start out as self-stimulation and may worsen or take different forms and create potential for injury to the child: face slapping, biting, head-banging •Self-injurious are often found in low functioning children Resistance to Change in Routine: Rigidity •Any deviation from a set pattern may upset them greatly

May insist on a particular furniture arrangement or on a particular food for a given meal •They may wash themselves in a particular pattern which is typical of obsessive-compulsive or repetitive behaviors •Relationship between the rigidity or perseveration of obsessive behaviors, including self-mutilation The ritualistic behaviors create numerous problems in daily life •Minor deviations often cause serious crisis Transitions from one activity to the other present challenges at home and school •Structured verbal and visual cues may smooth transitions from activities Intelligence Most children with autism exhibit a lower intellectual functioning than other children •About 75% have IQs that would place them as having intellectual disabilities at some level •The verbal and reasoning parts of the test pose particular difficulties •Autism may be viewed as one or more specific deficits in information processing or cognition Intellectual ability varies High-functioning may test at a normal or near normal level •May have substantial vocabularies, but they do not understand the appropriate use of terms that they can spell and define Approximately 10-15% of those with autism spectrum disorders exhibit splinter skills •Areas of ability in which levels of performance are unexpectedly high compared with those of other domains of functioning •May perform well in memory tasks or drawing, but have deficits in language skills and abstract reasoning •Many parents blame themselves There is evidence that splinter skills can be effectively exploited in a functional way to facilitate school or work activity Learning Characteristics

Learning characteristics are frequently different from those if their normally developing peers and may present significant educational challenges •Students who resist change may perseverate on a specific item to be learned and encounter cognitive shifting difficulties in turning their attention to the next topic or problem in an instructional sequence •May experience difficulty interacting with teachers and other students in a school setting •The abilities of children often develop unevenly, both within and among skills •They may not generalize already learned skills to other settings or topics •Often impulsive and inconsistent in their responses •Difficulty with information-processing and abstract ideas, may focus on one or more stimuli while failing to understand the general concept •Some characteristics can be seen as educational strengths or can be focused on for instructional purposes oSome have strong long-term memory skills •Learning characteristics are highly variable and they must be individually assessed •Some behavior may limit inclusion options, but the success of inclusion depends on classmates, because inclusion is a social process as much as an academic one Causation

Two main theories about the causes 1. Psychodynamic Perspective: an approach to psychological disorders that views unconscious conflicts and anxieties as the cause of such disorders 1. Family interactions as casual factors 2. The child withdraws from rejection and erects defenses against psychological pain and in doing so he retreats to an inner world and essentially does not interact with the outside environment 3. Research fails to support this position, although people still examine the topic and it has been extended to Asperger syndrome 2. Biological Causation dominated the current research on autism spectrum disorders, particularly genetics A.

Fragile X Syndrome: a condition found in some males with autism, involves the breaking or splitting at the end of the X chromosome: Previously thought of as a potential cause, but now is believed to be co-occurring and not the cause B. Genetics causation, but there is not clear and complete explanation of how causation occurs because it is so rare C. Abnormal development and neurological problems, such as brain cell differences, absence of specialization in brain hemispheres, arrested neurological development, and neurological chemical imbalances •Some appear to have an abnormality in a portion the brain •Vermis: a portion of the cerebellum that appears to be underdeveloped in children with autism spectrum disorders •May be related to cognitive malfunctions

D. Neurological damage to the central nervous system may cause problems during prenatal development and early infancy •Maternal infection, alcohol abuse, and other problems during pregnancy that have potential of damaging the fetus have been associated with autism •Viral infections, such as rubella •Problems during birth, such as hemorrhaging, difficult deliveries, and anoxia •No single type of trauma has been identified •Some biological malfunctions may be related to environmental influences E. Many view the disorder as a behavior syndrome with multiple biological causes F. Appears to be an assortment of symptoms instead of a specific disease

Multidisciplinary Collaboration: Diagnosis and Intervention Because of the variety of characteristics of the disability, the diversity of the collaboration team is quite broad. •Often included medicine, psychology, education, social workers, counselors Parents have an ongoing relationship with the physician because autism is diagnosed so early Assessment is typically undertaken in multiple skills areas including communication and language, intelligence, and social interaction. The evaluations quickly enlist additional disciplines and collaboration by school psychologists, behavior modification specialists, psychiatry, language specialists, and child development specialists

Different approaches have been used as interventions. Some are based on theories of causation, other have been focused on specific observable behaviors, but empirical supporting effectiveness is important in all cases Educational Interventions A wide range of instructional options are required for the effective education of these children. •Specialized individual programs integrated placement with support services Current literature has emphasized integration for educational purposes to the greatest degree possible, with educational placement and instructional programming dependent on the student’s age and functioning level Early intervention is important for these children

The IEP should have a component of functional communication and social skills and that it focus on individual strengths and skills required for maximum independence For some children, functional instruction will mean heavy use of language training, augmentative communication, and social, self-help, and self-protection skills For others, functional instruction will focus on traditional academic subjects, subjects not included in general curriculum, such as sexual awareness, sexual behavior, and sex education. Also, interventions are beginning to have greater use of technology enhancements in the teaching process. Creative, innovative, and positive teachers are particularly important in providing effective education for students with autism spectrum disorders

Parent participation in preparing students for school and other aspects of life can be of greater assistance •Insisting a positive attitude, helping him or her with scheduling, and teaching him or her how to find the way around the school, also identifying a safe place and person to seek out if the child becomes confused or upset Psychological and Medical Interventions Interventions based on the psychodynamic theory of causation focus on repairing emotional damage and resolving inner conflict •Aimed at remedying the faulty relationship between the child and his or her parents •This treatment model has been criticized because there is little evidence Various medical treatments have been used Early treatments include electroconvulsive shock and psychosurgery: discredited because of questionable results and harmful side effects •Medications used in the past are very controversial •Other medications include antipsychotics, anticonvulsants, and serotonin and dopamine •Specific medications address specific symptoms •There is mixed results in drug therapy Generally medication has shown promise in the treatment of autism spectrum disorders •There appears to be potential for improvement, but medication should be used in conjunction with multicomponent, comprehensive treatment plan Autism spectrum represents such a heterogeneous set of symptoms that no single treatment will effectively treat all children with the condition Behavior Interventions

Behavior modification represents an intervention strategy that has become multidisciplinary •Used in a wide array of circumstances within education, psychology, medicine, and family therapy •Undertaken without concern for the underlying causes of the disability •Focuses on enhancing appropriate behavior and reducing inappropriate or maladaptive behaviors •Behavior management for individuals required a statement of precise operational definition, careful observation, and recording of data on behaviors viewed as appropriate and in appropriate •Reliable data collection is very important •May focus on conduct, such as self-stimulation, tantrums, or self-inflicted injury oBehavior therapy has reduced these problems in many cases Effective in remediating deficiencies in fundamental social skills and language development, and facilitating community integration •Parental involvement is very important •Research as demonstrated that certain students can be effectively taught to employ self-directed behavior management •Behavior therapy does not cure autism Early 1990s, treatment from Australia that focused on using facilitative communication •Emphasized the use of typing as a means of communication •Therapist-facilitator provided physical support by touching and putting light pressure on the student’s arm or shoulder and provided interpersonal support via positive attitudes and interactions •Unable to obtain results that support its effectiveness Impact on the Family