Introduction to Special Education Chapter 9 Study Guide/Outline I.

Orientation

II.

Terms and Definitions A.

Defining autism. 1. Autism is a lifelong developmental disability that is best described as a collection of behavioral symptoms. The extent and severity of those symptoms provide a range of diagnoses referred as autism spectrum disorders (ASD)

2. Autism was not identified as a separate category of special education until the IDEA reauthorization of 1990.

3. Autism Spectrum Disorders/Pervasive Developmental Disorders. There are a number of disorders related to autism, referred to as pervasive developmental disorders (PDD), or autism spectrum disorders. The terms autism spectrum disorders and PDD refer to a collection of syndromes and conditions ranging from those in which only a few of the characteristics of autism are present or the characteristics are present in a very mild form, to autism itself.

4. Asperger’s syndrome is one of the most common autism spectrum disorders. Individuals with Asperger’s syndrome may exhibit many of the social and behavioral characteristics of people with autism, but, importantly, without the marked delays in language and cognitive development.

5. Rett’s disorder is a rare genetic neurodegenerative disorder that mainly affects girls. After a few years of normal development, children with childhood disintegrative disorders regress progressively in all areas. B.

Dual diagnosis 1. Another difficulty in attempting to diagnosis autism is the fact that it coexists with a number of conditions, such as Fragile X syndrome, an inherited disorder caused by chromosomal abnormalities. Approximately 1/3 of children diagnosed with fragile-X syndrome are also diagnosed with autism. It is believed that fragile –X syndrome is the cause of 2-6 percent of cases of autism.

2. It is estimated that 40 to 55 percent of individuals with autism have intellectual disabilities, however more research is needed before accurate statistics can be determined. C.

Prevalence. 1. Estimates of the prevalence of autism fluctuate and often include the entire spectrum of autism disorders. In general, the average estimate is 1 in 110 children are diagnosed each year with autism or a related disorder. 2. The number of children identified as having autism has increased dramatically in recent years. a. The relatively recent identification of autism as a separate category in special education is partially responsible for this increase;

b. Some professionals suggest that the rise in the number of children identified as having autism represents a true increase in numbers, and speculate about possible environmental and medical causes

III.

Causes of Autism. A.

Historical views of causes 1. Bettleheim (1967) strongly considered autism to be a psychiatric response to an unsupportive and deprived environment.

B.

Current hypotheses about causes 1. Today, our hypotheses about the causes of autism focus on physiological differences, although there is still much speculation in the field.

2. Most scientists agree that the collection of symptoms comprising autism spectrum disorders are neurodevelopmental disorders originating before birth.

3. It also appears that most cases of autism begin very early in the embryonic development of the child. Children with autism have specific differences in brain development, specifically in the brain stem.

4. Research has long provided support that there is a genetic component to autism. Many children with autism have specific genetic abnormalities, though while many genes appear to be associated with autism, no clear causal relationships have been established.

5. The fact that in nearly 30% of the cases of autism symptoms do not appear until the child is a toddler has led to many unsubstantiated speculations about direct environmental influences, such as childhood vaccines or prenatal exposure to diseases such as Rebella as possible causes of autism.

IV.

Characteristics of Children with Autism A. Individuals with autism often demonstrate unusual patterns of learning, speech, and behavior. There is great variability in symptoms among children who are identified as having autism. 1. Cognitive characteristics. Children with autism can be found in all ranges of intellectual ability. Even without significant intellectual disabilities, they may display unusual, uneven learning patterns, often consisting of a relative strength in one or two areas of learning.

2. Physical characteristics. Most children with autism are usually described as average in appearance, if not as unusually attractive children.

3. Social interaction. Individuals with autism typically demonstrate patterns of social behavior that reflect social withdrawal and avoidance of others. a. These patterns can include failure to make eye contact and not attending to others in the room.

b. Many children with autism focus their attentions on objects instead of other people. They seem to disregard the desire for joint attention—the mutual sharing of experiences, activities, or even objects with friends, teachers, or parents.

c. Even those with less severe social deficits may have difficulty seeing things from the perspective of others, and engaging appropriately in reciprocal social exchanges.

d. For just about all individuals with autism, therefore, acquiring appropriate social skills and adaptive behavior comprises a substantial portion of educational programs at any age.

4. Language and communication. Difficulties and delays with language and communication are the hallmarks of children with autism. a. Children with autism may have delayed speech and language, or lose the communication skills that they have around age 2.

b.

Others may not acquire verbal language at all.

c. The speech patterns of individuals with autism will often take unusual forms, such as difficulty with reciprocal speech. Another example common to individuals with autism is echolalia, the repetition of speech sounds the child has heard.

d. Individuals with autism may present other types of language differences, such as speaking telegraphically (omitting articles, conjunctions, and tense markers), referring to themselves in the third person, and avoiding the use of pronouns.

5. Behavior. Individuals with autism may display a range of characteristic, sometimes disturbing, behaviors. a. Often behaviors reflect the characteristics of rigidity, or need for structure or sameness, often present in children with autism.

b. Some individuals with autism perform repetitive patterns of behavior such as rocking, twirling objects, clapping hands, and flapping a hand in front of one’s face, referred to as stereotypic behaviors.

c. A few individuals with autism exhibit self-injurious or self-abusive behaviors, ranging from hand biting or head slapping to life-threatening behaviors such as head banging.

d. Many individuals with autism appear to be highly sensitive to and have strong reactions to certain sensory information, such as loud noises.

e. Most behaviors of children with autism have a function, either communication or efforts to manipulate the environment and avoid demanding or stressful situations.

6.

Family issues and interactions a. Parents have been substantial contributors to the knowledge base on autism, both as ethnographers and as sources of empirical data on the effectiveness of various interventions.

b. Parents report difficulties trying to get an accurate diagnosis and appropriate intervention for their child. Because early diagnosis is so critical, a number of screening tools have been developed that can be given in the home, doctor’s office, or day care settings and can depend largely on parent input.

c. Once a diagnosis is obtained, parents must decide among literally dozens of interventions.

d. Once an intervention is chosen, the role of the parents and other family members will only increase: Almost all recommended interventions include intensive teaching, often within the child’s home, involving virtually round-the-clock teaching, measuring, and evaluating by parents.

V.

Teaching Strategies and Accommodations A. Individuals with autism and moderate to severe cognitive disabilities will require extensive behavior support and skill instruction, and will benefit from a functional, communitybased curriculum that focuses on life skills.

B. Other individuals with autism, those with mild cognitive disabilities or typical cognitive ability may progress through a general education academic curriculum and receive less intensive behavioral, academic, and social support.

C. The areas of communication, socialization, and generalization, or transfer of learning, are particularly important in programs for individuals with autism spectrum disorders.

D. The importance of early intervention. Proponents of virtually all available interventions agree on one thing—the earlier the better. The National Research Council has identified several key components of early intervention for children with ASD that can serve as guidelines for both teachers and parents as they search for comprehensive preschool programs..

E.

Applied behavior analysis (ABA) 1. ABA focuses on clearly defining behavior in the context of the environment, arranging the environment, and providing consequences for increasing or decreasing specific behaviors. a. The role or function the student’s behavior plays in his environment is determined, and alternative behaviors that can serve the same function are identified.

b. New behaviors are taught through reinforcement-based opportunities for response. c. Complex or multistep behaviors such as some vocational tasks may be taught in segments and then linked together. d. Students with autism may require many instructional trials (discrete trials) and explicit training across environments and data is recorded over time

to determine if the reinforcement strategies are resulting in the new, desired behavior. 2. The Lovaas method is based on the principles of applied behavior analysis and also incorporates discrete trial training. a. Some professionals question the curriculum context (what skills are taught and where they are taught) and criticize the quality and validity of the program’s experimental research.

b. This intervention is requires intensive training of teachers or parents and begins when the child is two to three years of age.

c. The trained interventionist provides intensive, discrete trial training with the child at home.

d. Training is recommended for up to forty hours per week for a minimum of three years.

e. Despite the expense and effort involved, this is the treatment most commonly requested by parents. F. Environmental interventions. These interventions focus on arranging the environment to provide support and extensive opportunities for behavioral expression. Project TEACCH, the most prominent of the environmental interventions, emphasizes maintaining existing behaviors and structured teaching of developmentally appropriate new skills, often using one-on-one instruction. 1. A fundamental component of the TEACCH program is the close working relationship the professionals in the program establish with families.

2. TEACCH focuses on early intervention but continues throughout adulthood, providing safe and interactive learning environments. G.

Social Skill Interventions

1. Although social skill training may be a component of many other types of instructional approaches, including applied behavior analysis and TEACCH, there is a current emphasis on training social skills as a distinct intervention.

2. Social skills may include initiating play activities, establishing eye contact, sharing toys, taking turns, and participating in cooperative recreational activities, such as games or reading stories.

3.

H.

Instruction in social skills and play skills should include peers.

Language-based interventions 1. A few popular instructional programs for individuals with autism are designed to prompt communication and link pictures or written language with verbal communication.

2. The Picture Exchange Communication System (PECS) is a communication system based on teaching nonverbal children to use pictorial symbols to request information.

3. Social stories, based primarily on verbal and written language, address the language and social needs of verbal children with autism spectrum disorders.

4. A social story is a brief sequence of sentences designed to provide almost a self-instruction plan for the student. Social stories use four types of sentences to talk a child through specific situations, scenarios, or tasks. I.

Visual Supports. 1. For children with limited language, the visual medium becomes an important tool for instruction.

2 In addition to focusing on language, both the PECS program and social stories involve the presentation of visual information, either in pictures or words.

3. Teachers often use visual activity schedules – pictures (photographs, drawings, icons) as reminders of the daily schedule or how to set the table, or what needs to be done to clean the reading corner.

4. Video-modeling involves recording a behavior or social interaction on video and using the video as an instructional tool. J. Biochemical interventions. Many biochemical interventions for autism have been tried over the years, but most lack supporting empirical data. 1. Pharmacological interventions are often used to address some of the symptoms of autism such as hyperactivity, depression, seizure disorders, agitation, aggression, and self-stimulatory behaviors.

2. Alternative interventions for children with autism are plentiful, but few are supported by research.

K. Transition to adulthood. Adults with autism have the same opportunities for independent performance at work and residential settings as others with disabilities. 1. Individuals with autism may perform various types of work through competitive employment or supported work programs.

2. Many adults with autism live with family, others in semi-independent group homes or apartments; some live in more restrictive settings. Individuals with autism who live independently may benefit from support services.