Autism Spectrum Disorder

By: Emily Bellas, Rosemary Burti, Elisa Cullaro, and

Sonyi Lopez

Activity One
Instructions
o
o
o

Number ones: Animatedly retell any fairytale story in number twos ear the entire
time
Number twos: Use your non-dominant hand to complete the crossword puzzle
Number threes: Hum or sing a song in number twos ear while consistently tapping
them on the shoulder gently

http://www.youtube.com/watch?v=KmDGvquzn2k
o This video is based on an excerpt from Carly's Voice: Breaking
Through Autism, written by a 17-year-old girl living with non-verbal
autism. The simulation shows how even getting a cup of coffee with
family can be difficult and anxiety-producing.

Definition of Autism Spectrum Disorder

Autism Spectrum Disorders, sometimes called pervasive Developmental Disorders (PDD), are a range of neurological
disorders that mostly involves some degree of difficulty with communication and interpersonal relationships, as well as
obsessions and repetitive behaviors. Children with Autism are less able to interact with the world as other children do.
Typically they have deficits in three key areas:
o
o
o

Verbal and nonVerbal communication

Social awareness and interactions
Imaginative play (Variable interests and behaviours.)

Those at the lower-functioning end of the spectrum may be profoundly unable to break out of their own
world and may be described as having Kanner's autism.
Those at the higher functioning end, sometimes diagnosed with Asperger Syndrome (AS) may be able to
lead independent lives but still be awkward in their social interactions.
Other, more rare autism spectrum disorders include Rett Syndrome (RS), which affects mostly girls, and
Childhood Disintegrative Disorder (CDD), which affects mostly boys; in both cases, there is a period of normal
development before the onset of autistic symptoms.

Aspergers
Asperger syndrome is a form of autism, which is a lifelong disability that affects how a
person makes sense of the world, processes information and relates to other people.
Asperger syndrome is mostly a 'hidden disability'. This means that you can't tell that
someone has the condition from their outward appearance. People with the condition
have difficulties in three main areas. They are:

social communication

social interaction

social imagination.

They are often referred to as 'the triad of impairments

Prevalence
About 1 in 68 children have been identified with autism spectrum disorder
(ASD)
ASD is reported to occur in all racial, ethnic, and socioeconomic groups.
ASD is almost 5 times more common among boys (1 in 42) than among
girls (1 in 189)
Studies in Asia, Europe, and North America have identified individuals
with ASD with an average prevalence of about 1%. A Study in Korea
reported a prevalence of 2.6%
About 1 in 6 children in the United States had a developmental disability in
2006-2008, ranging from mild disabilities such as speech and language
impairments to serious developmental disabilities, such as intellectual
disabilities, cerebral palsy, and autism.

Prevalence (continued)

Studies have shown that among identical twins, if one child has ASD, then the other
will be affected about 36-95% of the time. In non identical twins, if one child has
ASD, then the other is affected about 0-31% of the time.
Parents who have a child with ASD have a 2%-18% chance of having a second child
who is also affected.
ASD tends to occur more often in people who have certain genetic or chromosomal
conditions. About 10% of children with autism are also identified as having Down
Syndrome, fragile X syndrome, tuberous sclerosis, or other genetic and
chromosomal disorders.
Almost half (46%) of children identified with ASD has average to above average
intellectual ability.

Prevalence (Continued)
Children born to older parents are at a higher risk for having ASD.
A small percentage of children who are born prematurely or with low birth
weight are at greater risk for having ASD
ASD commonly co-occurs with other developmental, psychiatric,
neurologic, chromosomal, and genetic diagnoses.

Characteristics of Autism
Behaviors

Obsessions with objects, ideas or desires

Ritualistic or compulsive behaviour patterns
(sniffing, licking, watching objects fall, flapping
arms, spinning, rocking, humming, tapping,
sucking, rubbing clothes).
Fascination with rotation.
Play is often repetitive.
Many and varied collections.
Unusual attachment to objects.
Quotes movies or video games.
Difficulty transferring skills from one area to
another.
Perfectionism in certain areas
Frustration is expressed in unusual ways.
Feels the need to fix or rearrange things.

Transitioning from one activity to another is

difficult
Difficulty attending to some tasks.
Gross motor skills are developmentally behind
peers (riding a bike, skating, running)
Fine motor skills are developmentally behind
peers (handwriting, tying shoes, scissors).
Inability to perceive potentially dangerous
situations.
Extreme fear (phobias) for no apparent reason.
Verbal outbursts.
Unexpected movements (running out into the
street).
Difficulty sensing time (knowing how long ten
minutes is or three days or a week).
Difficulty waiting for their turn (such as in a line).
Causes injury to self (biting, banging head).

Characteristics of Autism
School related skills

Exceptionally high skills in some areas and very low in others.

Excellent rote memory in some areas.
Difficulty with reading comprehension (can quote an answer, but unable to predict,
summarize or find symbolism).
Difficulty with fine motor activities (Colouring, printing, scissors, gluing).
Short attention span for most lessons.
Resistance or inability to follow directions.
Difficulty transitioning from one activity to another in school.

Characteristics of Autism
Emotions or sensitivities
Sensitivity or lack of sensitivity to sounds, textures (touch), tastes, smells or light.
Difficulty with loud or sudden sounds.
Unusually high or low pain tolerance.
Intolerance to certain food textures, colours of the way the are presented on the plate (one food can't
touch another
Inappropriate touching of self in public situations.
Desires comfort items (blankets, teddy, rock, string).
Laughs, cries or throws a tantrum for no apparent reason.
Resists change in the environment (people, places, objects.)
An emotional incident can determine the mood for the day emotions can pass very suddenly or are
drawn out for a long period of time.
Becomes overwhelmed with too much verbal direction.
Tends to either tune out or break down when being reprimanded.
Calmed by external stimulation soothing sound, brushing, rotating object, constant pressure
(hammock, rolled in a blanket)
May need to be left alone to release tension and frustration

Characteristics of Autism
Health/Movement
Walks on toes.
Unusual gait.
Difficulty changing from one floor surface to another (Carpet to wood, sidewalk to grass).
Odd or unnatural posture (rigid or floppy).
Difficulty moving through a space (bumps into objects or people).
Walks without swinging arms freely.
Incontinence of bowel and/or bladder.
Constipation.
Frequent gas (flatulence, burping) or throwing up.
Appearance of hearing problems, but hearing has been checked and is fine.
Seizure activity.
Allergies and food sensitivities.
Irregular sleep patterns.
Apparent lack of concern for personal hygiene (hair, teeth, body odours).

Characteristics of Aspergers
Invisible Disability
Individuals with Asperger Syndrome...
May appear to be more competent than they are.

May have good verbal skills, but no ability to plan and carry through tasks requiring a series of steps.

May be able to describe the correct response to a conflict situation, but have no ability to apply the knowledge
to their situation.

Mind Blindness
Individuals with Asperger Syndrome...
May be unable to see things from the other person's point of view

May not be able to imagine what the other person may be thinking and feeling, including how the other person
may be reacting to their behaviour.

Language
Individuals with Asperger Syndrome...
May interpret language literally, and become confused unless people say things using concrete and specific
language.

Characteristics of Aspergers
Planning and Organization (Executive Function)
Individuals with Asperger Syndrome...
May not be able to plan - not able to break down a complex task into a series of steps, not able to figure out
what to do first, not able to plan the use of their time.

May be totally disorganized with respect to time, materials and their belongings.

Learning
Individuals with Asperger Syndrome...
May not be able to learn from mistakes, because of their inability to apply lessons learned in one situation to a
different situation.
Neurological under-sensitivity or over-sensitivity to sound, light, touch, etc.
Individuals with Asperger Syndrome...
May experience their environment differently. For example, they may experience sunlight or touch as painful
or certain smells as sickening.
Emotional and Mental Fatigue
The effort it takes to figure out what the expectations are, to figure out why others are disapproving, etc. is
emotionally and mentally exhausting.

The young adult needs to be able to remove him or herself to a quiet area when s/he begins to feel
overwhelmed.

Characteristics of Aspergers
Poor Self Esteem

Repeated failure experiences and not being able to understand why they cannot keep up with
their peers or why they are often criticized may be demoralizing for individuals with AS.

This can result in them believing that they are stupid, useless, etc.

Rages or meltdowns

Individuals with AS have differences in brain function and may have difficulty with regulation
of emotion, impulsivity or a buildup of frustration from expending enormous energy on
suppressing symptoms. The rage or neurological storm may be triggered by a minor event,
be out of proportion with the event that triggered the anger and may result in the individual
losing control, screaming, and/or becoming self-abusive or aggressive with others.

Characteristics of Aspergers..
Depression

Persistent failure in response to their best efforts can lead to feelings of

hopelessness and depression.

Social Involvement
Individuals with Asperger Syndrome...

social situations or have a rigid or

Levels of depression and risk of suicidal attempts need to be closely monitored.

unusual way of interacting with

others

Substance Abuse

Many aspects of the disability, including naivety, not understanding the

consequences of behaviour, feelings of isolation and loneliness, depression or

awareness of and understanding

abuse.

of facial expressions, gestures,

etc.

Apparent Defiant and Oppositional Behaviour

The hidden nature of the disability may result in others expecting more of
individuals than they are able to deliver. Caution should be used in applying
these labels as the young adults apparent refusal to comply may be an inability
to comply, related to some aspect of their disability.

May have difficulties with nonverbal communication including

anxiety, and discrimination and victimization by others can lead to substance

May refuse to become involved in

May have an inability to pick up

on unwritten social rules, so may
stand too close to other people,
talk about taboo subjects, be

Characteristics of Aspergers.
Repetitive Behaviours, Actions and Thoughts
Rocking, tapping, fidgeting

Insistence on talking about only one or two subjects of personal interest

Language
Individuals with Asperger Syndrome...
May have difficulty carrying on social conversations, may not be aware of the rules of conversation. They may
interrupt, change topics abruptly, etc.

May have difficulty starting and finishing conversations, or talk in a formal way

May have advanced language and vocabulary

Average to above average testable intellectual ability

Uneven skills and abilities
Individuals with Asperger Syndrome...
May know what is expected, but not be able to do what is expected. This could be due to difficulties with
planning in advance, organization of thought, breaking a task down into a series of steps, etc.

May have advanced skills in one area and very low skills in another, for example, may have advanced
computer programming skill but need significant guidance and support with daily living skills

Characteristics of Aspergers
Anxiety

A significant and serious symptom which may interfere with day to day activities

Excessive worry about things such as appearing stupid or different, failure, losing control

Adapting to Change

change is often confusing and upsetting and may lead to major anxiety or aggressive episodes,
unexpected change is worse.

Adaptive skills and social emotional functioning

are often significantly delayed

May function at about 2/3 of their chronological age; for example, an 18 year old may function at the
age equivalent of a 12 year old

Relationships

may have difficulty initiating and maintaining relationships due to challenges with social norms and

Activity two
Instructions
Turn to the person next to you and tell them about your plans for
Thanksgiving without using words that begin with the letters

R, P, L or A.

Instructional Methodologies

Use visual methods for teaching

Provide a structured, predictable classroom
environment.
Provide a customized visual daily schedule
Know the individual, and maintain a list of
strengths and interests.
Provide positive praise while learning, and provide
information about what the student does right or
well.
Use meaningful reinforcements
Consider sensory
Note tasks and activities, which create frustration
Have a relaxation area.
Plan and present tasks at an appropriate level of
difficulty.
Use age-appropriate materials.
Provide opportunities for choice.

Avoid long strings of verbal information. Break down

instructions and use visual aids.
Pay attention to processing and pacing issues
Use concrete examples and hand -on activities
Introduce unfamiliar tasks in a familiar environment
Use organizational aids and visual supports
Provide opportunities for meaningful contact with peers
Encourage independent
Plan for transitions and prepare the student for change.
Direct and broaden fixations into useful activities.
Develop talent areas. If a child demonstrates a particular
interest and strength in a specific areas (i.e., music,
drama, art, graphics, computer), provide opportunities
to develop further expertise in the area. This may not
only provide enjoyment and success, but may also lead
to the development of skills for future employment.

Assessment
Intellectual Assessment
severity of symptoms affects the individuals overall
level of functioning, particularly in language and social
skills
intellectual assessment is important in determining an
individuals eligibility for special education services, in
making psychiatric diagnoses and in placement for
group homes or vocational settings

Assessment - Diagnosis
There is no specific test to diagnosis ASD
Physicians look for behavioral symptoms to make a
diagnosis
o May be noticeable within the first few months of life or
anytime prior to age three

The diagnosis of ASD should include two steps:

o 1. Developmental screening & surveillance
o 2. Comprehensive evaluation by a team of professionals

Assessment- Screenings
Developmental Screening & Surveillance
A brief assessment designed to identify children who
should receive a more thorough evaluation
Surveillance - a process whereby health care
professionals monitor children who may have a
developmental disability
Comprehensive Evaluation
clinical and educational observations, caregiver
interviews, developmental histories, psychological
testing, speech-language assessments

Assessment - Screening for

Aspergers Syndrome
The Autism Spectrum Screening Questionnaire and the
Childhood Asperger Syndrome Test provide a reliable
means for identifying school-age children with Asperger
syndrome or milder forms of ASD
o Focus on social and behavioral impairments in children
without significant language delays

Etiology
Neurological, heterogeneous disorder often diagnosed
based on the existence or absence of specific
characteristics
The cause is unknown but it is likely that genetic
contributions and environmental stressors along with
abnormal brain chemistry and development are the
primary suspected factors
In a small percentage of instances, autism can be caused
by medical conditions such as fragile X syndrome and
tuberous sclerosis

Etiology (cont.)
MMR Vaccine Theory - claimed that ASD is linked to the combined
measles, mumps and rubella (MMR) vaccine. It was later discredited.
Autism Leaky Gut Theory - also known as increased intestinal
permeability, claimed that ASD children have tears and holes in their
intestinal walls that may cause them to lose healthy digestive bacteria and
have damage to the cells that produce enzymes needed to absorb certain
proteins (such as gluten) properly
Diet - the benefit of gluten-free/casein-free diets (foods like wheat, barley,
rye and dairy products) is based on the theory that autistic children may be
allergic or highly sensitive to those kinds of foods. The idea behind the diet
is to reduce symptoms and improve social and cognitive behaviors and
speech

Placement
General education classroom
o improved social interaction

Resource rooms and Self-contained classrooms

o Severe end of the spectrum need highly individualized
program of intensive specialized instruction focused on
social/communication, self-control and independence
skills
o Strategies to promote the generalization of a new skill to
the regular classroom community and home
o Recording of data on childs performance of targeted
skills as specified in IEP

Related Services
Autism is not curable, but early intervention of
appropriate services can play a significant role in
enhancing functioning in the future.
Services include:
o School nursing services
o Parent counseling
o Nutrition services
o Recreational therapy
o Occupational therapy
o Speech and language therapy

Applied Behavior Analysis

Widely recognized as a safe and effective treatment for
autism.
Focuses on principles that explain how learning takes place
(ex: Positive reinforcement)
Many techniques have been developed for increasing useful
behaviors and reducing those that may cause harm or
interfere with learning.
ABA is the use of these techniques to bring about meaningful
and positive change in behavior.
https://www.youtube.com/watch?v=iyCx-OLzgJw

Accommodations/
Modifications
For Testing:
o
o
o
o
o

Alternate testing setting

Extra time
Word boxes
Highlighted or underlined instructions
Allow typed or audio recorded answers

In the classroom:
o
o
o
o
o

Provide audio recordings of books

Create checklists and routine schedules for transitions
Provide pictures, circle/highlight/underline important facts
Create a visual boundary on table areas that are shared
Peer support/Buddy system throughout the day

Physical Classroom Setup for Autistic Students

Classroom should be clearly laid out so students know
where theyre supposed to be and what theyre supposed
to be doing
Adequate space for independent and group work
Desks should be arranged in least distractible setting
Work areas should be clearly marked, along with clearly
marked boundaries
All work and play areas should be well organized and
clear of clutter

Sign Language
Nonverbal people with autism can learn to
communicate with sign language
Respond well to sign language because its visually
based
If used along with spoken language it could accelerate
verbal communication
Not as common today because of the use of
computerized communication systems

Music/Visuals
Music
provokes engagement and interest
in kids with ASD
musical memory and pitch
abilities in children with ASD have
been found to be as good if not
better than typically developing
children
naturally interested in music and
respond well to music-based
therapy

Visuals
autistic brains exhibit more activity
in the temporal and occipital
regions involved in perceiving and
recognizing patterns and objects
help make abstract concepts more
concrete for children
used to teach autistic children a
variety of skills including literacy,
math, and life skills like cooking
and positive behavior

Social Stories
Developed by Carol Gray, who is also the president of the Gray
Center for Social Learning and Understanding (a non profit
organization dedicated to individuals with autism spectrum
disorders and those who work alongside them)
A teaching tool to help individuals with autism better
understand social situations so they can learn how to interact
in an effective and appropriate manner.
o They describe expected behaviors and simple steps for
achieving goals
o They teach new routines to minimize a childs anxiety,
help them understand the situation from other
perspectives, and improve their behavior

Social Stories (ctd)

Observe the student in a particular situation that you want to address.
Choose which aspects of the situation that should be focused on based on
the students perspective.
There are 3 types of sentences when writing social stories:
o Descriptive Sentences: These objectively define where a situation
occurs, who is involved, what the person is doing and why.
o Perspective Sentences: Describe the reactions and feelings of
others in the situation.
o Directive Sentences: Positively stated, individualized statements of
desired responses. Usually begin with I can try or I will work
on
A social story has three to five descriptive and perspective sentences for
each directive sentence.

Example of a Social Story

The following is an example of a social story that is designed to explain to a
student when it is appropriate to run at school:
I like to run. It is fun to run fast.
It is okay to run when I am playing outside.
I can run when I am on the playground or in P.E.
It is not okay to run when I am inside.
Running in the Hallways is not safe.
Teachers worry that someone may get hurt if I run into them.
When people are inside, they walk.
I will try to walk in the hallways and only run when I am outside.

Activity Three
Instructions:
o
o

Put yourself in the perspective of a young autistic

student and write your own social story
Examples of topics:
Greeting someone
Asking someone to play with me
Feeding my dog
Following rules in school
Or just make one up yourself!

Materials and Equipment

Audio texts
Flashcards with pictures
Manipulatives
Variety of writing utensils (golf pencils,
magic markers, highlighters, pencil grips
Desk organizers
Talking calculators

Assistive Technology
High-Tech Devices
Voice Output Communication
Aids are electronic devices that
can be programed to produce
synthetic speech
producing yes or no statements
or multiple words, sentences and
social comments
pictures or icons enable the child
to choose what they would like to
say by pressing the appropriate
response

Low-Tech Devices
Picture Exchange
Communication System, pictures
used as a form of
communication
has been shown to increase
spontaneous communication
skills, improve social
interactions and decrease
problem behaviors

Assistive Technology
GoTalk Pocket
o

a portable communication aid, features six message

buttons with built-in key-guard and built-in overlay
storage. Includes five recording levels with 10 seconds of
recording time on all 30 messages.

Language Acquisition through Motor Planning (LAMP)

o

a therapeutic approach based on neurological and motor

learning principles. The goal is to give individuals who are
nonverbal or have limited verbal activities a method of
independently expressing themselves
focuses on giving the individual independent access to
vocabulary on voice output devices that use consistent
motor plans for accessing vocabulary

Assistive Technology
SmartEdPad: A Dedicated Therapy
and Intervention Tool
o

A therapy tablet for special education

bundled with over 100s of therapy
apps that can be customized to each
child or group and it can be used at
school, in clinics, or at home.

Voice4u
o
o
o

helps individuals to express their feeling,

thought, actions and things they need
breaks down the barriers of
communication for individuals with
special needs
never have to guess at an individuals
wants and needs

Post Secondary/ Vocational

There are three main types of Post Secondary Education Models:

1. Mixed Hybrid Model:
o Students participate in social situations/classes with students without
disabilities and with disabilities. Students Concentrate on learning life
skills. There are usually on campus or off campus employment
opportunities.
2. Substantially Separate Model:
o Only in classes with students with disabilities. This model also
concentrates on teaching life skills to students.
3. Inclusive Individual Support Model
o Individualized services in college programs. Students work with tutors or
an educational coach.

Recreational Services

Big Apple Day Program

o This is a co-ed day camp located on the upper west side. It accommodates kids
with social and emotional issues, including children with aspergers and other
forms of high functioning autism.
Marvin Camp
o A day camp located on Staten Island that offers assistance to kids with special
needs. It is a six week day camp and has services for children on the autism
spectrum.
Operation F.U.N
o A recreational program operated by the catholic charities of Brooklyn and
Queens. It is designed for both children and adults. This program provides fun
activities and field trips for developmentally disabled individuals, including
people on the autism spectrum disorder.

Recreational Services (cont.)

Thai Elephant - Assistance Therapy Project

Commonly used in Thailand, it provides a place for children with autism to bond with elephants
in order to feel more comfortable in their community and to show a growth in self-confidence.
http://www.autismspeaks.org/news/news-item/video-elephant-therapy-provides-comfort-thai-peopl
e-autism

Organizations and Agencies

Autism Speaks
o The worlds leading autism advocacy program. They do work in over
forty countries. Their mission is to change the future for all who
struggle with autism spectrum disorder. They fund research to find
the cause, prevention, and cure for autism.
NYFAC- New York Families For Autistic Children
o Recognized as the worldwide leader in the development of training
materials for professionals working with children diagnosed with an
autism spectrum disorder. Their mission is to facilitate
improvements in current educational offerings.

Activity Four: Case Study

Guided Questions:
1. Why might the IEP team choose to improve Tommys
communication skills, rather than focusing on his
social/behavioral skills?
2. What else can be done to help Tommy develop his
communication skills?
3. Now that Tommy has a means of communicating his
needs to others, what should the IEP team establish as
Tommys next goal?

Childrens Literature
When an autistic child joins a mainstream
school, many children can find it difficult to
understand and cope with a student that is
somewhat different to them. This story
encourages other children to be mindful
and patient of the differences that exist
and to also appreciate the positive
contribution that an autistic child can make
to the group.
Step into Russell's World for an inside look
at a real-life family as they share their photos
and stories. Kids can see just what Russell
and his family experience as well as the surprises
and challenges that can come with autism.

Professional Literature
This improbable story of Christopher's
quest to investigate the suspicious death
of a neighborhood dog makes for one of
the most captivating, unusual, and widely
heralded novels in recent years.
Temple Grandin, Ph.D., is a gifted animal scientist who
has designed one-third of all the livestock-handling
facilities in the United States. She also lectures widely
on autism--because Temple Grandin is autistic, a woman
who thinks, feels, and experiences the world in ways that
are incomprehensible to the rest of us.

Webliography
www.autismspeaks.org
http://www.yai.org/agencies/autism/
http://www.nyc4a.org/aboutus
http://autismnow.org
http://www.autism-community.com/
http://www.pinterest.com/sandram38/social-stories/
http://www.pinterest.com/source/setbc.org/
http://www.autism.net.au/Autism
http://www.cdc.gov/ncbddd/autism/data.html?mobile=nocontent
http://www.calgaryautism.com/characteristics.htm
http://autismforteachers.wikispaces.com/Instructional+Strategies+for+Teachin
g+Students+with+Autism