Autism / Asperger syndrome © Hermine Posch

Slide 1-2

To you in your world, Locked inside yourself, An island, Isolated winds in your mind, To you, locked inside beauty, Inside anguish, inside joy, You live, Breathe Die... Your face a delicate empty mask to those who see only with eyes, Those who don´t understand your world,... ("For an Autistic Child" in: Lee O´Neill 1999)

Slide 3

Language

Growing Spirale of Cognitive Faculty (Riedl 1985) creative language learner creative thinker

Slide 4

 Perception and Processing

Nonlinear processes

Perception Processes (feelings, thoughts, interests, emotions, expectations, moods etc.)

Information Processes (internal + external stimuli)

Slide 5

Perception Deficits

Various degrees - depending on how many modularities of information processing are affected.

CONTINUMM
	Dyslexia		Asperger		Autism

Slide 6

Pervasive Developmental.(Autism Spectrum) Disorders.
(American Psychiatric Association 1994).

• Autistic Disorder (Childhood Autism)
• Asperger Disorder (syndrome)
• Childhood Disintegrative Disorder
• Rett Disorder (syndrome)
• PDD-NOS/Atypical Autism (Pervasive Developmental Disorder - Not Otherwise Specified)

Slide 7

A U T I S M

Research Symptoms Diagnosis Approaches

Involving Therapy Autism and School Role of Parents Autistic Adults

A S P E R G E R   S Y N D R O M E

Symptoms Assessment

Aspergers and School Behaviour problems

Slide 8

A U T I S M

(with many thanks to Dr. Schein, Dep. Of Education, Karl-Franzens-University of Graz and Ursula Pail, Head of the Autism Society in Styria )

KANNER (1943) Impairment of social interaction Impairment of social communication Impairment of social imagination, flexible thinking and imaginative play

About 4 out of every 10000 develop autism.

Slide 9

Autism - Research

Current main research in

• Genetics (90 %; chromosom 13, region of . chrom. 7, maybe more...)
• Biology and physiology (e.g. Rutter 1978, Olsson et al. 1988 - epilepsy; Beck 1999; Gluten/casein intolerance, gross deficiencies in vitamins and. minerals, abnormal EEG, food intolerances etc.)
• Biochemical approach (e.g.Danczak 2000; immunology)

The complexity of symptoms requires long observations.

Slide 10

Autism - Symptoms

Autistic children may

 

• avoid eye-contact and physical contact
• show unusual auditive and/or visual perception
• show speech distortion
• have imitation problems
• show stereotypic habits
• show a fear of changes
• stick to certain activities
• show unexpected emotional changes
• not realize danger
• show repeatedly self-observations
• show self-centered behaviour

Slide 11

Autism - Assessment and Diagnosis (Cumine et al. 2000)

 

• Wing's Triad of Impairments

• ICD10 (WHO 1992)

• DSM IV (APA 1994)

• Cognitive assessment

• Social and adaptive behaviour

• Communication and language skills

• Play-based assessment

• Contribution of parents and Early Years practitioners to assessment and diagnosis

Slide 12

Low-functioning and High-functioning Austism

Slide 13

Theories and Teaching Approaches (Cumine et al. 2000)

• Theory of Mind - difficulty in understanding others' mental states
• Intersubjectivity th. - emotional understanding
• Central coherence deficit th. - focus of attention; appropriate learning style
• Experiencing self - enhance self-awareness
• Executive function defict - structure and clarity in teaching approaches

Slide 14

Involving Therapy.(Muchitsch 1999)

 

I am entering your world
and become part of it
and I will be leading you
step by step
into our world
then we will have
one part of the world in
common.

Slide 15

Respecting Autism. (Involving Therapy)

• Refer to objects the individuum likes (shows already interaction with the environment; perception and action are connected)
• Observation of child and training parents
• Further education (institutions; involve teachers in the program of the child)
• Combine: involving therapy (behaviour) psychotherapy and family therapy

Slide 16

Individual Program

 

• social behaviour (eye-contact, reduction of self-aggression, imitation exercises...)
• non-verbal discrimination exercises (visual and auditive perception, fixation of objects..)
• developing language (passive vocabulary, phonetic exercises)
• memory exercises (motor skills, concentration, exercises for daily life...)

Slide 17

Program for groups

 

• musical education (development of conscisousness of the body; combination of auditive, visual and tactile perception, development of space and time and social interactions)
• pedagogical behaviour program (compensation of deficiencies in the fields of motor skills, perception, language and social behaviour)

Slide 18-19

Autism and School. (Powell 2001)

 

• Teacher/Learner Relationship (teacher follows and leads the child)
• Social and asocial learning (coputer-generated set of activities as context for social interaction)
• Humour (I could eat a horse - flexibility of language can develop)
• Using the concrete, visual and spatial (pictures, things)
• 'Tune in' to autistic pupils (musical interaction)
• Potential of mutuality (information can be shared)
• From self-regulation to independent thinking (organizing the physical environment)
• Learning by using senses (sounds + physical movement and contact + visual messages)
• Evaluation of the teaching and learning process (teacher´s utterance may trigger a child´s memory - mark positively)
• Teaching versus learning (provide a predictable and ordered environment)
• Learning about learning (video, visual structure)
• Teaching towards increased independence (highest pedagogical aim for autistic children)

Slide 20-22

Other Intervention Approaches

Visual Processing Problems

• Vision shut down at times
• Problem with depth perception (downstairs)
• Problem with face recognition
• Problem with fluorescent lighting

  Coloured glasses (Irlen) - help in some cases; experienced diagnostician needed.

  • Italy (University of Modena, 1995): blood flow rate to the brain was measured - slowing of blood flow rate to the brain with Irlen filters giving the brain more time for info-processing;
  • Robinson and Whiting (2001): Irlen syndrome is claimed to have central nervous system origin, with a deficit in the magnocellular visual neurological pathway being implicated (= a possible cause of visual processing problems leading to social misperception). Focussed on the interpretation of emotion from facial expression.
    Result: Correlation between interpreting facial expressions and social interaction
  • Autistics: preliminary investigation has shown a change in the neuropeptide levels of dopamine when Irlen coloured lenses are worn.
   
  • PECS (Picture Exchange Communication System)
  • TEACCH
  • Intensive interaction
  • Applied behavioural analysis
  • Son-Rise Program
  • Daily Life Therapy
  • Auditory integration training
  • Diet
  • Secretin
  • Irlen
  • and others...

  Slide 23-24

  Parents

  
  • Identify health problems (list in appendix)
  • Develop an individual plan with specialists and those who are involved with the program
  • Autistics need reassurance of love
  • Voice of parents: keep it soft and even
  • Interrupting daily routine makes child upset
  • Prepare your child when changes are ahead (e.g. visitor coming)
  • Prepare visitors (they shall ask when touching belongings of the child)
  • Think of yourself (stress reduction - appendix)

  Slide 25

  Six Stress Savers (Beck 1999)

  
  • Expectations of others
  • Expectations of Self
  • Organization/Time Management
  • Targeting Actions
  • Managing Feelings and Emotions
  • Nurturing Important Relationships

  I.M. able to see things every day that are clues to my child´s development that no one else has the opportunity to capture.

  Slide 26-27

  Autistic Adults

  
  • Live their own lives (different perception)
  • Often not aware of the needs of others (but can be tolerant)
  • Feel often discriminated
  • Victims of oppression
  • Some enjoy being autistic, some don´t
  • Many lead extremely limited lives (cannot handle deviations from the routine)
  • Problems at work possible (communication)
  • Can be aggressive when disturbed (noise, light, crowds, narrow rooms, temperature, stress, time pressure etc.)

  Talents

   
  • librarian
  • hospital
  • architect
  • production
  • writer
  • programr
  • farm
  • artist

  Slide 28

  A S P E R G E R   S Y N D R O M E

  Slide 29

   

  "Just as I hold on to things that excite me,
  the terror of change and separation
  is all-consuming.
  Sucking the roof of my mouth
  or being calmed down by the person
  who loves me
  are my main routes to peace again.
  Other calming activities, such as being alone
  in an empty room, listening to easy music
  or using a relaxation technique
  are also helpful."

  (Wendy Lawson, diagnosed with Asperger syndrome in: Lawson 1998)

  Slide 30

  Hans Asperger (Vienna; 1906-1980)
  syndromes:

  • difficulties with the social use of language
  • difficulties to fit in socially
  • limited ability to use and understand gesture and facial expression
  • repetitive, stereotypical behaviours

  Slide 31

   Asperger today

  syndrome should be regarded as a sub-category of autism because it is generally accepted that intervention and treatment approaches for children anywhere within the autism spectrum will share the same foundation. (Cumine et al. 2001)

  Slide 32

  Asperger - Causes (Cumine et al. 2001)

  

  Slide 33

  Asperger - Diagnoses

   

  A good test should look for the following criteria (Wing 1981b; Cumine et al 2001):

  • impairment of two-way social interaction
  • odd and pedantic speech; stereotyped content
  • limited non-verbal communication skills
  • resistance to change; enjoyment of repetition
  • special interests; good rote memory
  • poor motor coordination; motor stereotypies

  Slide 34

  Asperger and Teaching

  Clear Tasks simplify lang. give time no ambiguety picture cards give a model connections

  A network of class teacher support teacher special support assistant Parents

  use pictures help with main idea support social interaction humour information Don´t give up!

  Slide 35

  Asperger learning style

  • no desire to "stand out"
  • hard to adjust imitations to own reference
  • unexpected responses to sensory input
  • narrow/obsessive focus of attention
  • episodic memory (not stored in context)
  • stored facts without meaningful framework
  • difficulties with sequencing
  • problem solving (not used for a new situation)

  Slide 36

  Asperger - Behaviour

   
  • Decoding people
  • Self concept
  • Imagination
  • Cracking language code
  • Rigidity and rule-bound behaviour
  • Exclusive interests and obsessions
  • Compulsivity, perseveration, perfectionism
  • Integrated learning
  • Sensory experience
  • Motor control

  Slide 37

  Asperger - The Point of View

   

  Try to take the point of view of the child in order to understand the function of a certain behaviour. Problems can be avoided...

  • Structured environment
  • Positive relationship
  • Remove potential stress triggers
  • Calm + objective
  • Rehearsal
  • Rules
  • Incorporate interests and obsessions

  <>Slide 38

  For Dr. R

   

  When you look at me
  With sea-pale eyes,
  my pain sails away,
  when you´re not watching
  I peek your way,
  My snow-bearded friend,
  I love you.
  I, snug in a ball
  In your arms rocking me,
  I call you Daddy in dreams,
  Wonderful creative healer,
  Thoughts always tickled by your face
  And your soft murmurs,
  My mornings with you
  Are like treasures like rosy seashells,
  you help unlock my big love
  bursting me,
  you love me as I am,
  in my own stained glass world.
  (O´Neill 1999)