Pervasive Developmental Disorder (PDD) – Autism Spectrum Disorder (ASD)
Autism can refer to a specific disorder (ASD) or it can be used to refer to other disorders that fall within the spectrum. Using a spectrum allows us to create strategies related to the severity and range of developmental impairments. In this lesson the first exceptionality that we will discuss is Autism Spectrum Disorder or more commonly referred to as PDD. It is a neurological disorder that effects one�s communication, behavior and social interaction. As educational assistants you may work with an autistic individual and you will need to recognize the signs and be able to apply strategies and accommodations to provide successful learning.�� ��
At the end of this lesson you should be able to:
Define Pervasive Developmental Disorder -Autism Spectrum �Disorder
Identify areas of language and communication that are affected by these disorders
Identify characteristics that are associated with PDD �ASD
Create strategies and accommodations for individuals who have PDD �ASD
Autism-PDD Resources Network ��
Studies in Autism/PDD – Dr. Peter Szatmari�����
[ http://www.geocities.com/autismandpdd ]www.geocities.com/autismandpdd
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Find an article on PDD/Autism on the internet, in a newspaper or magazine, or use one of the resources listed below
In the discussion folder write a short paragraph summarizing what you learned from the article that would be of interest to the class.
Please state the name of the article and the source.
Marks will be given� for completed assignment and participation
It is through the process of identifying characteristics of PDD/ASD that we can better serve the needs of the student.� We must be aware of the behaviours and lack of social skills that may be exhibited. Individuals with PDD and/orASD are as unique within this label of autism as typical children are unique within the label of normalcy. �As Educational Assistants we need to use all available resources to successfully deliver the program set up for students within the educational system.
In the next lesson you will be introduced to three more disorders that are under the umbrella of autism and will be able to identify the similarities and differences of each.
Applied Behavior Analysis (ABA)
This sometimes referred to as the Lovaas Method.
[ http://www.autism.org ]www.autism.org
�� TE ACCH – Treatment and Education of Autistic and related
Communication handicapped Children
Dietary Interventions – including gluten and casein free diets, and
VitaminB6 with magnesium supplements.
Medications – used to treat behavioral problems such as aggression,
injury, behaviour and severe tantrums.
[ http://www.nimh.nih.gov/publicat/autism.cfm ]www.nimh.nih.gov/publicat/autism.cfm
PECS – Picture Exchange Communication System
[ http://www.bbbautism.com/pecs_contents.htm ]www.bbbautism.com/pecs_contents.htm
[ http://www.musictherapy.org ]www.musictherapy.org
Speech and Language Therapy
www.Lburkhart.com �- an excellent website with a ton of links
[ http://cbc.ucsd.edu/pdf/brokenmirrors_asd.pdf ]http://cbc.ucsd.edu/pdf/brokenmirrors_asd.pdf
Associated Features of PDD-ASD:
? Effects 15 in 10,000 Canadians
? 4 times more likely to affect males than females
? 50 % of individuals with autism are non-verbal
? individuals may have difficulty with expressive communication
? echolalia may be evident
? cannot reciprocate social interactions
? individuals may exhibit difficulty in understanding verbal and non verbal communication
? may have difficulty with pronoun reversal
? may exhibit unusual behaviour such as finger twisting or involuntary
? difficulty making generalizations: able to complete peg board activity
with round pegs but not with square pegs (no transfer of knowledge)
? exhibits unusual mood changes: – inappropriate giggling or
? developmental milestones are uneven, in particular, social
and communication skills
? sleeping and eating habits are unusual: -may eat certain foods one
week but not the next
? may exhibit general anxiety & unusual fears or intellectual
There are 3 categories of language characteristics.
� Nonverbal: During the 1980’s it was estimated that 50 % of children with autism never developed any functional communication skills and the other 50 % developed some type of language but it was not always conventional. Now, with early intervention, it is estimated that 70 % of the first 50 % of children who were nonverbal, can learn some expressive language if begun before 3 years of age. For those who are unable to develop any expressive language, communicated intentions can be taught by use of gestures, simple signs and /or pictures.
� Delayed Verbal: / Speech may differ from their typical peers quantitatively, in the number of utterances they make and in the quality of language they use. A typical child’s most frequent communicative act is labeling whereas a child with autism most frequently uses language to request – to request objects, to request actions, or to protest.
� Echolalia: Echolalia refers to, “the repetition of utterances heard in the immediate or distant past” ( Koegel & Koegel, 1995). Although, this imitative repetition is a part of a typically developing child’s language, it’s continuance past the first few years of language development is used as a diagnostic tool for autism. Sometimes this echolalia can be produced using the exact same intonation, pitch and intensity as it was heard. For example, one student could imitate and echo a radio weathercaster so exactly that someone thought that the radio was left on in the school office and it was being broadcast through the P.A. system. This echolalia behavior may be due to the child’s lack of communicative intent or it may occur due to a child’s inability to produce an appropriate response to a question or request. Under stress to respond the child may use this method.
Pragmatics: Another area of communication that children with Autism experience difficulty in is the area of pragmatics. There are 4 general areas in pragmatics.
� Paralinguistic Skills: These skills stress our intent of communication and they include intonation, pitch of voice, intensity, and duration. Individuals with autism frequently lack these skills so they often speak in a monotone voice.
� Nonverbal Skills: Nonverbal skills refer to the body movements that aid our communication, including facial expressions, hand & arm movements, and body posturing. Children with autism, often, are not able to recognize these nonverbal skills and therefore cannot imitate them. Think of how much information one would lose if one could not recognize the spread of someone’s arm when they are telling, “how big the one was that got away!”, or how big the box is that needs to fit in the car. We use facial expressions to show our delight, displeasure, fear and shock at something or someone. When you are unable to read that type of message, you are also unable to anticipate what may happen next.
� Linguistic Intent: Linguistic intent involves the use of utterances in context of social situations and social communication. For young children it involves the ability to request information or action from another person, the ability to respond to a request, the ability to comment on something said and the ability to regulate conversation. Individuals with autism have difficulty in using these linguistic skills primarily because of 2 reasons. Firstly, they do not give adequate attention to the other person speaking to be able to participate in a conversational exchange and secondly they have not developed adequate language skills to participate in the conversation.
� Social Competence: Social competence includes the ability to use verbal and nonverbal skills. Verbal skills include: the selection, introduction, maintenance and changing of topics, the ability to take turns within conversation, including the initiation of conversation, the response, pause time, interruption, providing feedback to the speaker, using concise speech and last, but not least, using manners. Nonverbal skills include, facing and looking at the speaker observing appropriate speaker distance and tantrums, aggressive behaviour, escape and attention seeking behaviors. (Although we don’t encourage these preceding behaviors they are used for communication and do give intent.) Once again however, the lack of sufficient language development can lead to significant disability in the use of pragmatic skills.
� May exhibit fascinations with a certain object (although the object may not be used in the way for which it was intended), person, idea or activity.
� May exhibit the need for routine & consistency for as the child with autism
has difficulty with anticipation, routine and consistency it is imperative for
the child to feel some control.
� May exhibit repetitive and ritualistic behaviors and for these children with autism these rituals can become paramount to the exclusion of other daily routines. �One student I taught could not come into or go out of the classroom without a little step dance over the threshold. If he was not allowed to do this he would become very agitated and upset. As this ritual did not harm anyone or take but a few seconds, I allowed this student to have his ritual as it gave him some form of control. These types of behaviors need to be examined on an individual basis. If they impede on other Sensory our little quirks and are allowed to indulge in them from time to time – “Pick your battles “. Lynne Lafluer
� May exhibit attachment to certain objects such as bringing a stuffed dog on class trips as to reduce anxiety.
� May exhibit aggressive behaviour which could cause harm to self or others.
Sensory integration and the hypo/hyper sensitivity to the sense of touch, may play a part in this behavior.
� They may exhibit decreased eye contact with others. Some individuals with autism prefer to use their peripheral vision rather than their central vision when looking at others. This may in part be due to the expectation to converse with another when direct eye contact is made and which may induce stress in the child with autism. As well, vision, motor and processing skills may make direct eye contact difficult.
� They may have difficulty with social rules & nuances. Often, children with autism have not had the opportunity to practice social skills and rules as typically developing children have and may need to have social situations contrived for them in order to practice social skills.
� They have no knowledge of play or pretend play. They may exhibit decreased social interest.
� Autism may make reading the emotions of others difficult, in particular facial expressions. Not being able to anticipate how another may respond can result in a stressful situation, one which the child would prefer to avoid.
� They may exhibit decreased imitative skills. If you are unable to recognize a gesture, facial expression, etc., you are unable to imitate it.
� Social relationships and friendships are important to all of us, including those with autism. The absence of a meaningful friendship/relationship can be detrimental to one’s development and quality of life. Often children with autism need assistance in acquiring friends but we must remember that learning/developing social skills is not the end product but rather a vehicle for developing social relationships. As well, it is possible for children with autism to have meaningful relationships but perhaps not the same types of relationships as typical children would have – the relationship is not any less important just different.
What is over-selectivity and what implications does it have for a student with PDD -ASD?
Over- selectivity refers to the behaviour of responding to a restricted portion of relevant cues when learning to differentiate various components of the environment. (Koegel & Koegel, 1995) The majority of all children in their initial stages of language development over generalize with their first words. All 4-legged animals may be labeled, “doggy”, all elderly men with gray hair are “grandpa”, but typically developing children quickly learn to differentiate objects and people based on more than one characteristic. Children with autism often exhibit this tendency to over- select to a greater extent and without intervention may continue for life. Furthermore, a typical child may focus on relevant components of a stimulus, all 4 legged animals are doggies, while a child with autism may focus on irrelevant components of a stimulus, a tear or bend in a card rather than any part of the picture of the card. As well, a child with autism often responds to the tactile, visual, or auditory cues, in mono-mode, one at a time, not simultaneously. �One of our staff always wore slacks to school to teach her primary class. One day she returned to school in the afternoon in a skirt having attended a funeral. Her one student with autism did not recognize her and kept asking for Miss T. It wasn’t until she changed into her slacks again that the student finally acknowledged her as Miss T�. Lynne Lafleur
Implications on Social Behaviour: As the child with autism tends to focus on environmental cues in mono-mode, such as the glasses that his/her mother is wearing. Once the glasses are off, he/she may not recognize his/her mother anymore and this results in a failure to bond to others, family and friends. Over-selectivity hinders the formal and informal interactions one can have with others, playing games, sharing lunch, etc. Eg. If the child with autism, over selects on the act of touching another, in a game of touch tag, they may just keep touching others and miss the whole point of the game. The other children will probably become annoyed and not wish the child with autism to join them again. Observational learning helps us to develop social interactions but if we are only aware of one component of social behaviour and imitate only a portion of the interactive behaviour, this will hinder social interaction with others. For example, in conversation, a child with autism may learn to respond to the question, “How are you?” with “Fine”, but if asked “How old are you?” they may respond with, “Fine”, again. They were focused on only three words not four.
Implications on Language Acquisition: Over-selectivity can result in the failure to respond to multiple cues in speech and language development; for example, a therapist may have the child imitate sounds but when the therapist covers her own mouth the child may not be able to imitate the sound anymore. They have over-selected watching the therapists’ mouth but not actually hearing the sound.
Implications in the Acquisition of New Skills: When learning a new skill, a physical or verbal prompt often helps us if we’re not sure what the next step may be. However, a child with PDD may respond to the prompt rather than the reason he is being given it.
Implications in Developing the Ability to Generalize: Over-selectivity can hinder the ability to “transfer learning”. For example, a student I taught could peg with the mushroom shaped pegs but when I gave her the straight circular pegs she had no idea how to start even though the pegboard was same. She had over selected on the peg not the whole action /purpose.
Implications for Safety: Over-selectivity in certain situations could result in the individual failing to recognize dangerous situations; for example, the child may be concentrating on the ball not the traffic it may be rolling into.
STRATEGIES AND ACCOMMODATIONS
The strategies and accommodations that can be used in the educational setting by educational assistants are as follows:
� Provide daily routine and intense instruction
� Make sure classroom environment and lessons are well structured
� Use augmentative tools such as picture symbols or sign language as a means of communication.
� Follow directions and instructions set up by occupational therapist or speech and language pathologist
� Teach the child how to play by using cues or hands on activities
� Include them in games where they interact with other students in their classroom.
� Use tactile objects for stimulation
� Design a word wall where they have pictures and words to identify what they have learned
� Set specific boundaries and expectations for the child through a planned timetable
� Find computer programs that allow the child to visually learn an activity or lesson
� Set and involve the student in a life skills program where independent skills can be learned. Cooking classes, shopping and taking a bus are all skills children need later in their life.
� Include them in activities or jobs within the classroom or school for instance taking down the attendance book each morning or setting up chairs in their group.
� Build on their strengths and encourage and praise them often.
� Redirect and prompt for eye contact when speaking
� Allow the student more time for processing information, days or weeks instead of hours through repetitive and constant instruction of given words or sentences
� Independent schedules (first/then) (visual/written) (demand/preferred)
As Educational Assistants we have many strategies and accommodations that can be used to help students with PDD-ASD to function effectively in the classroom. Children with PDD need routine and do not handle change well. They must have a program set up and it must be followed on a daily basis. If change is to occur the student needs to be prepared. Assemblies, class trips and absent teachers /educational assistants will often create chaos for the child for it will be a diversion from his/her normal day. Therefore, his/her desk and area in the classroom must be consistent, organized and identified. He/she must become familiar with his/her surroundings and those around them. Involvement, participation and interaction with the class will allow his/her fears and anxieties to lower. He/she will begin to feel more part of a group and more comfortable with social interaction.
It is also very important that time frames be set in place. This can be achieved by using clocks and timers for tasks. This will visually allow the student to see the amount set and required for that task to be completed.
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