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Next week: Conduct Disorder (Kids who lack empathy for others, use aggression and manipulation, violate youth community ordinances, etc.)
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G’DAY FELLOW B-LISTERS!! Yet again this week, we continue with our write-ups and (free) videos regarding DSM-5 diagnoses that are found in the records of our students identified as having mental health and/or behavio(u)ral disabilities.
This week, we look at the “The Spectrum”. The “Autism Spectrum Disorder” is a range or continuum of neurological conditions that develop early in childhood (before age 2) and continue for the remainder of life. These youngsters typically display abnormalities that result in in social communication and interaction impairments, repetitiveness of behaviors, and limited interests or activities.
Depending on which article you read, you’ll see one of two explanations of “the spectrum”. The first explanation is that “ASD” is an umbrella term covering five distinct conditions (the olive colored ovals in the image above): Autism, Asperger Syndrome, Rett Syndrome, Childhood Disintegrative Disorder and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). The latter term is assigned when the youngster’s symptoms don’t fully meet one of the other four diagnoses, but the characteristics are highly similar and s/he definitely has social, behavioral, and communication needs requiring special services. The second explanation is that ASD is itself under a larger umbrella, and that Pervasive Developmental Disorders is the all-inclusive label, with ASD covering the 3 diagnoses seen in the diagram above.
Whenever we discuss “kids on the spectrum”, the conversation moves toward discussions of which is the best way to help kids with ASD develop better ways to handle life’s situations. Is it the highly structured ABA practices? The “loose” and spontaneous interpersonal Floor time intervention? The CABO approach? Does a change in diet reduce the symptoms?
Another discussion point involves the “overrepresentation” (higher percentage than we would expect given the % of the total population) of kids identified as “white”. Is there something about the genetics or lifestyle/diet of European heritage pregnant females that places their children more at risk for ASD? Or could the underrepresentation of some groups be due to issues with regard to diagnosis and service provision?
Either way, our discussions are quite far removed from the consideration of the 1940 to 1960’s view by Kanner and Bettelheim that autism was a result of cold and unemotional parenting by “refrigerator parents”, the 1970′ to 1980’s when the inside (bad) jokes among educators and psychologists included that the child should be diagnosed with “FLK Syndrome” (Funny-Looking Kid Syndrome) or “Pain-in-the-Asperger Syndrome”, Breggin’s 1990’s return to the emotionally cold trauma-inducing refrigerator parent theory (That theory is still widely held in France, other parts of Europe, and South Korea.), or the now disproven early-2000’s idea that a preservative in early childhood inoculations brought on the condition.
* Regarding the questionable material in the previous sentence; I don’t want to shield professionals in our micro-field from our history, be it good or bad. Our history has warts on it. Knowing this material helps us to defuse misguided understandings and handle errant attempts at humor when they surface (and they still do).
We can expect the field to further change and gain precision in diagnosis and service/supports. It’s yet another reason that teachers need to keep up with the professional literature, or subscribe to free sites that distribute summations. (BehaviorAdvisor.com on facebook, School Psyched-Your School Psychologist on facebook, and the CEC Smartbrief at http://www2.smartbrief.com/signupSystem/subscribe.action?pageSequence=1&briefName=specialed&utm_source=brief
How many youngsters have Autism?
The number of youngsters with autism around the world continues to increase. According to the Centers for Disease Control and Prevention (CDC) in the U.S. (March-April, 2013), it is estimated that 1 in 88 American children has some variation or degree of autism. That is an increase of nearly 80% compared to just a decade earlier. Now the estimates state that 1 in 68 children is “on the spectrum”.
How was this finding determined? Since 2000, the CDC’s Autism and Developmental Disabilities Monitoring Network has based its estimates on a bi-annual counting of how many 8-year-olds in about a dozen communities across the nation have autism. (The number of sites has ranged from 6 to 14 over the years, depending on the availability of funding in a particular year.)
In 2000 and 2002, the autism estimate was about 1 in 150 children. Two years later 1 in 125 of the 8-year-olds had autism. In 2006, the number was 1 in 110, and in 2008 — 1 in 88 children had the condition. Estimates from later studies cite 1 in 68 children are involved.
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Boys with autism continue to outnumber girls 5-to-1, according to the CDC reports. It estimates that 1 in 54 boys in the United States have autism to some degree.
Note: As of May 2013, Aspergers syndrome was no longer be recognized as a condition separate from autism. The youngsters who have the symptoms of this now defunct condition will be labeled as having autism.
What are the signs & symptoms of Autism?
In general, kids with autism have a neurodevelopment disorder (brain neurology-biology complications) that leads to impaired language abilities, difficulties in inter-personal communication, and under-developed social skills. The videos found below will answer this sub-title question in more depth.
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Intervention and strategies
Well-conducted research studies show that the earlier the implementation of effective the interventions, the better the long-term outcomes for kids on the autistic spectrum. Of course, early intervention is dependent on early identification of the disorder. The videos (below) discuss some of those approaches.
This week, in addition to the videos by my wonderful graduate students, I include other pertinent and essential information.
CASE STUDY VIDEOS
These vids provide a case history of a child, compares his/her characteristices to the identification criteria
in the Diagnostic and Prescriptive Manual of the American Psychiatric Association (DSM-5)
1. Autism overview (DSM-5) criteria – https://www.youtube.com/watch?v=3RG4oJ51PTw
2. Connor, a 7 year old boy with Autism (DSM-5 criteria) – Part 1 and Part 2
3. “Sally”, a 10 year old girl with (as it is known in April 2013, DSM-4tr criteria) Autism. Part 1 …. Part 2
4. 2-part case study video regarding Aspergers Syndrome: https://youtu.be/BJP9AoyU34o and https://youtu.be/R9tEej7qS5k
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INTERVENTION VIDEOS
These videos & documents describe the various approaches and strategies
5. (Overview of ASD and) ABA Therapy – https://youtu.be/RBB_81ao7uo
6. The DRI-Floor Time model (Overview & case study) – https://www.youtube.com/watch?v=enRX7Nu2j8E (For more information, search for “Floortime” on youtube)
7. Zones of Regulation (teaching self-control to students on the spectrum) – https://www.youtube.com/watch?v=RK834FbWA4o
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OTHER STUFF
8.What is Sensory Integration Disorder? (Often reported in kids “on the spectrum”) – http://www.behavioradvisor.com/SID.html
9. About “sensory rooms” & “sensory therapy” (Often recommended for kids “on the spectrum”) – Read the second column on page 21 (right side page of the two pages) at: http://www.pageturnpro.com/Midwest-Symposium-for-Leadership-in-Behavior-Disorders/81890-Rethinking-Behavior/default.html#page/23
10. Characteristics of Quality Programs for Youngsters on the Autistic Spectrum (Checklist) – Click here
11. Fifteen general strategies for working with students with ASD – Click here
12. General strategies for addressing different characteristics common among students with ASD – Click here
13. Research proven practices (and unproven) – AutismEffectivePractices.pdf
14. Differential Reinforcement; powerful and positive behavior change procedures
15. FreeSpirit.com has a self-help book for kids with autism titled “The survival guide for kids with Autism Spectrum Disorders (and their parents)“. (and Dr. Mac’s book for kids with acting out behaviors)
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Next week: Conduct Disorder
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Dr. Mac
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Tom McIntyre, Ph.D. (Dr. Mac)
Professor of Special Education and Coordinator of the Graduate Program in Behavior Disorders
Hunter College of the City University of New York
DoctorMac@BehaviorAdvisor.com
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