College of Education

Department of Special Needs and Inclusive

Education
Course on Autism Spectrum Disorder
 Unit One
1.1. Definition of Autism
It is defined by the presence of abnormal or
impaired development that is manifest before
the age of 3 years, characterized by
abnormalities of social development,
communication and a restriction of behavior and
interest.
 1.2. Historical Overview
 First described by Leo Kanner in 1943 as early Infantile
Autism
 “Auto” children are “locked within themselves.”
 For next 30 years, considered to be an emotional disturbance
 Lauretta Bender first used the term “childhood
schizophrenia” for childhood autism

 1.3. Prevalence
 prevalence is 2-6/1000 individuals (1/2 to 1 ½
million affected)
 4 times more prevalent in boys
 No known racial, ethnic, or social boundaries
 1.4. Etiology/causes
1. Genetic factors
 more in monozygotic twin than dizygotic
twins
 Siblings of Autistic children shows a
prevalence of autistic disorder of 2 %
2. Biochemical factors
 1/3 of clients with autistic disorder have
elevated plasma serotonin
 Con;

3. Medical factors
 postnatal neurological infections Fragile X
chromosome syndrome
4. Perinatal factors
 Maternal bleeding after 1st trimester and
meconium in amniotic fluid
4. Parenting influence and social environmental
factors
 Parental rejection
 Con;
 Family breakup
 Family stress
 Faulty communication patterns
 Refrigerator parents, Kenner 1973
 Fixation in presymbiotic phase, according to
Mahler 1975. Child creates a barrier between
self and others.
 1.5. Clinical features
1. Social interaction
 Inability to make warm relationship with
people.
 children do not respond to their parents
affectionate behavior
 Smile and look to others less often, and
respond less to their own name
 They tend to their own things regardless of who
is around or what is happening in the
environment.
 Con;

 Poor use of social signals and weak

integration of social, emotional and
communicative behavior
 Failure to make eye to eye contact with
people
2. Impairments in communication
 Failure to develop normal speech, failure to
communicate by gestures, body movements
or facial expressions
 Lack of social usage of whatever language
skills are present
 Con;
 delayed onset of babbling, unusual gestures
 diminished responsiveness, and vocal patterns
that are not synchronized with the caregiver
 their gestures are less often integrated with
words
 Deficit in joint attention
 Less likely to make requests or share
experiences
 impairment in social imitative play
 Con;

 difficulty with imaginative play and with

developing symbols into language
 lack of creativity and fantasy in though process
 may exhibit echolalia
3. Behavioral abnormalities
 restricted repetitive and stereotyped pattern of
behavior
 tendency to impose rigidity and routine in a
wide range of aspects of day to day functioning
 Con;
 gets very upset by minor changes in routine
 difficulty in generalizing newly learned skills to
new situations
 ritualistic behavior like checking and touching
rituals and dressing up in particular way. When
the rituals are interrupted , children may
became anxious and angry
 Con;

 rocking, twirling, head banging and similar

repetitive behavior are often seen especially in
autistic children
 Over activity, disruptive behavior and temper
tantrums which may occur for little or no
reason
 Phobias, eating and sleeping disturbances
 Con;

4. Cognitive abnormalities
 poor at symbolization, understanding abstract
ideas and grasping theoretical concepts
 memory may be excellent
Other features
 many autistic children enjoys music particularly

 Chapter two
2.1 Types of Pervasive Developmental Disorders
1. Autistic disorder
 Impairments in social interaction,
communication, and Imaginative play
 Apparent before age 3
 Also includes stereotyped behaviors, interests,
and activities
 2. Asperger’s Disorder

 impairments in social interactions, and presence

of social restricted interests and activities
 no clinically significant general delay in
language
 average to above average intelligence
 3. Pervasive Developmental Disorder-Not Otherwise
Specified (PDD-NOS)

 often referred to as atypical autism

 used when a child does not meet the criteria for
a specific diagnosis, but there is severe and
pervasive impairment in specified behaviors
 4. RETT’s Disorder

 Progressive disorder which, to date, has only

occurred in girls
 period of normal development and then the loss
previously acquired skills
 Also loss of purposeful use of hands, which is
replaced by repetitive hand movements
 Beginning at age of 1-4 years
 5. Childhood Disintegrative Disorder
 Normal development for at least the first 2
years
 Then significant loss of previously acquired
skills
 Chapter 3. Diagnostic Criteria
1 of 150 children are diagnosed with some form of
Autism
A. Exam and tests
 routine developmental exams
 language milestones
 hearing evaluation
 blood lead test
 Screening test for autism
 genetic testing
 Con;
 complete physical examination
 nervous system (neurologic) examination
B. Specific Screening Tool
 Autism diagnostic interview-Revised (ADI-R)
 Autism Diagnostic Observation Schedule
(ADOS)
 Childhood Autism Rating Scale (CARS)
 Gilliam Autism Rating Scale
 Pervasive Developmental Disorders Screening
Test Stage 3
 C. Treatment
I. Behavioral Therapy
 Development of regular routine
 structured classroom training
 Positive reinforcement to teach
 speech therapy or sign language teaching
 Story boarding
 Sensory integration therapy
 Relationship Development Intervention (RDI)
 Con;

II. Other evidence-Based Therapies

 Speech Therapy
 Occupational Therapy/Physical Therapy
 Physical Therapy
 Sensory Integration
 Auditory Integration Therapy (AIT)
 Vocational Therapy
 Con;

II. Psychotherapy
 not effective in infantile autism
 parental counseling and supportive therapy are
useful in allaying parental anxiety and guilt
III. Pharmacotherapy
 Fenfluramine helps in decreasing behavioral
symptoms, and helpful in increasing IQ
 Haloperidol decreases hyperactivity and abnormal
behavioral symptoms
 Other dugs like chlorpromazine, imipramine etc
 Antiepileptic medication
 Con;

IV. Diet
 a gluten-free (wheat, barely)
 or casein-free diet (milk, cheese)
V. Other Approaches
 to talk with other parents of children with autism
 using secretin infusions
 2.2 Prognosis
 Autism is a very challenging disability to solve
because of many unknown factors.
 since there is no cure for Autism, proper procedures
such as therapy must be taken to help these
individuals handle their problems
 With proper therapy sessions, individuals with
autism can improve their modes of communication
and socialization to live very productive
independent lifestyles in society
 Autistic children with IQ scores of 70 and above,
normally can live and work more productive
independent lifestyles with society
 Con;
 Autism symptoms vary from mild to severe.
The prognosis for these individuals depends on the
severity of their disability and the level of therapy they
receive.
 Individuals with autism usually demonstrate some
aspect of impairment of their senses throughout life
 Individuals with autism are often labeled incorrectly as
“loners” because of their inability to socially interact.
 Approximately 33% of children with autism will
eventually develop epilepsy. The highest risk is with
children that have severe cognitive impairments and
motor deficits.
 Con;

 individuals with autism can live very active

lifestyles. They are very capable of performing
most physical activities. This will depend on the
severity of the disability.
 Also, an active lifestyle is more likely to help
these individuals with weight control, muscular
endurance, muscular strength, cardiovascular
endurance, self esteem, and self-confidence
 2.3. Implication for Physical Education

 May need 1:1 supervision for child

 Provide an initial screening process to determine
student’s physical strengths and weaknesses.
This will help in writing IEP objectives and goals
 Establish routines and smooth transitions
throughout the lesson
 Modify equipment-Provide balls that will provide
sensory output during activities. (ie: Knobby
balls)
 Videotapes can be useful for autistic children
who can follow visual cues.
 2.3. Recommended Activities

 Any activity that requires vigorous activity will

improve their overall fitness levels. (flexibility,
cardiovascular, endurance, strength, muscular
endurance)
 Walking/Hiking
 Bike riding (Type bike will depend on
ability/balance levels)
 Swimming: An excellent low impact activity that
can benefit student in a variety of health-related
ways
 Con;

 Activities that require the use of their senses.

Autistic children like deep pressure that helps them
relax. Weighted backpacks/vest can help provide
this deep pressure.
 Find out the students physical activity intersts
 2.4. Contrainedicated Activities

 having class in loud and/ or bright environment;

providing too much stimuli within the
environment.
 Activities that require a lot of contact
 Spending too much time on a single activity and
not providing enough choices
 2.5. Effective Teaching Strategies

 Use teaching stations

 Change activities regularly
 Eliminate different distractions
 keep directions short and age-apropraite.
 Use sensory stimulation to increase attention
span
 Use smooth transitions
 Instruct in an environment were noise, smells,
lights will not interfere with learning. Teach in
less stimulating enviroment.
 Con;

 Provide students with ear plugs/cotton balls in

nosier enviroment
 Keep motivational music at low level
 Establish predictable routines within lessons
 Create high structured environment which is
organized and predictable
 Warm-up activity, Closure
 Using visual aids during activities
 Use vigorous aerobic exercises to keep student on
task
 Con;
 Use a consistent behavior modification
program
 provide lots of practice time/repititions
 Show enthusiasm when teaching.
 2.6. Preschool-elementary considerations

• Use a reward system like sticker chart

• Teach students basic loco-motor and object
control skills.
 2.7. Middle School- Secondary
 Provide reward system that allows students the
opportunity to participate in enjoyable activity.
 Teach students lead-up activities for team,
individual, and cooperative activities.
 Have children preform and draw parts of a
picture (face) every time task is completed
 Use a peer tutor to assist child in learning.
 Allow choices when setting up the curriculum so
they can choose an activity that is of interest to
them.
 Chapter 4. Autism and ADHD
What is the difference between autism and ADHD?
• Autism and ADHD are sometimes confused with
one another.
• Children with an ADHD diagnosis consistently
have issues with fidgeting, concentrating, and
maintaining eye contact with others. These
symptoms are also seen in some autistic people.
• Despite some similarities, ADHD is not considered
a spectrum disorder. One major difference
between the two is that people with ADHD do not
tend to lack socio-communicative skills.
 Con;

• If you think your child may be hyperactive, talk

with their doctor about possible ADHD testing.
Getting a clear diagnosis is essential to ensure
that your child is receiving the right support.
• It’s also possible for a person to have both
autism and ADHD.
 Myths and Facts

Myths Facts
ASD is rare ASD is not rare. It affects approximately 1 in
every 165 persons (Fombonne et al., 2006).
ASD is an emotional disorder ASD is a neurological disorder.
Poor parenting causes ASD. Parents do not cause ASD in children
There is a cure for ASD, or children will “grow Children do not grow out of ASD. With early
out of ” the disorders intervention and good educational programs,
students may make significant progress.
Everyone with ASD behaves in the same way Students with ASD are individuals who each
have unique strengths and needs.
Students with ASD have to be in special Individually designed programs best meet
programs for “the autistic”. the needs of students affected by ASD.
Students need to be learning, living, and
working in settings where there are ample
opportunities to communicate and interact
with others who have the skills they need.
 Chapter 5. Inclusion Strategies
Inclusion does not need to cost more money

Often it requires only basic adaptations and accommodations

– slower pace
– adjusted rules
– altered lighting, sounds, movement
– simplified, direct instruction, activities, handouts
– use of photographs and other learning tools
– understanding and flexibility
– being open and prepared for the need to “escape”
and/or return as needed
 focus on the family

• Don’t
• assume or presume

• pass judgment

• ask a family to participate

separately
Families with autism are passionate about being
accepted within their community.
 special accommodations

• People with autism may need

private, personal assistance
of a parent or caretaker during
their outing
• Support accommodations for family restrooms, fitting rooms and
locker rooms at your facility
• Post signs that clearly
indicate who to contact for these
types of accommodations
 encourage participation
• Value the dignity of each individual
Maintain the respect of all participants.
• Break tasks into small parts. Avoid
multi-step directions. Be patient and
allow person time to complete each task.
• Offer ways to signal when a break, or help is needed.

• Clearly define boundaries (circles of intimacy).

• Provide signals or cues to prepare for transitions in schedules, events,

and locations.
• Use respectful and age-appropriate
ways to modify activities.
 Con;
• When offering help, first ask what help is needed. Promote
independence by fading your assistance.

• Environments that are over-stimulating present additional

challenges.

• Encourage activities for family interaction that relieve dependence

on the other members. This helps create a positive experience for
all.

• Learn a person’s interests and provide opportunities for involvement

and sharing.
 Moving forward

• Consider distinctive selling strategies for products

or services to reach this niche market
• Attend to this growing population in promotional
events and awareness campaigns
 Social Networks
• People with autism and their families look for “safe” places to
interact
• They want to participate free of criticism or judgment
• Businesses can create inclusive social settings
• Families will want to share their
positive experiences with others
 Recreation and Leisure
• Recreation providers have a role to
help people with and without disabilities…

• become valued and active through community-

based leisure activities
• develop meaningful and supportive relationships
• overcome physical and attitudinal barriers that
deter participation
 library services
A library serves informational, literary, and
recreation needs people expect it to be a
welcoming environment for all community
members.
 Faith Communities
• Many families turn to religious congregations for support
and acceptance

• Congregations will experience personal benefits as a

result
of inclusion

• Help organize and sustain supports and services to meet

individual spiritual needs
 Personal Interactions
• Talk directly to the person, not a family member or caretaker
• Listen carefully to understand the real meaning
• Don’t speak too forcefully or loudly
• Don’t use slang, sarcasm, or complex language
• Try to keep the conversation on topic
• Pause between statements to allow for processing
Allow sufficient time for them to respond
• Using pictures helps understanding
 Destructions
• Limit environmental distractions
– loud, unexpected, unnecessary sounds/noises

– visual challenges (bright

lighting, complex layouts,
numerous colors, excessive wording, etc.)

– sudden transitions

– unnecessary interactions, movements, changes in a

physical arrangement or
a schedule
 Alternative communications
• gestures
• sign language
• sounds
• objects
• photographs / pictures / symbols
• voice output devices
• computerized and technological devices
• writing
• physical contact
 Functional Skills
. Categorizing Matching
. Collating Money Exchange
. Copying Number Application
. Data entry Packaging
. Folding Preparation
. Following a sample Printing
. Handcrafts Quality control
.Handling Sequencing
. Horticulture activities Sewing
. Laundering Simple assembly
. Machine operation Sorting
. Making lists Stuffing
.Manipulation of objects Weighing
 Employment/Vocational Options

• Offer collaborative programs with

school and/or governmental organizations

• Provide experiential learning opportunities with families

• Offer resources for career education

• Provide on-the-job training

• Assist individuals with functional living skills