Quiz 3- Chapter 9

CODY
Diagnosed with autism; placed in preschool program and had been in special ed since.  From K-1st grade placed in a self-contained special ed classroom.  Cody regressed during those 2 years.  Parents convinced school to put Cody in gen-ed with supports.  She now does very well, even with ltd oral language and is able to do much of the academic work with paraprofessional assistance. 
ASD
Autism Spectrum Disorders=pervasive developmental disorders (PDD).  ASD (1988) and PPD (1980) considered “umbrella” concepts includisive of the conditions of autism, Asperger syndrome, Rett syndrome, and childhood disintegrative disorder, and PPD not otherwise specified.
Brief Autism History
1980’s it was found to be an organic disorder; not a seperate category under IDEA until 1990 (prior they were only eligible under the category “other health impaired.” It’s increased prevalence creates need to highlight the need for: 1)Enhanced teacher training 2)Support for gen-ed teachers to promote successful inclusion 3) >vocational rehab services for adults 4) >commitment to research etiology 5)advanced understanding of effective interventions for use by parents and teachers
Defining Autism
2 Key Definitions (one by IDEA and one by the DSM):  1) a dev. disability that results in significant deficits in verbal and non-verbal comm. and social interactions 2)Fig. 9.1 on p. 280 (very lengthy).  It is found to appear typically within the 1st three years of life. 
ASD
Def:  a pervasive dev. disability that primarily effects social interaction, language and behaviors. 
Problems Related to Identification of Children w/ ASD:
1)Display many characteristics exhibited by individuals with other disabilities like speech and language disorders. 2)Many children w/ autism (b/c they exhibit disorders across mult. domains) are mistakenly classified as having mult. disabilities. 3)No stable classification system is used among educators and other professionals who encounter children with autism  
Professional and Parental Disagreement Concerning Identification of ASD:
…whether ASD reflects a continuum of disorders or several discrete categories.  “Clumpers”=those who will include Asperger syndrome under ASD b/c all have social deficits vs. “Splitters”=those who keep Asperger on its own b/c of advanced lang. and higher cognitive functioning
Aspergers
high functioning autism which has been encouraged to be deleted from DSM.  According to DSM, a child can still have autism even w/out lang. or cognitive delays, and a diagnosis of autism takes precedence over Aspergers disorder.  If a child meets DSM autism criteria, the child cannot have Aspergers disorder.
Early Identification
Critical concern in field of ASD.  Common challenge=how early autism can be detected.  Better detection rates during the 2nd year, but abnormalitites can be detected in the 1st. 
Key Characteristics for Early Detection
Lack of eye contact and limited social skills; differences in postural and motoric characteristics; lack of responsiveness to others and to one’s own name; pattern of solidarity or unusual play; marked passivity; fixation on objects in the environment; delayed expressive and receptive language (including gestural communication); and difficulties in self-regualtion that may be reflected in impulsivity, irritability, and interference with the formation of attachments
Causes of ASD
There is no single SPECIFIC cause of autism.; Organic factors like brain damage, genetic links, and pregnancy complications may be contributors.; The most accepted models suggest a combo of genetic base (ex: brain structure/function);influenced by environmental events (ex: toxins and infections)
Prevalence

More restricted definitions: .7-2.3 per 10,000 individuals being identified with autism

Less restrictive: 7-14 per 10,000 individuals

As of 2006, 1.5 million Americans identified as having autism (1 in 166 births)

An increase of 10-17% per year w/ as many as 4 mil affected by 2015.

Ave. annual expenditure for students w/ ASD= $18,790 (1999-2000)

Likely Reasons for Prevalence

1. Greater awareness of the condition

2. Gen. overall population increase

3.; Definitional changes

4. Influx of children from out-of state

5.; Prior misdiagnosis (ex: MR)

6.; Vaccinations

(none of the above have been confirmed)

–>Also “diagnostic substitutions” and “epidemic proportions”

Characteristics of those w/ ASD

  • Ltd. social interaction
  • Persistent preoccupation w/ parts of things
  • Sig. impairment in soc., occupational, and other functioning areas
  • No significant delay in lang., self-help, adaptive behavior (other than social), and cognition

Behavioral Patterns

  1. Behavioral deficits: inability to relate to others, lack of functional language, sensory processing deficits, cognitive deficits
  2. Behavioral excesses: self-stimulation, resistance to change, bixarre and challenging behaviors, self-injurous behaviors.

***AS= Thought to be socially stiff, awkward, emotionally blunted, self-centered, deficient in understanding nonverbal social cues, and inflexible; aware enough to know they are diff from their other peers.  Self-esteem and self-concept difficulties are common

Academic Assesment for ASD Students

  1. Letter-Word Identification- 49% of children w/ autism fall into the bottom 20% of students in the gen. population, 19% are in the upper 40%
  2. Passage Comprehension- 66% w/ autism fall into lower 20%, only 8% in the upper 40%
  3. Calculation- 49% w/ autism fall into the lower 20%, 18% in the upper 40%
  4. Applied Problems- 65% w/ autism fall into the lowest 20% of gen. pop., only 12% are within upper 40%

**Some children w/ autism present pos. characteristics.  They also sometimes have “hyperlexia” where an advance of at least one standard deviation in the reading over the verbal IQ level. 

Splinter Skills of Students w/ Autism

  1. Calendar abilities
  2. Ability to count visual things quickly
  3. Artistic ability
  4. Musical ability

**Those w/ AS: strength in oral expression and reading recognition, while difficulties including oral comprehension, written expression, and math (prob. solving).  Also strenghts in grammar, vocab, rote memory, absorbing facts, and honesty.

—–>LOOK AT TABLE 9.1

Autism: Gender and Ethnicity

  • 83% of children 6-12 were male
  • ages 13-17, 84.8%
  • .64% Native Americans
  • 4.9% Asians
  • 16.5% African Americans
  • 10.1% Hispanic
  • 67.5% Euro-Americans

Rett Syndrome

  • Present in 1 in 10,000-15,000 female births (representing a genetic disorder on the X chromosome)
  • 4 Dev. Stages Associated w/ Rett Syndrome:
  1. Early Onset: 6-18 mo.; < eye contact and interest in toys; hand-wringing
  2. Rapid Destructive: age 1-4 (can last weeks or months); hand skills and spoken lang. may be lost; initiating motor movement difficult
  3. Plateau: age 2-10 and can last for years; motor probs and seizures are prominent; behavior may improve along w/ communication and attn span
  4. Late Motor Deterioration: can last for decades; reduced mobility, muscle weakness, rigidity; generally no decline in cognition or communication

**Key intervention foci= symptomatic treatment assoc. w/ key characteristics discussed above

Placement Patterns

  • 24.5% of preschoolers (2-5) served in an early childhood setting, 49.5% served in early childhood special-ed setting, 2.1 % recieved services at home-based program, 15.2% 50-50 btw. early childhood and special-ed, .5% residential facility, 5.9% served in seperate school, 1.2% Intinerant services outside of the home, 1.6% in reverse mainstreaming program

Placement Patterns Cont’d…

For students age 6-21:

  • 24.7% served in reg. class for 79%+ of the day
  • 17.8% outside of the classroom btw 21-60% of the time
  • 45.5% served outside reg. class for 60%+ of the day
  • 5.8% served in public facilities and 4.6% in priv. facilities
  • 1.1% served in pub. or priv. residential facilties
  • .4% served w/in the home or in hospital environ.

Placement Patterns in Sum…
For younger students (6-11), a larger % were served mainly in the gen-ed programs and fewer served in seperate facilities.  But, students btw 12-17+18-21 were more likely served in restrictive settings.  13% of ALL children w/ autism spent 100% of their time in the gen-ed classroom (2005).
Key Goals for Students with ASD

  • Develop basic language and social skills
  • Provide academic instruction consistent w/ cognitive level
  • Teach fund. skills for postschool success
  • Tie instruction to parental ed.

**Another goal is to implement effective early intervention programs

Effective, Broad Based Ed. Practices for ASD Students:

  1. Individualized services and supports for both family and child
  2. Systemic instruction of meaningful skills
  3. Reliance on data-based decision making in ed. programs
  4. Creation of structured learning environments
  5. Implementation of specialized curriculum for language and social skills
  6. Application of a functional approach to understanding prob. behavior

 Interventions Worthy of Consideration Fall Into One of These Categories:

  1. Well-established: adult directed intervention
  2. Emerging and effective: peer-mediated interventions, visual supports, self-monitoring, involving families
  3. Probably efficacious: positive behavior supports; videotaped modeling of apt behaviors, moderating task characteristics

Social Stories

  • The use of social stories is a recent intervention strategy
  • They identify steps in social situations and facilitate learning bc students w/ ASD have diff. reading environmental, societal, and behavioral cues.
  • They typically:
  1. Target a specific problematic social situation
  2. Identify salient features of context and setting
  3. Share this infor w/ child and others

PECS (Picture Exchange Communication Systems)

  • based on teaching kids how to exchange pic. symbols to make varied social requests
  • Similar concept as communication board for those with severe disabilities

Educational Outcomes of Students w/ ASD

  • Graduated w/ a standard diploma: increase from 33.7% in 1994- 51.1% in 2002.
  • Students w/ autism dropping out: decrease from 25.9% in 1994- 17.6% in 2002

Behaviors Warranting Medical Interventions:

  • Aggression that has moved beyond what can be tolerated or has become significantly less manageable
  • Self-injurious behavior that poses a threat to her/his health and safety and/or significantly interferes w/ the activities of daily living
  • Obsessions/compulsions that significantly interfere w/ the child’s participation in the activities of daily living or safety
  • Ongoing, unsafe impulsivity that may including running, climbing, mouthing, or eating inappropriate objects

Controversial Interventions

  • Facilitated Communication (FC)- process where a facilitator helps the person w/ autism to type or use a keyboard for communication purposes; provides an apt illustration of “miracle cures” that have been too common in this field
  • Controversial: evidence often showed that the facilitator influences the autistic person although the facilitator may be unaware of it

Core Instructional Objectives for Children w/ ASD in the Gen-Ed Classroom Should Include:

  1. Social skills
  2. Expressive verbal lang, receptive lang, non-verbal comm skills
  3. Functional symbolic comm system, engagement and flexibility in developmentally appropriate tasks and play
  4. Fine and gross motor skills
  5. Cog. skills (symbolic play and academic skills)
  6. Conventionalc/appropriate behaviors
  7. Independent org. skills and skills for successes in a reg. classroom

Special Considerations for Students w/ AS:

  1. Carefully structure seating arrangements and group work
  2. Provide a safe haven
  3. Save the student from him/herself
  4. Prepare for changes in routine
  5. Use available resources/make needed accommodations
  6. Connect w/ each other, parents, Internet support groups, and other groups
  7. Promotoe positive peer interactions
  8. Capitalize on special interests
  9. Don’ t take it personally
  10. Help your classroom become a caring community

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