powerpoint on ASpergers

1. Introduction

2. According to the Autism Society
website
 In December 2009, the Centers for Disease Control
and Prevention issued their ADDM autism prevalence
report. The report concluded that the prevalence of
autism had risen to 1 in every 110 births in the United
States and almost 1 in 70 boys. The issuance of this
report caused a media uproar, but the news was not a
surprise to the Autism Society or to the 1.5 million
Americans living with the effects of autism spectrum
disorder.

3. Costs
 Currently, the Autism Society estimates that the
lifetime cost of caring for a child with autism ranges
from $3.5 million to $5 million, and that the United
States is facing almost $90 billion annually in costs for
autism (this figure includes research, insurance costs
and non-covered expenses, Medicaid waivers for
autism, educational
spending, housing, transportation, employment, in
addition to related therapeutic services and caregiver
costs).

4.  The diagnostic category of pervasive
developmental disorders (PDD) refers to a
group of disorders characterized by delays
in the development of socialization and
communication skills. Parents may note
symptoms as early as infancy, although the
typical age of onset is before 3 years of age.
Symptoms may include problems with using
and understanding language; difficulty
relating to people, objects, and events;
unusual play with toys and other objects;
difficulty with changes in routine or familiar
surroundings, and repetitive body
movements or behavior patterns. Autism (a
developmental brain disorder characterized
by impaired social interaction and
communication skills, and a limited range of
activities and interests) is the most
characteristic and best studied PDD.
The DSM-IV-TR defines

5. Zero to Three Casebook Addition
 According to the 0-3 casebook there is a pdd listed for those 24 months and younger
called Multi-System developmental disorder. A child with MSDD does not totally lack
the ability to develop a social/emotional relationship with a primary caregiver but will
have impairment in developing this relationship. The child may:
1) avoid contact with caregivers, but will give slight cues that show attachment. These
children have difficulty forming, maintaining, and/or developing communication, including
preverbal gestures. For many toddlers with MSDD, language does not serve a communicative
intent. They may memorize parts of songs or dialogue but they do not use speech to
communicate.
2)A child with MSDD may have major difficulty processing
visual, auditory, tactile, proprioceptive (spatial awareness of one’s body), and vestibular
sensations. Most have poor motor planning—they lack the ability to sequence their
movements to create a desired outcome—and may appear very clumsy when learning a new
skill.
3) Infants and toddlers diagnosed with MSDD also show impairments in processing
sensations. For example, they may be extremely sensitive to touch (startling or even having a
tantrum when touched lightly), or they may show great pleasure in heavy pressure (being
sat on or wedging themselves in small spaces behind furniture).
4)Get an interactive brain map which provides information on brain development of young
children.

6. People who have Aspergers say its like being locked in a shell with
little ability to communicate with the outside world. Its hard to
stay involved with your world.
http://www.youtube.com/watch?v=OV_CcmLlaw4&feature=relate
d

7. Types of PDD
 Autistic Disorder central feature is the markedly abnormal or impaired development in
social interaction and communication and a restricted repertoire of activity and interest.
 Asperger's disorder-Severe or sustained impairment in social interaction and the
significant development of restrictive patterns of behavior, interest and activity. The
difference is that there was no clinically significant delays in Language or cognitive
development. No delays in the development of age-appropriate self-help skills, adaptive
behavior and curiosity about the environment.
 Rett's Syndrome is the development of multiple specific deficits following a period of
normal functioning after birth. A loss of previously acquired purposeful hand skills
before the development of a characteristic resembling hand wringing or hand washing.
The interest in the social environment diminishes in the first several years after the onset
of the disorder. Significant impairment in expressive and receptive language
development with severe psychomotor retardation.
 Childhood Disintegrative Disorder is a marked regression in multiple areas of
functioning following two years of apparently normal behavior development. A clinically
significant loss in at least two areas ; expressive or receptive language; social skills or
adaptive behavior; bowel or bladder control; or play and motor skills. They also display
characteristics of Autistic disorder.
 PDD- NOS is used when the criteria has not been met in the descriptors above because of
a typical symptomatology.

8. What impediments are there
during childhood
Difficulty with Sometimes children These children have a
understanding verbal have odd behaviors low frustration
and non-verbal social which aren’t readily tolerance and may
interactions accepted by peers strike others
Motor skills may not
Could to be both a
be like their peers –
bully and a victim.
lack interest in play

9. To Improve Social Skill
Currently, some school uses the Step 2
Social skills training program for children with different levels of
social skill attainment[i.e.Asperger's Syndrome].
One common theme is accessing peer interactions to model the
things learned in training when using this Step 2 program.
Children without these impediments could benefit from increasing
their skills in handling interactions with others.
A recurrent theme in research is to increase social and conflict
resolution skills as a mechanism to decrease bullying behavior and
change the learning environment.
In one instance a psychologist developed a way for nuero-typical
kids helped those with Aspergers learn to interact with peers and
develop a freindships with others. Thereby decreases the level of
bullying by others.

10. Communication
2) verbal and nonverbal communication
 By age 3, most children have passed predictable milestones on the path to
learning language; one of the earliest is babbling. By the first birthday, a typical
toddler says words, turns when he hears his name, points when he wants a
toy, and when offered something distasteful, makes it clear that the answer is
“no.”
 Some children diagnosed with ASD remain mute throughout their lives. Some
infants who later show signs of ASD coo and babble during the first few
months of life, but they soon stop. Others may be delayed, developing
language as late as age 5 to 9. Some children may learn to use communication
systems such as pictures or sign language.
 Those who do speak often use language in unusual ways. They seem unable to
combine words into meaningful sentences. Some speak only single
words, while others repeat the same phrase over and over softly. Some ASD
children parrot what they hear, a condition called echolalia. Although many
children with no ASD go through a stage where they repeat what they hear, it
normally passes by the time they are 3.

11. Repetitive Behavior
 3) They will often have unusual responses to sensory experiences, such as
certain sounds or the way objects look. Each of these symptoms can range
from mild to severe. Although children with ASD usually appear physically
normal and have good muscle control, odd repetitive motions may set them off
from other children. These behaviors might be extreme and highly apparent or
more subtle. Some children and older individuals spend a lot of time
repeatedly flapping their arms or walking on their toes. Some suddenly freeze
in position.
 As children, they might spend hours lining up their cars and trains in a certain
way, rather than using them for pretend play. If someone accidentally moves
one of the toys, the child may be tremendously upset. ASD children need, and
demand, absolute consistency in their environment. A slight change in any
routine—in mealtimes, dressing, taking a bath, going to school at a certain
time and by the same route—can be extremely disturbing. Perhaps order and
sameness lend some stability in a world of confusion.
 Repetitive behavior sometimes takes the form of a persistent, intense
preoccupation. For example, the child might be obsessed with learning all
about vacuum cleaners, train schedules, or lighthouses. Often there is great
interest in numbers, symbols, or science topics.

12. There is no known cure for PDD. Medications are used to
address specific behavioral problems; therapy for children
with PDD should be specialized according to need. Some
children with PDD benefit from specialized classrooms in
which the class size is small and instruction is given on a
one-to-one basis. Others function well in standard special
education classes or regular classes with additional
support.

13. Some children need therapy for
depression symptoms
 Use medication to assist with depression symptoms.
 Seek therapy where CBT can be used to restructure
thought patterns. Learn to see how thoughts impact
experiences. Provide direction as to how to deal with
the depression and changes that could improve
symptoms and dealing with change.

14. Some of the treatment programs
 Applied Behavior Analysis (ABA)
 ABA is a broad set of principles and guidelines that is often used as a framework for treating
autism. ABA is a one-on-one, intensive, structured teaching program based on the ideas of behavior
modification and involving reinforced practice of different skills. You may also hear it called Discrete
Trial Therapy (or DTT). Other terms associated with ABA are: functional communication
training, incidental teaching, script/script fading, self-management, shaping, behavior
chaining, errorless learning, functional assessment, reinforcement systems and activity schedules.
Each word in the name “Applied Behavior Analysis” is important:
 “Applied” means that you are trying cause positive change in socially significant behaviors.
 “Behavior” changes over time are observed and measured.
 “Analysis” refers to the way the evidence is collected and evaluated to show how an intervention
caused a behavior change.
 Lovaas Therapy
 The Lovaas Model of Applied Behavior Analysis is a specific ABA treatment method developed by Ivar
Lovaas. For more information, visit his website.
 Developmental, Individual-Difference, Relationship-Based (DIR) Therapy : DIR—also called Floor
time or the Greenspan Method—is based more on relationships than behavior modification. The
Interdisciplinary Council on Developmental and Learning Disorders (founded by Stanley Greenspan)
has information about the DIR/Floor time model. You can also visit The Floortime Foundation to
learn more.
 Augmentative and Alternative Communication (AAC)-This augmentative communication glossary
will help you learn the terms. AAC can use strategies like the Picture Exchange Communication
System (PECS) and sign language.

15. Unconventional therapies
 Auditory Integration therapy
 After 35+ years of clinical practice and study, Dr. Berard determined that, in many cases, distortions in
hearing or auditory processing contribute to behavioral or learning disorders. In the large majority of
Dr. Berard's cases, AIT significantly reduced some or many of the handicaps associated with autism
spectrum disorders, central auditory processing disorders (CAPD),
 speech and language disorders, sensory issues including auditory, tactile or other sensory sensitivities
(hyper or hypo), dyslexia, pervasive developmental disorder (PDD), attention deficit disorder with or
without hyperactivity, anxiety, and depression.
 Berard Auditory Integration Training was designed to normalize hearing and the ways in which the
brain processes auditory information. For example, an individual tests as hypersensitive to the
frequencies of 1,000 and 8,000 Hertz while perception of all other frequencies falls within the normal
range. The individual becomes over stimulated, disoriented or agitated in the presence of sounds at
1,000 and 8,000 Hertz. Therefore, Berard AIT works to normalize the hearing response across all
frequencies within the normal hearing range.
 In another example, an individual's hearing is asymmetrical (significantly different between the two
ears). When the right and left ears perceive sounds in an extremely different way, problems with
sound discrimination can occur. Again, Berard AIT works to normalize the hearing of both ears.

16. Unconventional Therapies Cont.
 Sensory integration therapy best if referred to Occupational therapy
 the child must be able to successfully meet the challenges that are presented through playful activities (Just Right
Challenge);
 the child adapts her behavior with new and useful strategies in response to the challenges presented (Adaptive
Response);
 the child will want to participate because the activities are fun (Active Engagement); and
 the child's preferences are used to initiate therapeutic experiences within the session (Child Directed).
 Suggestions for activities:
 swinging in a hammock (movement through space);
 dancing to music (sound);
 playing in boxes filled with beans (touch);
 crawling through tunnels (touch and movement through space);
 hitting swinging balls (eye-hand coordination);
 spinning on a chair (balance and vision); and
 balancing on a beam (balance

 Pasted from <http://autism.healingthresholds.com/therapy/sensory-integration

17. Observations or questions used to
identify traits
1. Poor eye contact, or staring from unusual angle
2. Ignores when called, pervasive ignoring, not turning head to voice
3. Excessive fear of noises (vacuum cleaner); covers ears frequently
4. In his/her own world (aloof)
5. Lack of curiosity about the environment
6. Facial expressions don't fit situations
7. Inappropriate crying or laughing
8. Temper tantrums, overreacting when not getting his/her way
9. Ignores pain (bumps head accidentally without reacting)
10. Doesn't like to be touched or held (body, head)
11. Hates crowds, difficulties in restaurants and supermarkets
12. Inappropriately anxious, scared
13. Inappropriate emotional response (not reaching to be picked up)
14. Abnormal joy expression when seeing parents
15. Lack of ability to imitate

18. Questions or Observations to
identify SOCIAL INTERACTION
DIFFICULTIES
1. Loss of acquired speech
2. Produces unusual noises or infantile squeals
3. Voice louder than required
4. Frequent gibberish or jargon
5. Difficulty understanding basic things ("just can't get it")
6. Pulls parents around when wants something
7. Difficulty expressing needs or desires, using gestures
8. No spontaneous initiation of speech and communication
9. Repeats heard words, parts of words or TV commercials
10. Repetitive language (same word or phrase over and over)
11. Can't sustain conversation
12. Monotonous speech, wrong pausing
13. Speaks same to kids, adults, objects (can't differentiated
14. Uses language inappropriately (wrong words or phrases

19. ABNORMAL SYMBOLIC OR
IMAGINARY PLAY / use as questions or observations
1. Hand or finer flapping; self stimulation
2. Head banging
3. Self mutilation, inflicting pain or injury
4. Toe walking, clumsy body posture
5. Arranging toys in rows
6. Smelling, banging, licking or other inappropriate use of toys
7. Interest in toy parts, such as car wheels
8. Obsessed with objects or topics (trains, weather, numbers, dates)
9. Spinning objects, self, or fascination with spinning objects
10. Restricted interest, (watching the same video over and over
11. Difficulty stopping repetitive "boring" activity or conversation
12. Attachment to unusual objects, (sticks, stones, strings, or hair)
13. Stubborn about rituals and routines; resists to change
14. Restricted taste by consistency, shape or form (refuses solids)
15. Savant ability, restricted skill superior to age group (reads early, memorizes books)

20. Individuals who have Aspergers
and Employment
 Employment should take advantage of the individual's strengths and abilities.
Temple Grandin, Ph.D., suggests, "jobs should have a well-defined goal or
endpoint," and that your "boss must recognize your social limitations." In A
Parent's Guide to Asperger Syndrome and High-Functioning Autism, the
authors describe three employment possibilities: competitive, supported, and
secure or sheltered.
 Competitive employment is the most independent, with no support offered in
the work environment. Individuals with Asperger’s Syndrome may be
successful in careers that require focus on details but have limited social
interaction with colleagues such as computer sciences, research or library
sciences. In supported employment, a system of supports allows individuals to
have paid employment in the community, sometimes as part of a mobile
crew, other times individually in a job developed for the person. In secure or
sheltered employment, an individual is guaranteed a job in a facility-based
setting. Individuals in secure settings generally also receive work skills and
behavior training, while sheltered employment may not provide training that
would allow for more independence. There is a 70% unemployment rate for
individuals 20 yrs old or older.

21. Concerns with vocational concerns
 One way to engage the client in therapy is to provide structure.
Individuals with Asperger‟s struggle with
planning, organizing, and prioritizing; external structure can
compensate for these weaknesses (Anderson & Morris, 2006). Be
clear about details concerning where to wait, where to sit, the
beginning and ending time of the session, etc. Set an agenda for
each session, including appropriate topics of discussion (Ramsay
et al., 2005). Be aware that the typical therapy hour may not be
appropriate for this population. Clients may need shorter
sessions because they are mentally exhausted due to the
combined stressors of social interaction and CBT therapy.
Conversely, clients may need longer sessions if they need extra
time to process information or are particularly difficult to
redirect from their restricted and repetitive interests (Anderson
& Morris, 2006). In order to develop workable treatment goals
that are relevant

22. Vocational Issues
Interview transcripts revealed four major themes identified by
people with Asperger’s concerning why they have difficulty
becoming successfully employed. The four themes are: 1) mastering
the job application process, 2) adapting to new job routines, 3)
communication, and 4) navigating social interactions with
employers and coworkers.
The job coach should be able to help the client break down larger
tasks into smaller, more manageable parts, and to help the client
develop strategies to prioritize which tasks should be completed
first, act as a social “translator” between the client , must be able to
explicitly decode coworkers and supervisors‟ body language, voice
tone, and facial expressions for the individual with Asperger‟s .
http://youtu.be/XP3zE1P2-a0- is a video about teaching vocational
skills

23. Researchers can be found
 The NINDS conducts and supports research on
developmental disabilities, including PDD. Much of
this research focuses on understanding the
neurological basis of PDD and on developing
techniques to diagnose, treat, prevent, and ultimately
cure this and similar disorders.
 NIH Patient Recruitment for Pervasive Developmental
Disorders Clinical Trials
 At NIH Clinical Center
 There is an Autism research Institute

24. Websites
 info@horizonsdrc.com Horizons Developmental Remediation Center. Horizons
Developmental Remediation Center has a reputation locally, nationally, and
abroad for providing exceptional quality assessment and treatment to
children, adolescents, and adults with autism, Asperger’s Syndrome, PDD-
NOS, ADHD, and other neurodevelopmental disorders. Through the use of a
comprehensive developmental and family-based approach, we develop
individualized treatment plans to meet the needs of your child and family.
 www.grasp.org- This organization was started by a man who was diagnosed after his son
was diagnosed. He has a lot of pertinent information
 .Parenting Aspergers,
Information Online LLC,
PO Box 789,
Portsmouth,
PO19DY,
UK.
Phone:
0845 519 3412
For the quickest response use our support desk
http://parentingaspergers.zendesk.com/anonymous_requests/new
 www.fraser.org Provides information and services for individuals with PDD and Autism
Spectrum Disorders.

25. Resources
 National Dissemination Center for Children with Disabilities
 U.S. Dept. of Education, Office of Special Education Programs
 1825 Connecticut Avenue NW, Suite 700
 Washington, DC 20009
 nichcy@aed.org
 http://www.nichcy.org
 Tel: 800-695-0285 202-884-8200
 Fax: 202-884-8441 National Institute of Mental Health (NIMH)
 National Institutes of Health, DHHS
 6001 Executive Blvd. Rm. 8184, MSC 9663
 Bethesda, MD 20892-9663
 nimhinfo@nih.gov
 http://www.nimh.nih.gov
 Tel: 301-443-4513/866-415-8051 301-443-8431 (TTY)
 Fax: 301-443-4279
 National Institute on Deafness and Other Communication Disorders Information Clearinghouse
 1 Communication Avenue
 Bethesda, MD 20892-3456
 nidcdinfo@nidcd.nih.gov
 http://www.nidcd.nih.gov
 Tel: 800-241-1044 800-241-1055 (TTD/TTY) National Institute of Child Health and Human Information Resource Center
 P.O. Box 3006
 Rockville, MD 20847
 NICHDInformationResourceCenter@mail.nih.gov
 Tel: 800-370-2943 888-320-6942 (TTY)

26. Resources Cont.
 National Organization for Rare Disorders (NORD)
 P.O. Box 1968
 (55 Kenosia Avenue)
 Danbury, CT 06813-1968
 orphan@rarediseases.org
 http://www.rarediseases.org
 Tel: 203-744-0100 Voice Mail 800-999-NORD (6673)
 Fax: 203-798-2291 American Speech-Language-Hearing Association
(ASHA)
 2200 Research Boulevard
 Rockville, MD 20850
 actioncenter@asha.org
 https://asha.org
 Tel: 800-638-8255
 Fax: 301-571-0457

27. Resources Cont.
 MAAP Services for Autism, Asperger Syndrome, and PDD
 P.O. Box 524
 Crown Point, IN 46307
 info@maapservices.org
 http://www.maapservices.org
 Tel: 219-662-1311
 Fax: 219-662-0638 Autism Network International (ANI)
 P.O. Box 35448
 Syracuse, NY 13235-5448
 jisincla@syr.edu
 http://www.ani.ac
 Autism Research Institute (ARI)
 4182 Adams Avenue
 San Diego, CA 92116
 director@autism.com
 http://www.autismresearchinstitute.com
 Tel: 866-366-3361
 Fax: 619-563-6840 Autism National Committee (AUTCOM)
 P.O. Box 429
 Forest Knolls, CA 94933
 http://www.autcom.org

28. References
 DSM-IV-TR

29. References
 Zero- Three Casebook(1997) Lieberman, Wieder, Fenichel
 www.zerotothree.org/baby-brain-map.html
 www.childrain.org The PDD Assessment Scale/
Screening Questionnaire
www.autism.com/ari - ATEC form screening tool
 Minnesota Association for Children’s Mental Health •
MACMH 800-528-4511 • 651-644-7333 • www.macmh.org
 National Institute of /neurological disorders and Stroke
http://www.ninds.nih.gov/
 http://www.autism-society.org/