Autism Spectrum Disorder Pre Cengage Learning. All rights reserved.

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1 Autism Spectrum Disorder Pre Cengage Learning. All rights reserved.

2 DSM- 5 In 2013, the American Psychiatric Association released the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 is now the standard reference that healthcare providers use to diagnose mental and behavioral conditions, including autism. By special permission of the American Psychiatric Association, you can read the full-text of the new diagnostic criteria for autism spectrum disorder and the related diagnosis of social communication disorder below. A. Persistent deficits in social communication and social interaction across multiple contexts 1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions. 2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication. 3. Deficits in developing, maintaining, and understanding relationships.

3 B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text): 1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases). 2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day). 3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interest). 4. Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

4 C. Symptoms must be present in the early developmental period. D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning. E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently cooccur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

5 Federal Definition A developmental disability significantly affecting verbal and non-verbal communication and social interaction, usually evident before age 3, that adversely affects a child s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movement, resistance to environmental change or change in daily routines, and unusual sensory experiences. Source: Cengage Learning. All rights reserved.

6 Federal Definition A developmental disability significantly affecting verbal and non-verbal communication and social interaction, that adversely affects a child s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movement, resistance to change and unusual sensory experiences. Source: Cengage Learning. All rights reserved.

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8 Remember Communication Social Interaction Behavior

9 not point at objects to show interest not look at objects when another person points at them have trouble relating to others or not have an interest in other people at all avoid eye contact and want to be alone have trouble understanding other people s feelings or talking about their own feelings prefer not to be held or cuddled, or might cuddle only when they want to

10 be very interested in people, but not know how to talk, play, or relate to them repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language have trouble expressing their needs using typical words or motions not play pretend games (for example, not pretend to feed a doll) repeat actions over and over again

11 have trouble adapting when a routine changes have unusual reactions to the way things smell, taste, look, feel, or sound lose skills they once had (for example, stop saying words they were using) appear to be unaware when people talk to them, but respond to other sounds CDC.gov

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13 What Do You See?

14 Clearly Define Behavior Disruptive Aggressive Disrespectful Distractible Making inappropriate commons in class Hitting other students with his fists Cursing at the teacher Not completing tasks on time

15 The Functions of Behavior S ensory E scape A ttention T angible

16 Outcome of the FBA Process 1. A clear description of the problem behaviors, 2. Direct observation data, 3. Events and times that predict when behaviors will and will not occur, 4. Consequnces that maintain the problem behavior, 5. Behavior Summary Sheet

17 Some common ones are that support regulation across the day: Visual schedules Social stories Check off lists Activity or task schedules Routine sensory diet activities