LEARNING AND COGNITION IN AUTISM

LEARNING AND COGNITION IN AUTISM

CURRENT ISSUES IN AUTISM Series Editors: Eric Schopler and Gary B. Mesibov University of North Carolina School of Medicine Chapel Hill, North Carolina AUTISM IN ADOLESCENTS AND ADULTS BEHAVIORAL ISSUES IN AUTISM COMMUNICATION PROBLEMS IN AUTISM DIAGNOSIS AND ASSESSMENT IN AUTISM THE EFFECTS OF AUTISM ON THE FAMILY HIGH-FUNCTIONING INDIVIDUALS WITH AUTISM LEARNING AND COGNITION IN AUTISM NEUROBIOLOGICAL ISSUES IN AUTISM PRESCHOOL ISSUES IN AUTISM Edited By Eric Schopler, Mary E. Van Bourgondien, and Marie M. Bristol SOCIAL BEHAVIOR IN AUTISM

LEARNING AND COGNITION IN AUTISM Edited by Eric Schopler and Gary B. Mesibov University of North Carolina School of Medicine Chapel Hill, North Carolina Springer Science+Business Media, LLC

Library of Congress Cataloging-in-Publication Data Learning and cognition 1n autism / edited by Eric Schopler and Gary B. Meslbov. p. cm. (Current Issues 1n autism) Includes bibliographical references and Index. ISBN 978-1-4899-1288-6 1. Autism In children. 2. Cognition disorders 1n children. 3. Learning disabilities. 4. Autistic children Education. 1. Schopler, Eric. II.-Meslbov, Gary B. III. Series. [DNLM: 1. Autism 1n Infancy & childhood congresses. 2. Cognition 1n infancy & childhood congresses. 3. Learning Disorders in infancy & childhood congresses. 4. Education, Special congresses. WM 203.5 L438 19951 RJ506.A9L43 1995 618.92'8982 dc20 DNLM/DLC for Library of Congress 94-44014 CIP ISBN 978-1-4899-1288-6 DOI 10.1007/978-1-4899-1286-2 ISBN 978-1-4899-1286-2 (ebook) 1995 Springer Science+Business Media New York Originally Published by Plenum Press, New York in 1995 Softcover reprint of the hardcover 1st edition 1995 109876543 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher

To our teachers, whose understanding of our students enables both to learn from each other

Contributors MARK H. ALLEN, Neuropsychology Research Laboratory, Children's Hospital Research Center, San Diego, California 92123 ANDREW S. BONDY, Delaware Autistic Program, 144 Brennen Drive, Newark, Delaware 19713 GRETCHEN BUTERA, Department of Special Education, West Virginia University, Morgantown, West Virginia 26506-6122 LISA CAPPS, Department of Psychology, University of California at Los Angeles, Los Angeles, California 90024 ROGER COX, Greensboro TEACCH Center, Greensboro, North Carolina 27401 GERALDINE DAWSON, Department of Psychology, University of Washington, Seattle, Washington 98195 DEBORAH FEIN, Department of Psychology, University of Connecticut, Storrs, Connecticut 06268; and Laboratory of Neuropsychology, Boston University School of Medicine, Boston, Massachusetts 02118 UTA FRITH, Cognitive Development Unit, Medical Research Council, London WC1H OBT, United Kingdom LORI A. FROST, Pyramid Educational Consultants, 5 Westbury Drive, Cherry Hill, New Jersey 08003 vii

viii CONTRIBUTORS TEMPLE GRANDIN, Department of Animal Science, Colorado State University, Fort Collins, Colorado 80523 LEE ANNE GREEN, Department of Psychology, University of Connecticut, Storrs, Connecticut 06268 FRANCESCA HAPPE, Cognitive Development Unit, Medical Research Council, London WC1H OBT, United Kingdom. SANDRA HARRIS, Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey 08855-0819 CARL HAYWOOD, Peabody College, Vanderbilt University, Nashville, Tennessee 37203 KA THY HEARSEY, Division TEACCH, Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7180 STEPHEN JOY, Department of Psychology, University of Connecticut, Storrs, Connecticut 06268; and Albertus Magnus College, New Haven, Connecticut 06511 ANGELA KILMAN, Neuropsychology Research Laboratory, Children's Hospital Research Center, and California School of Professional Psychology, San Diego, California 92123 LAURA G. KLINGER, Department of Psychology, University of Alabama, Tuscaloosa, Alabama 35847 LYNN KERN KOEGEL, Autism Research Center, Counseling/Clinical! School Psychology Program, Graduate School of Education, University of California at Santa Barbara, Santa Barbara, California 93106 ROBERT 1. KOEGEL, Autism Research Center, Counseling/Clinical! School Psychology Program, Graduate School of Education, University of California at Santa Barbara, Santa Barbara, California 93106 ALAN LINCOLN, Neuropsychology Research Laboratory, Children's Hospital Research Center, and California School of Professional Psychology, San Diego, California 92123

CONTRIBUTORS ix CATHERINE LORD, Department of Psychiatry, University of Chicago Hospital, Chicago, Illinois 60637 GARY B. MESIBOV, Division TEACCH, Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7180 HELMER MYKLEBUST, Emeritus Professor of Psychology, Neurology, and Psychiatry, Northwestern University, Chicago, Illinois 60611 SALLY OZONOFF, Department of Psychology, University of Utah, Salt Lake City, Utah 84112 ERIC SCHOPLER, Division TEACCH, Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7180 MARIAN SIGMAN, Neuropsychiatric Institute and Hospital, University of California at Los Angeles, Los Angeles, California 90024-1759 LYNN WATERHOUSE, Trenton State College, Ewing Township, New Jersey 08625-0550 NURIT YIRMIY A, Department of Psychology, Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel 91905

Preface This volume, like the other eight in the Current Issues in Autism series, grew from our annual TEACCH conference. The book is not, however, simply a compilation of conference proceedings. Instead, selected conference participants whose work has already achieved national and international recognition were asked to develop chapters around their presentations. Other recognized experts in areas relevant to the conference theme were also asked to contribute chapters. Although we were not able to include all of the workers who have contributed to the theme, this volume represents our best effort to pull together for our readers the most current knowledge and state of the art practices. Although aspects of cognition, learning, and behavioral motivation have been touched on for relevance to autism in other books in this series, the growing integration of behavioral and cognitive theories has greatly enriched our educational interventions on behalf of autism. While this volume does not include all the fascinating facets of this recent integration, we believe that it offers useful information to teachers, parents, and researchers on some of the progress produced by their interaction. ERIC SCHOPLER GARY B. MEsmov xi

Acknowledgments As with the other volumes in our Autism Series, this book would not have seen the light of day without the help of many dedicated people. First, we are grateful to Helen Garrison, who organized the conference that gave us the mandate for this book. As the audiences continue to increase, her organizational skills have stayed right up with the new demands. Thanks also to Vickie Weaver, whose expert secretarial assistance and good cheer have been most valuable, and to Suzanne Orr, just beginning her work as Editorial Assistant, who has reviewed each chapter with a natural intuition for the nuts and bolts of good writing. Like all of our projects, these books would not be possible without our superb TEACCH colleagues, who are too numerous to name. Not only do they apply their clinical insights and know-how to the topic of cognition and learning, they also consistently use the new material provided by these chapters to enrich the families and students who are looking for the latest information. We especially appreciate the contributions of the families who struggle with the special problems of autism every day. Their energy in behalf of their children and their cooperation and participation in our program consistently inspire all our learning efforts. Finally, the School of Medicine at the University of North Carolina at Chapel Hill, and especially the Department of Psychiatry under the capable leadership of David Janowsky, have provided the eiwironment that cultivates and nurtures scholarly pursuits of this kind. We are also most grateful to the members of the North Carolina State Legislature, who have continued to support both services and scholarly research aimed at understanding and ameliorating the disadvantages of autism and related developmental disabilities. xiii

Contents Part I: Introduction and General Issues Chapter 1 INTRODUCTION TO LEARNING AND COGNITION IN AUTISM...... 3 Eric Schopler and Gary B. Mesibov Introduction................................................... 3 Cognitive and Social Deficits.................................... 4 Strengths in Cognition.......................................... 5 Intervention Strategies.......................................... 6 Overview of Chapters.......................................... 6 References................................................ 10 Chapter 2 COGNITIVE FUNCTIONING IN AUTISM: AN OVERViEW... 13 LeeAnne Green, Deborah Fein, Stephen Joy, and Lynn Waterhouse Introduction................................................... 13 General Intellectual Functioning: Strengths and Weaknesses........ 14 Early Cognitive Development................................... 16 xv

xvi CONTENTS Perception and Attention....................................... 16 Executive Function............................................ 18 Language..................................................... 19 Memory... 22 Social Cognition............................................... 22 Summary and Conclusions..................................... 25 References.................................................... 26 Chapter 3 VERBAL AND NONVERBAL COGNITIVE PROCESSES................ 33 Helmer K. Myklebust Introduction................................................... 33 Language Disorders............................................ 33 Language and Meaning........................................ 39 Nonverbal Learning Disabilities................................. 43 Brain Status and Cognitive Dysfunctions......................... 47 Conclusions................................................... 50 References.................................................... 50 Chapter 4 RELATIONSHIP BETWEEN AUTISM AND LEARNING DiSABILITIES... 57 Roger D. Cox and Gary B. Mesibov Introduction................................................... 57 Early Conceptualizations of Autism............................. 57 Adjustments in Autism Definition............................... 58 Early Conceptualizations of Learning Disabilities................. 61 Exclusion Principle............................................ 63 Similarities between Severe Learning Disabilities and Higher Functioning Autism.......................................... 64

CONTENTS xvii Differences between Learning Disabilities and Autism............. 66 Clinical Implications of Learning Disabilities versus Autism Diagnoses................................................... 67 References...,............................... 68 Part II: Thinking and Learning Chapter 5 MOTIVATING COMMUNICATION IN CHILDREN WITH AUTiSM... 73 Lynn Kern Koegel and Robert L. Koegel Introduction................................................... 73 Motivational Treatment......................................... 74 Motivation and Social-Communicative Interactions in School....... 82 Summary and Conclusions...................................... 84 References..................................................... 85 Chapter 6 THE ASSESSMENT AND INTERPRETATION OF INTELLECTUAL ABILITIES IN PEOPLE WITH AUTISM... '" 89 Alan J. Lincoln, Mark H. Allen, and Angela Kilman Introduction................................................... 89 Assessment of Intelligence: The Wechsler Scales................... 91 Assessment of Autistic Individuals with the Wechsler Scales....... 92 Sequential and Simultaneous-Processing Abilities...,.... 99 Memory Functioning... 107 Practical Considerations for the Assessment of Intellectual and Cognitive Abilities... 110 Conclusions... 112 References... 114

xviii CONTENTS Chapter 7 A FRESH LOOK AT CATEGORIZATION ABILITIES IN PERSONS WITH AUTISM..., 119 Laura G. Klinger and Geraldine Dawson Introduction...,... 119 Categorization in Normal Development... '.'........... 122 Categorization in Autism....................................... 124 Processes Underlying Categorization in Autism... 128 A Fresh Look at Categorization Abilities in Autism............... 132 Conclusions................................................... 133 References... 134 Chapter 8 HOW PEOPLE WITH AUTISM THINK............................ 137 Temple Grandin Introduction................................................... 137 Autism Subtypes.............................................. 138 Visual Thinking...,... 141 Implications of Visual Thinking... 144 Emotions and Empathy... 148 Sensory Problems and Attention...,...,. 150 Summary..................................................... 153 References... 154 Part III: Social Cognition Chapter 9 SOCIAL AND COGNITIVE UNDERSTANDING IN HIGH-FUNCTIONING CHILDREN WITH AUTISM................. 159 Marian D. Sigman, Nurit Yirmiya, and Lisa Capps

CONTENTS xix Introduction... 159 Sample Description... 162 Social Understanding... 163 Cognitive Abilities... 170 General Discussion... 172 References... 174 Chapter 10 THEORY OF MIND IN AUTISM... 177 Francesca Happe and Uta Frith Introduction... "...,... 177 Addressing Causes at Different Levels... ". 178 The Puzzle ofthe Triad... 179 The Theory-of-Mind Hypothesis... 179 Testing the Hypothesis... "... 181 Further Experimental Evidence... 183 Arguments and Artifacts... 183 Fine-Cuts Technique... 187 Puzzles That Remain... 189 Practical Implications of the Mind-Blindness Theory... 192 References... 194 Chapter 11 EXECUTIVE FUNCTIONS IN AUTISM... 199 Sally Ozonoff Introduction... 199 Identifying Primary Deficits of Autism... 200 Executive Functions and Autism... ~... 200 Toward a Unifying Model of Autism: Prefrontal Dysfunction?... 205 Implications for Treatment and Educational Remediation... 214 Summary... 214 References... 215

xx CONTENTS Chapter 12 FACILITATING SOCIAL INCLUSION: EXAMPLES FROM PEER INTERVENTION PROGRAMS..................................... 221 Catherine Lord Introduction................................................... 221 Principles Underlying Peer Intervention.......................... 222 Peer Tutor I Buddies Program................................... 226 Integrated Social Groups/Daycamps... 232 Conclusions................................................... 238 References.................................................... 239 Part IV: Education and Treatment Chapter 13 STRUCTURED TEACHING IN THE TEACCH SySTEM.. ;... 243 Eric Schopler, Gary B. Mesibov, and Kathy Hearsey Introduction................................................... 243 Autism Characteristics... 244 Guiding TEACCH Principles... " 245 The Four Major Components of Structured Teaching.............. 246 Other Structured Teaching Concepts. "... 263 Summary and Conclusions..................................... 266 References.................................................... 267 Chapter 14 COGNITIVE EDUCATION OF YOUNG CHILDREN WITH AUTISM: AN APPLICATION OF BRIGHT START............................. 269 Gretchen Butera and H. Carl Haywood Introduction................................................... 269 Characteristics of Children with Autism... 270

CONTENTS xxi Bright Start... 275 Application of Bright Start to Children with Autism... 283 Summary... 287 References... 289 Chapter 15 EDUCATIONAL STRATEGIES IN AUTiSM... 293 Sandra 1. Harris Introduction... 293 The Context for Instruction... 294 Enhancing Social and Interpersonal Functioning... 295 Developing Speech and Language... 299 Managing Disruptive Behavior... 302 Summary... 304 References... 305 Chapter 16 EDUCATIONAL APPROACHES IN PRESCHOOL: BEHAVIOR TECHNIQUES IN A PUBLIC SCHOOL SETTING... 311 Andrew S. Bondy and Lori A. Frost Introduction... 311 The Delaware Autistic Program... 311 Behavior Management... 320 Communication Training... 321 Approaches to Integration... 326 Parent Involvement... 327 Outcome Measures... 327 Conclusions... 330 References... 331 INDEX... 335