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Autism Spectrum Disorders

Symptoms and Theories

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Neurodevelopmental condition with genetic origins
Characterised by abnormalities in:
o Social interaction and communication impairments
o Repetitive and restricted interests and behaviour
Biological basis in the brain and begins early in life (developed by at least age 1)
Developmental so have it for the rest of their lives

The Spectrum
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Severe (low functioning)- intellectual impairment
o Echolalia; repeats back words of other people
o Stimming (flapping); self-stimulation- serves to calm people down
o Need routine and for things to stay the same
Ø 30% minimally verbal in school and sig portion continue into
adulthood
High functioning (Aspergers)
o Most likely to be seen in schools
o Strange language
o Socially inappropriate and awkward
o Lack of emotional understanding
o Fixated interests
o Insisting on routine

Pathological Demand Avoidance (PDA)- relevant to educational settings
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Individuals that are high-functioning but have core difficulties in social
understanding and communication skills
o Children diagnosed with PDA due to anxiety over above explosively emerges
Pattern of behaviour in response to ASD difficulties
o Can have PDA as well as Autism
Ø Based on how anxiety from ASD emerges (disruptive)
o Act against demands and have mood swings


High Functioning Autism
• No appreciation for listener; won’t let them talk
• Domineering in games and may struggle in imaginative play
• Lack facial expressions and vocal tone
• Anxious and need routine


Genetic Origins
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Concordance rates in MZ twins up to 95% (siblings/DZ lower but at much higher risk)
o Geschwind, 2011
Not 100% concordance so some dispositional and environmental role



Sociocognitive Models of Autism

Theory of Mind Hypothesis
• Ability to understand that you have different mind to mind
o Understand others mental states and emotions
• Tested by the Sally-Anne task (Baren-Cohen, 1985)
• Abilities that rely on ToM
o Committing social faux pas (Happe, 1994)
o Recognising facial expressions (Baren-Cohen, 2001)
o Struggle with joint attention (following gaze)
• Suggest that other symptoms of ASC (language and social difficulties) arise from ToM
o Autistic people are ‘mindblind’- blind to mental states of other people

Weak Central Coherence Theory
• The ability to process globally and meaningfully
o Ability to look pass details and see the whole picture
o Common in autistic people to not see the whole picture
• Measured using visuo-spatial paradigms (see small letters not big)
• Cognitive style of autistic people explains performance in tests
• Explains other elements of ASD
o Routine- upset if something is changed
o Language difficulties- can’t understand irony/sarcasm
Ø Not able to process wider context; process literal words (Kaland 2002)
o Social problems- stuck on one thing someone said so cant process whole
sentence

Executive Dysfunction Account
• The higher order things we do in our brain e
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planning, reasoning and complex
demands
• People with ASD resemble patients with ‘dysexecutive syndrome’ (Baddeley, 1988)
o Frontal lobe damage
o Difficulties planning, set-shifting and inhibition
• Cognitive style characterised by perseveration- can’t switch from one task to another
EF deficits and ASD symptoms:
o Impaired generativity= impaired ability to generate new plan when routine
abandoned (Turner, 1999)
o Impaired mental flexibility and inhibition= problems understanding nonliteral language (Mashal, 2011)
• EF deficits explain failure in ToM tasks
o Inability to disengage from what you know is in the box (perseverating) so
can’t switch to the other perspective
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Ø Do understand other point of view but can’t inhibit own (Ozonoff,
1991)





• These models identify particular symptoms and suggest these might be causal of
other ASD symptoms
o Causal model; one of these things causes autism and gives rise to all other
symptoms
• ToM, weak central coherence and EDF are not specific to autism and seen in many
conditions
• Baren-Cohen (2009) Empathising-systemizing theory; ratio of more males explained
o Lots of differences in the brain, particularly connectivity
• ASC is neurologically based
o Models explain the social and cognitive differences in autism which is
relevant to how they function in school

Autism Inclusion

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ASC is heterogeneous so children with it have common and unique needs
o Some have intellectual, anxiety or behavioural difficulties
Integration= ASD in mainstream with no additional support
o Inclusion- education adapt itself to childs needs (Batten, 2005)
32,500 children educated in mainstream education
o But often excluded because of inappropriate behaviour (Bernard, 2005)
More likely to be bullied than other SEN (Humphreys, 2008)
Greater risk of developing psychiatric problems (Evans, 2005)


Language and Comms difficulties
• Can’t pick up eye contact, gestures, tonal changes, facial expressions and metaphors
• Jordan (2005); ‘can you do’ requires action but they just give simple yes answer
o Teachers use questions as way of issuing instructions or encouraging
participation
o ASD misinterpret instructions and become anxious and agitated and may
react negatively
• How can school help?
o Staff training in autism awareness, communication and strategies to deal
with escalation
o Student training in particular situations and strategies to communicate upset
and confusion

Social Difficulties
• Social learning for autism is like learning a different language in adulthood (Jordan,
1995)
• May be rude or socially inappropriate and upset/frighten other children
unintentionally
• Difficulty with reciprocity- may not identify signals about sharing

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May dominate games
Trouble distinguishing between good natured teasing and malice (Heerey, 2005)


Friendships
• Double deprivation; have poor social skills and denied into context of peer
relationships which is where they might develop them
• Do want friends and feel lonely (Bauminger, 2000)
• Experience less acceptance and companionship (Chamberlain, 2011)

Bullying
• Due to issues with ToM, may not report bullying as don’t understand that teacher
doesn’t know it’s going on (Moore, 2007)
o Have difficulty reporting bullying so go under the radar
• Less socially impaired students report more bullying (Rowley, 2012)
o More aware or more willingness to approach making them vulnerable
• Biggest predictor of bullying is social vulnerability and being gullible (Sofronoff,
2010)
• Humphreys (2010); ASD in mainstream should be given adult confidante with
experience and expertise in ASC

Helping social inclusion in schools
• Sanosti (2010)- can intervene on many levels within a school
o Whole school, classes, small groups and individual child
• Teaching character education; curriculum that promotes:
o Prosocial behaviour
o Conflict resolution
o Tolerance
o Understanding and promotes differences
o Create a sense of community
• Integrated play groups
o Small group of children with ASD child and train peers to interact with them
Ø Sharing, getting attention and giving compliments to engage ASD
• Collaborative working relationships- help ASD and normal
• Circles of friends
o Identify vulnerable children to engage with peer group to establish small
friendship group for that child
o Evoking and educating empathy and help them understand the difficulties
faces by the vulnerable child
Ø Children and teacher come up with ways to include child to celebrate
their strengths and alleviate their weaknesses
• Structuring their play


Ø Improve social skills in children (Kalyva, 2005)
Ø Increase social acceptance by peers (Turner, 2003)


Benefits for peers in group interventions and social skills
• Peers involved enjoy it (Jones, 2007)

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Success of inclusion is dependent on peer group so important to involve (Symes,
2010)
Children are generally altruistic and enjoy helping others


Helping ASD with social skills
• Using social stories; describe typical scenarios- how people feel and react (Howley,
2005)
• Intervention should be structured and predictable and incorporate home and school
to be able to generalise learning (Humphrey, 2008)


Sensory problems
• Classroom noise is distracting for ASD (Shea, 1996)
o Busy class is stressful and can’t block it out which affects concentration
• More problems with auditory filtering and hyper-sensitivity means they:
o Withdraw (Zingerevich, 2009)
o Poorly perform academically (Ashburner, 2009)

Attentional problems
• ASC often overlap with ADHD symptoms
o Can be treated the same way as sensory issues
Ø Pick quiet, well behaved classes for ASC with resource rooms and
libraries for students that struggle with noise (Humphrey, 2008)

Emotional and behavioural problems
• Psychiatric comorbidities (Gadow, 2005)
o Hyperactivity, anxiety and low self-esteem (Macintosh, 2006)
• Rapid mood changes, emotional outbursts (Ashburner, 2010)
o Getting in trouble will lower self-esteem more
• More common in high functioning end of the spectrum
o Know you are different so lots of anxiety and low SE
• Teachers need autism specific training- training in how to de-escalate things
o Take them out of situation to calm down
o Recognise when children getting wound up

Harnessing Strengths and ASD Thinking Styles
• Complex and abstract subjects such as science and maths made more accessible for
ASD by bringing them to a concrete level- using models and objects etc
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