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Learning Disorders

Management ModuleAutism


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Autism Spectrum Disorder

Childhood

DisintegrationDisorder

Kanner(Classical Autism)

RettSyndrome

PervasiveDevelopmentDisorder-Not

Otherwise

Defined Syndrome(PDD-NOS)

Triads of impairmentDimensions

Asperger(Mild Form Autism)

Modified by:

1. Cognitive Abilities2. Severity3. Personality

Impairment ofsocial interaction

Impairment ofsocial language

andcommunications

Impairment offlexibility of

thought

Impairment ofsensory

processing andmotor skills

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(a) Wimmer and Perner (1983) Paradigm Sally-AnneDoll test.

(b) mental-physical distinction tests (Baron-Cohen,

1989a). That is, they do not show a clearunderstanding of how physical objects differ fromthoughts about objects. For example, when askedwhich can be touched: a biscuit, or a thought(about a biscuit), young normal 3 year olds rapidlyidentify the former, whereas most children with autismrespond at chance levels.

(c) appearance-reality distinction test(Baron-Cohen, 1989a), meaning that, in theirdescription of misleading objects (like a red candle in

the shape of an apple), they do not distinguish betweenwhat the object looks like, and what they know itreally is. For example, the normal 4 year old child willsay of an ambiguous object, when asked what it lookslike, and what it really is, that It looks like an apple,but really its a candle made of wax (Flavell, Flavell, andGreen, 1983). In contrast, children with autism tend torefer to just one aspect of the object (e.g., sayingIt looks like an apple, and it really is an apple).

Theories& Assessment

PsychologicalTheories

BiologicalTheories

(a) Theory of mind is the

ability to attribute mental

statesbeliefs, intents,

desires, pretending,knowledge, etc.to

oneself and others

1. Mind blindness

Assessment Assessment

(a) Marcel Just et. al (2004) Thatautism is a system-wide braindisorder that limits thecoordination and integration

among brain areas.

1. Underconnectivity theory

(a) Functional magneticresonance imaging (fMRI)scans.
http://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Pretendhttp://en.wikipedia.org/wiki/Pretendhttp://en.wikipedia.org/wiki/Intenthttp://en.wikipedia.org/wiki/Intenthttp://en.wikipedia.org/wiki/Beliefhttp://en.wikipedia.org/wiki/Beliefhttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_state


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BiologicalTheories





oneself and others

1. Mind blindness

Assessment Assessment

(d) "seeing leads to knowing" test (Baron-Cohen and Goodhart, 1994; Leslie and Frith,1988). For example, when presented with twodolls, one of whom touches a box, and the

other of whom looks inside the box, andwhen asked "Which one knows what's insidethe box?", they are at chance in theirresponse. In contrast, normal children of 3-4years of age correctly judge that it is the onewho looked, who knows what's in the box.

(e) mental state words (like "think", "know",and "imagine") in a wordlist that contains bothmental state and non-mental state words,most children with autism are at chance

(Baron-Cohen, Ring, Moriarty, Shmitz, Costa,and Ell, 1994). In contrast, they have nodifficulty in picking out words describingphysical states.

2. Genetic

(b) Sebat J, Lakshmi B, et

al, (2007) that mutations

are more prevalent

among children with

autism

(b) Genetic (DNA) testing

Theory of MIndMechanism
http://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Pretendhttp://en.wikipedia.org/wiki/Pretendhttp://en.wikipedia.org/wiki/Intenthttp://en.wikipedia.org/wiki/Intenthttp://en.wikipedia.org/wiki/Beliefhttp://en.wikipedia.org/wiki/Beliefhttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_state


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oneself and others

1. Mind blindness

Assessment

(f) Unable to interpret the eye-region ofthe face as indicating when a person isthinking and what a person might want(Baron-Cohen and Cross, 1992; Baron-

Cohen, Campbell, Karmiloff-Smith,Grant, and Walker, 1995). Children andadults without autism use gaze to inferboth of these mental states.

(g) failure to make the accidental-intentional distinction (Phillips, 1993).That is, they are poor at distinguishing ifsomeone "meant" to do something, or ifsomething simply happened accidentally.

(h) Inability to deceive (Baron-Cohen,1992; Sodian and Frith, 1992), a resultthat would be expected if one wasunaware that people's beliefs can differand therefore can be manipulated. Incontrast, normal children of 4 begin tobe quite adept at lying, thus revealingtheir awareness of the mental lives ofothers.

http://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Pretendhttp://en.wikipedia.org/wiki/Pretendhttp://en.wikipedia.org/wiki/Intenthttp://en.wikipedia.org/wiki/Intenthttp://en.wikipedia.org/wiki/Beliefhttp://en.wikipedia.org/wiki/Beliefhttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_state


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oneself and others

1. Mind blindness

Assessment

(i) Disproportionate difficulty on tests ofunderstanding metaphor, sarcasm, and irony -these all being statements which cannot bedecoded literally, but which are only meaningful

by reference to the speakers intention(Happe, 1994). An example would beunderstanding the phrase the drinks are onthe house, which one adult with autism (ofabove average IQ) could only interpretliterally. This suggests that children with autismare aware of the physical (the actual wordsuttered), but are relatively unaware of themental states (the intentions) behind them.

http://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Pretendhttp://en.wikipedia.org/wiki/Pretendhttp://en.wikipedia.org/wiki/Intenthttp://en.wikipedia.org/wiki/Intenthttp://en.wikipedia.org/wiki/Beliefhttp://en.wikipedia.org/wiki/Beliefhttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_statehttp://en.wikipedia.org/wiki/Mental_state


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(a) the normal drive tointegrate information intoa context, or Gestalt.For example, "there was a

tear in her eye" might bemisread so as to soundlike "there was a tear inher dress".

2. Central Coherence

Assessment

(a) Transitive inference tests [A>B,and B>C, therefore A=C ?] (Scottand Baron-Cohen, 1996);

(b) Analogical reasoning tests [A is toB as C is to ?] (Scott and Baron-Cohen, 1996); and

(c) Counterfactual syllogisticreasoning tests [eg. All cats bark, Rexis a cat, therefore Rex is a ?](Scott, Baron-Cohen, and Leslie,1996).

Theory of InterpersonalRelatedness


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3. Executive Function

Assessment

(a) Executive function isthe postulatedmechanism (frontallobe) which enables thenormal person to shiftattention flexibly, inhibitprepotent responses,generate goal-directed behavior, andsolve problems in aplanful, strategic way(see Shallice, 1988;Baddeley, 1991).

(a) The Wisconsin Card Sorting Test (Milner,1964) in which the subject has to shift card-sorting strategies flexibly.

(b) The Tower of Hanoi (and its modifiedversion, the Tower of London [Shallice, 1982]), inwhich the subject has to solve problems byplanning before acting.(c) The Verbal Fluency Test (or F-A-S test: seePerret, 1974) in which the subject has togenerate novel examples of words beginning witha given letter, in a fixed time period.

(d) The Detour Reaching Test (Diamond, 1991),in which the subject has to inhibit reaching

straight for a visible goal, and instead take adetour route to the goal.

Theory of ExecutiveFunction


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Diagnosis

Must encompass thefollowing difficulties

(a) PervasiveAffects all aspects of the personslives;

(b) DevelopmentalBegins in infancy and affects all areasof development;

(c) Life Long

Sharing the diagnosis

(a) Age of child when diagnosed.

(b) Nature and Confidence level ofcorrect diagnosis.

(c) Can the child understand thediagnosis.

(d) Is there a need to be told.

(e) How much or how little shouldbe told.

The Typical assessors

(a) Pediatrician

(b) Child/Adolescent Psychiatrist

(c) Educational Psychologist

(d) Clinical Psychologist

(e) Speech and Language Therapist

(f) Specialist Teaching Service


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Teaching and Learning Support Assistants

Role

(a) Support teachers with respect toindividual pupils.

Tasks

(a) Promote listening skills andprolong attention span.

(b) Assist in pupil skills ininformation processing.

(c) Assist in pupil skills in

appropriate response at theappropriate time.

Instruction Application

(a) Assist in the planning andorganization of assigned tasks.

(b) Assist in the completion of thosetasks.

(c) Assist in developingindependence.

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