Autism
Keith’s notes from Elaine’s talk.
Elaine Coonrod, PhD
elaine_coonrod@med.unc.edu
Division TEACCH
Treatment and Education of Autistic and related Communication handicapped CHildren
Unique in country by being primarily state funded, as opposed to typical private funding
Slides available here
* Condensing multi-day presentation on Autism into 75 minutes of slides and discussion!
- Slide 3
- Neurodevelopment disorder
- Problem in development of brain
- Not much know besides that
- Signs not usually seen until 2 years old, but think it is present at birth
- Autism is a life-long development disorder
- Neurodevelopment disorder
- Slide 4
- Increase in number of cases of Autism
- Better tracking, diagnosis and awareness accounts for some of this
- Strict interpretation of Autism spectrum could also contribute
- Increase in number of cases of Autism
- Slide 5
- Myths about Autism
- Poor parenting
- In the 1950’s they though Autism was due to emotional trauma from emotionally withdrawn mother, causing child to withdraw into world of Autism
- Only welathy families
- They had the money to get experts and professionals
- Vaccines
- Robert Kennedy Jr
- MMR vaccine and mercury
- Denouncement of vaccine as cause is scientific, even though many parents are convinced otherwise
- Poor parenting
- Myths about Autism
- Slide 6
- No biological marker or test
- No medical test (i.e. catscan) can detect
- Diagnosis by behavior (subjective)
- When scientists and experts decide what is the ‘line’ for Autism, people close to the ‘line’ on either side may be misdiagnosed
- Slide 7
- What is Autism?
- 1) Bad communication skills is requirement (can’t be Autistic otherrwise)
- 2) ???
- 3) Obsession with their interests and activities
- What is Autism?
- Slide 8
- Autistic – Uneven development
- Very good in things (i.e. puzzles, calendar dates, math) and very bad in things (i.e. reading facial expressions)
- Typical – Even development
- Overall good in many things, slightly better or worse in some particular areas
- Savant
- Only 3% of people with Autism fall in this category
- i.e. high skill in painting, music, etc
- Dustin Hoffman in Rain Man
- Open questions: What percentage of typical population is savant? Are more savants Autistic than not?
- Autistic – Uneven development
- Slide 9
- Interventions are more effective the earlier they are imployed
- Speech langauge therapy
- Structured teaching
- Ineffective/False interventions
- Facilitated communication (Law & Order Episode #???)
- Vitamins and supplements
- Interventions are more effective the earlier they are imployed
- Slide 10
- There is actually a spectrum of disorders
- Autism is manifested very differently for each individual
- Slide 11
- Controversy over differences between PDD NOS, Aspergers(sp?) and Autism
- PDD NOS: Pervasive Developmental Disorder Not Otherwise Specified
- Experts don’t really know what the differences are
- Controversy over differences between PDD NOS, Aspergers(sp?) and Autism
- Slide 14
- Myth: Autistic kids don’t like being touched
- Truth: Avoid social contact, i.e. eye contact, smiling, interacting just because
- Truth: Interactions usually lack sense of reciprocity, i.e. you hug someone because that person wants to be hugged, not because you want to hug them.
- Soccer story and phone calling story illustrate lack of other’s perspective
- Problem with judging proximity, i.e. talking too close or two far away
- Too close (Seinfeld, Season 5, Raincoats Part I – Elaine Benes dates a “close talker”)
- Too far away (I can hear myself talking, so they should be able to hear me, regardless of where they are…)
- Myth: Autistic kids don’t like being touched
- Slide 16
- Connection between language and communication
- Few gestures: don’t use hand, body or vocal abilities to communicate
- Formal langauge: pendantic in informal settings (pizza in the cafe story)
- Intonation in unusually places: don’t understand why people vary volume and speed of talk, so randomly change own volume and speed
- Connection between language and communication
- Slide 18
- repetitive use of objects
- unusual use of objects
- varied response to sensory responses
- myth: don’t play with toys
- truth: play in different ways
- spin toy car wheels over and over rather than pretending to drive it
- line up dolls in symmetric order rather than comb doll hair or dress doll up
- Slides 20–25
- difficulty in generalizing (i.e. toilet training)
- concrete thinking (follow the letter, not the spirit, of the law/rule)
- literal interpretation of words, as opposed to distinguishing between literal and figurative
- Slide 26
- Divison TEACHH started in the 1970’s
- 5000 individuals currently served in NC (approximately 50% of NC individuals with Autism)
- Slide 33
- Work is play and play is work
- Work is structured
- Play is unstructures
- Work is play and play is work
- Slides 34 & 35
- Supported employment
- One-to-One: One job coach per inidividual; Assembly, quiet setting, cleaning
- Mobile Crew: One job coach per 2–3 individuals; lawn care and gardening
- Shared support: Enclave with job coach on-site; kitchen, mail room
- Standard: Regular job; job coach sets up work system, then visits on regular basis; food service
- Supported employment