Enabling Technology

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
  • 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
  • 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        • In the 1950’s they though Autism was due to emotional trauma from emotionally withdrawn mother, causing child to withdraw into world of Autism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
  • 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
  • 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?
  • 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
  • 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
  • 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…)
  • 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
  • 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
  • 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