Chapter 10 defines autism spectrum disorder, specifically focusing on the key features of the DSM-5. This chapter provides examples of etiology and covers the wide array of behavioral, social, and communication characteristics typical of spectrum students. Diagnosis and instructional strategies are describes as well as technological support and services across the life span.

Learning Objectives:

• Describe the evolution of the definition of autism spectrum disorders.
• Identify the key features of the DSM-5 definition of autism spectrum disorder.
• Provide examples of etiological possibilities of autism spectrum disorders.
• Outline the behavioral, social, and communication characteristics typically associated with individuals with autism spectrum disorders.
• Explain how autism spectrum disorders are diagnosed.
• Describe instructional strategies often used with students with autism spectrum disorders.
• Summarize services for young children with autism spectrum disorders.
• Characterize adult services for individuals with autism spectrum disorders.
• Explain how low-tech and high-tech devices are used to facilitate communication in pupils with autism spectrum disorders.

Chapter Outline:

1. Defining Autism Spectrum Disorders
   
   1. Fastest growing developmental disability
   2. Cultural misperceptions and stereotypes
   3. 1943 Leo Kanner
      
      1. Coined term autism means “to escape from reality” based on his research
   4. Autism is a spectrum of disorders with a range of cognitive and functional skills
      
      1. Individuals on the autism spectrum exhibit different characteristics and to different degrees
   5. DSM-5 diagnostic criteria
      
      1. Refer to Table 10.1 for specific criteria.
   6. IDEA criteria
      
      1. Autism is a developmental delay significantly affecting verbal and nonverbal communication and social interaction, usually evident before age 3, that adversely affects a child’s educational performance. Other characteristics often associated with autism are repetitive activities and stereotyped movements, resistance to change, and unusual responses to sensory information. Other disabilities must be ruled out.
   7. Asperger syndrome
      
      1. Social disorder
      2. Average to above average intelligence
      3. Ability to read at grade level (with or without comprehension)
      4. Language development not significantly delayed
      5. Screening for Asperger syndrome
         1. Autism Spectrum Screening Questionnaire
         2. Childhood Asperger Syndrome Test
   8. The IEP team determines eligibility for special education services based on the child’s unique needs
   9. Students with ASD may have strong visual-spatial abilities, nonverbal problem- solving skills or exceptional auditory memories
2. Brief History of the Field since Kanner
   
   1. Psychogenic theories
      
      1. Early work blamed families, particularly mothers, for the child’s autism. The phrase “refrigerator mothers” was used for mothers who were thought not to show their children enough affection. This theory has been discredited but caused great stress in families who were blamed for their child’s disability.
   2. Organic theories
      
      1. Research in the 1940s and 1950s showed the likelihood of biological or hereditary factors. Incidence of seizures and association with intellectual disability lead to biological or hereditary factors.
   3. Behavioral theories
      
      1. Environmental factors may contribute to autism. Alteration of the environment may help the individual to achieve success. Applied behavior analysis (ABA) seeks to modify students’ behavior through reinforcing select behaviors.
3. Increasing Prevalence of Autism
   
   1. Range of estimates for prevalence:
      
      1. CDC estimates 1 in every 88 at age 8 identified
      2. A 2009 study suggests 1 per 110
      3. 407,000 individuals were identified as having autism during the 2001-2012 school year
      4. currently 51,000 preschoolers identified with autism
4. Suspected Etiologies of ASD
   
   1. No single cause
   2. A genetic link is suspected based on family and twin studies
   3. Environmental stressors
   4. Brain abnormalities in the cerebellum, cerebral cortex, and brain stem
   5. Neurochemical research investigating neurotransmitters in the brain
   6. Vaccinations have not been scientifically linked to ASD
5. Characteristics of Individuals with ASD
   
   1. Social interaction symptoms
      
      1. Difficulties with nonverbal language use and interpretation, difficulty developing peer relationships, lack of social and emotional reciprocity with others, difficulty understanding other’s perspectives and opinions
   2. Communication symptoms
      
      1. Limited or lack of speech, speech often is not functional or echoes the speech of others, deficits in conversational skills and pragmatics, lack of spontaneous language use, rhythm of speech in abnormal
   3. Repetitive and restrictive behaviors
      
      1. Preoccupation with at least one interest area, inflexibility to changes in routines, stereotypical and repetitive behaviors, attachment to inanimate objects
   4. Other characteristics
      
      1. Refer to Table 10.2 for others commonly associated characteristics
6. Assessment and Diagnosis of Individuals with ASD
   
   1. Intellectual Assessment
      
      1. Often significant cognitive deficits
   2. Screening and Diagnosis
      
      1. Based on behavioral symptoms
      2. Developmental screening
      3. Comprehensive evaluation
         1. Autism Diagnostic Observation Schedule (ADOS-2)
         2. Autism Diagnostic Interview—Revised (ADI-R)
7. Education Placements for Students with ASD
   
   1. Teachers can use a variety of strategies to support students with ASD in inclusive classrooms
   2. Variety of early intervention services for young children with ASD and their families
   3. Curriculum often includes functional, communication, and social skills instruction
8. Adulthood with ASD
   
   1. Transition from high school
   2. Employment
   3. Living arrangements
      
      1. Supervised group and independent living
      2. Adult foster care
      3. Residential services
9. Other Issues
   
   1. Family needs and issues
   2. Diversity
   3. Technology to facilitate communication
   4. Treatment options
   5. Lack of research regarding effective treatments