Autism Spectrum Disorder

Transcription

1 Autism Spectrum Disorder State Definition A developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects a child s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. Autism does not apply if a child s educational performance is adversely affected primarily because the child has an emotional disturbance. A child who manifests the characteristics of autism after age three could be identified as having autism if the criteria in this definition are satisfied. District Eligibility Criteria Autism Spectrum Disorders (ASD) means a range of pervasive developmental disorders, with onset in childhood, that adversely affect a student s functioning and result in the need for special education instruction and related services. ASD is a disability category characterized by an uneven developmental profile and a pattern of qualitative impairments in several areas of development, including social interaction, communication, or the presence of restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. These core features may present themselves in a wide variety of combinations that range from mild to severe. The number of behavioral indicators present may vary. In order to meet eligibility under ASD the child must demonstrate qualitative impairment in: reciprocal social interactions, o The impaired development of reciprocal interpersonal interaction is characterized by a lack of responsiveness to and a lack of interest in people, in addition to a failure to develop normal attachment behavior (i.e. lack of eye contact and facial responsiveness, indifference or aversion to affection). As well as one of the following: qualitative impairments in communication, and/or o Impairment in communication includes both verbal and nonverbal skills. Language may be totally absent. When language does develop it is often characterized by: immature grammatical structure, delayed or immediate echolalia, pronoun reversals, abnormal speech melodies, perseverative jargoning and/or idiosyncratic articulation or usage. Nonverbal communication (gestures, facial expressions, point) may be absent, minimal, or socially inappropriate.

2 restricted range of interests/repetitive behavior. o Atypical responses to the environment or routine may take several forms. There may be resistance and even catastrophic reactions to minor changes in the environment. There may be unusual attachment to, or uses of objects. Ritualistic behavior may involve motor acts such as hand flapping or repetitive peculiar hand posture, inordinate interest in spinning objects, and/or unusual preoccupation with one narrow interest. Likewise, many associated features may be evident as well (e.g. impulsivity, distractibility, echo-praxia, or echolalia). ASD is considered a lifelong developmental disability that adversely affects a student s educational performance. The criteria listed below reflect an educational identification of Autism and related disabilities under the Autism Spectrum Disorder educational category. Students eligible under the category of ASD meet the criteria for one of the following disorders: 1. Autism is defined as the presence of at least two behaviors from Group A, one behavior from Group B, and one behavior from Group C. The descriptors for these groups are as follows: Group A-Failure to Develop Reciprocal Social Interactions Lack of responsiveness to other people Lack of facial responsiveness (e.g., averting gaze, fleeting eye contact, etc.) Lack of awareness of feelings for others Failure to make reciprocal responses to physical or social contact Lack of responsiveness to others stress or distress (e.g. indifference or aversion to affection) Failure to seek comfort from others in time of stress May utilize others as an extension of self Experience difficulty separating self from others Peer relationships may develop but are superficial Absence of imitation or impaired imitation Group B-Qualitative Impairment in verbal and Nonverbal Communication Lack of nonverbal responses (e.g. absent or delayed development of appropriate gestures, failure to assign symbolic meaning to gestures). Immediate echolalia or delayed echolalia without communicative intent. Marked abnormalities in the production of speech (e.g. volume, pitch, articulations, stress, rate, intonation, dysrythmia, monotone speech inflection, melodious speech inflection, high pitch). Immature or disordered grammatical structure (e.g. immature syntax, idiosyncratic jargon). Absence of imaginative activity. Marked abnormalities in the form and content of speech (e.g. pronominal reversal, stereotyped and repetitive speech, idiosyncratic use of words and/or phrases, television and radio commercials disassociated from context). Failure to develop the use of abstract terms, concepts, and reasoning.

3 Group C-Markedly Restricted Repertoire of Activities and Interests Stereotypic body movements (e.g. finger licking, rocking, spinning, head banging) Visual Symptoms: close scrutiny of visual details, staring, prolonged regarding of hands or objects, attention to changing levels of illumination Auditory Symptoms: close attention to self produced sounds, non-response or over-response to varying levels of sound Tactile Symptoms: over-response or under-response to touch, pain, or temperature, prolonged rubbing of surfaces, sensitivity to food textures Vestibular Symptoms: over-reactions or under-reactions to gravity stimuli, whirling without dizziness, and preoccupation with spinning objects Olfactory and Gustatory Symptoms: repetitive sniffing, specific food preferences, mouthing, licking, or swallowing of inedible objects Proprioceptive Symptoms: posturing, darting, lunging movements, hand flapping, gesticulation, and/or grimaces Unreasonable insistence on following routines (e.g. individual may seek consistency in environmental events to the point of exhibiting rigidity in routines). Restricted range of interests 2. Asperger s Syndrome is defined as: Qualitative impairment in social interaction, as manifested by at least two of the following: Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction Failure to develop peer relationships appropriate to developmental level A lack of spontaneous seeking to share enjoyment, interest, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people) Lack of social or emotional reciprocity Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following: Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus Apparently inflexible adherence to specific, nonfunctional routines or rituals Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements) Persistent preoccupation with parts of objects

4 The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years). There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia. 3. Rett s Disorder is less common than Autistic Disorder and has only been diagnosed in females. The essential feature of Rett s Disorder is the development of multiple specific deficits following a period of normal functioning after birth. Individuals have an apparently normal prenatal and perinatal period with psychomotor development through the first five months of life. Between five to forty-eight months of age, there is a characteristic pattern of head growth deceleration, loss of previously acquired purposeful hand skills with the subsequent development of characteristic stereotyped hand movements (e.g., hand wringing), and the appearance of poorly coordinated gait or trunk movements. There is a loss of social engagement early in the course (although often social interaction develops later). In contrast to Asperger s Syndrome, Rett s Disorder is characterized by severe impairments in expressive and receptive language development and psychomotor degeneration. 4. Childhood Disintegrative Disorder (CDD) has as its essential feature a marked regression in multiple areas of functioning before ten years of age following a period of at least two years of apparently normal development. The child has a clinically significant loss of previously acquired skills in at least two of the following areas: expressive or receptive language, social skills or adaptive behavior, bowel or bladder control, play, or motor skills. Most typically acquired skills are lost in almost all areas. Individuals with Childhood Disintegrative Disorder exhibit the social and communicative deficits and behavioral features generally observed in Autistic Disorder. There is qualitative impairment in social interaction and in communication, and restricted, repetitive, and stereotypical patterns of behavior, interests, and activities. Autistic Disorder differs from Childhood Disintegrative Disorder in that CDD involves a distinctive pattern of regression after the first two years of life (but before age ten) while Autistic Disorder involves developmental abnormalities within the first year of life. CDD has also been termed Heller Syndrome, Dementia Infantitis, or Disintegrative Psychosis.

5 5. PDD-NOS is a diagnostic category that is used when there is a qualitative impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills or when stereotyped behavior, interests, and activities are present. With PDD-NOS not all of the necessary criteria for autism are met. Pervasive impairment in more than one developmental area must be present. Impairment in reciprocal social interaction that is associated with impairment in communication skills or with the presence of stereotyped behaviors, interests, or activities must be present. Students with a medical diagnosis of Autism or related disorders must still meet all of the eligibility criteria, including the disability having an adverse effect on educational performance in order to be eligible for special education services. The characteristics identified as significant enough to validate eligibility for ASD in the school setting must be so different from his/her generally accepted, age appropriate, ethnic or cultural norms that they adversely affect performance in such areas as self care, social relationships, personal adjustment, academic progress, classroom behavior, or work adjustment. Exclusionary Criteria The student s evaluation results can best be explained by another eligibility category (e.g. Cognitive Impairment, Emotional Disability, Traumatic Brain Injury, Speech/Language Impairment, etc.) The disability does not adversely affect educational performance. Exit Criteria The student no longer meets the entrance criteria. The student s disability no longer demonstrates an adverse effect on educational performance. The student has demonstrated adequate functioning over a period of time (nine weeks) in a general education classroom with minimally invasive (monitor and/or consult) special education services. The student has demonstrated adequate functioning with general education supports only.