From SFARI: 

Diagnosis of autism is based on a core set of symptoms in each of three domains — social interest, language ability and repetitive behaviors — and differences among individuals with the disorder are often considered a question of degree. But the vast diversity of genetic profiles that appear to underlie the disorder often prompts researchers to call it ‘the autisms,’ emphasizing the disorder’s heterogeneity.

In a 2010 study, researchers took thorough medical histories for 252 individuals with autism and performed a statistical analysis to see if certain symptoms are more likely than others to occur together². They identified four categories: sensory problems, immune system issues, neurodevelopmental delay and repetitive behaviors.

In the new study, the same researchers reanalyzed the data from all 252 participants to see whether they are more likely to have symptoms that fall into one category and not the others. The participants cluster into four discrete groups, the study found: those with immune abnormalities, along with sleep disruption and sensory sensitivity, but with little developmental delay; those with sleep and sensory deficits, but no immune abnormalities; those with pronounced repetitive behavior; and those who have a combination of all symptoms described in the other three groups and more severe developmental delay.

Read more here. 

“Because my parents presumed my competence, they included me in the family, they believed I was able to understand what I already knew I could: anything a girl my age would.”

From SFARI:

To better understand the interaction between autism, intellectual disability and language, researchers in the new study compared the language ability of 36 children with both autism and intellectual disability, 26 children with intellectual disability only and 34 typically developing controls. Children were matched on the basis of mental age, independent of language ability. The mean age for children with autism was about 7 years; those with intellectual disability were about 6.5 years old and controls were about 3 years old.

The researchers used a number of measures to rate expressive language, or speaking ability, and receptive language, the ability to understand the speech of others, in each of the children. These measures included both direct tests and parental-report questionnaires.

Overall, children with autism and intellectual disability have lower scores in receptive language than do those with intellectual disability alone, who themselves score lower than controls. There is no statistically significant difference in expressive language between children with autism and intellectual disability compared with children with intellectual disability alone; but, again, both groups score lower than controls.

This suggests that, overall, children with autism have stronger expressive than receptive language skills, whereas this trend is reversed in the other two groups. Specifically, about 34 percent of children with autism and intellectual disability have better expressive compared with receptive language, the study found. By contrast, 54 percent of children with intellectual disability only and 44 percent of controls have better receptive than expressive language.

The researchers also looked at whether the children’s ability to engage the attention of others, called joint attention, and their understanding of symbols was related to their language ability. These two factors account for 81 percent of the variation in receptive language scores and 72 percent of the variation in expressive language scores among the children with autism, the study found. For example, children with autism who have more difficulty with joint attention have lower language scores than those with better joint attention ability.

Fascinating; this highlights the important role of shared or joint attention in the acquisition and functional use of language, both expressive and receptive and supports our assertion that it should be the foundation for assessment and intervention. 

Read the rest here. 

Can’t wait for more submissions to this blog for people with SPD. 

(Source: fyeahsensoryseaturtle)

From Science Daily:

The children in the study were randomly assigned to medication alone for six months or medication plus a structured training program for their parents for six months. Parent training included regular visits to the clinic to teach parents how to respond to behavior problems to help children adapt to daily living situations. The study medication, risperidone, is approved for the treatment of serious behavioral problems in children with autism.

“In a previous report from this trial, we showed that the combined treatment was superior to medication alone in reducing the serious behavioral problems,” said Scahill. “In the current report, we show that combination treatment was better than medication alone on measures of adaptive behavior. We note that both groups — medication alone and combined treatment group — demonstrated improvement in functional communication and social interaction. But the combined group showed greater improvement on several measures of everyday adaptive functioning.”

As he posits in this TED Talk, the brain evolved exclusively to control movement, so studying brain functions, such as executive functioning, is futile without also considering how those functions might influence and be influenced by sensory/motor processing. 

This equation is absolutely brilliant, and so beautifully illustrates one of the primary differences we see in kids with sensory processing challenges: without well-integrated, well-coordinated information from the senses, children don’t develop the same richly varied database of information about how things work, including, sometimes, their own bodies. Instead, these intelligent kids compensate by depending on their memory, rather than dynamic in-the-moment processing, which typically presents as rigidity, inflexibility, or “stereotyped” behaviors. Though I’m reluctant to make such a dehumanizing comparison, there’s an analogy to the “brain” of a supercomputer, which is able to maintain a large database of static “rules” to guide specific actions, but flounders when challenged to generalize those rules to a novel variation.

These children are not, of course, automatons, but are using their own best-available strategy to solve the problem of feeling a sense of mastery and control over their own experiences. Unfortunately, this strategy is often insufficient to the demands of moving though an inherently unpredictable and variable world. And so, in the kind of work we do, we typically aim to support the child to develop a more robust and varied database by following their interests, engineering the activity and interaction from the inside to enhance their processing and scaffold their success. 

Here are two articles, both from Science Daily, describing research that demonstrates how poorly standardized tests predict academic ability in kids with autism and Aspergers.  

 IQ Scores Fail to Predict Academic Performance in Children With Autism

New data show that many children with autism spectrum disorders have greater academic abilities than previously thought. In a study by researchers at the University of Washington, 90 percent of high-functioning children with autism spectrum disorders showed a discrepancy between their IQ score and their performance on reading, spelling and math tests.

 (…) 

 Little is known about how these children actually perform in regular classrooms, which has implications for how to assign support services. Since IQ scores in the general population reliably predict academic performance — as measured by standardized tests for word reading, spelling and basic number skills — Estes and her colleagues thought the same would be true in their sample of 30 high-functioning 9 year olds with autism spectrum disorders.

“What we found was astounding: 27 out of the 30 children — that’s 90 percent — had discrepancies between their IQ score and scores on at least one of the academic achievement tests,” Estes said. “Some scored higher and some scored lower than what their IQ score would predict.”

To the researchers’ surprise, 18 of the 30 children tested higher than predicted on at least one of the academic tests. This was especially true for spelling and word reading. Across the three academic tests, 18 of the 30 children scored lower than what their IQs would predict, suggesting a learning disability.”

 These findings shouldn’t be so surprising, given how dependent IQ tests are on receptive and expressive language and, no matter what inter-rater reliability claims can be made, on a positive rapport between tester and student. 

The researchers also didn’t compare IQ and achievement test scores with actual school participation or performance, which would provide a valuable dimension to this picture, especially since they noted a positive correlation between social skills and academic performance. Shared or joint attention is a foundation for both social interactions and the ability to learn implicitly through observation of others.

Read the whole article here. 

Level and Nature of Autistic Intelligence: What About Asperger Syndrome?

(…) Both autistic and Asperger individuals display uneven profiles of performance in commonly used intelligence test batteries such as Wechsler scales, and their strongest performances are often considered evidence for deficits.

However, this study reports that Asperger individuals’ scores are much higher when they are evaluated by a test called Raven’s Progressive Matrices, which encompasses reasoning, novel problem-solving abilities, and high-level abstraction. By comparison, scores for non-Asperger individuals are much more consistent across different tests. Interestingly, Asperger participants’ performance on Raven’s Matrices was associated with their strongest peaks of performance on Wechsler.

(…) 

According to co-author Michelle Dawson, “while we know autistics process information atypically, very little thought has gone into how to fairly assess their abilities. In fact there is so little understanding of what autistics do well that their strong abilities are often regarded as dysfunctional. Here we have again found that measurable strengths in autistic spectrum individuals are not “isolated islets of abilities” as previously thought, but are in fact representative of autistics’ intellectual abilities. This in turn raises questions about how we can provide autistics with the kinds of information they can process well, as we do with non-autistic individuals. We consider the effort to understand and encourage autistic strengths to be of paramount importance. “

Based on these results, the authors emphasize that autistic spectrum intelligence is atypical, but also genuine, general, and underestimated.

Again, these findings should not be so surprising, but really highlight the need to look at the individual differences of each child (i.e. unique strengths and challenges) rather than trying to create a better academic mold in which to stuff all children.    

Read more here. 

From Science Daily: 

“Making play sets more interactive and giving children with autism greater opportunities to control and add content of their own to the game could improve cooperative play with other children as well as giving them greater confidence in understanding how objects interact.

William Farr and Nicola Yuill of the University of Sussex, UK and Steve Hinske of ETH Zurich, Switzerland, explain that children with autism are often affected not only by social difficulties, but also have an impaired understanding of the way objects interact. They have investigated how toys, such as the “Augmented Knight’s Castle” (AKC) might be adapted to be more beneficial to those children and perhaps even act as a therapeutic tool. 

Writing in the International Journal of Arts and Technology, the team,from the Children and Technology Lab at the University of Sussex explains how they have examined childhood playexplains how they have examined childhood play with the popular Playmobil Knight’s Castle play set, which as the name would suggest comprises a toy castle with various obvious components of towers, parapets, a moat and the various model people that can be used in imaginative play to enact various roles within the play set.

The team has thus augmented the play set by adding a wireless networking system and radio frequency identification tags (RFIDs) to the components to add feedback and programmable aspects to the play set. The play set might thus produce sound or movement given certain actions by the child playing with the toys. Their tests with autistic children volunteered to play with the AKC reveal promising results that are allowing the team to conclude that such adapted play sets can improve understanding and interest in the play set itself, but more importantly boost the level of interaction with other children playing with the toys. Indeed, the team noticed more parallel and cooperative play and less solitary play with the fully configurable setup for the AKC. They add that autistic children playing with the configurable AKC were also more inclined to actively play with the Playmobil figures.”

This is an interesting concept. I can almost imagine how adding some multi-sensory feedback mechanisms might encourage or even enhance the kind of exploratory play that develops a strong and varied database of object affordances (i.e. cause/effect relationship between an object and its potential purpose), but as an OT and toy connoisseur, I can’t help but feel a bit skeptical, since there already exists a world of readily available toys that can be used in the context of supported play. 

What the researchers are attempting to address is agency: the implict knowledge that one’s purposeful actions have the ability to influence or impact on their environment. (This is, in essence, a primary focus of our approach.) However, I can’t help but think that the researchers have re-invented an unnecessarily complex wheel.

To illustrate my point, I’m pretty sure we have the Playmobil castle floating around the office somewhere; it’s a really fantastic toy for the very few children we see who have good constructional praxis, executive functioning to sustain attention and organize many detailed pieces, fine motor coordination to assemble the toy, fine motor control to manipulate the toy, and emotional regulation to manage the inevitable frustration of mistakes and pieces falling apart. 

As an alternative, we might select the Imaginext castle, which also affords a wide range of imaginative ideas, but has pieces that are larger, more distinctly detailed, and moving parts that are more specific in their purpose. For kids with mild challenges, this provides an appropriate level of challenge while still allowing them to feel successful enough to move from exploratory play to representational and symbolic ideas. 

To further reduce the motor demands, we might choose the Fisher Price Little People (I strongly prefer the vintage version), again, providing toys that provide the developmentally appropriate level of motor challenge to allow the child to demonstrate their ideas. 

It’s also just as likely that we might transform a playhouse into a castle, provide foam swords and stuffed dragons… you get the idea. 

First of all, I’m highly skeptical about the efficacy of prescribing a particular toy to facilitate the development of a sense of agency; by definition, this must be driven by the child’s own innate interests, ideas, and motivation. It seems to me that it would be more effective to consider the child’s natural interests, then match the toy or activity to the child’s individual differences, i.e. their capacity for visual spatial processing, fine motor control and coordination… and then to consider what kind of support might be provided to facilitate their ability to express their ideas, rather than evaluating their ability to play with a toy “appropriately.”

Read the full article here. 

pbsparents:

This kid has 99 problems, and counting to 99 is one of them.

I’ve heard of “First World Problems” but “First Grade Problems??” I’m intrigued obsessed. It’s like, sometimes we grow up so fast, we forget how hard it really is to be a 6 year old.

(Source: )