Coursera - Autism Spectrum Disorder - Week 2 - December 15/16, 2020

Topic: Developmental Differences in Autism Across the Lifespan

Video: Why is Early Identification Important?

• less than half of children identified with autism spectrum disorder are being evaluated for developmental concerns by the time they reached age three. Presently the average age of diagnosis for an autism spectrum disorder is four years of age. 
• research indicates that the earlier we identify characteristics of autism and the earlier that interventions and treatment can begin, the better the outcome.

Dr. Robin Hansen 

• research is indicating that the earlier that we start intervention, the better the prognosis. 
• when kids are missing out on social learning opportunities because of a variety of reasons, it just kind of snowballs on itself. 
• the earlier that we try and intervene and change learning, we change developmental trajectories. We think that's because there's some much more developmental plasticity in young brains. 
• neural connections are being made so rapidly that the earlier that we can sort of change that learning and where those neurons are going and how they're connecting the better 
• if diagnosis gets delayed, there's lots of other second difficulties that occur in terms of family interactions, in terms of expectations, in terms of just behaviors that develop because of frustration, confusion.
• the most important one, is just getting the right kinds of interventions, the right kinds of services so kids are learning. 
• One way clearly is to try and make sure that children are getting systematic screening and that it's not just for kids who show a lot of symptoms. 
• start getting pediatricians, getting family practice, anybody who has regular contact with children to just systematically be screening, not only for autism, but for all kinds of early developmental delays. 
• as health care professionals, we really need to be listening to parents' concerns and responding to them and not saying let's just wait and see, but really responding and taking parents' concerns very, very sincerely and carefully that we need to respond to those early. 

Video: What are Indicators of ASD in Infants and Toddlers?

• Research has indicated that there is a significantly increased risk of a younger sibling developing or showing signs of autism if they have an older sibling who's been diagnosed on the autism spectrum. 
• Studying the younger siblings of children with autism has given us a substantial amount of information about the early signs and indicators. 
• Some of the red flags indicated in infant development include no big smile or other warm, joyful expression by six months of age or thereafter. 
• No back and forth sharing of sounds, smiles, or other facial expressions by nine months of age or thereafter. 
• No babbling by 12 months of age. 
• No use of back and forth gestures, such as pointing, showing, reaching, or waving. 
• No words by 18 months of age, and no two-word meaningful by the 24 month age. 
• any noted loss of speech, babbling, or social interaction are a red flag for autism.
• There are also several red flags during toddler development, a lack or delay in spoken language is often the first sign and symptom recognized during this period of development. 
• There may also be a limited use of gestures or pointing to reference objects. 
• There may be limited pretend play, or inappropriate play with objects such as lining things up or engaging in repetitive patterns of behavior with toys and objects. 
• There may be a limited interest in other children and a limited sharing of enjoyment or emotional reciprocity. 
• sensory avoidant behaviors, such as a refusal to wear shoes, or clothing, or eat certain foods. And while tantrums are common in the toddler years, there may be extreme tantrums where the child is simply inconsolable.

Video: What are Indicators of ASD in Preschoolers?

• Red flags and indicators during the preschool years can include a lack of joint attention, imitation, and social referencing. 
• There may be a delay in spoken language or the child may have communication, but there may be differences in communication. 
• It's often during the preschool years that parents seek out support. This is typically due to the delay the delay in langauge or due to the extreme tantrums and problematic behaviors that the parent is encountering. 
• The child may not play with toys in the manner that they were designed or intended for. 
• there may be extreme distress when someone attempts to get the child to play with the toys in a different way. 
• There's often a lack of spontaneous functional play and the child may show a limited range of affect or emotion. 
• May begin showing a restricted area of interest, and they may have difficulty anticipating events and dealing with change. 
• There may also be a delayed use of pointing and other gestures in order to get and sustain the attention of others.

Video: What are Indicators of ASD in K-12 Students?

• diagnosis and challenges of kindergarten through 12th grade students on the autism spectrum. 
• While many children on the autism spectrum are identified and diagnosed during the preschool years, many others begin first grade without an official diagnosis. 
• Some are identified as having a speech and language delay and do receive speech and language therapy services during the beginning of their school career, while others may go undiagnosed. 
• challenges faced by school-aged children on the autism spectrum include social deficits that impact their participation in activities. 
• Their restricted interest may consume much of their time and attention and may result in additional social isolation. 
• Behavioral challenges may become more of a problem as they protest shifting from activity to another or the demands of doing academic tasks which may require more inferencing
• more written expression
• a demonstration of social comprehension. 
• deficits in empathy and may use language or vocabulary that's significantly above their age level. when a school-aged child is referred for special education assessment, the initial referral may be because someone suspects attention deficit or a learning disability. 
• School professionals should look closely at social communication as well as for signs and indicators of restricted or repetitive patterns of behavior or rigidity when a school-aged child is referred as these may indicate the presence of an autism spectrum disorder. 
• While most individuals on the autism spectrum are diagnosed and receiving support if needed by middle and high school, the challenges associated with middle and high school can become a paramount concern at this age. 
• Social challenges and the sophistication of social relationships becomes very complex. Bullying and victimization are often reported at higher rates for middle school and high school students affected by autism. 
• This is also the age where we see coexisting mental health issues, such as anxiety and depression become increasingly problematic. 
• Those who were able to keep pace with the academic demands in elementary school may find it difficult in middle and high school to keep pace with the academic rigor and being able to work on developing social and adaptive, or independent living skills, while also trying to maintain passing grades. 
• It's important for people to learn how to do is to decide how they want to talk about their disability and the supports they need, and when did they want to do that. 
• that's a really important thing for people to practice when they're younger, because in college and in a job, there's gonna be much less support for people guiding how that happens. 
• learning how to disclose your disability when you're younger, and to really know how to talk about those kinds of supports that you require, is something that really is very, very helpful.

Video: What Happens After High School?

• In transition to adulthood by looking at some of the data on outcomes for individuals with autism spectrum disorders
• what happens when an individual with an Autism Spectrum Disorder leaves public education, either at age 18, or when they receive a diploma, or at age 22, when they age out of special education supports and services? 
• Only about 15 to 20% of adults diagnosed with an autism spectrum disorder live independently and work without supports regardless of their cognitive functioning level. 
• Many experience what's called mal-employment, which means working in a job that's far below their skill level. 
• Around 44% of young adults with an autism spectrum disorder do participate in some type of post-secondary education. 
• A high percentage of individuals with autism that attend college gravitate towards the STEM majors of science, technology, engineering, or math. 
• Many require academic accommodations including accommodations for test taking and for writing. In order to access the accommodations that they need, they have to have a level of self awareness and self advocacy. 
• The ability to self-disclose and access the supports needed is a skill that many entering college don't have or have not had an opportunity to practice prior to leaving K-12 education system. 
• Self-disclosure and self-advocacy are critical skills required to be able to access the student disability service centers at local colleges and universities. 
• skills should be practiced during the high school years prior to leaving the safety of public education. College students with autism also report challenges and difficulties in social and relationship skills. Organization and time management, as well as regulating their emotions and stress, are also a paramount issue for college age students with autism.

Video: How to Transition to Work

• the transition from school to work for people with autism.
• people who are on the spectrum, in terms of going into either education or employment, is that for a lot of disabilities people recognize the types of supports that people with disability need. 
• People who have hearing impairments or visual impairments or ambulatory impairments. We understand how you support people with those kinds of disability. 
• people who are on the spectrum, they often times have needs and supports that they need that are a little bit more unusual for the way that we currently support people. 
• One of the roles of a job coach is, of course, to help people with disabilities learn the tasks that are involved in the job. 
• But the other part of that role of the job coach is to help the people who are surrounding the individual, the supervisors and the coworkers, with knowing the ways that they can help the person who's on the spectrum be successful. 
• One of the challenges for people who are on the spectrum to find employment is to really first of all find out what they're good at doing. 
• spend time volunteering with different types of locations and different types of work. 
• that gives people a great opportunity to be learning different types of skills, to be practicing real life situations with supervisors and coworkers. 
• it's just a wonderful opportunity for people to develop those types of understandings of what happens in a workplace and how they fit into that.

Video: What are Some Helpful Tips for Finding Work?

• helpful tips for supporting adults in finding work.
• tips for adults with autism spectrum disorders include:
• assessing strengths and interests in order to try to find work and match employment opportunities to those strengths, passions, and interests. 
• some type of micro-enterprise or self-employment. 
• volunteer and to do internships. Both to learn job skills and to establish relationships with potential employers. 
• developing a portfolio or a website that showcases one's talents and abilities can be a far more effective way than a traditional resume and job interview approach to finding work.
• find out about the supports available to adults.
• don't be afraid to take some risks and try new things. 
• Being able to advocate for one's self is important. 
• take an active role in developing their individualized plan. 
• for people with disabilities, if they're not given tasks that maybe more difficult than they're ready to do at that particular moment. And aren't given the ability to make mistakes and sometimes fail from those. We're really holding them down because the reality is, when we faced with those types of opportunities,
• we will often times raise up to the level from what's required from that. And I think that for people with disabilities, it's a very important thing to not always determine whether or not a person is ready to do a certain task. But, instead, to simply just say let's try this out. And allow the person the opportunity to rise up to the challenge.

Video: Summary

• importance of early identification of autism, and then describe the stages of development and what to be aware of at each stage. 
• parent perspectives about advocacy, and helping others understand the needs of people on the autism spectrum. 
• insights about the importance of self awareness and self disclosure. 

Quiz

Attempt 1: 92.44%

Attempt 2: 98.61%