CSAD 142 midterm Mojibi

six proposed causes of ASD

Genetics Neurology Metabolism Errors Infections during Pregnancy/Early Childhood Family History Gender Differences

postive contributions in EBP for ASD part 2

In 2009: the National Center on Autism released the National Standards Project (NSP) report(2009)- created and applied criteria to common interventions ¥ 11 established, 22 emerging, 5 unestablished treatments the National Professional Development Center on Autism Spectrum Disorders carried out a comprehensive review of literature focusing on individuals with ASD up to age 22 ¥ Resulted in 24 interventions that met criteria for EBP ¥ Much overlap between NSP and NPDC studies Council for Exceptional Children adopted professional standards for teaching students with ASD (2009)

relationship between communicative intentions and pragmatic functions

There is a relationship between communicative intentions and pragmatic functions 1. Function: Language use is highly dependent on the speaker's intentions and depends on the communicative goal 2. Presuppositional Knowledge: The speaker makes judgments about what the listener needs with regards to informational content and communicative style Conversational Maxims: Rules of discourse in conversations

Joint Attention

Two people sharing the understanding that they are attending to do the same thing Concerns with interpersonal relatedness and social cognition can restrict language development • Deficits in joint attention are stable in individuals with ASD • Behaviors to observe/deficits in ASD: o Lack of gaze following o Lack of proto-declarative (social) pointing o Lack of showing/offering gestures • Required for language development • Active process of sharing attention; shared focus • Opportunities for language learning are missed because children with ASD do not perceive games using joint attention/shared focused to be "fun"; or find them overstimulating

Central coherence & how it applies in ASD

Weak Central Coherence: Children are very good at attending to detail; difficulty perceiving the gist of something ¥ Concerns with focus ¥ Hard for children to complete activities on time (get pre-occupied with details)

Aspects of Autism #1 Social Reasoning

a. Aloof child/actively avoids social interactions; b. Passive child/tolerates social interactions; c. "Active but odd" child/wants to interact but appears odd; d. Child wants to be friends/presents with delays in social maturity

Aspects of Autism #6 Expression and Management of Functions

a. Assessment and management of child's ability to express social-emotional functions b. Cognitive behavior therapy to treat mood disorders at 5-7 years of age

Aspects of Autism #4: Special Interests

a. Children may have intense special interests ♣ Can be usual or eccentric b. Acquire information or facts about a topic ♣ Sometimes similar to peers' interests; sometimes idiosyncratic c. Focus of the child changes; chosen by child according to developmental level or capacity

six steps to positive behavior support

a. Defining the behavior of concern b. Gathering info c. Developing hypotheses d. Creating the behavioral support plan e. Implementing interventions f. Monitoring implementation and outcomes

Aspects of Autism #5: Sensory Sensitivity

a. Hyper-sensitive to sensory information ♣ Lights, sounds, touch, smell ♣ Children might be hypervigilant in anticipation of next alarming sensory experience b. Lack of visible response to sensory experiences ♣ Child fails to communicate pain limited discomfort when cold c. Sensory Meltdown: when experiences are overwhelming and unavoidable

Aspects of Autism #3: Cognition

a. Profound learning difficulties and a significant intellectual impairment on a standardized intelligence scale b. Delays in play skills; interested in sensory qualities of objects c. Children will exhibit an uneven cognitive profile d. Children can have higher-level math skills but deficits in reading or number skills e. Children may also have problems with organization, time management or working memory f. Approximately 10% of children with Autism develop savant characteristics g. Savant: Remarkable abilities in an area compared to the child's overall level of ability i. E.g., math, music, drawing, mechanics, IT h. Important to remember that the child's area of strength can be used to support the development of other skills in and out of the classroom

Aspects of Autism #2 Language Abilities

a. Silent child who has sounds, but not words ♣ Child has better comprehension than expression but doesn't develop spontaneous gestural language b. Vocalizations but speech requires an external prompt ♣ Presents with echolalia c. Remarkable verbal fluency and vocabulary but encounters problems with pragmatic aspects of language ♣ Child is pedantic, has an unusual prosody, literal interpretation of comments ♣ Challenges with auditory discrimination and auditory processing

What is planned ignoring?

ignoring the behavior no matter how much it escalates (not good to use)

How are consequcnes assessed?

in terms of what motivates the individual

Warning signs of ASD: communication

lacks gestures: poignant, reaching, waving doesn't appear to understand simple questions or directions speaks in abnormal tone of voice or with odd rhythm may repeat words or phrases exactly as heard but feint understand how to use them

sensory processing

refers to a person's way of noticing and responding to sensory events

What is shaping?

reinforcement of successive approximations of preferred behavior

warning signs of ASD: behavior

repeats the same actions or movements over and over again develops specific routines and rituals and becomes upset at the slightest change is preoccupied with a narrow topic of interest

experiential learning

shapes the structure of the brain and promotes connectivity

SIX aspects of Autism

social reasoning language abilities cognition special interests sensory sensitivity expression & management of functions

intention reading

the ability of the child to "read" the adult's communicative intent

10 principles of symbolic communication intervention

1. Must begin where the learner is 2. Experience both prunes and powers the brain 3. The use of augmentative means to direct or facilitate the child's attention and provide language inputs channel is backed by considerable research 4. Emphasis must be placed on comprehension 5. Intake is more important that output- so engage in language-learning activities 6. 6. Targets should be within child's conceptual grasp (concept formation vs. concept identification) 7. 7. Intervention techniques should vary for learning types of vocabulary (nouns vs. verbs, etc.) 8. 8. Language therapy should be carried out in contexts that support meaning 9. 9. TOM activities should be woven into the fabric of language-learning activities 10. 10. Contextually relevant, usage based, interactive routine that mirror language learning process

12 questions to help identify the true function of the behavior

1. What is the history of the behavior? 2. When is the student most successful? 3. What are the student's strengths? Are they being reinforced? 4. What type of curriculum is the student enrolled in? Is it a good match (i.e., engaging and meaningful for him)? 5. Is student actively engaged in instruction or other activities for at least 80% of the school day? during unstructured time 6. When is the student more likely to engage in problem behaviors? 7. Are varied instructional approaches being used in the classrooms? 8. Does the behavior serve a purpose for the student? 9. What is the student's primary means of communication? 10. Could there be a medical explanation for student's behavior? 11. Is the student having any issues with eating or sleeping? 12. What is the student's life like outside school?

Average age of diagnosis

Average age of diagnosis is 4-5 years

Definition & purpose of Evidence Based Practice

Evidence -based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available clinical evidence from systematic research" (Sacker et al, 1996, pg 71 in Buron & Wolfberg, 2014) Any practice that has been established as effective through scientific research following an explicit set of criteria

ESEA/NCLB and how it impacted students with Autism

No Child Left Behind Accountability ¥ Demonstrate knowledge and skill in applying state-wide standards, assessments and alternate assessments ¥ Collect data to assess for instruction and monitor student progress Scientifically based instruction ¥ Demonstrate knowledge and skill in applying EBP supported by research that applies rigorous, systematic and objective procedures to obtain relevant knowledge Highly qualified teachers ¥ Demonstrate knowledge and skill-based competencies in the design and delivery of effective educational programs ¥ Understand and apply core elements of effective educational practice

who assess sensory processing

OT, not the SLP ¥ Occupational Therapists assess children to determine sensory processing profiles ¥ Perform assessments to determine how sensory processing impacts learning ¥ Make modifications to the learning environment to allow the child to excel

issues with evidence based practice

Personnel preparation Lack of university-level special education and clinical preparation programs with specialization in ASD a. ASD not recognized as a eligibility category for special education until IDEA (1990) b. ASD not a distinct category by the Council for Exceptional Children (CEC), for teacher training, for over a decade (2009) c. Because there was no set standards, university programs created their own... but it did not always align with credential criteria School districts left to develop their own trainings or hired outside contractors to support at premium cost

Warning signs of ASD: Social

Poor eye contact Lacks sharing interest and enjoyment with others fails to respond to his/her name Appears disinterested in or unaware of others

state of babies brains (blank slate vs "survival of the busiest"

Pruning, busiest neurons make it out • Babies brains are not a "blank slate" • Their brains have an excess of neurons primed for connectivity cause by experience • The brain prunes unused neurons- survival of the busiest

areas SLP diagnosis

Receptive and expressive language skills including: verbal and non-verbal gestural communication Social communication, including: use of gaze, joint attention, initiation of communication, social reciprocity and the range of communicative functions, sharing affect, play behaviors, use of gestures; Conversational skills, including: topic management (initiating, maintaining, and terminating relevant, shared topics); turn-taking; providing appropriate amounts of information in conversational contexts; Speech prosody

What is a redirection?

Redirecting student to a preferred behavior when challenging behavior is starting

conversation maxims:

Rules of how we communicate/conversation The third aspect of pragmatics: -quantity- only provide information needed -quality-truth value of utterances -relevance of utterance -clarity- utterance is clear and understandable to listener

modifications for Dunn's model

Seeking: ¥ Goal is to improve active participation in education ¥ Increase opportunities for stimulation if child is sensory seeking ¥ Incorporate movement into the school day Registration: For children who register less than peers, increase sensory input for them • Reduce predictability of routines • Break seat-work into smaller parts • Add multi-sensory components to each task (smelly markers, construction paper, use of bumpy surfaces, etc.) Sensitivity: • For children who are sensitive and are passive o Keep things consistent and low in stimulation ♣ Food textures, low noise level, consistent routines ♣ Unscented products Avoiding • For children with low thresholds and avoidance behaviors o Do not push student to try new things o Keep routines the same o Likely to display anxiety and hypervigilance

Hypothesis/problem behavior pathway

Setting the event: nonverbal, social skills deficit --> Fast trigger: sees classmate on swing --> Problem behavior: pushes classmate off swing --> Maintaining consequences: Briefly gets swing, brief interaction with classmate

Level 3 "Requiring very substantial support"

Social Com: Severe deficits in verbal & nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions & minimal response to a social overtures from others. Behavior: inflexible, extreme difficulty coping with change, interferes with functioning infall spheres

Level 2 "Requiring substantial support"

Social: Makes deficits in verbal and nonverbal social communication skills, social impairments apparent even with support, limited initiation of interaction, reduced/abnormal responses to social overtures Behavior: inflexible, difficulty coping with change, restricted/repetitive behaviors appear frequently enough to be obvious & interfere with functioning in various contexts

Level 1: "Requiring Support"

Social: without support, deficits in social communication cause noticeable impairments. difficulty initiating social interaction & clear example of atypical or unsuccessful responses to social overtures to others. Decreased interest in being social. Behavior: inflexible behavior causes significant interference with functioning in one or more contexts. difficulty switching between activities, problems with organization and planning hamper independence.

2 types of antecedents: Step One

Step 1: Defining the Behavior of Concern Behavior must be described and written in a measurable and observable format ¥ Poor descriptors: "Aggressive" & "Destructive" ¥ Measurable/observable descriptors: Pushes other students off swing on playground. Tears instructional materials when presented Is it truly a problem or just an annoyance to someone? ¥ Measures such as frequency, duration, and intensity can help determine significance of a behavior Also look at the long-term impact of a behavior on a child's adult options

2 types of antecedents: Step 2

Step 2: Gathering Behavioral Information Examine the relationship between the challenging behaviors and conditions in the student's life 2 points regarding FBA ¥ One person may guide the process, but data gathering must be conducted by multiple people in multiple situations ¥ Goal is to identify the underlying cause of the behavior ¥ Crisis management deals with symptoms ¥ FBA deals with cause

Symbol and referent

Symbol referring to the symbolism and referent referring to the item/object

Theory of Mind

The ability to recognize and understand the thoughts, beliefs, desires, and intentions of other people in order to make sense of behavior and predict what they are going to do next

what is a specifier?

describes additional information about a diagnosis:

Mindblindness

difficulty in putting oneself together in another person's shoes

Proposed cause of ASD: Infections during Pregnancy/Early Childhood

o 1970s proposed that ASD caused by congenital rubella (no supportive evidence) o Herpes virus, post-measles encephalitis No research showing that the MMR vaccine containing mercury causes Autism

Core Deficit Approach: Old theory

o A single deficit causes a cascade which results in a constellation (a variety or multiple) of deficits o Research showed there were many deficits that could be considered "core"

4 proposed reasons why ASD is increasing

o Broadened the definition of ASD o Children can have multiple disorders o Better at diagnosing ASD o Children previously diagnosed as ID are now more accurately diagnosed

core deficit approach: new theory

o Currently, No evidence has substantiated a core deficit o New theories propose a primary disengagement of attention in: 1 representational capacity 2 social motivation 3 or orienting to social stimuli

Joint Attention role in Language Development

o Fueled by experience o Provides a rich milieu within which relatedness and emotional sharing take place o Intersubjectivity- shared understanding o Sets stage for intention reading- related to development of symbolic communication o Deficits in JA are among the most robust behavioral finding in ASD

early onset traits...

o May not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies later in life o Early onset feeding problems and sleep disturbance are also present

impairment and ability approach

o Research evidence of all simultaneously occurring impairments and intact abilities o Purpose is to identify a common denominator of impairments and abilities that will give insight into the cognition and brain in autism o Pattern of impairment and ability reflect the nature of the biological disturbance

simple skills vs complex skills

o Simple skills versus complex skills for people with ASD o Simple tasks easier o Complex tasks more difficult due to increase need to process more information o Individuals with ASD may have trouble with language because of the grammatical complexity of sentences o This concept is IMPORTANT for teaching and therapy: o How can we use this information to change our presentation of stimuli to better meet our student's needs? o How does this directly apply to language?

importance of games

o Social-cognitive precursors to the development of social communication o Contributors to emerging joint attention o Involve social reciprocity- early turn taking o Enable infant to regulate the interaction o Establish predictability o Anticipate what's next o Engage with others and teaching them to engage the subjective state of others (early TOM)

core deficit approach: temporal primacy

o They started to look at the temporal primacy of specific deficits o Looking for one deficit that preceded all other deficits onset in infancy

4 specifiers about ASD in DSM-V

o With or without accompanying intellectual and/or language impairment o Association with a known medical, genetic condition, or environmental factor o Association with another neuro-developmental, mental, or behavior disorder or catatonia o Severity of expression from Level 1 to Level 3 based on the level of support needed for social communication and restricted, repetitive behaviors

information processing:

o the term "information-processing" was used to cover both deficits and intact abilities o Process whereby the brain attaches meanings to information o The deficit in complex skills demonstrates that within the domains, the highest level skills ere affected the most

How many levels of severity are there in ASD?

three

thresholds

¥ Refer to the point at which the sensory system responds to stimuli ¥ If thresholds are too low, then children respond frequently and can be distracted from tasks because of all the information around them ¥ If thresholds are too high, then children miss important cues about what is going on around them

Proposed cause of ASD: Neurology

¥ 10-25% of children with Autism/ASD have macrocephaly ¥ Dysfunctions with serotonin and dopamine ¥ Concerns with limbic system, amygdala, cerebellum, inferior olive, reduced neuron size and density ¥ Large brain volumes on MRI, increased cerebellar and cerebral cortex white matter, increased grey matter ¥ Different functioning in the amygdala and orbitofrontal cortex

Early Onset

¥ At 2-6 months of age, a decline in eye fixation takes place for children with ASD which is not noted in infants who did not develop autism ¥ At 9-12 months of age, subtle differences in sensory-motor and social behavior as well as differences in the use of communicative gestures ¥ At 1-year of age, children with ASD exhibit fewer joint attention and communication behaviors when compared to TD same-age peers and they exhibit atypical eye contact, passivity, decreased activity level, and delayed language ¥ At 14-months of age, abnormalities in children's language development and social relatedness are noted

underlying assumptions of a positive behavioral support approach

¥ Behavior is: ¥ Influenced or governed by context ¥ Functional, purposeful, and meaningful to the individual ¥ Affected by internal events, including emotional and medical issues ¥ Influenced by factors outside the immediate environment (relationships, opportunities for engaging in various activities, and lifestyle issues) ¥ Behaviors will change as people mature and develop new competencies. ¥ Puberty demonstrates that not all maturation improves behavior. ¥ Behavioral supports are guided by a strong value base

Antecedents: Slow triggers

¥ Can "chip away" at a student's tolerance and ability to perform/cope ¥ Slow triggers may explain why a student can handle a task one day, but not the next

Antecedents: Fast triggers

¥ Events that are directly related to the challenging behavior or immediately precede ¥ Easier to spot, but not always immediately obvious Immediate antecedents are easier to identify, but setting events play a critical role in increasing the likelihood that a behavior will occur

A-B-C antecedent, behavior, consequence

¥ Focus on identifying antecedents and consequences that maintain the behavior ¥ antecedent = what happens before the behavior occurs ¥ consequence = what happens after the behavior

Proposed causes of ASD: Gender differences

¥ Males:females - 4:1 ¥ Males:females - 2:1 for ASD Level 1 ¥ Females often undiagnosed until adolescence when secondary mood, eating or personality disorders emerge

recommendations for classroom management

¥ Minimize free/unstructured time by actively engaging ¥ Develop a schedule that includes varying tasks to minimize boredom and frustration- behavioral momentum ¥ Build in time downtime or physical activity as needed ¥ Get student engaged as soon as he enters the classroom ¥ Intersperse easy and difficult tasks ¥ Embed opportunities for choice ¥ Allow student to preview/rehearse new materials or activities ¥ Clearly articulate and visually demonstrate expectations for instruction and interaction ¥ Make sure the majority of your interactions with the student are positive ones (not corrections or reprimands) ¥ Establish rapport ¥ Teach rules, limits, and boundaries clearly and visually through repeated rehearsals ¥ Establish routines, but build in changes to prevent rigidity ¥ Consider the student's learning style ¥ Teach strategies for coping and negotiating the stress of daily life

goal of sensory processing modifications

¥ Need to integrate effective educational strategies and sensory processing knowledge to best severe children who have ASD ¥ Remember the goal is to increase participation... not change the sensory pattern

Late onset in ASD

¥ Occurs after the second year ¥ Children achieve developmental milestones in motor, linguistic, and cognitive skills ¥ Demonstrate a reasonable spoken vocabulary ¥ Develop early symbolic and imaginative play ¥ Sudden regression in speech, vocab (peaks at 18 months) ¥ Similar to a child with early onset ASD at 3 years

Proposed cause of ASD: Metabolism Errors

¥ Phenylketonuria (PKU): deficiency in the enzyme that converts the amino acid phenylaline to tyrosine ¥ Children with PKU have to consume a phenylaline-free diet ¥ No research has established the value of a gluten or casein-free diets

What is central coherence?

¥ Refers to a constellation of impairments in high-order cognitive and language abilities and strengths on tasks that required perception of details, primarily visuospatial in nature ¥ Included concerns with comprehension ¥ Doesn't include concerns with simple information ¥ Term did not cover the deficits in expression found in autism

Consequences:

¥ Responses that follow a behavior and make it more likely to occur again ¥ Keep in mind that some "punishments" could be a reinforcing consequence for a student with ASD ¥ Missing recess ¥ Making teacher yell ¥ Sitting in corner by self

4 patterns in Dunn's model

¥ Seeking ¥ Reflects high threshold and active self-regulation ¥ Looking for more sensory input then TD peers ¥ Presents as fidgeting, noise making, touching, chewing, etc. ¥ Registration ¥ Reflects high threshold and passive self-regulation ¥ Do not know what is going on around them ¥ Presents as uninterested, quiet, easy-going, dull, etc. ¥ Sensitivity ¥ Low threshold and passive self-regulation ¥ Detect more details than others ¥ Presents as very discerning about what is in their environment, may be hyperactive, distracted, trouble learning because they are focused on new stimuli ¥ Avoiding ¥ Low threshold and active self-regulation ¥ Actively work to reduce input ¥ Routinized, resistant, unwilling to participate in activities, experience discomfort quickly so they reduce activity, withdrawal, etc.

FBA (Functional Behavior Analysis)

¥ The process of gathering information necessary to understanding the function of a behavior ¥ Long considered best practice, it is now articulated under IDEA

Proposed causes of ASD: Family History

¥ Type 1 diabetes, rheumatoid arthritis, asthma, Crohn's disease, increased level of Celiac ¥ Especially in mother's of children with ASD

criss management

¥ When a student with an ASD engages in dangerous behaviors, an expert is often called in to provide a "quick fix" that will have an immediate impact on the situation

FBA inclues:

¥ members from all environments in which the student interacts, including: ¥ Family ¥ Teachers ¥ Paraprofessionals ¥ Therapists ¥ Doctors ¥ Student himself

key features of an effective EI program for ASD

• 25 hours/week of intervention for young children with ASD (recommended by the NRC, 2001 report) • Combination of center, home and community services with multidisciplinary instruction -16-40 hours of intervention -Some programs include Applied Behavior Analysis (ABA) • Individualized or specialized instruction • Sufficient number of hours and intensity of services • Comprehensive environments with access to typical peers • Specialized curriculum with an appropriate scope and sequence • Family involvement • Problem-solving approach to challenging behaviors • Appropriate evaluation tools to monitor progress

Age of reliable diagnosis

• ASD can be reliably diagnosed in the first two years of life

social communication:

• Allows us to bring an intended effect in the attentional and mental states of others so they can act upon the perceived message

symbolic communications considerations: Natural contexts

• Assessing the environmental variables that either help to facilitate or interfere with communication • Assess several different contexts- some contexts are more facilitative then others • Assess range of function in a child's repertoire- especially because of restricted and repetitive behaviors Conversational Maxims- rules of discourse by which speakers co-operate in their conversations with one another Presuppositional Knowledge-judgments that the speakers must make about their listeners' needs with respect to the informational content needed and the communicative style appropriate to the situation

Experimental learning for ASD

• Infants with ASD do not readily engage in games • Lack of experiences is likely a key factor in their social cognitive, communicative, and language deficit • Not uncommon to see them unengaged in language-learning situations- why? • Not uncommon to see them in forced Language learning situations which promote discomfort and resistance- why? • Missing opportunity to engage in: emotional regulation, affect and sharing attention, anticipation, and reciprocity with caregivers... all of which set foundation for joint attention and symbolic communication • Often engage in self regulatory or repetitive activities- non social, unilateral, and no variety

symbolic communication considerations: comprehension

• Level one- Literal: Ê Assessing the ability to derive an understanding of words and sentences • Level two- Discourse: Ê Intention reading and the integration of knowledge with the social context Ê Why is this especially important with ASD? (think part vs. whole) Ê Theory of mind Ê Don't want people to just have the symbol, but use it in real world situations Ê Generalize

What is a double interview:

• Part I - educator interviews student • Part II - student identifies photos of educator's family, friends, hobbies, etc. • Part III - student interviews the educator for the stated purpose of finding out more about her • Turn taking • Topic maintenance • Processing of pictures and coming up with follow up questions

Early intervention benefits

• Refers to services that are provided at an early age to remediate concerns in speech, language and/or play • It is generally accepted that early identification, diagnosis and treatment is optimal for children with ASD o Considerable cost-savings in long term o Improvements noted in cognitive functioning, level of independence, and communication skills

symbolic communication considerations: vocal development

• Standardized tests are available (ROWPVT, EOWPVT) they should be supplemented with non standardized assessment measures • Gather information from parents and teachers on vocabulary and vocabulary development • Analysis of expressive language in multiple environments and contexts

Symbolic communication considerations: situated pragmatics

• Takes into account contextual variables, possible barriers to communication, and the contributions of communicative interactants (positive and negative) o Recognizes that there is a shared responsibility for communicative breakdown that goes beyond the individual with the language impairment • Observation of attention and affect sharing, joint attention and social referencing behaviors, and intention reading • 4 main features: o Looks at the entire interaction including the relationship between the interactants for clues regarding comm breakdown o Situated pragmatic is competenceas opposed to deficit-based o Focus on context to determine the match between communicative expectations and ability level o Child-centered: involves understanding what the child is intending to do

Assessment considerations

• There often are not standardized tests for the skills you want to assess. • Assessment of pragmatics requires you to consider the context and situation • "Snapshots in time" have limited predictive value for future language performance or learning potential • Supplement standardized tests with informal assessment procedures Assess across multiple, naturalistic contexts

social pragmatic theory

• understanding people as intentional agents is necessary for language acquisition to take place o Children use wide array of social-pragmatic cues to perceive and comprehend adult intentions

Proposed cause of ASD: Genetics

♣ Identical twins: 70-90% ♣ Non-identical: 0-5% ♣ Recurrence in families: 18-22%, 26% if the child is male ♣ Fragile X increased risk ♣ Chromosomal abnormalities on 2, 7, 15, 16 & 19

positive contributions of EBP for ASD

♣ Individualized supports and services ♣ Systematic, carefully-planned instruction ♣ Comprehensible and structured learning environments ♣ Specialized curricula focused on core challenges (social/communication) ♣ Functional approach to problem behavior ♣ Family involvement

disparities in the field of EBP and ASD

♣ Overrepresentation of ABA in the field because of outcomes measurement procedures ♣ Interventions targeting spontaneous initiation, imitation, mutual engagement, etc. are less likely to meet criteria for EBP ♣ Teacher shortages mean that teachers with minimal CEUs in ASD can be authorized as "highly qualified"

DSM-V description of ASD

♣ Persistent deficits in social communication and social interaction across multiple contexts ♣ Restricted, repetitive patterns of behavior, interests and activities ♣ The symptoms are present in the early developmental period ♣ Cause clinically significant impairment in social, occupational or other important areas of current functioning ♣ These disturbances are not better explained by intellectual disability or global developmental delay. Social communication should be below that expected for general developmental level