Week 2 Flashcards
(38 cards)
Describe early signs and outcomes of ASD
Name evidence-based interventions for ASD and explain how they work
Describe the optimal timing and dosage of these interventions
Discuss options on how to deliver treatments when families experience barriers to care
Explain the difference between efficacy and effectiveness
Give some arguments about why ASD is a disorder
- Clinically significant impairment
- ASD is defined in diagnostic manuals (e.g., DSM-5) by impairments in social communication and restricted behaviors that interfere with daily functioning. - Developmental delay
- Many individuals with ASD experience delays in language, social interaction, or cognitive flexibility compared to typical developmental milestones. - High co-occurrence with other conditions
- Anxiety, depression, epilepsy, ADHD, and intellectual disability frequently co-occur, suggesting neurological or functional challenges. - Need for support
- Many autistic individuals require support in education, employment, relationships, or self-care — which can be lifelong. - Scientific classification
- From a medical and psychological standpoint, ASD meets criteria for a neurodevelopmental disorder: symptoms appear early and affect functioning across multiple domains.
Give some arguments why ASD is not a disorder
- Neurodiversity perspective
- Advocates argue autism is a neurological difference, not a deficit. The brain just processes information differently — not wrongly. - Social model of disability
- Many “difficulties” arise from how society is structured, not from autism itself. For example, social communication is a two-way street, and many barriers are environmental. - Unique strengths
- Many autistic individuals have strengths in memory, attention to detail, creativity, or systemizing. Labeling ASD as a disorder may overlook these abilities. - Stigma and identity
- The term “disorder” can pathologize and devalue autistic individuals, making them feel “broken” rather than different. - Not always impairing
- Some autistic people live independently and successfully, and may not want — or need — medical treatment or therapy.
Explain what is meant by the Neurodiversity movement and how it relates to ASD
What is the neurodiversity movement?
- It’s a social and cultural perspective that advocates for acceptance and inclusion of people with neurological differences (e.g., ASD, ADHD).
- It views these differences as natural variations of the human brain — not necessarily as disorders or deficits.
Core arguments of the movement:
- Autism is not a disorder, but a neurological difference.
— People with autism may learn, think, and solve problems in unique, valuable ways.
- What we call “impairment” is often just a mismatch between the individual’s traits and the demands of a neurotypical (non-autistic) society.
— For example, a person might struggle socially not because they’re impaired, but because social norms weren’t designed with their brain style in mind.
The movement supports clinical treatment, but not to “fix” autism.
- Instead, treatment should aim to provide support (e.g., for communication, sensory needs).
At the same time, it calls for changing how society thinks and behaves — to make the world more inclusive of neurodiverse people.
What are the DSM-5 symptoms of ASD?
2 areas of difficulties:
1. Persistent deficits in social communication and social interactions across multiple contexts
- It is important that it occurs across multiple contexts. Otherwise it is a more contextual factor that causes the impairments
2. Restricted, repetitive patterns of behaviour, interests or activities
Symptom severity/ intensity can vary extensively
Name some early signs of ASD in young children
- Communication & interaction difficulties:
- Lack of responsiveness: the child may not respond when their name is called, may avoid eye contact, or seem uninterested in social interaction - Repetitive behaviours:
- Hand flapping: repeated, rhythmic movement of the hands
- Tiptoeing: walking on the toes frequently, rather than flat feet
- Stimming: self-stimulatory behaviours like rocking, spinning, or flicking fingers, often used to self-regulate or cope with sensory input - Agressiveness:
- Some toddlers may show irritability or agression, often due to frustration from communication challenges or sensory overload.
The behaviours are often normal for development but the frequency and consistency is important
Describe the prevalence of ASD
- 1-2% of toddlers and children are diagnosed with ASD
- Boys are diagnosed significantly more often than girls (4:1)
Describe the comorbidity in ASD
Children with ASD commonly experience:
- ADHD (Attention Deficit Hyperactivity Disorder)
- Anxiety and depression
- Sleep disorders
Explain what is meant by secondary symptoms in ASD
These are not core diagnostic features but occur frequently, often as a reaction to stress or sensory overload:
- Self-harm: head-banging
- Agressiveness and tantrums
These behaviors can serve a communicative function, especially in nonverbal or overwhelmed children:
“Something is wrong,” “I feel overstimulated.”
Why is it important to recognize early signs of ASD and acting quickly with early intervention?
- ASD is a neurodevelopmental disorder, meaning it begins in early brain development.
- It’s caused by a combination of genetic and environmental factors (not just one or the other).
- Signs can be seen as early as 6 months, and diagnosis in toddlerhood is now common and well-supported by research.
- ASD often comes with:
— Developmental delays (e.g., language or motor skills),
— Co-morbidities (like ADHD or anxiety),
— Secondary symptoms (e.g., tantrums or self-injury),
— All of which can lead to psychosocial impairment — difficulties in functioning socially, emotionally, and behaviorally.
There’s a wide range in how ASD presents: no one-size-fits-all. Because of this variability, it’s crucial to detect ASD early and tailor interventions to the child’s specific strengths and needs.
What is the goal of intervention for ASD?
> To improve their functioning and ability to lead satisfying lives in the community.
It is important that the intervention match with the goals of the child and parents. Every family has other goals for the child.
Describe the first interventions for ASD
The first attempts to treat autism were intense, radical and ineffective:
- Electroconvulsive therapy
- strict dietary restrictions
These interventions lacked an understanding of autism as a neurodevelopmental condition.
Critically, there was little to no early intervention, which we now know is key to better outcomes.
Poor outcomes:
- Nearly all children diagnosed with ASD were institutionalized by adolescence — removed from families and placed in mental health facilities.
- Around 50% remained non-verbal into adulthood.
- Only 1.5% reached “normal” functioning, reflecting how poorly children with ASD were supported at the time.
Explain the behavioural interventions that were inspired by Skinner.
Key Concepts:
- Based on Skinner’s theory of operant conditioning (1965), which states that behavior is shaped by its consequences.
- Behavior is understood using the ABC model:
— Antecedent: What happens before the behavior (the trigger).
— Behavior: The observable action.
— Consequence: What happens after the behavior (reward or punishment).
Application:
This model laid the groundwork for Applied Behavior Analysis (ABA) — a central method in ASD intervention, especially in early behavioral therapy.
How Behavior Is Shaped:
1. Reinforcement – Increases the likelihood of a behavior repeating:
— Positive reinforcement: Adding something pleasant (e.g., praise, toy).
— Negative reinforcement: Removing something unpleasant (e.g., taking away a loud noise).
2. Punishment – Decreases the likelihood of a behavior repeating:
— Positive punishment: Adding something unpleasant (e.g., scolding).
— Negative punishment: Removing something desirable (e.g., taking away a toy).
These principles are used to encourage desired behaviors (like using words to communicate) and reduce unwanted ones (like hitting or screaming).
What is Extinction?
- Extinction means removing reinforcement for a behavior so that it eventually stops.
- Example: If a child cries to get candy and the parent stops giving candy, the behavior will increase briefly (called an extinction burst) and then fade out.
Visual:
The graph shows how the behavior (crying) initially spikes when reinforcement is removed, then drops off over time.
SAMENVATTING:
- Early behavioral interventions were heavily based on Skinner’s reinforcement model.
- These strategies evolved into modern ABA techniques used today, which remain evidence-based for improving communication, behavior, and learning in children with ASD.
- They’ve moved from rigid, reward-based systems to more naturalistic approaches like PRT and ESDM — still grounded in Skinner’s theory but adapted for child-centered, flexible learning.
Name the 4 principles of Applied behaviour analysis (ABA)
- Behaviours are affected by their environment
- Behaviours can be strengthened or weakened by their consequences
- Behaviour changes are more effective with positive instead of negative consequences
- Behviours need to be reinforced or disciplined for socially significant changes.
- Interventions focus on teaching behaviors that matter in daily life — communication, safety, cooperation.
- The goal is to increase adaptive behaviors and reduce harmful or disruptive behaviors using structured reinforcement or correction.
Explain what ABA is and entails
O. Ivar Lovaas was one of the first to develop intensive ABA treatments for autistic children.
- His early methods focused on:
– Punishment-based techniques, including aversive methods like electric shocks for self-injury.
– Sterile environments: therapy was conducted in impersonal, empty rooms to eliminate distractions.
– No family involvement: interventions were done without engaging parents.
– Over time, he also began incorporating positive reinforcement (like food or affection).
Context: These methods were harsh by today’s standards and have been widely criticized, but they laid the groundwork for future ABA practices.
LATER:
- Lovaas introduced EIBI, comparing:
— Children receiving 40+ hours/week of therapy
— Versus children with less than 10 hours/week
- Children received Discrete-Trial Training (DTT):
— Skills are broken into small steps, taught one by one.
— Each step is taught using clear prompts, repetition, and reinforcement.
— Progress is tracked meticulously.
— Based on Skinner’s operant conditioning, it’s aimed at building skills and reducing atypical behavior.
How does Discrete-Trial Training (DTT) work?
- Trial 1: Child doesn’t succeed → receives encouragement.
- Trial 2: Partial success → receives praise.
- Trial 3: Correct response → receives high reward (praise, hug).
This visual illustrates the step-by-step nature and reinforcement system of DTT.
Describe Lovaas’s EIBI study
Results of his famous 1987 study:
- Intensive treatment group:
— 47% reached “normal” intellectual and educational levels.
— Only 10% remained intellectually disabled.
- Light treatment group:
— Only 2% reached “normal” functioning.
— 98% had some degree of intellectual disability and needed special education.
Impact: These findings were groundbreaking at the time and sparked global adoption of ABA-based early intervention programs — although ethical and methodological criticisms have emerged since.
which skills are taught to children with ASD through ABA?
- Social skills (e.g. sharing, turn-taking)
- Communication Skills (e.g. using words to get what you want)
- Play (e.g. joint attention)
- behviour (e.g., waiting, emotion regulation0
- motor skills (e.g. fine/gross)
- cognitive skills (e.g. imitation)
- Adaptive skills (e.g. dressing, feeding, toileting)
Name some insights on learning from developmental science
- Joint attention:
- The ability to share focus on an object or event with another person.
- Seen as a crucial precursor to language development and social interaction. - Imitation:
- Children learn by copying others, which supports understanding others’ intentions and thoughts — key for language and empathy. - Children are active learners:
- They explore, test, and experiment — they don’t just absorb information passively. - Relationships are essential for learning
- Interactions with caregivers and therapists provide the emotional and social context that fuels development. - Affective engagement supports learning:
- Emotional connection (fun, joy, interest) enhances attention and memory.
Describe the limitations of early ABA
Early ABA interventions (like Discrete Trial Training) can teach basic skills, but they:
1. Lack generalization
- Skills learned in therapy don’t always transfer to everyday settings (e.g., child uses new word in clinic but not at home).
2. Lack spontaneity:
- Because ABA is often rigid and scripted, children may not apply skills creatively or flexibly.
3. overdependence on prompts
- Children may only respond when a therapist prompts them, rather than initiating behavior on their own.
4. Avoidance behaviours
- If learning isn’t meaningful or enjoyable, children may disengage or resist.
5. Very time and labor intensive
- Traditional ABA (like 40 hours/week) requires huge resources from families and professionals.
