PSY 3410

AUTISM SPECTRUM DISORDERS &

INTELLECTUAL DISABILITY
Unit 1– Introduction:
Organization & Overview of ASD & ID
Instructor: Dr. Lauren Moskowitz

Class #1 Thursday, September 5, 2018

Review Syllabus

¨ Course description/textbook
¨ Exams

¨ Extra credit

¨ Topics overview
Purpose of this course

¨ Learn:
¤ History of developmental disorders
¤ Etiology of ASD and ID

¤ Typical development vs. atypical development

¤ Assessment and diagnosis of ASD & ID

¤ Intervention

¤ Information about special populations (siblings,

females, adults)
Course format

¨ Lectures
¨ Discussions

¨ Readings from textbook AND articles

¨ Videos/demonstrations

¨ Guest speakers
What do you know about autism?

¨ Do you know someone with autism?

Autism is a social impairment. That is the difference between autism and intellectual
disability. ID is a cognitive impairment in which individuals are very social, but
autistic individuals have no cognitive impairments just social.

¨ Impressions?
What do you know about Intellectual
Disability?

¨ Do you know someone with ID?

¨ Impressions?
What do we mean by a “spectrum”
disorder?
Severe and pervasive impairment in several
areas of development
Core characteristics (according to DSM-5):

Social communication & social interaction

impairments

Repetitive, stereotypical behavior, interests, &

activities
Video Example

Autism Every Day – 7 minute version

 Terminology
¨ Person-first language
¤ Would say a child with autism so they are not defined by their disability
Person with __________.
¤ e.g., “a child with autism” (versus “an autistic child”)
¤ (Although some with the disorder prefer to refer to themselves as
“autistics” or “aspies”)

¨ Intellectual disability
¤ Not called “mental retardation” anymore
Retardation has a negative connotation and is considered an insult
¨ Autism spectrum disorder (ASD)
¤ Neurodevelopmental disorder that affects how one socializes with others
¤ Term “disorder” in keeping with DSM-5 and ICD-10 terminology
¤ Some argue not a disorder, but a difference

¨ “Typical” instead of “normal”

Adapted from Durand (2014)
 Person-First Language

¨In groups of 4, discuss the following…

•Does it really matter?????
•Why is it important? Important so that we do not define
and label someone by their
disability

•What does it look like?

¤ Child with autism vs. autistic child
¤“Intellectual Disability vs. mentally retarded
History of ASD
 First Use of the Word “Autism”
¨ The word autism comes from the Greek word autos
(meaning “self”)
Very fitting for at least the originally defined autistic child because kids were “in their
own world”
¨ In 1911, Eugen Bleuler coined the terms “autism”
and “autistic” to describe aspect of schizophrenia
in which a person withdraws from the outside
world into himself (Sicile-Kira, 2004)
Now we know it is not at all
related to schizophrenia
¨ “Autismus” = to lose relationship with
external world and lead a life
of one’s own world
 “Classic Autism” (Leo Kanner)
Really coined the term autism; “father” of autism

¨ In 1943, Dr. Leo Kanner used term “autistic” in his

publication describing 11 children who responded
in unusual ways to people and to the environment
¤ Kanner viewed the main problem of children with autism as
being their “inability to relate themselves in the ordinary
way to people and to situations from the beginning of life”
¤ Kanner considered the two hallmark features of autism to be:
1) extreme self-isolation
2) obsessive insistence on the preservation of sameness
Current criteria are social interaction impairments and restrictive dependent behaviors; not far off
¤ He considered the odd language and other features to be
derivatives of the basic disturbance in human relatedness
¤ Lack of social interest & over-engagement in non-social world
 “Classic Autism”
¨ “There is from the start an extreme autistic aloneness that,
whenever possible, disregards, ignores, shuts out anything
that comes into the child from the outside” (Kanner, 1943)
¨ A father described his son in this way:
¤ "He seems to be self-satisfied. He has no apparent
affection when petted. He does not observe the fact that
anyone comes or goes, and never seems glad to see
father or mother or any playmate. He seems almost to
draw into his shell and live within himself” (Kanner, 1943).
Autism was originally mainly see as lack of social interest and unapparent social desire, but
has now broadened to those who may want social relationships but lack social skills
Kanner’s original publication:
http://www.neurodiversity.com/library_kanner_1943.pdf
 Characteristics Kanner Described
¨ An inability to relate to others in an ordinary manner
¨ An extreme aloneness that isolates the child from the outside world
¨ An apparent resistance to being picked up or held by the parents
¨ Deficits in language, including mutism and echolalia ofVery unusual memory
facts and sometimes
things from long ago
¨ In some cases, an excellent rote memory
Echolalia- repetition of sounds or noises;
¨ Early specific food preferences immediate (repeated right after
someone says something) or delayed
¨ Extreme fear reactions to loud noises (repeated from past, either last night,
last week, etc.)
¨ Obsessive desire for repetition and maintenance of sameness
¨ Few spontaneous activities such as typical play behavior
¨ Bizarre & repetitive physical movement such as spinning or rocking
¨ Normal physical appearance
Scheuermann & Webber (2002)
 Asperger’s Type (Hans Asperger)
¨ In 1944, Hans Asperger used the term “autistic
psychopathy” to describe a similar condition
¨ Children had higher cognitive skills & overall
functioning, but same specific challenges in
social understanding first reported by Kanner
Originally was in a separate category, but is now all gouped together as part of ASD Spectrum disorder
¨ He described 4 boys with difficulty relating to other children:
¤ Appeared to be intact intellectually
¤ Behavioral outbursts in situations with others
¤ Appeared to lack the ability to understand why others did
not behave in ways they wanted (which greatly upset them)
Researchers debate whether or not they are really the same or
are they different, just somewhat socially related disorders Adapted from Durand (2014)
 Video Example of Asperger’s

Typically when we say low-functioning we mean limited

speech and cognitive ability (seem more socially
impaired); whereas higher function refers to more
advanced cognitive and language ability (but these
people may be more at risk for anxiety, depression and
social impairment)
Can you really say you are higher functioning and
functioning well if you are still depressed and not able to
form social relationships. This is why prof. Moskowitz does
not like to use these terms

Asperger’s support group

 Bruno Bettelhiem
¨ In the late 1940’s, Bettleheim coined the term “refrigerator
mothers,” claiming that the cause of autism was unfeeling,
cold parents
¤ While Bettelheim was said to be a Hungarian psychotherapist, it
was discovered in the later 1990s that before emigrating to the
U.S. he had worked in the family lumber business and earned a
degree in art history with no expertise in autism (Sicile-Kira,
2004)
¤ Unfortunately, his theory of “refrigerator mothers” was widely
accepted for two decades
Led to he extreme damage of parents’ psyche; also led to attachment and
holding therapy to try and help parents be more warm and gain child
attachment, which was proved to be unsuccessful
 Bernard Rimland
¨ In 1964, a psychologist named Bernard Rimland published a
book that insisted that autism was a biological disorder, not
an emotional illness caused by unfeeling parents
¨ Rimland was also a parent of a child with autism and the
founder of the Autism Society of America (ASA)
¨ ASA was the first parent-driven organization to provide
information and support to parents and professionals
¨ To view ASA website, go to:
¨ www.autism-society.org
 Ivar Lovaas
¨ In 1987, O. Ivar Lovaas published his landmark study
showing dramatic IQ gains for a large number of young
children with autism participating in applied behavior
analytic intervention program called “discrete trial training”

Psychologist at UCLA conducting studies of children with autism in the 1960s; but found improvement
and “treatment” for children with autism in improving IQ but not making them more social. Led to
children with autism being mainstreamed in school
 Autism and IDEA
¨ In 1990, the Individuals with Disabilities Education Act (IDEA)
recognizes autism as one of 13 disabilities under which a
student can be eligible for special education services
Not perfect but it is an improvement in what we had previously and what other countries have
Guarantees at least some kind of education for these children, but does not mean it is the best
 History of DSM and Autism
DSM is how we diagnose all mental disorders (separated from physical or medical/genetic disorders)

¨ 1968: DSM II used the label autism to describe

childhood schizophrenia
¨ 1980: DSM III included Autism as Infantile Autism.
¨ 1994: DSM IV introduced PDD with 5 subtypes
¤ Autistic Disorder Like Kanner’s austism
¤ Asperger’s Syndrome
¤ Childhood Disintegrative Disorder
¤ PDD-NOS
¤ Rett’s syndrome ( found a gene to identify with Rett’s so was taken out of the DSM V )

¨ 2013: DSM V collapsed first four under umbrella of

ASD and got rid of subtypes – now it’s all “Autism
Spectrum Disorder”
 Outcomes for individuals with ASD

¤ Kanner (1971): 2 out of 11 were “success stories”

¤ Lack of long-term prospective studies
Not a lot of data on adult outcomes because most research is done on young children
¤ By 19, 9% no longer had diagnosis of ASD
(Anderson, Liang, & Lord, 2014)
Very small percentage of children may be able to lose diagnosis
¤ Outcomes may need to be reconceptualized
n Person-environment fit
n “Niche-picking”
May need to reconceptualize not finding cure but how to live with the disorder; good fit in
environment, finding life thats a good fit for you with job, friends, school, etc.
 IQ & Prognosis
¨ ~38% of individuals with ASD have ID
¨ Cognitive impairment is observed in 2 out of 3
(67%) persons diagnosed with ASD
¨ This is higher for those with “Kanner’s autism”
IQ does not really matter in terms of autism, except that it
¨ IQ & Prognosis: is proven higher IQ shows less need for extensive support
and care (can better manage on own)
¤ Higher IQ scores - less need extensive support by
family members or people in the helping professions
¤ Lower IQ scores - severely delayed in acquiring
communication skills and need a great deal of
educational and social support as they grow older
Durand (2014)
What is a “Successful” Outcome?
¨ Person-environment fit
¨ If living arrangements, employment opportunities
and available peers for socializing are available in
ways that are adapted to the needs of the person
with ASD, the “outcomes” may be more positive.

Durand (2014)
 Key Point

*Consider adopting this alternative way of thinking about ASD…it

may help you to better understand the field & connect with individuals
with ASD & their families
http://www.youtube.com/watch?v=QX-xToQI34I