L O G Y O F E X C E P TI O N A L

PSYCHO
R E N : A N IN T R O D U C T IO N
CHILD APRIL GAY M. PUGONG, RP
M
 UNDERSTANDING SPECIAL NEEDS
• SPECIAL NEEDS- a term used in clinical diagnostic and functional
development to describe individuals who require assistance for
disabilities that may be medical, mental, or psychological.
• -it is a diagnosis used to classify children as needing “more” services
than those children without special needs who are in the foster care
system based on behavior, childhood and family history and is usually
made by a health care professional.
•SPECIAL NEEDS – a short term for special education
needs and is a way to refer to students with disabilities
•DISABILITY- a physical or mental impairment that
substantially limits one or more major life activities-
impairments include physical, sensory, and cognitive or
intellectual.
•-mental disorders (also known as psychiatric or
psychosocial disability) and various types of chronic
disease may also be considered qualifying disabilities.
 DEVELOPMENTAL DISABILITY
• a term used to describe life-long, disabilities attributable to mental and or physical
or combination of mental and physical impairments, manifested prior to age 18.

• disabilities affecting daily functioning in three or more of the following areas

• capacity for independent living
• economic self-sufficiency
• learning
• mobility
• receptive and expressive language
• self-care
• self-direction
NEURODEVELOPMENTAL DISORDERS
 AUTISM SPECTRUM DISORDER (ASD)
• A developmental disability significantly affecting verbal and nonverbal
communication and social interaction, generally evident before age three that
adversely affects a child’s educational performance (IDEA)

• A collection of neurobehavioral conditions that share in common primary oddities

of socialization and communication (Schaefer and Luta 2006)

• Primary core deficit areas (David and Tsung 2009)

• Atypical or qualitative impairment in social interaction
• Qualitative impairment in communication
• Presence of repetitive and stereotyped patterns of behavior or activities
AUTISM SPECTRUM DISORDER (ASD)

• DSM 5 termed the five different pervasive developmental disorders

namely Autism, Asperger’s Disorder, Pervasive Developmental
Disorder Not Otherwise Specified (PDD-NOS), Childhood
Disintegrative Disorder and Rett’s Syndrome into the umbrella
called Autism Spectrum Disorder (ASD)
TYPES OF AUTISM SPECTRUM DISORDER
1. CLASSIC AUTISM
• Children with this condition have sever challenges including impaired
social and communication interactions leading to difficulty in conversing
and relating to people.
• Qualitative impairment in social interaction marked impairment in the
use of multiple nonverbal behaviors, such as eye-to-eye gaze, facial
expression, body postures and gestures to regulate social interaction
leading to difficulty in conversing and relating to people.
TYPES OF AUTISM SPECTRUM DISORDER
1. CLASSIC AUTISM
•May show repetitive or stereotyped behavior and may be
hypersensitive to their environment. This explains why
children with this condition are distressed to certain sounds,
color and textures and are anxious to differing schedules and
routines (New 2012)
• Other terms for classic Autism are Childhood Autism, Early Infantile
Autism, and Kanner’s Syndrome or Infantile Psychosis
TYPES OF AUTISM
2. ASPERGER’S SYNDROME
SPECTRUM DISORDER
• Characterized by social and communication skill deficits, relatively
exceptional language and cognitive development, and the presence of
idiosyncratic interests
• Frequently use pedantic speech as well as scientific or technical
vocabulary with an avoidance of slang
• This fits ASD diagnosis but with milder indicator of ASD (New 2012)
• Sometimes labeled as “geek syndrome” or little professor syndrome
• Children with this condition interpret things literally and they can appear
socially awkward
TYPES OF AUTISM SPECTRUM DISORDER
2. ASPERGER’S SYNDROME
• Although they generally test at an average to Above average intelligence
level, they are usually perceived as immature and overly emotional
• Often not understanding social rules and appear to demonstrate lack of
empathy by making limited eye contact, appearing to be unengaged in a
conversation and being confused by the use of gestures
• Risi (2012) explains that rather than a lack of empathy, brains of
individuals with this condition are differently wired causing them to
sometimes perceive things differently from other people and often has
different values and priorities
TYPES OF AUTISM SPECTRUM DISORDER
3. Childhood Disintegrative Disorder
• Develops in children who seem to be developing typically by achieving
the age-appropriate milestones until the child reached the ages of three
to five
• Children with this condition stop talking, lose potty-training skills and
stop socializing (Tambongan et.al 2014) and even stop playing, lose
motor skills and fail to make friends (Special Education Guide 2013)
• Children with this condition usually develop severe intellectual
disabilities
TYPES OF AUTISM SPECTRUM DISORDER
4. RETT’S DISORDER
• A developmental disorder, not degenerative that is mostly prevalent in
girls.
• Symptoms appear after an early period of what seems to be usual
development.
• The child displays a slowing down or stagnation of skills and most likely
can profoundly impair the child’s ability to use her hands as she did
before (Rudy 2016)
TYPES OF AUTISM SPECTRUM DISORDER
4. RETT’S DISORDER
• Other problems may include seizures and disorganized breathing
patterns, walking on toes, sleep problems, a wide-based gait, difficulty
chewing, slowed growth, seizures and cognitive disabilities
• In the initial years, a child may undergo0 a period of isolation and
withdrawal where he is irritable and may cry inconsolably
• Motor difficulty may increase, communication generally improves and
irritability decreases
TYPES OF AUTISM SPECTRUM DISORDER
5. PERVASSIVE DEVELOPMENTAL DISORDER NOT OTHERWISE
SPECIFIED (PDD-NOS)
• Disorder that often not as obvious as autism but were used to describe
individuals who didn’t fully fit the criteria for other specific diagnosis but
are nevertheless autistic thus termed atypical autism (Research Autism
2016)
• People with this condition show symptoms of autism at various times
but not often enough to get a full diagnosis of autism thus leading to
misintervened needs in social and speech
HISTORY OF AUTISM
•1908 – the word Autism was first used (Smith 2014).
•The word Autism s used to describe a subset of
schizophrenic patient who were especially withdrawn and
self-absorbed.
•1943 – American child psychiatrist Leo Kanner published a
paper describing 11 children who were highly intelligent but
displayed “a powerful desire for aloneness” and “an obsessive
insistence on persistent sameness” and later named their
condition “early infantile autism”.`
HISTORY OF AUTISM
•1944 –German scientist Hans Asperger described a “milder”
form of autism now known as Asperger’s Syndrome.
• The cases he reported were all boys who were highly intelligent but
had trouble with social interactions and specific obsessive interests,
hence he first describe Asperger’s Syndrome as a type of personality
disorder.
•1967 –psychologist Bruno Bettelheim popularized the theory
that “refrigerator mothers” as he term them, caused autism by
not loving their children enough.
HISTORY OF AUTISM
•1968 –Leo Kanner first describe autism disorder though his
focus was classic autism.
•During the Post-World War II, there were a lot of
psychoanalytic researches on autism. Researchers look solely
at the impact of autism to the life experiences of person
having such condition, (State, 2012) - little consideration on
the role of biology or genetics were made, knowing that it was
the main cause of disorder.
HISTORY OF AUTISM
• 1967 –Autism was classified under schizophrenia in the international
statistical classification of diseases and related health problems
• 1977 –a research was conducted on twins that proved that autism is
largely caused genetics and biological differences in brain
development (Hallmayer, 2012).
• 1980 –”Infantile autism” is listed for the first time in the Diagnostic and
Statistical Manual of Mental Disorder (DSM); the condition was also
officially separated from childhood Schizophrenia in 1987.
HISTORY OF AUTISM
•1988 –psychologist Ivar Lovaas published the first study
showing how intensive behavior therapy can help children with
autism that gave new hope to parents of persons with autism.
•-The movie entitled “rain man” was released starring a child
with savant autism, who has a photographic memory and can
calculate huge numbers in his head which raised public
awareness of the disorder but noted that not all children with
autism have the kinds of skills that were present in the movie.
HISTORY OF AUTISM
• 1991 – Public schools began identifying children on the spectrum and
offered them special services.
• 1994 –Asperger’s Syndrome is added to the DSM expanding the
autism spectrum to include milder cases in which individuals tend to be
more highly functioning.
• 1998 –study published “The Lancet” suggested that measles-mumps
rubella (MMR) vaccine causes autism. manufacturers started to
remove thimerosal (a mercury-based preservative) from all routinely
given vaccine to children due to public fears on its effect.
HISTORY OF AUTISM
• 2000 –the vaccine linked on autism has been rebunked.
• 2003 –the U.S. Centers for Disease Control and Prevention (CDC) estimated that
one in 110 children have autism spectrum disorder and up from one in 150 in 2007
though the CDC noted that the increase is due to the improved screening and
diagnostic techniques.
• 2013 –the DSM-V folded all subcategories of the condition into one umbrella
diagnosis of Autism Spectrum Disorder (ASD). Asperger’s Syndrome is no longer
considered a separate condition. ASD is defined by two categories: 1) impaired
social communication and/or interaction. 2) Restricted and/or repetitive behaviors.
HISTORY OF AUTISM IN THE PHILIPPINES

• 1987 – Birth of autism in the Philippines

• 1989 –the Foundation of Autistic Children and Adults of the Philippines
(ACAP) foundation was formally organized and recognized
• 1988 –a magazine published an issue about autism and became the
defining point for the organization to gain more parents attending their
meetings.
CHARACTERISTICS
•Social Skills Deficits
• Deficits in social relatedness or inherent drive to connect with
others and share complementary feeling states (DSM 5)
• Children with ASD do not appear to seek connection with other
people and usually contented being alone, ignore their parent’s
efforts for attention and seldom make eye contact or attempt to
catch others’ attention with gestures or vocalizations
• Difficulty sharing the emotional state of others in cooperative
games and group settings
• Deficit in joint attention
CHARACTERISTICS
•Communication Deficits
• Lack of speech or Earlier pre speech deficits often facilitate
diagnosis of ASD especially when associated with the lack of
desire to communicate and lack of nonverbal compensatory efforts
such as gestures.
• ECHOLALIA – “parroting” or the repetition of another person’s
speech
• Echolalia may give the impression of “advanced” speech because
of sophisticated vocabulary, grammar and syntax
CHARACTERISTICS
• REGRESSION
• Approximately 25-30% of children with ASD begin to say words but
then stop speaking often between the ages of 15 to 24months
(Tuchman and Rapin 2007)
• Regression of skills in children with ASD may include loss of
gestural communication and social skills or a combination of both.
CHARACTERISTICS
•Play Skills
• Lack of or significantly delayed, pretend play skills coupled with persistent
sensory-motor and/or ritualistic plays are characteristics of ASD
• Some children with ASD may never pass the sensory-motor play stage – they
mouth, twirl, bang and manipulate objects in a stereotypic or ritualistic
manner.
• The play of children with ASD often is repetitive and lacks creativity and
imitation (DSM 5)
• Often contented to play alone for hours, requiring little attention or supervision
• Play is constructive (puzzles, computer games and blocks), ritualistic (lining
objects up or sorting/matching shapes or colors) or sensory motor (mouthing,
banging, twirling) in nature
CHARACTERISTICS
•Restricted, Repetitive and Stereotyped Patterns of
Behavior
• Children with ASD demonstrate atypical behaviors in a variety of areas
including peculiar mannerisms, unusual attachments to objects, obsessions,
compulsions, self-injurious behaviors and stereotypies.
• Stereotypes are repetitive, nonfunctional, atypical behaviors such as hand
clapping, finger movements, rocking or twirling (Chawarska and Volkmar
2005)
• Most stereotypies are harmless but they are problematic that they may
prevent the child from accomplishing a task or learning new skills.
CHARACTERISTICS
•Restricted, Repetitive and Stereotyped Patterns of
Behavior
• Children with ASD form attachments with stuffed animal, special pillow or
blanket – the attachment is more persistent in that they may insist on holding
the objects at all times although these are rarely used in real play
(Gernsbacher et.al 2005)
• during Earlier development, parents of children with ASD note that their child
seems overly independent because rather than ask for desired objects, they
uses advanced motor skills to obtain them (moving a stool to a counter top to
obtain an object at an age younger than typically expected)
SCREENING AND DIAGNOSIS
• Parents’ Evaluation of Developmental Status (PEDS)
• First screening tool for children
• Modified Checklist for Autism in Toddlers (MCHAT)
• Consists of parent-completed questionnaire designed to identify
children at risk for autism
• Ages and Stages Questionnaires (ASQ)
• General developmental screening tool consist of perent questionnaire,
series of 19 age-specific questionnaires screening for communication,
gross motor, fine motor, problem-solving and personal adaptive skills
• Results is in a pass/fail score for domains
PREVALENCE
•2016 – approximately 1 in 68 children in the US have been
identified with an ASD (Center for Disease Control’s Autism
and Development Disabilities Monitoring (ADDM)
•ASD is five times most common in boys (1 in 42) than
among girls (1 in 189) in most all countries
•In the Philippines, estimated cases of autism rose from
500, 000 in 2008 to 1, 000, 000 at present and even higher
since there are lots of areas not covered (Jaymalin 2014)
 CAUSES
• Autism is not curable
•There is no known single cause for autism but is generally
accepted that it is caused by abnormalities in the brain
structure or function
•Brains scan show differences in the shape and structure of
children with autism
•Genetics plays some part in the cause of Autism (State &
Sestan 2012)