No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
A Review of Intervention Studies Conducted with Individuals with Autism and Sensory Impairments
Abstract
Introduction
Recently, there has been heightened interest in individuals with autism and sensory impairments, and interventions that affect this population. To date, no reviews have analyzed intervention studies, and the present study adds to intervention research literature.
Methods
Based on an electronic search, eight studies were included in the review.
Results
The results indicated that four of the studies focused on communication skills, while the other four targeted problem behaviors. All participants made progress in communication and showed improvements in their behaviors.
Discussion
Although positive results were seen in all participants, the studies suffer from methodological limitations. Thus, future research is needed to replicate studies as well as provide maintenance and generalization data.
Implications for practitioners
Some suggestions are to include preference assessments prior to the development of intervention studies to create a modified picture exchange communication system with tangible objects or symbols.
... These reviews do not specify which studies included children or youths with comorbid conditions such as visual impairments. A review of the literature of intervention studies with people who have ASD and sensory impairments found only eight studies; of those eight, only four addressed the communication needs of people with visual impairments (Banda, Griffin-Shirley, Okungu, Ogot, & Meeks, 2014). Given the increased co-occurrence of ASD and visual impairment, it is critical that the effectiveness of evidence-based practices be assessed for children with both ASD and visual impairments. ...
... This practice report presents the study of a young girl with ASD and visual impairment who was taught basic requesting skills through an adapted augmentative and alternative communication (AAC) system, which is an evidence-based practice for addressing communication with children who have ASD but has limited research efficacy for those with ASD and visual impairments (Banda et al., 2014). ...
... Four studies have assessed the use of an adapted Picture Exchange Communication System (PECS) to teach the act of requesting to people who have ASD and visual impairments (Ali, MacFarland, & Umbreit, 2011;Kee, Casey, Cea, Bicard, & Bicard, 2012;Lund & Troha, 2008;Parker, Banda, Davidson, & Liu-Gitz, 2010). All four studies indicated that PECS may be an effective intervention for this population; however, more research is needed (Banda et al., 2014). ...
... Li also promoted strategies based on Applied Behavior Analysis (ABA), as much of the literature on EBPs for learners with ASD is represented by such practices (National Professional Development Center on Autism Spectrum Disorder (NPDC) [6]. Banda et al. conducted a literature review to establish successful interventions for individuals with comorbid ASD and sensory impairments [7]. Not surprisingly, many of the identified interventions among these reviews incorporated components of EBPs (e.g., prompting, reinforcement, etc.) from the field of ASD (NPDC in 2014) [6]. ...
... Each year, the American Printing House for the Blind (APH) surveys each state in the United States for data regarding the number of legally blind children enrolled in school (aged [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. These are likely the most exact numbers available regarding blindness among students in the United States (National Federation for the Blind, 2015) [8]. ...
Students who have comorbid conditions, diagnosis of Visual Impairment (VI) coupled with other disabilities have specific areas of need of which teachers who only have experience with the visually impaired (TVIs) are expected to identify and address. As such TVIs in a Midwestern state (N=56) completed a survey which asked them to report their level of familiarity, use, and perceived effectiveness of Evidence-Based Practices (EBPs) in their classrooms. Results show much incongruity in the familiarity, use, and perceived effectiveness of EBPs by TVIs. The data indicates that TVIs may need more resources and consistent training in practices that go beyond what they know in order to meet the needs of all students in their classrooms.
... Future studies comparing ASD symptoms in individuals with VI should consider the impact of maturity on social interaction skills and implement longitudinal designs to better understand the trajectories of this difference. Additionally, research exploring the efficacy of specific instructional practices for learners with comorbid diagnoses of VI and ASD or other sensory differences is warranted as this population grows (Banda et al., 2014;Probst & Walker, 2017). ...
Children with visual impairments (VI) display challenges in social interaction, may have elevated repetitive behaviors, and sensory features similar to children diagnosed with autism spectrum disorder (ASD). ASD is frequently diagnosed comorbidly in children with VI, making it important for educators to better understand the behavioral similarities and differences between ASD and VI. For this study, the researchers compared 27 children with VI between the ages of 5 and 12 with 177 children with ASD using parent reports of ASD symptomology. Statistical means comparisons were conducted between these two groups on items related to social communication, repetitive behaviors and sensory features. Results: The children with VI displayed similar overall levels of autism symptoms but had better social interaction skills and less behavior and sensory problems. This pilot investigation may help educators better understand the unique needs of children with visual impairments and develop more targeted supports for children with VI who exhibit sensory differences or social communication impairments. Future research should include observational assessments and validated measures.
... A few literature reviews have been conducted to identify effective interven tions for individuals with autism spec trum disorder and sensory impairments (Banda, Griffin-Shirley, Okungu, Ogot, & Meeks, 2014), communication develop ment of children with visual impairments (Parker & Ivy, 2014), and literacy of students with visual impairments and ad ditional disabilities (Parker & Pogrund, 2009). Not surprisingly, many of the identified interventions among these reviews incorporated components of evidence-based practices from the field of autism spectrum disorder (for example, prompting or reinforcement; NPDC, 2014). ...
Introduction
This study evaluated the effectiveness of a workshop and follow-up coaching sessions on the implementation of the system of least prompts procedure by classroom team members and explored whether this intervention resulted in personal hygiene skill acquisition by a male high school student with comorbid visual impairment and autism spectrum disorder.
Methods
Implementation fidelity data were analyzed descriptively through visual analysis. A multiple baseline design across behaviors was utilized to evaluate the effectiveness of the system of least prompts procedure on student skill acquisition.
Results
Implementation fidelity was high and increased over the course of the study: paraeducator 1: 93.9% (range, 70 to 100%); paraeducator 2: 78.2% (range, 11 to 90%); and special education teacher: 94.1% (range, 35 to 100%). In addition, the student's independent performance improved from baseline to intervention across each targeted skill, with Tau -U scores as follows: cleaning the augmentative and alternative communication device: 0.78; washing hands: 0.76; and brushing teeth: 0.92. Classroom team members found both the training procedures and the system of least prompts intervention to be of value and effective.
Discussion
During intervention, classroom team members implemented the system of least prompts with fidelity and the student mastered each skill. These results are promising and add to the significantly limited literature on instructional interventions for students with comorbid visual impairment and autism spectrum disorder.
Implications for practitioners
Classroom team members can effectively be taught to use the system of least prompts with students with comorbid visual impairment and autism spectrum disorder. Furthermore, the intervention might be used to increase independent functioning for students with these comorbid conditions.
... In the past, interventions have been developed to manage problems stemming from issues related to sensory processing for students with ASD in the classroom (Case-Smith, Weaver, & Fristad, 2015;Banda, Griffin-Shirley, Okungu, Ogot, & Meeks, 2014), which suggested that such issues are of high concern to educators. Many of these interventions addressed individual coping rather than environmental solutions. ...
Background:
With more students being educated in schools for Autism Spectrum Disorder (ASD) than ever before, architects and interior designers need to consider the environmental features that may be modified to enhance the academic and social success of autistic students in school.
Aim:
This study explored existing empirical research on the impact of noise on children with ASD and provides recommendations regarding design features that can contribute to noise reduction.
Methods and procedures:
A survey, which addressed the impact of architectural design elements on autism-related behavior, was developed for teachers of children with ASD and distributed to three schools.
Outcomes and results:
Most teachers found noise control to be an important issue for students with autism and many observed children using ear defenders. In terms of managing issues related to noise, most teachers agreed that thick or soundproof walls and carpet in the classroom were the most important issues for children with ASD.
Conclusions:
Suggested future research should address architectural considerations for building an acoustically friendly environment for children with autism, identifying patterns of problematic behaviors in response to acoustical features of the built environment of the classroom setting, and ways to manage maladaptive behaviors in acoustically unfriendly environments.
... A review of literature indicates a paucity of intervention studies using experimental designs (e.g., group or single-subject design) concerning O&M training for students with autism and vision impairment (Banda, Griffin-Shirley, Okungu, Ogot, & Meeks, 2014). Careful methodological design considerations are necessary in studies involving low-incidence disabilities. ...
Two students with autism, visual impairment, and intellectual disabilities participated in an orientation and mobility (O&M) intervention to travel in school settings using their folding canes. A multiple-baseline across participants design to determine the effectiveness of the intervention was used. The dependent variable was time taken to travel the specified route. The independent variable was orientation and mobility training. Results indicate that both participants took less time to travel during the intervention compared to baseline. Students with visual impairments and autism can be trained using systematic orientation and mobility training. The O&M specialists working with children with autism and visual impairments should collect data and make data-based decisions while providing O&M instruction.
http://www.ijorientationandmobility.com/products/copy-of-new-2013-2014-journal-hardcopy
Translated and published article
A variety of strategies have been used to help children with autism acquire functional communication skills. The Picture Exchange Communication System (PECS) is a unique communication training program that was developed as a means of circumventing some shortcomings associatd with these strategies. A description of the steps within PECS is provided. Long-term group data have indicated that a large proportion of children started on PECS as preschoolers acquire speech. Individual and group data supporting the use of PECS are provided.
The abstract for this document is available on CSA Illumina.To view the Abstract, click the Abstract button above the document title.
The Picture Exchange Communication System (PECS) is an augmentative and alternative communication (AAC) program used to teach functional requesting and commenting skills to people with disabilities (Bondy & Frost, 1993; Frost & Bondy, 2002). In this study, tangible symbols were added to PECS in teaching requesting to four students (ages 7-14) with multiple disabilities that included a visual impairment. First, an assessment was conducted to determine the preferred (i.e., reinforcing) and non-preferred items for each participant. Then, a multiple probe design across participants was used to evaluate the effectiveness of the adapted training. Data were collected across baseline, training and maintenance conditions, and generalization probes were conducted periodically throughout all conditions. All four participants learned requesting skills, generalized these skills to their classrooms, and maintained the skills after training. Recommendations are presented for future research regarding the use of adapted PECS with other AAC programs.
Professionals in the field of deaf-blindness are challenged to use instructional practices that have been tested using experimental methodology. Single-subject design has been examined as a form of research that assists in substantiating practice. In a review of the literature, the authors identified 54 single-subject studies from 1969 to 2006 that provided emerging evidence for practitioners.
Single-subject research plays an important role in the development of evidence-based practice in special education. The defining features of single-subject research are presented, the contributions of single-subject research for special education are reviewed, and a specific proposal is offered for using single-subject research to document evidence-based practice. This article allows readers to determine if a specific study is a credible example of single-subject research and if a specific practice or procedure has been validated as "evidence-based" via single-subject research.
Limited population-based data on prevalence of childhood vision impairment (VI) and hearing loss (HL), and their co-occurrence with autism spectrum disorder (ASD) exists.
To examine prevalence and characteristics of VI, HL and co-occurring ASD among 8-year-olds in metropolitan Atlanta 2000-2008.
We used data from the population-based Metropolitan Atlanta Developmental Disabilities Surveillance Program. Prevalence, birth and parental characteristics, presence and severity of other co-occurring developmental disabilities, and age of earliest identification of ASD, were examined for children with VI and HL, by co-occurring ASD.
VI and HL prevalences were 1.2 and 1.3 per 1000 8-year-olds, respectively. Approximately 6-7% of children with VI or HL had co-occurring ASD. Children with VI or HL with co-occurring ASD differed from those without co-occurring ASD by select birth characteristics and the presence of other co-occurring DDs. The median age of earliest known ASD diagnosis was significantly later among children with VI and ASD compared to children with ASD without VI (79 vs. 56 months). Children with HL and ASD were first evaluated by a community provider significantly earlier than those with ASD without HL (40 vs. 50 months).
The frequency of co-occurring ASD with VI and HL is higher than the population prevalence of ASD. The significant delays in diagnosis of ASD in children with VI and lack of earlier diagnosis of ASD among children with HL despite earlier evaluation highlight the importance of developing screening tools for early identification of ASD among children with VI and HL.
A 10-year-old nonverbal Greek boy, C.Z., Who had been diagnosed With both bilateral sensorineural profound hearing loss and autism, Was taught to use the Picture Exchange Communication System (PECS), With some modifications and extensions, over a 4-month intensive intervention period. C.Z.'s original communication and behavioral status as Well as the PECS application process are presented, along With the communicative, language, and psychosocial outcomes folloWing the intervention program. FolloW-up data Were collected 6 months post.
The purpose of this article is to review the current research on preference assessment and reinforcer testing for individuals with profound multiple disabilities (PMD). It briefly reviews the literature that describes a subpopulation of individuals with PMD distinct from the general population of individuals labeled as having profound disabilities. The article describes the types of preference assessment procedures that have been used with individuals with PMD. Results from 13 published studies, which assessed preferences and tested reinforcers with individuals with PMD, suggest that preference procedures currently used with individuals at the higher levels of profound disabilities and individuals with severe disabilities are not always successful in identifying preferred stimuli that function as consistent reinforcers for individuals with PMD. Based on this review and other studies over a 3-year period, this article provides a rationale for conducting preference assessments to assist in curriculum development and describes a process for conducting preference assessments and targeting social, affective, and motor behaviors to increase with individuals with PMD.
This article discusses some of the issues associated with effective instruction for students with severe disabilities who are enrolled in general education classes. It is argued that developing a valid technology of instruction will require the field to reconceptualize our current model of teaching and learning for this group of students. Specifically, we must begin to view student learning as the combined effects of instructional methods used for all students in the class and those used to meet the unique needs of each student. Achieving these aims will require a two pronged approach. First, general and special educators in inclusive programs must adopt and implement teaching practices that can accommodate the diverse educational needs of all students in the class. Second, teachers must begin to employ strategies that infuse opportunities for students with severe disabilities to receive instruction on targeted routines, activities, and skills within the on-going activities of the class.
The reported increasing prevalence of autism spectrum disorder (ASD) and attendant health and family impact make monitoring of ASD prevalence a public health priority.
The prevalence of parent-reported diagnosis of ASD among US children aged 3 to 17 years was estimated from the 2007 National Survey of Children's Health (sample size: 78037). A child was considered to have ASD if a parent/guardian reported that a doctor or other health care provider had ever said that the child had ASD and that the child currently had the condition. The point-prevalence for ASD was calculated for those children meeting both criteria. We examined sociodemographic factors associated with current ASD and with a past (but not current) ASD diagnosis. The health care experiences for children in both ASD groups were explored.
The weighted current ASD point-prevalence was 110 per 10,000. We estimate that 673,000 US children have ASD. Odds of having ASD were 4 times as large for boys than girls. Non-Hispanic (NH) black and multiracial children had lower odds of ASD than NH white children. Nearly 40% of those ever diagnosed with ASD did not currently have the condition; NH black children were more likely than NH white children to not have current ASD. Children in both ASD groups were less likely than children without ASD to receive care within a medical home.
The observed point-prevalence is higher than previous US estimates. More inclusive survey questions, increased population awareness, and improved screening and identification by providers may partly explain this finding.
We evaluated the effects of three different methods of denying access to requested high-preference activities on escalating problem behavior. Functional analysis and response class hierarchy (RCH) assessment results indicated that 4 topographies of problem behaviors displayed by a 13-year-old boy with high-functioning autism constituted an RCH maintained by positive (tangible) reinforcement. Identification of the RCH comprised the baseline phase, during which computer access was denied by saying "no" and providing an explanation for the restriction. Two alternative methods of saying "no" were then evaluated. These methods included (a) denying computer access while providing an opportunity to engage in an alternative preferred activity and (b) denying immediate computer access by arranging a contingency between completion of a low-preference task and subsequent computer access. Results indicated that a hierarchy of problem behavior may be identified in the context of denying access to a preferred activity and that it may be possible to prevent occurrences of escalating problem behavior by either presenting alternative options or arranging contingencies when saying "no" to a child's requests.
Available observational tools used in the identification of social communication difficulties and diagnosis of autism spectrum disorder (ASD) rely partly on visual behaviours and therefore may not be valid in children with visual impairment. A pilot observational instrument, the Visual Impairment and Social Communication Schedule (VISS), was developed to aid in identifying social communication difficulties and ASD in young children with visual impairment affected by congenital disorders of the peripheral visual system (disorders of the globe, retina, and anterior optic nerve). The VISS was administered to 23 consecutive children (age range 1 y 9 mo-6 y 11 mo, mean 4 y 1 mo [SD 1.6]; 12 males, 11 females) with visual impairment (nine with severe and 14 with profound visual impairment). Item analysis was carried out by fit of the items to the Rasch model. Validity of the VISS was explored by comparison with the Childhood Autism Rating Scale (CARS) score, and the clinical ASD diagnosis (n=9). Correlation between the VISS and CARS total scores was highly significant (Spearman's rho=-0.89; p=0.01). Below threshold rating on the VISS (score of 35) showed good agreement with the clinical ASD diagnosis (sensitivity 89%, specificity 100%). This preliminary study shows the VISS to be a promising schedule to aid the identification of ASD in young children with visual impairment.
A 10-year-old nonverbal Greek boy, C.Z., who had been
diagnosed with both bilateral sensorineural profound hearing
loss and autism, was taught to use the Picture Exchange
Communication System (PECS), with some modifications and
extensions, over a 4-month intensive intervention period. C.Z.’s
original communication and behavioral status as well as the
PECS application process are presented, along with the
communicative, language, and psychosocial outcomes following
the intervention program. Follow-up data were collected
6 months post.
Children with blindness due to retinopathy of prematurity (ROP)--who are at greatly increased risk of cerebral damage--have been noted to have a high rate of autistic symptoms, but systematic controlled studies have been lacking. A controlled population-based study was performed; one group was blind due to ROP (N=27) and the other was congenitally blind due to hereditary retinal disease (N=14). Fifteen of the 27 children with ROP had autistic disorder. All these children were mentally retarded and about one-third of them had cerebral palsy. In the comparison group, two of the 14 children had autistic disorder. It is concluded that there is a strong association between ROP and autistic disorder. The association is most probably mediated by brain damage and is largely independent of the blindness per se.
The Picture Exchange Communication System (PECS) is an alternative/augmentative communication system that was developed to teach functional communication to children with limited speech. The approach is unique in that it teaches children to initiate communicative interactions within a social framework. This article describes the advantages to implementing PECS over traditional approaches. The PECS training protocol is described wherein children are taught to exchange a single picture for a desired item and eventually to construct picture-based sentences and use a variety of attributes in their requests. The relationship of PECS's implementation to the development of speech in previously nonvocal students is reviewed.
We evaluated the effects of concurrent schedules of reinforcement on negatively reinforced problem behavior and task completion with 3 children with autism. Results indicated that problem behavior occurred at high levels and relatively few tasks were completed when problem behavior produced a break (from tasks) and task completion produced either no consequence or a break. By contrast, problem behavior was eliminated and tasks were completed when problem behavior produced a break and task completion produced a break with access to preferred activities. Treatment gains were maintained without the use of extinction when the response requirement was increased and the schedule of reinforcement was thinned.
The picture exchange communication system (PECS) is an augmentative communication system frequently used with children with autism (Bondy & Frost, 1994; Siegel, 2000; Yamall, 2000). Despite its common clinical use, no well-controlled empirical investigations have been conducted to test the effectiveness of PECS. Using a multiple baseline design, the present study examined the acquisition of PECS with 3 children with autism. In addition, the study examined the effects of PECS training on the emergence of speech in play and academic settings. Ancillary measures of social-communicative behaviors and problem behaviors were recorded. Results indicated that all 3 children met the learning criterion for PECS and showed concomitant increases in verbal speech. Ancillary gains were associated with increases in social-communicative behaviors and decreases in problem behaviors. The results are discussed in terms of the provision of empirical support for PECS as well as the concomitant positive side effects of its use.
The aim of the present study was to assess the prevalence and associated risk factors of autism in a sample of visually impaired children and adolescents. A total of 257 blind children and adolescents (age range: 7-18 years) were examined for autism using a three-stage process. The first stage estimated probable cases of autistic disorder based on the Autism Behavior Checklist and the second stage by direct observation of the subjects in different settings. In the third stage, subjects with the probable diagnosis of autistic disorder were asked to undergo psychiatric examination. A final diagnosis of autistic disorder (based on the criteria in DSM-IV) was given after interviewing the caregivers and clinical observation. Thirty of 257 subjects met the criteria for autistic disorder. Comparison of the characteristics of the two groups (autistic and non-autistic) with chi2-squared and independent sample t-tests revealed a statistically significant difference in terms of severity of blindness (P = 0.015), cerebral palsy (P = 0.02) and intellectual level (P = 0.001). The results of the present study suggest that subjects with blindness plus autism have greater neurological impairment (as suggested by the presence of lower intellectual level and cerebral palsy), and more severe visual impairment than the subjects with blindness only.
This study used a single-subject multiple baseline across participants design to evaluate the effectiveness of a modified picture exchange communication system (PECS) teaching protocol with tactile symbols. Three students (two male, one female) aged 12-17 years who had autism and were blind participated in the study. The instructional program involved three phases. First, each participant learned to exchange a tactile symbol with his/her communication partner to request a preferred item/activity. Second, the distance between the communication partner and the participant was increased. Third, the participants were required to discriminate between two dissimilar tactile symbols. One out of three participants completed all phases of the instructional program. Although the other two participants did not complete the program, they demonstrated improvement from baseline responding rates. This study provided preliminary results that using tactile symbols with strategies from PECS may be an effective method to teach requesting to youth who are blind and have autism.
Nonverbal individuals with autism spectrum disorders (ASD) often require the use of picture-based, aided augmentative and alternative communication (AAC) systems. Such systems are used widely, but little research has investigated the generalization of these devices to a variety of communicative partners and under a variety of conditions. We investigated use of a modified Picture Exchange Communication System (PECS) protocol to teach AAC-supported functional communication skills to a 12-year-old boy with autism. Results indicate that the participant was able to generalize his communication skills across a variety of instructors and to use functional non-verbal strategies to respond to communication obstacles.
Since 2002, the body of literature examining choice interventions and preference assessments for individuals with severe to profound disabilities has grown substantially. This paper is an extension of the Lancioni, O’Reilly, & Emerson (1996) and Cannella, O’Reilly, & Lancioni (2005) papers and reviews 50 studies conducted between 2002 and 2010 that were divided into five categories: (a) effectiveness of various preference assessment formats and methodologies, (b) comparisons of specific components of preference assess- ments, (c) underlying mechanisms of preference, (d) effects of choice on behavior, and (e) staff and participant training. Findings from these studies support previous research findings in that choice was an effective intervention for changing behavior, reinforcers were identified for individuals with severe to profound disabilities using preference assessments, and participants were taught to make, and staff were trained to provide, choices. Other major findings highlight some mechanisms that underlie preference and provide insight into some nuances of the various preference assessment methodologies. The findings are discussed in terms of their implications on practice related to individuals with severe to profound disabilities and suggestions for future research are provided.
Applied behavior analysis has emphasized that the effects of treatment interventions should be evaluated in part on the basis of whether changes of clinical, social, or applied importance have been achieved. Recently, social validation has been proposed as a means of evaluating whether behavior changes achieved during treatment are clinically important. In the context of evaluating treatment outcome, social validation consists of two procedures. First, the behavior of the target subject is compared with that of his or her peers who have not been identified as problematic. Second, subjective evaluations of the target subject's behavior by individuals in the natural environment are solicited. Behavior changes can be viewed as clinically important if the intervention has brought the client's performance within the range of socially acceptable levels, as evidenced by the client's peer group, or if the client's behavior is judged by others as reflecting a qualitative improvement on global ratings. The present paper reviews the literature on social validation in applied behavior analysis and discusses problems in assessing and interpreting normative data and subjective evaluations.
Autism spectrum disorders are particularly difficult to diagnose in the presence of early profound deafness because of communication related issues. Two parts of the Autism Screening Instrument were administered to 13 deaf individuals with autism and two comparison groups: hearing autistic and deaf learning disabled. A parental questionnaire was also used. No differences in autistic symptomatology were found between the deaf autistic and the hearing autistic group. However, the deaf autistic group was diagnosed later than the hearing autistic group. It is concluded that autism can be diagnosed in the deaf; that it resembles autism in the hearing; and that it is not a consequence of deafness per se. Learning disabled deaf individuals who are not autistic do not resemble people with autism in behavioural terms. The findings have implications for remediation, education, and the emergence and management of challenging behaviours.
In the course of studying the behavioral characteristics of 243 preschool children with congenital rubella, we identified the syndrome of autism in 10 children and a partial syndrome of autism in an additional 8. These findings are discussed against the background of the behavioral investigations of rubella children. The methodology of our psychiatric study and the criteria for a diagnosis of autism are presented. The incidence of autism is considered with regard to the prevalence of other psychiatric disorders in this group and the physical status of the children. Two case histories of autistic rubella children are given and their behavioral characteristics are contrasted with nonautistic rubella children with matching sensory and other defects. The prevalence rate is compared with that found in two epidemiological studies and also with the rate indicated by other centers studying rubella children. Etiological implications of these findings are discussed. It is argued that these data support the concept of organic causation of the syndrome of autism.
The nature of autism in congenitally blind children has long been a source of interest and perplexity. A group of nine congenitally blind children with an autism-like syndrome were closely matched on chronological age and verbal mental age with nine sighted autistic children, and were compared on the Childhood Autism Rating Scale (Schopler, Reichler, & Renner, 1986) and the Behavior Checklist for Disordered Preschoolers, together with the Play Items for Disordered Preschoolers (Sherman, Shapiro, & Glassman, 1983). A checklist of clinical features characteristic of autism (derived from DSM-III-R) was also completed through an interview with teachers. There was substantial similarity between the groups, but also suggestive evidence of possible group differences, specifically in the domain of social-emotional responsiveness. Research on the psychological development of congenitally blind children promises to yield insights into the nature of autism itself.
Purpose:
To determine the incidence of ophthalmologic disorders in children with autism and related disorders.
Design:
Retrospective chart review. Four hundred and seven children diagnosed with autism or a related disorder between 1998 and 2006. one hundred and fifty-four of these children completed a comprehensive ophthalmology exam by a pediatric ophthalmologist.
Results:
Ophthalmologic pathology was found in 40% of patients with autism or a related disorder with 29% having significant refractive errors, 21% demonstrating strabismus, and 10% having amblyopia.
Conclusions:
Children with autism or a related disorder will frequently have an ophthalmologic abnormality. Since cooperation with vision screening is understandably limited in these children, a comprehensive eye examination by a pediatric ophthalmologist is recommended for all such children.
Epidemiological studies investigating the prevalence of autism have increased in recent years, within the United States and abroad. However, statistics as to how many of those children may also have a comorbid hearing loss is lacking. The prevalence of school-administrator reported diagnosis of autism spectrum disorders (clinical diagnosis [DSM-IV] and/or IDEA classification) among children with hearing loss in the US was estimated from the 2009-2010 Annual Survey of Deaf and Hard of Hearing Children and Youth conducted by the Gallaudet Research Institute. Results indicate that during the 2009-2010 school year 1 in 59 children (specifically 8-year olds) with hearing loss were also receiving services for autism; considerably higher, than reported national estimates of 1 in 91 (Kogan et al. in Pediatrics 124(4):1-8, 2009) and 1 in 110 (CDC 2007) for hearing children. Significantly more children with profound hearing loss had a comorbid diagnosis of autism than those with milder forms of hearing loss. These results are discussed, while highlighting the need for increased awareness and research in a population that has thus far received little services or attention.
We synthesized studies that assessed preference for using different augmentative and alternative communication (AAC) options. Studies were identified via systematic searches of electronic databases, journals, and reference lists. Studies were evaluated in terms of: (a) participants, (b) setting, (c) communication options assessed, (d) design, (e) communication skill(s) taught to the participant, (f) intervention procedures, (g) outcomes of the intervention and outcome of the preference assessment, (h) follow-up and generalization, and (i) reliability of data collection and treatment integrity. Seven studies, involving 12 participants, met the inclusion criteria. In these studies, individuals were taught to use either speech-generating devices (SGD), (b) picture exchange (PE) systems, and/or (c) manual signs. Assessments to identify preferences for using each AAC option were conducted in each study. Sixty-seven percent (n=8) of participants demonstrated some degree (≥55%) of preference for using SGD compared to 33% (n=4) of participants who demonstrated some degree (≥55%) of preference for PE. The results indicate that individuals with developmental disabilities often show a preference for different AAC options. Incorporating an assessment of such preferences might therefore enable individuals to exert some degree of self-determination with respect to AAC intervention.
Teachers and parents completed the Autism Behavior Checklist (ABC) on a clinical sample of 17 congenitally blind children. Of the 17 children, 4 had a definite or likely pervasive developmental disorder (PDD) as judged by independent case note review. The ABC was administered both in its original format and in a slightly modified format. Only teacher-completed ABCs detected group differences and had satisfactory test-retest reliability. The modified-format ABC completed by teachers detected 3 of the 4 children with PDDs without any false positives. Screening questionnaires may have a limited but useful role in locating subjects with blindness plus putative PDDs for further study.
Twenty-four congenitally blind children between 3 and 9 years of age were studied for the prevalence of "autistic-like" features, as assessed by teacher reports and by systematic observations of the children's behaviour. A comparison between the 15 blind children who had IQs over 70 and 10 sighted children group-matched for age and verbal ability revealed that a number of autistic-like features were more common in the blind. When the nine blind children who had IQs less than 70 were compared with nine group-matched autistic children, the picture that emerged was of substantial overlap in clinical presentation, despite subtle differences on clinical impression. Similar results were obtained when blind subgroups were reconstituted according to the children's nonautistic or autistic-like clinical presentation, rather than IQ. These findings are discussed in relation to competing theories concerning the development of autism and "theory of mind".
A literature review was conducted to provide a synthesis of 18 years of research on preference assessment with individuals who have severe disabilities (e.g., severe mental retardation, autism, multiple disabilities). Through this synthesis, several procedural variables were identified that may influence the outcome of preference assessment, including context, assessment stimuli, selection response, and format. Recommendations were given for designing preference assessment, and questions were raised for future research.
The present review looks at: (1) prevalence studies of sensory impairments in people with intellectual disability (ID); (2) studies looking at psychological and psychiatric disorders in people with sensory impairments; and (3) studies that have examined the association of sensory impairments with autism. Research has indicated that sensory impairments are more common in people with ID. Psychiatric disorders are believed to be more common in children with visual impairment (VI) when associated with other handicaps. Some authors believe that hearing impairment (HI) can result in personality disorders. Studies have also shown a higher prevalence of psychiatric disorders in children with HI and a higher incidence of deaf people in psychiatric hospitals than in the general population. Psychiatric disorders in children with HI are particularly associated with low IQ and low communication ability, especially in those with multiple handicaps. There is little evidence for a higher incidence of schizophrenia in people with HI. Blind people demonstrate many autistic-like features and there has been discussion in the literature as to their cause. Deaf people also demonstrate some similar features to those in autism, but an association with autism has not been conclusively made. Deaf-blind people commonly demonstrate problem behaviour (e.g. self-injury). Usher syndrome, which is the most common cause of deaf-blindness, is associated with psychiatric disorders, particularly psychosis. The need for assessment of sensory functioning in people with ID, the difficulties inherent in this and the need for specialist services is stressed.
Autism spectrum disorders are particularly difficult to diagnose in the presence of early profound deafness because of communication related issues. Two parts of the Autism Screening Instrument were administered to 13 deaf individuals with autism and two comparison groups: hearing autistic and deaf learning disabled. A parental questionnaire was also used. No differences in autistic symptomatology were found between the deaf autistic and the hearing autistic group. However, the deaf autistic group was diagnosed later than the hearing autistic group. It is concluded that autism can be diagnosed in the deaf; that it resembles autism in the hearing; and that it is not a consequence of deafness per se. Learning disabled deaf individuals who are not autistic do not resemble people with autism in behavioural terms. The findings have implications for remediation, education, and the emergence and management of challenging behaviours.
The duration or magnitude of reinforcement has varied and often appears to have been selected arbitrarily in functional analysis research. Few studies have evaluated the effects of reinforcement magnitude on problem behavior, even though basic findings indicate that this parameter may affect response rates during functional analyses. In the current study, 6 children with autism or developmental disabilities who engaged in severe problem behavior were exposed to three separate functional analyses, each of which varied in reinforcement magnitude. Results of these functional analyses were compared to determine if a particular reinforcement magnitude was associated with the most conclusive outcomes. In most cases, the same conclusion about the functions of problem behavior was drawn regardless of the reinforcement magnitude.
Two students with developmental disabilities were taught to request six snack items. Requesting involved giving a graphic symbol to the trainer in exchange for the matching snack item. Following acquisition, we assessed the correspondence between requests and subsequent item selections by requiring the student to select the previously requested snack item from an array containing all six items. The effects of acquisition training were evaluated in a multiple-probe across subjects design. Acquisition was achieved in from 9 to 29 trials per item. Following acquisition, Jason showed a high level of correspondence between requesting and selecting, but Ryan required additional training to achieve correspondence. These data support the use of exchange-based communication systems, but suggest that some students may require explicit correspondence training.
The broad term pervasive developmental disorder (PPD) describes a set of symptoms that occur along a continuum of severity; these symptoms are often referred to as autism spectrum disorders (ASDs). Little is known about the incidence and prevalence of ASDs among students who are deaf or hard of hearing (DHH). Teachers of DHH students, who must work with individuals with dual diagnoses, are at a loss for guidance from the literature. The authors review the literature on ASDs (also referred to as PDD) within the DHH population, provide results of a single-subject study to reduce PDD-type behaviors in a child with hearing loss, and argue that teachers of students who are DHH must learn about practices associated with applied behavior analysis as an tool for intervening therapeutically with children with dual diagnoses of hearing loss plus an ASD.
Assessment of auditory abilities is important in the diagnosis and treatment of children with autism. The aim was to evaluate hearing objectively by using transient evoked otoacoustic emission (TEOAE) and auditory brainstem response (ABR). Tests were performed on 30 children with autism and 15 typically developing children, following otomicroscopy and tympanometry. The children with autism were sedated before the tests. Positive emissions and normal hearing level at ABR were obtained in both ears of all children in the control group and of 25 children with autism. TEOAE and ABR results varied in the remaining five children with autism. The mean III-V interpeak latencies (IPLs) in both ears of children with autism were longer than those in the control group. Hearing loss may be more common in children with autism than in typically developing children.
Autism spectrum disorders and visual impairment: Meeting students' learning needs
- M H Gense
- D J Gense
Gense, M. H., & Gense, D. J. (2005). Autism
spectrum disorders and visual impairment:
Meeting students' learning needs. New
York: AFB Press.
Core curriculum-The right to be different
- P Hatlen
Hatlen, P. (2011). Core curriculum-The
right to be different. Retrieved from http://
www.afb.org/section.aspx?FolderIDϭ3&
SectionIDϭ44&TopicIDϭ462&SubTopic
IDϭ4&DocumentIDϭ2115
Foundations of education: History and theory of teaching children and youth with visual impairments
- M C Holbrook
- A J Koenig
Holbrook, M. C., & Koenig, A. J. (2000).
Foundations of education: History and theory of teaching children and youth with
visual impairments (2nd ed.). New York:
AFB Press.
AFB, All Rights Reserved congenitally blind children
- R Brown
- R P Hobson
- A Lee
- J Stevenson
Brown, R., Hobson, R. P., Lee, A., & Stevenson,
J. (1997). Are there 'autistic-like' features in
306 Journal of Visual Impairment & Blindness, July-August 2014 ©2014 AFB, All Rights Reserved
congenitally blind children? Journal of Child
Psychology and Psychiatry, 38, 693-703. doi:
10.1111/j.1469-7610.1997.tb01696.x
Sensory impairments, intellectual disability and psychiatry
- S Carvill
Carvill, S. (2001). Sensory impairments, intellectual disability and psychiatry. Journal
of Intellectual Disability Research, 45, 467483. doi: 10.1046/j.1365-2788.2001.00366.x
Centers for Disease Control and Prevention.
(2012). Autism spectrum disorders-Data
and statistics. Retrived from http://www.
cdc.gov/ncbddd/autism/data.html
Prevalence of parent-reported diagnosis of autism spectrum disorder among children in the US
- M D Kogan
- S J Blumberg
- L A Schieve
- C A Boyle
- J M Perrin
- R M Ghandour
- . . Van Dyck
Kogan, M. D., Blumberg, S. J., Schieve,
L. A., Boyle, C. A., Perrin, J. M., Ghandour, R. M.,... van Dyck, P. C. (2009).
Prevalence of parent-reported diagnosis of
autism spectrum disorder among children
in the US, 2007. Pediatrics, 124(5), 1395-1403. doi: 10.1542/peds.2009-1522