Professional Documents
Culture Documents
Syndrome &
the Spectrum
of Autism
Based on population projections for 2000 (middle series) Review ed March 06,2001
Increase in Autism:
Public Schools
The number of students with autism
being served in public schools under
IDEA rose in 2000-01.
from 5,415 in 1991-92 to 78,749
In comparison, the number of students
with all disabilities being served under
IDEA rose during the same period.
from 4,499,824 to 5,775,722
Figures from the most
recent U.S. DOE’s 2002
Report to Congress on IDEA
Students with autism jumped 1,354%
eight-year period from the school year
1991-92 to 2000-2001.
Rateof increase is almost 50 times
higher than the rate of increase of for all
disabilities (28.4% ),
or 26.75% for all disabilities excluding
autism.
Department of Education's
"Twenty-first Annual
Report*"
period from 1988-89 to 1997-98
rate of change of 173% for autism
16% for all disabilities
(b) on others
4. Speech and language
problems
(at least three of the following)
poor performance on
neurodevelopmental
examination
NLD not yet
AS vs NLD accepted diagnosis
A cognitive
description
Considerable
overlap with NLD
a more general
term
Many - but not all –
NLD AS AS have NL profile
A continuum of functionality
Repetitive/narrow interests
Delays in
language or use
of gesture
Lack of make-believe or
social imitative play
Failure to initiate or sustain
conversational interchange
Restricted, Repetitive and
Stereotyped Patterns of Compulsive
Behavior adherence to
nonfunctional
routines or rituals
Preoccupations or
circumscribed pattern of
interests
Single words
First phrases
Parent’s 1st noticed
Diagnosis based on
ADOS/ADI
Autism diagnosis is confirmed if
scores exceed cutoff
Autism spectrum diagnosis is
considered if just below cut-offs
The dimensional nature of
the Autism spectrum
The variety of patterns is
considerable
Subtyping is an attempt to
organize patterns
Low vs High Functioning
Autism (Stevens et al, 2000)
evidence for the validity of 2 subgroups of
differentiated at school age by behavioral
measures of social abnormality, language
ability, and cognitive level.
Both development of normal social skills and
the presence of deviant social behaviors
contribute independently to subgroup
membership
Can have some normal skills and some ‘deviant’
behaviors
High Functioning Group Over Time
At preschool social behavioral abnormalities equal or
almost equal to those of the low-functioning group;
these subsided by school age, leaving only mild residual
social symptoms.
Nonverbal IQ was within average range at preschool and
remained there.
Receptive vocabulary score mildly depressed at preschool
but normalized, as did Vineland Communication.
Development of adaptive social skills (as measured by the
Vineland) was mildly delayed at preschool and recovered
into the low normal range,
suggesting mild social delays, consistent with the residual
mild social abnormalities indicated in this group.
Low Functioning Group Over Time
The development of language skills appears
arrested, actually declining relative to same-age
normal peers over time.
At preschool, significant abnormalities in all 3 associated
behavioral areas
social, communicative, restricted/repetitive behaviors,
as well as cognitive measures.
behavior abnormalities indicative of autism continued to be
quite pronounced at school age.
Nonverbal IQ and the development of social skills were
moderately impaired and remained unchanged relative to
peers.
school-age nonverbal IQ was very heterogeneous, ranging
from 22 to 133.
Prediction of group membership at
school-age
normal or near normal nonverbal IQ is the most potent
predictor of school-age subgroup membership.
Normal IQ is necessary for an optimal outcome,
but it is not sufficient in the presence of significant
language and social delays and abnormalities.
Lower-functioning preschool subgroup children
overwhelmingly remained in the lower-functioning school-
age group,
Functional outcomes
the higher-functioning preschool group split into a good
outcome and a less good outcome group.
Improvement
Approximately 38% of the subjects classified in the high-
functioning subgroup at preschool not only improved, but
showed relatively normal scores at school-age follow-up.
If an a priori cutoff of at least 80 nonverbal IQ is used,
nearly half of the high-functioning subjects at preschool
had generally normal scores upon follow-up several
years later.
Nonverbal IQ, receptive language, and
adaptive functioning (as measured by
Vineland Socialization) were the most
predictive variables of later outcome
COGNITIVE PROFILES IN AUTISM
Tager-Flusberg & Thomas, 2003