Activities for Autistic Children

Parenting Children With Asperger's And High-functioning Autism

Mark Hutten, M.A is a practicing counseling psychologist and a professional parent-coach with experience of over 20 years in the field of High-Functioning Autism (HFA) and Asperger's. being the executive director of online parent support, LLC, Hutten presents several workshops and conducts numerous training courses for both professionals and parents dealing with HFA and Asperger's; besides, he works with hundreds of teenagers and children with HFA and Asperger's. Hutten is also an author of several articles that highlight parenting techniques based on highly effective research for dealing with children with HFA and Asperger's. The founder of the support group has published 'My out of control Child' and 'My out of control teen' eBooks. Most of Hutten's columns and articles discuss several ways of parenting young ones with conduct disorder, ODD, ADHD, Autism, Asperger's syndrome, Bipolar disorder, reactive attachment disorder, and many more conditions. The helpful parenting toolkit is all about a system that enables parents to minimize the child's meltdowns, low frustration tolerance, and tantrums, physical and verbal aggression, school-related behavior problems, social skills deficits, picky eating, attention difficulties, rigid thinking, problems completing homework, sleep problems, rituals and obsessions, and many more behavioral problems. The eBook is available for download. Continue reading...

Parenting Children With Aspergers And Highfunctioning Autism Summary


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Are children with autism conscious of the mental

This section is necessarily longer than the previous one, since a long line of evidence collected over the last two decades suggests that children with autism are relatively unaware of the mental Wimmer and Perner (1983) devised an elegant paradigm to test when normally developing children become conscious of the mental specifically, when they are aware of another person's beliefs. The child was presented with a short story, with the simplest of plots. The story involves one character not being present when an object was moved, and therefore not knowing that the object was in a new location. The child being tested is asked where the character thinks the object is. Wimmer and Perner called this the False Belief test, since the focus was on the subject's ability to infer a story character's mistaken belief about a situation. These authors found that normal 4 year olds correctly infer that the character thinks the object is where the character last left it, rather than where it actually...

Are children with autism conscious of the physical

This section can be relatively brief, since the answer to the above question is clearly yes. We know this because of the following pieces of evidence. First, children with autism search to find occluded objects (Sigman, Ungerer, Mundy, and Sherman, 1987 Frith and Baron-Cohen, 1987). That is, they behave in ways which are intended to cause them to see something. Secondly, they are capable of mental rotation (Shah, 1988). This suggests that they have representations in their mind of how physical objects appear from different visual perspectives, in the same way that the rest of us do. Thirdly, they respond to the same range of sensory stimuli as other people (though they may be hypersensitive to some sounds and tactile stimuli) (Wing, 1976 Frith, 1989). Fourthly, as far as we know, their color perception is normal. They may attend to parts of objects in a different manner to others (Shah and Frith, 1983, 1993 Frith and Happe, 1994 Jolliffe and Baron-Cohen, 1997), but there is little...

About autism

Autism is defined as a severe developmental disorder characterized by deficits in communication and language, problems with social behaviour, and repetitive and stereotypical behaviour. Asperger's syndrome is often referred to as a milder variant of autism, but it is probably more accurate to say that it is a form of autism in people with a normal level of intelligence and when early speech development has not been delayed. Children with autism and those with Asperger's syndrome often share the same basic psychological deficits, and the basic principles of their education are often also similar. Autism cannot be cured, but many of the difficulties that this disorder creates can be eased via education, with a starting point of highlighting and clarifying the essential parts of any form of information we want to communicate to the child. Visual support aids are one of the obvious choices for this. However, when communication is aimed at people with autism,the need for visual support is...

Structured Activities

Once the autistic child has understood this way of working and the adults remember to vary the exercises without necessarily making them more difficult, these kinds of set exercises can be very relaxing. Many children who find it difficult to initiate play will ask to do exercises.

The Physical Arrangements

Many autistic children find it difficult to remain focused on what they are doing, and a picture can help remind them. Once the child's attention is secured, he or she is spared the interruptions of impulse actions. On reaching a particular destination, the child will then be able to match the picture with another one, or simply put it in his or her pocket to indicate that the activity has been successfully completed.

Preparing For Special Occasions

It may be possible to take autistic children to new places without preparation when they are younger, but as they get older and develop, their demands to understand their surroundings may increase. Unusual occasions can require more preparation than is necessary for events on the ordinary daily schedule.

Visual Support For Communication

A young non-autistic child who has not yet developed verbal language will normally communicate via gestures, which are interpreted by adults, and the child seems to have an expectation that the adults will be able to understand his or her needs. Autistic children who have yet to learn to speak can find it difficult to understand other people's signals, as well as having problems expressing their own basic needs such as hunger, thirst and the need for care, help and comfort. Autistic children with a well-developed spoken language can experience the same difficulties. Some children can therefore benefit from carrying a key ring with a card or a picture attached to remind them that they can ask for help. The autistic child can also find it difficult to communicate a choice. You can train the child to choose between two things,for example by presenting two very different items and, later on, two pictures.

Support For Learning New Skills

Children without autism often learn new skills by comparing themselves with others. Many autistic children do not show initiative in learning anything new, but need support to help them gain greater independence. Autistic children also need to experience as much pleasure and dignity as possible by being able to do things on their own. Being able to carry out something independently makes them less 'people dependent'. It can be difficult for the autistic child to relate experiences from one incident to another. By using a support system, the child is helped to become more flexible. For example, bath times at home and at the swimming pool are not very similar, but a support system can be the link that reinforces the similarities in the routine. Once the child - assisted by the support system -has learnt to apply the bath-time routine at the swimming pool, it may be possible for the support system to be phased out gradually

Everyday Education

Visual support for children with autism First published in 2002 in Danish by Center for Autisme, Bagsv rd, Denmark, as Hverdagsptfdagogik om visuel st0tte til hern med autisme Copyright Center for Autisme 2007 Foreword copyright Lennart Pedersen 2007 Translation copyright Karina Smedemark 2007

Arranging a bedroom

Dicte has a table where she can play and another one where she can work on the exercises in her boxes. The contents of her boxes vary (see Chapter 5). As autistic children often find it difficult to play on their own for any significant period of time, the assigned exercises can be put away so that the child can relax.

Scheduled break

For some children, it can be difficult not to be kept busy. It can be hard to take a break if having to make your own plans is a problem. By using a few pictures, the child can participate in choosing which activities he or she would like to relax with. Most people with autism are most comfortable with a tidy room and therefore the room used for breaks should be tidied before it is used for puzzles, sewing and computer games.

Learning to choose

Many autistic children find it difficult to choose between two things and often repeat the last thing being offered. To make it easier to learn how to choose, you can start by letting the child choose between something desirable and something irrelevant, e.g. chocolate and a cucumber. Once the child is confident with this selection process, you can let him or her choose between two equally exciting things,for example chocolate and ice-cream.

Daily Schedule

The purpose of the daily schedule is to make the day more manageable for the person with autism. The schedule needs to emphasize whether it is an ordinary day or whether there are likely to be changes. Will there be visitors, or does the shopping need to be done Will there be a trip to the hairdresser or to the dentist

Raymond G Romanczyk and Jennifer M Gillis

Keywords autism, autism spectrum disorder, fears phobias, Asperger's disorder, social skills anxiety Currently, there are five different disorders under the category of Pervasive Developmental Disorders (PDD) in the DSM-IV-TR (APA, 2000). The term Autism Spectrum Disorders (ASD) is commonly used in place of PDD, particularly by the lay public. The most prevalent diagnoses in this category Autistic Disorder, Asperger's Disorder, and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) are the three most commonly associated with ASD. These developmental disorders have profound effects on specific areas of development. The three share substantial deficits in social development and restricted or stereotyped patterns of activities, interests, and behaviors. Unlike Asperger's Disorder, language development in individuals with autism and PDD-NOS is typically significantly delayed or absent. While specific prevalence rates are controversial (estimates of 2-6 per 1000 for ASD),...

Intentional attunement embodied simulation and empathy

Of course, embodied simulation is not the only functional mechanism underpinning social cognition. The same actions performed by others in different contexts can lead the observer to radically different interpretations. Social stimuli can also be understood on the basis of the explicit cognitive elaboration of their contextual perceptual features, by exploiting previously acquired knowledge about relevant aspects of the situation to be analysed. Our capacity of attributing false beliefs to others, our most sophisticated mind reading abilities, likely involve the activation of large regions of our brain, certainly larger than a putative and domain-specific theory of mind module. Embodied simulation and the still poorly understood more sophisticated mentalizing cognitive skills, however, are not mutually exclusive. Embodied simulation, probably the most ancient mechanism from an evolutionary point of view, is experience-based, while the second mechanism can be characterized as a...

Biosocial Theory See Murphys Biosocial Theory

The Swiss physician psychiatrist Eugen Bleuler (1857-1939) formulated theories of schizophrenia and mania-depression that include the following conjectures there are four fundamental symptoms (the four As ) of schizophrenia autism, ambivalence, inappropriate affect, and loosening of associations there is a fragmentation of thinking, i. e., a psychological disturbance in which thoughts and actions that are normally integrated are split apart, and thinking processes become confused where actions and ideas are impossible to complete there is a total incapacity to feel sympathy for, or to be concerned with, the welfare of others (Bleuler used the obsolete terms moral idiocy and imbecility ) there are inconsistencies in the explanations and reasons that some patients create to justify their previous behaviors ( pseudomotivations ) there may be episodes of elation or mental disturbance that tend to occur on the anniversary ( anniversary excitement ) of a significant date...

DNA Methylation and Human Disease

Rett syndrome and Fragile X syndrome are other genetic disorders that result from a disruption in the function of methylated DNA. Rett patients, who are almost all young females, at first develop normally. Later on, however, they develop mental retardation, autism, and movement disorders. These patients have a mutation in the gene for the methyl-binding protein MeCP2. This protein usually represses gene expression by binding tightly to methylated DNA and causing repression.

Anatomical Brain Defects A Multiple Anatomical Abnormalities

Subcortical Structures Color

Among all types of biological abnormalities in autism, evidence for neuroanatomical abnormality is the strongest. Studies show that in autism, most major brain structures are affected (Fig. 6) these include the cerebellum, cerebrum, limbic system, corpus callosum, basal ganglia, and brain stem. Recent evidence shows that within the cerebellum and cerebrum, there is abnormality in white and gray matter. Such widespread anatomic abnormality explains why autism involves pervasive and persistent neurological and behavioral dysfunction. Among all anatomic findings, the most consistent is abnormality in the cerebellum. According to MRI data on large numbers of autistic children and adults, there is a reduction in the size of the neocerebellar vermis and the volume of cerebellar cortex. Also in autistic children, there is an inverse relationship between the size of the cerebellar vermis lobules VI and VII and the size of frontal lobes, such that the smaller the vermis, the larger the frontal...

Neuroimaging and the intentional stance

Animations meant to elicit theory-of-mind attributions elicited more activation in several areas relative to the random animations (1) the bilateral temporal parietal junction (TPJ) in the posterior superior temporal sulcus (STS) (2) bilateral basal temporal regions, including the temporal poles (3) the bilateral extrastriate cortex and (4) the medial prefrontal cortex (MPFC). A follow-up study involving both autistic patients and normally developing controls replicated this finding, and also found that autistics had less activation in the basal temporal area, the STS and TPJ, and the MPFC (Castelli et al 2002). Behavioural data have shown that those with autism are less likely to report percepts of intentionality when viewing these types of stimuli, allowing for the inference that these brain areas are responsible for engaging the intentional stance (Abell et al 2000, Castelli et al 2002). Corroborating this supposition, the TPJ and STS, temporal poles and MPFC have all been...

Empirical Studies

In addition, there is a wealth of clinical research supporting the effectiveness of discrimination training in real world settings, especially among populations that demonstrate difficulty with discrimination tasks. Discrimination training in the clinical realm has proven effective in teaching new skills, as well as modifying inappropriate behaviors such as impulsivity, either as a treatment modality in itself, or integrated in a multicomponent behavioral intervention. One way in which discrimination training is used in a clinical population was formulated in the 1960s by Ole Ivar Lovaas to teach autistic children receptive and expressive language skills. First, the child is taught receptive labeling, followed by speech imitation training. In receptive labeling, a teacher presents desired objects such as toys or edibles and gives a simple phrase or question, such as cookie, or Where's the cookie For children to earn this reward, they must perform a simple task such as...

Language Origins Theories Of

Environment the onomatopoetic theory (also called the ding-dong theory, the animal-cry theory, the bow-wow theory (from dogs barking ), the splish-splash theory, and the nativist theory) - holds that imitations of sounds of animals and natural events constitute the origins of human language (cf., the echo principle - a tendency for children to imitate the linguistic patterns behaviors of their parents the theory of imitation and the autism theory of language learning by the American psychologist Orval Hobart Mowrer (1907-1982) which states that a word initially acquired on an autistic, or self-satisfying, basis then may become instrumental in producing subsequent and predictable behavior on the part of others) the interjectional theory (also called the pooh-pooh and exclamation theories) -suggests that humans' emotional exclamations (such as ow, ah, oh, and oof') were the first words of humankind the ta-ta theory holds that language began in combinations of tongue movements and...

Fear recognition and the amygdala

Model Brain With Dementia

A further role for the amygdala in processing aspects of faces comes from studies of the interaction between facial emotion and eye gaze. The direction of eye gaze in other individuals' faces is an important source of information about their emotional state, intention, and likely future behaviour. Eye gaze is a key social signal in many species (Emery 2000), especially apes and humans, whose white sclera makes the pupil more easily visible and permits better discrimination of gaze. Human viewers make preferential fixations onto the eye region of others' faces (Janik et al 1978), a behaviour that appears early in development and may contribute to the socioemotional impairments seen in developmental disorders like autism (Baron-Cohen 1995). Eyes signal important information about emotional states, and there is evidence from functional imaging studies that at least some of this processing recruits the amygdala (Baron-Cohen et al 1999, Kawashima et al 1999, Wicker et al 2003). The...

Placental Insufficiency and Fetal Growth

True intrauterine growth restriction (IUGR) resulting from utero-placental insufficiency is a serious pathology that is associated with a greatly increased risk of adverse outcomes including perinatal mortality and morbidity, impaired mental, visual and aural development, autism, and cerebral palsy. IUGR is often detected indirectly by measuring abnormal umbilical artery flow velocity waveforms and or abnormal fetal heart rate. The abnormal waveforms are thought to result from increased vascular resistance associated with abnormal arter-iolar tree and villi branching and a reduction in the

Murphys Biosocial Theory

The American psychologist Gardner Murphy (1895-1979) formulated a biosocial theory of personality that was popular in the 1950s and was eclectic in nature by combining holistic, evolutionary, functional, and biosocial concepts into a comprehensive psychological system cf., the Swiss-American physician Adolf Meyer's (1866-1950) integrative theory of psychobiology, which emphasizes the importance of biological, social, and psychological influences on the individual and the American physician (and the first American to become a psychoanalyst) Trigant Burrow's (1875-1950) phyloana-lytic phylobiological theory that attempts to unite biological and social factors to form a total personality view of individuals, as well as a total view of human societies . Although Murphy's approach overlaps with the theories of other psychologists, his systematization efforts include some core ideas that are his own. For example, Murphy emphasizes sensory and activity needs in describing...

Schizophrenia Theories Of

Is confused, often, by laypeople with schizophrenia). In the simplest terms, multiple personality is a split within self, whereas schizophrenia is a split between self and others. Various categories, descriptions, and subtypes of schizophrenia have been developed (e.g., acute, borderline, catatonic, childhood or infantile autism, chronic, disorganized, hebephrenic, latent, paranoid paraphrenic, process, reactive, residual, schizoaffective, simple, and undifferentiated), but there are certain common aspects to all types (1) deterioration from previous levels of social, cognitive, and vocational functioning (2) onset before midlife (i.e., about 45-50 years of age) (3) a duration of at least six months and (4) a pattern of psychotic features including thought disturbances, bizarre delusions, hallucinations, disturbed sense of self, and a loss of reality testing. The progressive teleological-regression hypothesis (Arieti, 1974) is a theory of schizophrenia that maintains that the disorder...

Prenatal Programming of Human Motor Function

There is emerging evidence that one of the developing systems that may be programmed by an adverse intrauterine environment is the human motor system. Programming has been described as a process whereby a disturbance of the environment, at critical stages of development of regulatory systems and their target tissues, alters development in such a way as to perma-nendy change functional capacity and predispose the individual to disease in later life. Adverse conditions in utero have been implicated in long-term alterations in brain structure and function, and possibly the later development of neurological diseases. There is increasing evidence that motor and vision disorders, schizophrenia (discussed elsewhere in this book, Ch. 17), epilepsy and autism may have their origins, at least in part, in altered prenatal neurodevelopment.1 2 Infants whose growth before birth has been restricted have increased rates of perinatal mortality and morbidity and increasingly, evidence of long-term...

Restricted Range of Interests Repetitive Behaviors and Stereotyped Patterns

In addition to salient disturbances in social behavior and language, individuals with autism may also exhibit abnormally intense preoccupations with one subject or activity, exhibit distress over changes in routines, insist on sameness in their environment, and engage in repetitive or ritualistic behaviors. For example, a child may exhibit signs of physical and emotional distress when a new piece of furniture is introduced into the home or if he or she is prevented from taking a traditional route up and down the aisles during grocery shopping. Still another child may center the majority of his or her activities around an obsessional object, such as toilets he or she may draw pictures of them, talk about them, and flush all toilets in proximity as part of his or her daily life. Finally, others may repetitively bang a spoon or flap their hands for minutes, sometimes hours, during a single day. Such restricted and repetitive behavior may have particularly important developmental...

Historical Overview

Between 1930 and 1940, mental health treatment providers largely abandoned the assumption that manic-depression and most other disorders, including schizophrenia and autism, developed from neurobio-logical abnormalities. Following World War II and until the early 1980s, mental health theory and treatment were mostly guided by psychoanalytic concepts proposed by Freud and his followers. Whereas psychoanalytic theory agreed that biological components played a role in affective disorders, practitioners insisted that early childhood parental or other environmental conflicts usually explained the onset and recurrence of manic-depressive episodes. As a result, it was thought that manic-depressive symptoms would resolve if individuals gained insight into their unconscious anger or other hidden emotional conflicts. Even though psychoanalysis and other forms of psychotherapy offered little help for most patients with severe manic-depressive problems, talk therapies nonetheless became the...

Bdv And Human Disease

Recognition of BDV's broad experimental host range, and the observation that disturbances in behaviors in experimentally infected animals are reminiscent of some aspects of human neuropsychiatric diseases, including major depressive disorder, bipolar disorder, schizophrenia, and autism, led to the proposal that BDV might be implicated in their pathogenesis. Although there is consensus that humans are likely to be susceptible to BDV infection, the epidemiology and clinical consequences of human infection remain

Mindmental States Theories

In its generalized form, mind theory refers to people's beliefs, cognitions, and intuitive understanding of their own, and other people's, mind mental states that develop over a period of time beginning at a very early age (cf., solipsistic doctrine - a philosophical speculation that there can be no proof that phenomena exist outside of the mind inasmuch as everything is assumed to be dependent on personal perception also, it is the extreme view that only the self exists, where everything and everyone else is a product of one's imagination). Although children typically have a well-developed theory of mind by about the age of three years, they do not yet possess the understanding that people's beliefs may be false (cf., Piaget, 1929). In some atypical and intrapersonal cases, such as children diagnosed with autism, there is an inability to understand the notion of mental states and the way in which such states modify or control behavior (cf., theory of impoverished mind - attempts...

Impact Of Catecholamines On Behavior

Much of the information that is available concerning the functions of catecholamines in regulating human behavior directly results from the use of a group of medications often called psychotropic drugs and antidepressant medications called thymoleptics. Other medications that impact on catecholamines include psychostimulants, such as dextroamphetamine and methylphenidate (commonly known by its trade name, Ritalin) and l-dopa (which has been used to treat Parkinsonism), as well as a medication that was initially used to treat hypertension. Most of these drugs affect more than one system (e.g., dopaminergic, noradrenergic, or serotonergic systems). Catechola-mines have been proposed as mediators of many psychiatric illnesses, including schizophrenia, Tour-ette's syndrome, depression, autism, attention deficit-hyperactivity disorder, stereotypic movements, tremors, and substance abuse. More generically, cate-cholamines also play a critical role in the stress response. Unfortunately,...

Brain Structures Involved In Human Classical Conditioning

Rabbits has shown that although the hippocampus can be removed without affecting acquisition in the delay paradigm, disrupting the hippocampus by inactivating the cholinergic input to the hippocampus can disrupt delay conditioning. Alzheimer's disease disrupts the septohippocampal cholinergic system and it is this disruption that likely causes the impairment in delay eyeblink conditioning. If fact, this classical conditioning paradigm is so sensitive to the early effects of Alzheimer's disease that, it has been proposed as a simple neuropsychological test for Alzheimer's. Finally, humans with autism, a developmental disorder characterized by severe impairments in communication and social relating and by ritualistic and repetitive patterns of behavior, also show abnormalities in the cerebellum. Subjects with autism also show abnormal acquisition and extinction of the CR. This finding further supports the involvement of the cerebellum in classical eyeblink conditioning.

David Reitman and Nichole Jurbergs

CST can be useful in helping patients with disabilities such as mental retardation or autism to communicate effectively in social settings. Although significant modifications are required to adapt CSTs for the communication impaired and developmentally disabled, Fred P. Orelove and Dick Sobsey have outlined a program to teach basic functional communication to children with severe or multiple disabilities. Before implementing such a program, four decisions must be made (1) which communication functions would be most useful to the individual, (2) what specific content or messages should be communicated, (3) which form (mode) of communication should be selected vocal, gestural, or graphic, (4) how each item should be taught. After these decisions have been made, a program of assessing and teaching specific patterns of communication can be implemented based on five fundamental principles maximization (striving for the greatest increase in appropriate communication), functionality...

Defensive Techniques Theory

The term deindividuation refers to the loss of one's sense of individuality during which the person behaves with little or no reference to personal internal values or standards of conduct. Dein-dividuated states are characterized as pleasurable wherein the person feels free to act on impulse and without regard to consequences. However, they can also be extremely dangerous in that they can result in violent and antisocial behavior. In the late 1800s, the French sociologist Gustave LeBon (1841-1931) postulated the phenomenon of a group mind and asserted that people in a crowd may lose their sense of personal responsibility and behave as if governed by a primitive, irrational, and hedonistic mind that seems to belong more to the group as a whole than to any one individual cf., shared autism theory - holds that members of groups may have shared beliefs ( delusions ) that have no foundation or validity in reality . Thus, the state of deindividua-tion seems to be...

Illness Narratives in Anthropology and Beyond

The use of narrative to describe other people's experiences of acute or chronic illness is also something of a growth industry. In the last few years, analyses of patient narratives have been used to explore everything from autism (Gray, 2001) to temporomandibular joint syndrome (Garro, 1994). In between one finds studies of breast cancer (Langellier & Sullivan, 1998), depression (Kangas, 2001), diabetes (Hunt, Valenzuela, & Pugh, 1998 Loewe & Freeman, 2000), HIV (Bloom, 2001 Ezzy, 2000), mental illness (Goodman, 2001), and schizophrenia (Lovell, 1997), to mention just a few of the more recent ones. Ironically, though, as Byron Good notes, there are relatively few studies that take an explicitly cross-cultural perspective (Good, 1994), or venture beyond the borders of the author's native land. Some that do, include Evelyn Early's study of the informal stories Baladi (Egyptian) women tell to clarify illness episodes and garner emotional support (Early, 1985), Laurie Price's use of...

Characteristics in the First Years and Clinical Onset

Despite the almost complete consensus that autism is a disorder with a biological onset prenatally or shortly after birth, behavioral indicators during the first 2 years of life are elusive. Difficulties in developing a clinical profile of autism at such young ages are due to the fact that most children do not receive a diagnosis until age 2-4 therefore, reliable early indicators may be missed. Some information, however, has been made available based on retrospective analyses of home videos taken of children before the diagnosis of autism has been made. Such retrospective videotaped studies have demonstrated that autism can be distinguished from normal at least as early as 1 year based on differences in social behaviors, such as looking at the face of another or orienting in response to his or her name, and in joint attention behaviors, such as pointing, showing objects to others, and alternating gaze between object and person. Given that these types of social and joint attention...

Complex Clinical Presenting Problems

With regard to cognitive characteristics, individuals with autism, Asperger's Disorder, and PDD-NOS vary widely in terms of deficits, delays, and advanced skills. Some of these cognitive deficits include difficulty with categorical thinking, emotion recognition, rule-governed behavior, perspective taking, logical reasoning, executive functioning, and abstract and symbolic representations. Individuals with Asperger's Disorder often demonstrate minimal impairment compared to individuals with autism and PDD-NOS. As an example of a specific deficit, in the context of categorical thinking, the category of chair would include lawn chair, recliner, rocking chair, table chair, and so on an individual with autism or PDD-NOS may have difficulty with placing these types of chairs under this one category. Rather, the individual might use each type of chair as its own category. Individuals with autism, Asperger's Disorder, or PDD-NOS may also have difficulty with rule-governed behavior either in...

Pharmacological Uses and Toxicity of Vitamin B6 Supplements

Supplements have also been used empirically, with little or no rational basis, and little or no evidence of efficacy, in the treatment of a variety of conditions, including acute alcohol intoxication, atopic dermatitis, autism, carpal tunnel syndrome, dental caries, diabetic neuropathy, Down's syndrome, Huntington's chorea, schizophrenia, and steroid-dependent asthma.

Pervasive Developmental Disorders PDD

A study that examined the development of children who were later diagnosed with PDD not otherwise specified (PDD-NOS) compared to children with ADHD found that in early childhood it was very hard to detect any significant differences between the groups 58 . In an examination of the social functioning of children suffering from ADHD, high functioning autism or PDD-NOS 59 , the children with autism were characterized by the highest (least normative) scores on social functioning scales the next highest scores were of children with PDD-NOS, and the lowest were those of ADHD children. On the other hand, on the ''acting-out'' scale, the highest scores were given to children with ADHD, whereas on the ''social insight'' scale there was no difference between children with ADHD and those with PDD-NOS.

Total Cerebral Volume

Autism, attention deficit hyperactivity disorder (ADHD), childhood-onset schizophrenia, dyslexia, eating disorders, fetal alcohol syndrome, obsessive-compulsive disorder, Sydenham's chorea, and Tourette's syndrome. It is evident that a normative sample must be carefully screened to rule out these conditions. Likewise, affective disorders and substance abuse have been associated with structural anomalies in adults and should be considered as potential confounds in pediatric samples as well.

Christine Maguth Nezu and Michelle A Peacock

In 2000 (Rush & Frances, 2000), practical clinical guidelines based on expert consensus and relevant research for treating persons with mental retardation suffering from major mental disorders were developed to assist clinicians in treatment decision making. Applied behavior analysis, managing the environment, and client and family education were the most highly recommended psychosocial treatments for many disorders including autism, attention-deficit hyperactivity disorder, conduct disorder, substance abuse and substance dependence, as well as target symptoms such as self-injurious behavior, aggression, and pica. CBT (e.g., anger management, assertiveness training, conflict resolution) was recommended as a first-line option for major depressive disorder, posttraumatic stress disorder, obsessive-compulsive disorder, and symptoms of anxiety. CBT was also recommended as a second-line option for bipolar disorder (manic phase), schizophrenia and other psychotic disorders, generalized...

Cerebellum and Psychiatric Disorders

Various reports suggesting a possible link between the cerebellum and emotional behavior have been published since the beginning of the 20th century. However, these findings have been overshadowed by the generally accepted view of the cerebellum as a pure motor structure. In the 1970s, the convergence of pathological observations and experimental findings induced some groups to implant a cerebellar pacemaker to treat intractable behavioral disorders. Since then, data have been collected linking gross cerebellar anatomical abnormalities to various psychiatric disorders. Schizophrenia has been linked to different types of abnormalities of the cerebellar vermis patients affected by attention deficithyperactivity disorder have been shown to have a reduced volume of the posterior vermal lobules (VIII-X). Currently, there is substantial evidence linking the cerebellum with autism, although the precise loci of the cerebellar damage (i.e., vermal lobules VI and VII, dentatothalamocor-tical...

Economic Pressures on the Political System

Politicians at the present time are trying to balance the complaints about HMOs and managed care with the inevitability that the industry must be part of the solution if there is to be one. Along with the professional societies exerting pressure, by 2000 the National Alliance for the Mentally Ill (NAMI) emerged as a potent force advocating the strengthening of the 1996 mental health parity law. The bill under serious consideration in the year 2000, called the Mental Health Equitable Treatment Act, would require full insurance parity for schizophrenia, bipolar disorder, major depression, obsessive-compulsive and panic disorders, posttraumatic stress syndrome, autism, anorexia nervosa, and ADD. It takes its lead from the states that have passed some kind of parity law, and cuts directly to parity only for a list of disabling disorders, eliminating the diffuse nature of much mental health diagnosis and treatment. Thirty-four states had passed some kind of parity law by 2000, suggesting...

Minitheories Of Emotion

Neurons, first located in the rostral part of monkeys' ventral premotor cortex (called area F5 ), discharge under conditions both when the animal performs a goal-directed hand action and when it observes another individual performing the same, or a similar, action (i.e., imitation gestures and affor-dances ). Also, in the same cortical area, mirror neurons have been found that respond to the observation of mouth actions. In humans, it has been shown that the observations of actions performed with the hand, the mouth, and the foot leads to activation of different sectors of Broca's area a cortical region involved in the production of language - named after the French surgeon and anthropologist Paul Broca (1824-1880) who discovered its function in 1861 and premotor cortex, according to the effector involved in the observed action, and follows a somatotopic pattern resembling the classical motor cortex homunculus. Such observations and results support the mirror neuron theory regarding...

Children With Disabilities

Hughes's (1998) review suggests that there are few meaningful qualitative differences in the play of children with disabilities compared to typically developing children, with some exceptions for children whose functioning would be described in terms of autism spectrum disorders (Rogers, 1988). Children with cognitive, sensory, and motor handicaps do play, and their play parallels that of children without disabilities, depending on their opportunities. For example, the play of a child who is blind depends greatly on individuals' making toys available to the child and presenting them in a way that the child can interact with them. When children with disabilities show delays in play, these delays tend to appear similar across types of disability in that the levels of play are delayed, the repertory of material exploitation is limited, and restricted imagination and symbolic thinking are evident (Brooks-Gunn & Lewis, 1982). However, there is little that distinguishes one disability from...

Associated Features 1 Mental Retardation

A robust finding is that approximately 75 of individuals with autism also meet DSM-IV criteria for mental retardation. For the minority with normal intellectual functioning, subtle deficits in social and language behavior clearly set them apart from their typically functioning peers. There is no consensus regarding the role of mental retardation in autism and scientists have approached the topic in several ways. One thought has been that since mental retardation is not specific to autism (e.g., children with Down's syndrome and cerebral palsy also have mental retardation), attempts to understand its role in the disorder will not elucidate etiological or pathobiological mechanisms. Thus, the role of mental retardation is largely ignored. Another approach has been to investigate only a pure form of the disorder and subtract out'' effects due to mental retardation by studying only nonretarded individuals with autism. A further idea has been to control for the presence of mental...

The limits of the motor theory of empathy

How far can we draw the parallel between empathy and imitation There are at least four main differences. First, it seems that we cannot help but share someone else's sadness. In contrast, we imitate because we want to, in order to learn for instance. Second, empathy has a salient phenomenological dimension. I empathize with you if I subjectively experience the same emotion as you. Goldman (1995) describes it as an 'online simulation'. It is difficult to make sense of what empathy would be if it remains offline. In contrast, the study of motor imagery has provided evidence of offline imitation. Third, autism and psychopathy are sometimes described as deficits of empathy, but as far as I know, there is no

Cognitive Neuroscience and Consciousness

While this book presents a strong evolutionary perspective, except for the important analysis of autism by Baron-Cohen (Chapter 3) it does not stress development. In studies of normal infants and children, we have found specific events that mark the development of attention to sensory events (Posner & Rothbart, 1994) during the first year of life and these are earlier than equally dramatic changes that mark the development of self regulation in the second and third year of life (Posner & Rothbart, 1998). Developmental changes must eventually fit into the brain systems that are said to underlie consciousness.

Nuclear Organization Chromatin Structure and Gene Silencing


Studies in model organisms, such as yeast and fruit flies, have clearly demonstrated that nuclear positioning affects gene expression. There is growing evidence in humans that some diseases might result from misregula-tion of gene expression due to translocations that place a disease-causing gene into an inappropriate zone. Examples include cases of aniridia (absence of the iris), autism, and Burkitt's lymphoma. In these cases the disease-related gene is not damaged by the translocation, in fact, the breakpoints of the translocation map several kilobases or megabases from the gene affected. It is hypothesized that altered expression of the disease gene is due to placement in an inappropriate nuclear zone as a consequence of the translocation. Therefore, understanding the rules of gene regulation has become a three-dimensional problem that will require sophisticated detection of gene expression coupled with highresolution nuclear imaging.

Psychiatric Disorders

If the patient appears to be psychotic, it is important to distinguish between true responses to internal stimuli, motor and verbal tics, and self-stimulating behaviors characteristic of autism. Catatonic behavior may reflect delirium, depression, or status epilepticus with absence or partial-complex seizures. Psychosis is probably the most common misdiagnosis in this population. Mood disorders typically present with changes in the patient's sleep, appetite, and activity level. Treatment with antidepressants is indicated and effective. Appropriate treatment for any underlying medical or psychiatric disorder should be undertaken. Remember that developmentally disabled individuals often require smaller doses of psychotropic medications and may be more sensitive to adverse effects.

Brain Behavior Findings

Language deficits in autism may be associated with a lack or reversal of left hemisphere dominance found in most normal adults. However, abnormal asymmetries have been observed in other electroencephalogram, ERP, PET, and SPECT studies that did not involve language tasks. It therefore remains open whether there is any specific link between functional asymmetries and language impairment in autism.

Understanding Neurological and Psychiatric Disorders

Using neurologically intact subjects supplies a natural baseline for using fMRI to derive more sensitive and or more specific diagnostic criteria. For every robust finding in the functional localization of tasks involving frontal cortex with healthy subjects, there will eventually be a comparison study involving patients with all manner of neuropsychiatric disorders, from Alzheimer's disease to psychosis, schizophrenia, and autism. Many such studies have been conducted already.

Recommended Readings

G. (Eds.) (1991). Autism Strategies for change A comprehensive approach to the education and treatment of children with autism and related disorders. New York Gardner Press. Lesniak-Karpiak, K., Mazzocco, M. M. M., & Ross, J. L. (2003). Behavioral assessment of social anxiety in females with Turner or fragile X syndrome. Journal of Autism and Developmental Disorders, 33, 55-67. Love, S. R., Matson, J. L., & West, D. (1990). Mothers as effective therapists for autistic children's phobias. Journal of Applied Behavioral Analysis, 23, 379-385. Palkowitz, R., & Wisenfeld, A. R. (1980). Differential autonomic responses of autistic and normal children. Journal of Autism and Developmental Disorders, 10, 347-360.

Spontaneous social perception versus controlled social judgements

The ability to comprehend the beliefs, emotions and intentions of others is both characteristic of, and necessary for, successful human interaction. Our richly social nature and complex societal hierarchies demand these skills, such that those who exhibit deficits in this domain experience considerable difficulty interacting with others (e.g. individuals with autism Tager-Flusberg 2001). Known as possessing a theory-of-mind (ToM), mentalizing, or adopting the intentional stance, this capacity to view others as possessing mental states can be directed to targets other than conspecifics. Not only are we tempted to believe that a pet hamster is 'just like a little person,' we routinely view quite abstract nonliving representations as if they were intentional agents. Be it an animated movie populated by talking

TABLE 3022 Frequently Used Medications and Side Effects

Next it is important to determine the patient's living situation. Even relatively minor changes in routine or caretakers can have a dramatic impact on the functioning of some developmentally disabled individuals, particularly those with autism. It is also essential to determine the patient's resources for appropriate follow-up care within the community. The provision of routine and preventative care is particularly important in the developmentally disabled population because of the higher incidence of medical problems. Finally, determine whether the patient has a guardian or, if not, whether they are capable of making their own decisions about medical care.

Applications Of Temporal Coding In Signal Processing

Mini Pendants Over Occasional Table

Synchronous oscillations have also been proposed to be the foundation of other complex phenomena, such as decision making, attention, and consciousness.38 Attentional mechanisms bias processing toward the brain regions necessary for a task. Global synchronous oscillations make up the dynamic core of conscious behavior, while local oscillations involved in lower-level functions such as sensory processing would be subconscious (Figure 2.11). Cognition requires the large-scale coordination of multiple neuronal networks. Deficits in synchronous activity have been linked to pathologies involving large-scale neuronal network coordination, including schizophrenia75 and autism.76

Symptom Profile And Neural Bases A Social Abnormalities 1 Characteristics

When Leo Kanner was deciding on a name that might most aptly characterize his original 11 cases, he chose the term autism, derived from the Greek work autos or self. His choice likely emerged from the strong sense of a preference for isolation, or the self, to the company of others observed in all his cases. Indicators of social abnormalities are noted early in autism, quite often as early as the first few months of life. Parents often remark that as infants, their autistic children stiffened when held, failed to make prolonged eye contact, and did not cry for help or consolation. A robust early indicator of social abnormality is a near absence of joint attention, or the coordination of attention between object and person, a skill that emerges in normal infants toward the end of the first year of life. As a category, joint attention behaviors may include pointing and showing objects and the use of eye contact and direction of visual gaze to and from an object and person. Normal...

Language and Speech Abnormalities 1 Characteristics

It is the delay or regression of language, usually at approximately age 2, that first prompts parents to seek professional help. Although such delays are significant indicators of problems in child development, they are not specific to autism and are commonly found in many other childhood disorders (e.g., general language delay). By itself, language delay does not account for most of the features of the disorder but can be used as a metric for predicting developmental outcome. For example, several studies have shown that autistic children without speech by age 5 are much less likely to live independently later in life than children with functional speech. Also, the presence or absence of language has often been used to distinguish high from low functioning autism. The understanding of language abnormalities in autism, however, is critical for the development of appropriate treatment approaches, offers insights into the relationship between various symptoms in the disorder (e.g.,...

Differential Reinforcement of Other or Incompatible Behavior

Differential reinforcement of other behavior (DRO) refers to rewarding behavior other than a specified undesirable behavior. A child with autism, for example, may be given a reward during any 5-minute interval during which he or she plays with no aggressive behavior. In related fashion, an adult may be rewarded for interacting with others and not avoiding an anxiety-provoking situation. Differential reinforcement of incompatible behavior is similar to DRO, but involves rewarding a behavior that is specifically antagonistic to, or not able to be done physically at the same time as, an undesirable behavior. For example, a child may be rewarded for folding his or her hands on a desk, a behavior incompatible with hair pulling. Or, an adult in a group home for persons with schizophrenia may be rewarded for doing a chore in the home, a behavior incompatible with running away.

TABLE 3021 Medical Problems Associated with Specific Mental Retardation Syndromes

Other developmental disorders important for health care providers to recognize are the autistic spectrum disorders and developmental language disabilities. Autism is defined by the presence of qualitative differences in social reciprocity, communication, and the ability to purposefully shift attention. About 50 to 70 percent of individuals with autism are also mentally retarded. The remainder, despite normal or superior cognitive abilities, has difficulty communicating their symptoms and understanding, appropriately generalizing, and responding to information about suggested medical treatments. A large number of autistic individuals have tactile defensiveness and become very agitated when they are touched, which complicates physical examination. Autism is estimated to have a prevalence of 1 to 2 1000 individuals, with as many as 5 to 7 1000 affected with milder forms of the disorder. Individuals with language disorders are also likely to have difficulty describing their medical...


Autism may give us an important clue that the brain in fact allows at least two distinct kinds of conscious experience consciousness of the physical (e.g., seeing an object) on the one hand, and consciousness of the mental (e.g., thinking about seeing an object) on the other. The latter is likely to be parasitic on the former, and whilst the former involves direct stimulation of perceptual systems, the mechanisms underlying the latter are still relatively unknown. As our understanding of the neurobiology of autism unfolds, so also our understanding of this second-order level of consciousness should too.

Aversion Relief

Hol dependence, smoking, overeating, obsessive-compulsive behavior, and various forms of deviant sexual behavior. Furthermore, perhaps most controversial, aversive methods have also been used in patients with autism and mental retardation. A classical example of aversion relief therapy in children with autism was presented by Lovaas and his co-workers. Autistic children were asked to approach the therapist. If the child did not approach, shock was delivered and continued until an approach was made. Subsequently, shocks could be avoided by approaching within 5 seconds of the request. This application of aversion relief led to a dramatic increase in the approach behavior of autistic children and had maintained its effect nine months later without further shocks.

Targeted Behaviors

Not only has backward chaining been used to teach self-help skills to persons with developmental disabilities, it has also been successful in helping children with autism to learn to speak in short sentences. In addition, several studies have demonstrated the effectiveness of backward chaining in treating children who refuse to eat or drink. For example, in 1996, Louis P Hagopian and colleagues used backward chaining as part of a procedure to treat a 12-year-old boy with autism and mental retardation who completely refused liquids. After obtaining a baseline measure of the boy's drinking and conducting a task analysis, backward chaining was implemented. In this case, drinking water from a cup was the target response, and the chain consisted of three segments (1) bringing the cup of water to the mouth, (2) accepting water into the mouth, and (3) swallowing. To implement this backward chain, the boy was first reinforced by being given access to a preferred activity for 90 sec when he...

George T Capone MD

Autism and autistic spectrum disorders (ASD) are best defined as a neu-robehavioral symptom complex involving qualitative impairments in social interaction and communication and a restricted or stereotyped pattern of behavioral interests and activity (First, 1994). As a neurobehavioral symptom complex, autism is a classification based on observed behaviors and not etiology. For the purpose of this discussion ASD is meant to include infantile autism, pervasive developmental disorder (PDD), and late-onset autism (childhood disintegrative disorder). Approximately 75 of autistic persons also have mental retardation (Rapin, 1997), and cognitive level is significantly associated with the severity of autistic symptoms. The prevalence of ASD in persons with Down syndrome (DS) is estimated to be between 5 and 7 (Kent et al., 1999). The prevalence of ASD appears to be substantially higher in the DS population than in the general population (0.1-0.2 ) and higher than the predicted prevalence...

Genetic Findings

Autism is among the most heritable of neuropsychia-tric disorders. Twin studies report pairwise concordance rates of up to 91 for autism among monozygotic twins and 24 among dizygotic twins, suggesting the disorder is strongly genetic. The increased risk of autism among siblings of autistic probands is 2 , which is about 45 times the rate expected in the general population. For the majority of the autistic population, multiple interacting genes are likely to be etiologically involved. About 5 of autistic patients have abnormalities in one or another of nearly all possible chromosomes therefore, across autistic individuals with a chromosomal abnormality, the site of abnormality is variable. Nonetheless, according to many reports, the most common site of chromosomal abnormality is 15q11-13. This abnormality occurs in about 2-4 of all autism cases, and it has been suggested that the autism phenotype occurs with maternal transmission of this particular chromosome defect. Because of the...

Brain Development

Information about what brain abnormalities are present early in development and how they change with age cannot be gained by observations of the brains of older children or adults alone because the older brain is the outcome or end product of developmental transformations. Animal model studies demonstrate that early abnormal perturbations can create complex cascades of structural alterations. Abundant evidence from developmental neurobiology shows that when the developing brain sustains significant neural insult precipitated by environmental or genetic factors, the typical balance of competition that mediates anatomical and functional organization is altered and can result in atypical functional activity and structural growth (reduced or enlarged dendritic arbors, neurons, representational maps, or even whole cytoarchitectonic regions). This neuroplasticity may produce arrangements that successfully compensate for the structural defect but may also produce arrangements that do not...

Gray Matter

Anomalies of temporal lobe and medial temporal lobe structures have been reported for a variety of psychiatric disorders, including affective disorders, autism, and, most consistently, schizophrenia, which is increasingly understood as a neurodevelop-mental disorder. These disorders have marked sex differences in age of onset, symptomatology, and risk factors. The sex-specific maturational differences may have relevance to the expression of these disorders.


A., 46 DNA chips (microarrays), 252 DNA polymorphisms, 295 DNA sequences, 249-250 knowledge of, 255 mouse models and, 253-255 research opportunities offered by, 251-253 Down, John Langdon, 442 Down syndrome (DS), xi. See also People with Down syndrome advances relating to, 132 ASD and, 330-331 autistic disorder and, 328 autistic spectrum disorders and, 327-335 Medical conditions, autistic spectrum


A wide range of pharmacological agents have been used as viable treatment options for autism, ranging from serotonin uptake inhibitors, such as clomipra-mine and even the common antidepressant Prozac, to dopamine antagonists such as haloperidol. Overall, drugs have not proven successful at ameliorating the key features of autism but, rather, may have a modest effect on specific features of the disorder for some children. For example, serotonin uptake inhibitors (known to be effective in the treatment of obsessive-compulsive disorder) have been shown to be effective in reducing repetitive behaviors seen in autism. Side effects common with psychotropic medications (e.g., tardive dyskenisia), however, typically limit the use of such interventions. Most children with autism participate in pharmacological intervention at some point during their treatment course, but it is the minority that maintains drug use across their life span.


Treating a broad range of psychological problems and psychiatric disorders including anxiety (e.g., fears, obsessive compulsive disorders, panic attacks), depression, substance use and abuse (e.g., drug, alcohol, cigarettes), conduct problems, hyperactivity, autism, and eating disorders.


The fifth study was conducted by Weinblatt in 1993. He rated 32 mothers during the course of play interactions with their 3- to 4-year-old children with mild to moderate disabilities. The ranges of education and income level of the mothers were wide, with most being single and working parents. The types of children's handicaps included speech impairment (over two thirds of the sample), emotional disturbance, mental retardation, learning disability, and autism. This study focused on furthering understanding of mediational interactions between mothers and their children with handicaps and the relationship between their mediations and the development of competence in the children. The mothers were observed in five conditions of interaction, and there was highly significant consistency in the mediation ratings among the five situations, varying from .62 to .86. The components of sharing and change were rarely observed in these interactions. This study documented a significant positive...


Montague A child's behaviour is difficult to characterize. It indexes a certain part of the parental behavioural space. This is why children with autism spectrum disorders are particularly hard on parents, because the parents are expecting a whole range of responses from the child which they don't get.


Identifying the goal of the program in most cases seems obvious and straightforward because of the direct and immediate implications of the behavior for the adjustment, impairment, and adaptive functioning of the individual in everyday life. For example, many interventions have decreased such behaviors as self-injury (e.g., headbanging) among autistic children, anxiety and panic attacks, and driving under the influence of alcohol, and have increased such behaviors as

Client Populations

Research demonstrates that backward chaining has been successfully used with diverse populations ranging from children to elderly adults. Although some research has demonstrated the effectiveness of this procedure with persons who are typically developing the majority of studies have focused on individuals with developmental disabilities. Within this latter population, backward chaining has been extensively used and found to be particularly effective in teaching skills to children and adults with mild to profound mental retardation and to children with other developmental disorders such as autism. It is not clear why research has focused so heavily on evaluating backward chaining in persons with developmental disabilities, but it may be the case that persons who are typically developing often do not require the intensive type of training to establish behavior sequences as provided by the procedure.


In conventional CBT programs, the client is encouraged to self-reflect to improve insight into his or her thoughts and feelings, thereby ideally promoting a realistic and positive self-image as well as enhancing the ability to self-talk for greater self-control. However, the concept of self-awareness may be different for individuals with Asperger's disorder. There may be a qualitative impairment in the ability to engage in introspection. Research evidence, autobiographies, and clinical experience have confirmed that some clients with Asperger's disorder and high-functioning autism can lack an inner voice and think in pictures rather than in words. They also have difficulty translating their visual thoughts into words. See also Autism spectrum disorders


When the disorder was first described almost 60 years ago, few if any treatment options were available, and parents were left with little hope of cognitive or behavioral advancement for their child. It was common for autistic children of this era to be placed in institutions, largely ignored, grouped together with children with other special needs (e.g., general mental retardation and blindness). Although there is still no cure for autism, modern-day treatment of this disorder affords several possibilities and research has shown that significant advances in cognitive and behavioral domains can be made. In fact, today, most children receive intervention on a daily basis, some as early as age 2. Furthermore, many school-aged children with autism are mainstreamed or are placed in classrooms with typically developing children for some or all of their school day. The reasons for this dramatic metamorphosis in thinking about the treatment of autism come from several sources. First, the...


Although biological abnormalities are becoming increasingly better understood in autism, currently this disorder is diagnosed exclusively based on behavioral characteristics. Traditionally, the Diagnostic and Statistical Manual IV (DSM-IV) has been the guide used for making diagnostic decisions about the presence or absence of autism. A burgeoning interest in early identification in autism, however, has prompted the need for instruments that will both reliably and validly diagnose autism at the youngest ages possible. The ability for the DSM-IV to meet this need has been questioned by many scientists. For example, part of the DSM-IVcriteria relates to language abnormalities, and given that language is minimal at young ages (for both autistic and normal children), children suspected of having autism could not be reliably diagnosed with this instrument. In order to meet this need, a relatively new diagnostic tool, the Pre-Linguistic Autism Diagnostic Observation Schedule (PL-ADOS)...

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Autism is a developmental disorder that manifests itself in early childhood and affects the functioning of the brain, primarily in the areas of social interaction and communication. Children with autism look like other children but do not play or behave like other children. They must struggle daily to cope and connect with the world around them.

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