Inclusão educacional de pessoas com Autismo no Brasil: uma revisão da literatura

The promise of precision medicine in autism

Most social skills interventions for students with autism spectrum disorder have been conducted in clinic-based settings. While students with autism spectrum disorder are able to acquire new skills, the generalization of these skills to authentic social environments, like school, is more difficult. To address this issue, there is an increase in research examining the implementation of social skills interventions for students with autism spectrum disorder who are educated in inclusive school settings. This review included 18 research studies that focused on school-based social interventions for students with autism spectrum disorder who were educated in inclusive school settings. Typically developing peers also participated in the interventions to varying degrees. Secondary aims explored naturalistic observation instruments and subsequent social outcomes used to record the social behaviors of students with autism spectrum disorder at school. Social intervention components varied across studies, but all studies reported improvement in the targeted social behaviors of students with autism spectrum disorder. There were many similarities in the ways in which researchers measured and defined social outcomes. Observation protocols were able to measure change in the social behaviors of students with autism spectrum disorder across a wide age range. The recognition of evidence-based practices used in school-based social skills interventions, as well as the identification of observation protocols and salient social outcomes, provides a starting point for school practitioners to consider as they move to implement social skills interventions for students with autism spectrum disorder into inclusive school settings.

Pten and the Brain: Sizing up Social Interaction

Lack of Association between Parental ABO Blood Type and Autism Spectrum Disorders

10 Tips For Testing Hearing in Children With Autism

Objective:Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are neurodevelopmental disorders with overlapping symptomatology and shared genetic makeup. Numerous previous studies have investigated ASD and ADHD using resting state functional networks. One functional network of particular interest is the Default Mode Network (DMN), as it has been shown to be abnormal in several mental disorders. Previous studies have investigated the DMN in ASD and ADHD separately but reported mixed trends of increased and decreased functional connectivity (FC) in the DMN in ASD and increased FC in ADHD. Additionally, little studies have investigated executive and attentional network dysfunction in the DMN for ASD and ADHD populations. To better understand the shared characteristics between ASD and ADHD, this study analyzed the DMN FC in children with ASD and ADHD.Participants and Methods:Archival datasets from Autism Brain Imaging Data Exchange (ABIDE)-I and ADHD-200 datasets were used, with 33 ADHD, 35 ASD, and 32 typically developing (TD) males (ages = 7-17 years). After applying a standard pre-processing pipeline, 11 regions of interest (ROIs) from the Dosenbach-160 atlas were examined with 55 ROI pairs generated for the 100 subjects.Results:Significant differences were noted between ASD-ADHD groups in attentional networks and executive functioning networks. Specifically, significant Group x VIQ interactions were noted for FC between the following pairs of regions: medial prefrontal cortex - ventromedial prefrontal cortex, anterior cingulate cortex -ventromedial prefrontal cortex, inferior temporal lobe - ventromedial prefrontal cortex, angular -ventromedial prefrontal cortex, angular -anterior cingulate cortex, inferior temporal lobe -ventrolateral prefrontal cortex, angular -superior frontal lobe, and intraparietal sulcus -superior frontal lobe. In the above FC pairs, FC in ADHD was negatively correlated with VIQ, with no correlation for ASD and positive correlation for TD. Previous literature has indicated that ADHD individuals demonstrate increased executive functioning deficits compared to ASD individuals. This study provides evidence at a neural level for these findings by demonstrating decreased FC trends in ADHD in attentional and executive functioning networks compared to ASD individuals. Group and VIQ main effects demonstrated mixed patterns across the three groups, as well as shared decreased FC in attention/executive networks for both ASD and ADHD groups.Conclusions:In summary, this study found similar findings from previous studies regarding mixed connectivity patterns, as well as shared dysfunction between ASD and ADHD groups. These results help in solidifying the theory that ASD and ADHD share clinical and neural patterns which need to be examined further. Future directions include utilizing more ASD+ADHD comorbid individuals in studies comparing ASD and ADHD FC trends as well as seeking to further understand the neuropsychological and neuroimaging profiles in ASD and ADHD.

“Success Doesn’t Happen in a Traditional Way”: Experiences of school personnel who provide employment preparation for youth with autism spectrum disorder

Few professionals working with children and families affected by autism spectrum disorders (ASD) would deny that behavioral intervention is the treatment of choice. Programs based in Applied Behavior Analysis (ABA) methodology such as discrete trial instruction (DTI) and applied verbal behavior (AVB) remain popular interventions for children diagnosed with ASD. They remain popular to the extent that special education litigation has increasingly involved requests that school districts provide or reimburse parents for a program characterized by ABA. Several distinctions, important for school personnel and educational consultants alike, can be made between a these programs. These distinctions are provided along the following dimensions: curriculum, reinforcement and motivation, delivery of instruction, prompting and error correction, language acquisition, augmentative communication, and data collection. Key Words: autism, behavioral intervention, Discrete Trial Instruction, Applied Verbal Behavior. ********** Schreibman (1997) indicates that few professionals working with children and families affected by autism spectrum disorders (ASD) would deny that behavioral intervention is the treatment of choice. Behavioral treatment has been defined as synonymous with applied behavior analysis (ABA), and as the application of the principles of learning to human behavior for the resultant effect of improved socially significant behaviors (Schreibman, 1997). Despite some methodological criticisms of the research (Connor, 2003, Eikeseth, 2001, Gresham, Beebe-Frankenberger, & MacMillan, 1999, Gresham & MacMillan, 1997, Gresham & MacMillan, 1998), ABA-based early intervention is empirically supported in helping children with ASD to achieve significant gains (Herbert & Brandsman, 2002). Programs based on ABA methodology remain popular interventions for children diagnosed with ASD (Herbert & Brandsma, 2002, Lovaas, 1987, McEachin, Smith, & Lovass, 1993, Schreibman, 1997). Special-education litigation has increasingly involved requests that school districts provide or reimburse parents for a program characterized by ABA (Yell & Drasgow, 2000). For example, the New York State Guideline Technical Report for clinical practice of the assessment and treatment of ASD for children ages 0-3 years recommends the principles of ABA be included as an important programmatic element (NYDH, 1999). Given the increased demand for ABA methodology for preschool and school-aged children with ASD in school settings, it is necessary that teachers of special education and other school personnel understand the distinction between different types of programs that fall under the umbrella of ABA and what is implied when parents request discrete trial or applied verbal behavior programs. In their selective review of treatments for children with autism, Gresham, Beebe-Frankenberger, and MacMillan (1999) evaluated several programs categorized as comprehensive behavioral and educational treatment programs. These include, among others, the UCLA Young Autism Project (YAP), based on the work by O. Ivar Lovaas (1987); Treatment and Education of Autistic and Related Communication Handicapped Children (Project TEACCH), based on the work of Schopler and Reichler (1971); and Learning Experiences Alternative Program (LEAP), based on the work of Strain and others (1977) (Gresham, Beebe-Frankenberger, & MacMillan, 1999). Since the publication of the Gresham, Beebe-Frankenberger, and MacMillan article in 1999, additional approaches considered behavior analytic in nature have come to the forefront. These include Pivotal Response Training (PRT) (Koegel, Koegel, & Carter, 1999) and Applied Verbal Behavior (AVB) (Sundberg & Michael, 2001). For some educators, the distinction among ABA programs remains nebulous. The purpose of this paper is to distinguish between two popular approaches currently provided for early intervention and school-aged children in home- and school-based settings: Lovaas' Young Autism Project (YAP), more commonly referred to as Discrete Trial Instruction (DTI) or Discrete Trial Teaching (DTT), and B. …

Introduction Autism spectrum disorders (ASD), which include autism, Asperger's Syndrome (AS), and pervasive developmental disorder-not otherwise specified (PDD-NOS), are a group of disorders characterized by a host of difficulties with social interactions, communication, and repetitive behaviors or interests (American Psychiatric Association, 2000). Although currently defined by a triad of impairments, difficulties with social relationships and interactions have been one of the hallmarks of autism since its first description (Kanner, 1943) and, more recently, have been suggested to be the defining feature of ASD (Laushey & Heflin, 2000). Across the spectrum, characteristics of the social sequela manifest uniquely, rarely being the same from one individual to the next. In general, children with ASD demonstrate extreme difficulties engaging in even the simplest of social behaviors, such as engaging in appropriate eye contact, initiating and maintaining conversations, listening to or responding to verbal requests, developing and maintaining age-appropriate friendships , and interacting in basic games (Carter, Ornstein-Davis, Volkmar, & Klin, 2005; Dawson et al., 2004). Despite these generalities, some children with ASD may appear to be social in the presence of familiar adults or peers and, at times, socially engaged. However, the majority of children with ASD will demonstrate extreme social difficulty when in the presence of novel people or stimuli (Handleman, 1999). Given such difficulties, efforts to teach children with ASD skills that enhance participation in family, school, and community activities become paramount. Within the past two decades, the number of children identified as having ASD has increased substantially. Traditionally, ASD were considered a low-incidence disability, occurring in only 4 to 6 per 10,000 (or 1 in approximately 1,600) live births (Lotter, 1967). However, the most current estimates from the Centers for Disease Control and Prevention (CDC, 2007) estimate that ASD occurs in 1 in every 150 births, making it the fastest growing developmental disability in the U.S. Such an increase likely has had a direct impact on educators in public schools across the country in relation to demands for educationally related services. In fact, the U.S. Department of Education reports that the number of children receiving services under the autism category of the Individuals with Disabilities Education Act (IDEA) has increased 1,342% between 1993 and 2006 (Fighting Autism, 2008). Moreover, there has been an increasing trend to include students with ASD in general education classrooms (National Research Council, 2001). Examination of data on inclusion relative to each disability category under the IDEA suggests that students with ASD are increasingly served in inclusive settings (Office of Special Education Programs, 2004). While only 4.8% of students with ASD were included in 1990-1991, nearly 29.1% were in general education for 80% or more of their day in 2003-2004. Truly, educating students with ASD in inclusive environments has become a more common practice. Due to the increased number of students with ASD in schools and the push for providing educationally related services within inclusive environments, effective means of planning and implementing social skills interventions are needed. To be effective, interventions targeting social behaviors should capitalize on the visual learning strengths of students with ASD and allow for repeated imitation of targeted social skills or behaviors (National Research Council, 2001). Furthermore, such interventions should be presented in ways that are unobtrusive and can be implemented within natural contexts. Social Stories[TM] One strategy that has emerged as a common practice for teaching social behaviors to individuals with ASD in schools is the use of Social Stories[TM]. Social Stories[TM] are individualized short stories that can be used to assist persons with ASD in interpreting and understanding challenging or confusing social situations (Gray, 1997, 2003). …

Familiarity breeds support: Speech-language pathologists’ perceptions of bullying of students with autism spectrum disorders

Structural variation is thought to play a major etiological role in the development of autism spectrum disorders (ASDs), and numerous studies documenting the relevance of copy number variants (CNVs) in ASD have been published since 2006. To determine if large ASD families harbor high-impact CNVs that may have broader impact in the general ASD population, we used the Affymetrix genome-wide human SNP array 6.0 to identify 153 putative autism-specific CNVs present in 55 individuals with ASD from 9 multiplex ASD pedigrees. To evaluate the actual prevalence of these CNVs as well as 185 CNVs reportedly associated with ASD from published studies many of which are insufficiently powered, we designed a custom Illumina array and used it to interrogate these CNVs in 3,000 ASD cases and 6,000 controls. Additional single nucleotide variants (SNVs) on the array identified 25 CNVs that we did not detect in our family studies at the standard SNP array resolution. After molecular validation, our results demonstrated that 15 CNVs identified in high-risk ASD families also were found in two or more ASD cases with odds ratios greater than 2.0, strengthening their support as ASD risk variants. In addition, of the 25 CNVs identified using SNV probes on our custom array, 9 also had odds ratios greater than 2.0, suggesting that these CNVs also are ASD risk variants. Eighteen of the validated CNVs have not been reported previously in individuals with ASD and three have only been observed once. Finally, we confirmed the association of 31 of 185 published ASD-associated CNVs in our dataset with odds ratios greater than 2.0, suggesting they may be of clinical relevance in the evaluation of children with ASDs. Taken together, these data provide strong support for the existence and application of high-impact CNVs in the clinical genetic evaluation of children with ASD.

The purpose of the study was to investigate the attitudes of teachers towards inclusion of pupils with autism spectrum disorder (ASD) in regular classrooms and also aiming to examine the relationship between teacher-related factors and teachers’ attitudes towards inclusion of pupils with ASD in regular classrooms. Three hundred regular primary teachers were selected as participants by using random sampling. A demographic questionnaire and TATIS (Teacher Attitudes toward Inclusion Scale) developed by Cullen et.al.(2010) were used for measuring teachers’ attitudes towards inclusion of pupils with ASD in regular classrooms. The descriptive and inferential statistics were used for analyzing data. The findings indicated that teachers’ attitudes toward inclusion of pupils with ASD in regular classrooms were slightly positive. One interesting finding was that half of teachers are willing to make classroom modifications and to follow inclusion model to meet the individual needs of students with ASD. However, the majority of the teachers are still in favor of the option of maintaining special classrooms for students with ASD. The result also indicated that the statistically significant correlation was highlighted between teachers’ attitudes and the following teacher-related factors: gender, age, educational qualification, teaching experience, being personally acquainted with a person with ASD, adequate training and formal training on ASD. The regression analysis suggested that about 21% of the variance on attitudes due to the variables like gender, age, educational qualification, adequate training and formal training on ASD. These variables contributed significantly to the prediction of teachers’ attitudes towards inclusion of pupils with ASD.

Introduction. The article examines the specifics of cognitive activity of students with autism spectrum disorders (ASD) in the course of mastering natural science disciplines, including the process of performing mathematical tasks. The necessity of a differentiated approach in teaching, taking into account the cognitive sphere of this category of children, is substantiated in order to increase the capabilities of each student in mastering the program material. Categories of errors and difficulties are identified, reflecting the special problems that arise in the educational activity of children with ASD and requiring systematic pedagogical work.Materials and methods. The theoretical part of the study is based on the analysis of scientific publications devoted to the peculiarities of the development of natural sciences by students with ASD. The data of own empirical research based on the analysis of the results of annual control works in mathematics performed by students with ASD, studying in the fourth, sixth and eighth grades of a general education school, are given. The works of 55 students with ASD aged 11-16 years old, studying according to the variant of the adapted educational program 8.2, intended for children with ASD, who do not have intellectual disabilities, are considered. The study also used data from questionnaires filled out by teachers who conducted the tests. Thus, the study is based on a synthesis of scientific literature and a quantitative and qualitative analysis of the results obtained through empirical research.Results. A summary of current research data has identified two main categories of cognitive challenges faced by children with ASD that must be taken into account when teaching them science: difficulties related to executive function deficits and difficulties related to verbal comprehension and social perception deficits. These two categories account for almost half of the errors made by students with ASD in math tests. The article provides an overview of the main types of errors in each category. In addition, the results of an empirical study showed that the proportion of errors related to executive function deficits decreases over the course of education, as does the proportion of "non-specific" errors for children with ASD, which are related to a lack of knowledge and computational skills. However, the proportion of errors caused by deficits in verbal comprehension and social perception increases from year to year.Discussion and conclusions. The data of the empirical study based on the assessment of errors and difficulties in the performance of students with ASD of control works in mathematics, allowed to analyze their specificity and assign to different categories. At the same time, the difficulties of one of the identified categories, associated with the deficiencies of verbal understanding and social perception, were the most stable and, accordingly, require special attention of teachers at all stages of education of children with ASD. By summarizing and analyzing the data obtained from the teachers' questionnaires, it was possible to identify a set of methods and techniques aimed at systematically addressing the challenges faced by children with ASD in the process of learning science subjects. The results of the study indicate that methods and techniques aimed at improving verbal understanding and social perception are the most relevant, as these specific problems for students with ASD are the most resistant to pedagogical interventions in our study.

As the number of students with Autism Spectrum Disorder (ASD) being prepared for statewide assessment rises, there is increased demand for effective instructional strategies to improve reading comprehension scores in these students. The authors synthesized the findings of 15 studies, which included 88 school-aged students identified with ASD The studies were conducted between 1989 and 2015. Findings indicate that Direct Instruction (DI) and graphic organizers have positive effects, while cooperative learning, anaphoric cueing, and question generation show promise. Electronic supported text shows little to no effect on reading comprehension measures in students with ASD. Keywords: autism, autism spectrum disorder, cooperative learning, direct instruction, reading comprehension, reading instruction, reading strategies ********** Reading comprehension is the act of gaining meaning from print. It is a complex task that requires the integration and coordination of numerous high-level cognitive processes, necessitating active reader engagement (Cain, Oakhill & Bryant, 2004; Garcia-Madruga, et al., 2013; Nation, Adams, Bowyer-Crane, & Snowling, 1999; Pressley & Afflerbach, 1995). Reading comprehension continues to be an area of weakness for students with ASD, though it is considered to be an essential component of developing literacy (National Institute of Child Health and Human Development (NICHD), 2000). It is now thought that as many as 70% of individuals with ASD have average to above average intelligence (Chakrabarti & Fombonne, 2005), but levels of reading comprehension for students with ASD have been reported as significantly lower than peers, even when groups are matched for reading accuracy and IQ (Brown, Oram-Cardy, & Johnson, 2013; Frith & Snowling, 1983). As with other individuals with disabilities, performance on reading comprehension tasks is correlated to individual's verbal ability (Snowling & Frith, 1986), however, there are factors related to reading comprehension that are unique to individuals with ASD. Autism Spectrum Disorder (ASD) is characterized by impairments in social interaction and communication, as well as restricted, repetitive, stereotyped patterns of behavior (American Psychiatric Association, 2013). In the 2012-2013 school year, there were 498,000 students aged 3-21 years in the US receiving educational services for Autism under IDEA. This represents an average annual increase of over 36,000 students since the 2002-2003 school year when 137,000 students were receiving services in this category (U.S. Department of Education, 2013). Some individuals with ASD will be dependent on life-long support and care, while others perform at levels comparable with their typically developing peers in academic settings and go on to graduate from college (Estes, Rivera, Bryan, Cali, & Dawson, 2011). Although individuals with ASD share common characteristics, they also exhibit a wide range of capabilities and strengths Many higher-functioning, school-aged children with ASD are placed in classrooms with typically developing peers and are working toward similar academic goals in the general education curriculum (Estes et al., 2011). Impaired reading comprehension, especially when paired with normative reading accuracy, has been reported as a specific area of deficit for individuals with ASD (Nation, Clarke, Wright, & Williams, 2006). That is, individuals with ASD often are able to read text fluently without substantial comprehension of what they have read. Individuals with ASD also show mild deficits in semantic knowledge (Brown et al., 2013). A correlation does exist between semantic knowledge and reading comprehension and this may impact reading comprehension for some individuals with ASD. Saldana & Frith (2007) demonstrated that individuals with ASD could make inferences when a limited amount of text is presented, but had difficulty when integrating specific knowledge with a global text. …

Numerous studies have attempted to identify early physiological abnormalities in infants and toddlers who later develop autism spectrum disorder (ASD). One potential measure of early neurophysiology is the auditory brainstem response (ABR), which has been reported to exhibit prolonged latencies in children with ASD. We examined whether prolonged ABR latencies appear in infancy, before the onset of ASD symptoms, and irrespective of hearing thresholds. To determine how early in development these differences appear, we retrospectively examined clinical ABR recordings of infants who were later diagnosed with ASD. Of the 118 children in the participant pool, 48 were excluded due to elevated ABR thresholds, genetic aberrations, or old testing age, leaving a sample of 70 children: 30 of which were tested at 0–3 months, and 40 were tested at toddlerhood (1.5–3.5 years). In the infant group, the ABR wave‐V was significantly prolonged in those who later developed ASD as compared with case‐matched controls (n = 30). Classification of infants who later developed ASD and case‐matched controls using this measure enabled accurate identification of ASD infants with 80% specificity and 70% sensitivity. In the group of toddlers with ASD, absolute and interpeak latencies were prolonged compared to clinical norms. Findings indicate that ABR latencies are significantly prolonged in infants who are later diagnosed with ASD irrespective of their hearing thresholds; suggesting that abnormal responses might be detected soon after birth. Further research is needed to determine if ABR might be a valid marker for ASD risk. Autism Res 2016, 9: 689–695. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research