Autism and the Brain

Last week I attended an Autism Conference at Utah Valley University.  One of the workshops I attended was about the neurological difference associated with ASD.  I thought it was so interesting, and I learned a lot so I wanted to share it with you.  The presenter was Brandon Condie, BCBA, LPC.

He talked about 5 main areas of the brain, including the amygdala, hippocampus, frontal lobe, corpus callosum, and cerebellum.  The thing that I found interesting was the strengths and weaknesses of each of those areas.  It just makes so much sense if you know many individuals that are affected with autism.

Here we go.

Amygdala.  In an individual with autism, this area is enlarged.

• Strengths include improved memory for interests and details.  Makes total sense for those individuals who know EVERYTHING about their special interest.  Makes sense for those who have Savant skills.
• Weaknesses include a low tolerance for stress and/or anxiety.  When I heard Temple Grandin speak last year she mentioned that her amygdala is 4 times the size of a typical brain, which meant that her fear center was 4 times as big.  We see this a lot where a situation that doesn't seem frightening to us may be completely overwhelming to an individual with autism.  This explains a lot.

Hippocampus.  This area is also enlarged in an individual with autism.

• Strengths include being logical, and is systems oriented.  Many individuals with autism excel in areas like engineering, math, etc.  We marvel at those kiddos who are unable to communicate, yet they are able to navigate things like the dvd player, ipads, computers, etc. with very little help and at a very young age.
• Weaknesses include perseveration.  We see this in a lot of individuals with autism, once they are focused on something it is difficult to change directions.  Whether it is a topic of conversation, lining things up, or making sure everything is where they feel like it needs to be.

Cerebellum.  In an individual with autism, they may have overloaded white matter.

• Strengths include a need for routine, and becoming an expert at a task.  As many parents know, routines and predictability are so important for individuals with autism.
• Weaknesses include unsteadiness, delayed physical or verbal response, and anxiety surrounding sudden change.

Frontal Lobe.  The frontal lobe is enlarged due to excessive white matter.

• Strengths include being visual learners.  Temple Grandin talks a lot about how she sees the world in pictures, and all her memories are in pictures.  That's why she's so good at what she does.
• Weaknesses include having a difficult time with abstract thought.  This may be part of why social interactions are so difficult as well because they are not concrete.  Some of our rules as pertaining to social interactions are abstract.

Corpus Callosum.   This area is undersized.  The corpus callosum links the two hemispheres of the brains and is the source for effective communication between the two hemispheres.

• Strengths include being able to hyper-focus on detail
• Weaknesses include missing the "bigger picture" and being able to bring concepts together.

Learning about this information was so eye opening for me.  I've worked with a lot of kids with autism, and I see common characteristics and I know how to work with their strengths and their areas of struggle, but learning about the brain helps me to see more of the WHY. 

Joy Mano

Utah PLAY Project Home Consultant

Early Intervention Services for Children with Autism

photo credit: Patrick Hoesly via photopin cc

Last week I attended an Autism Conference at Utah Valley University.  One of the workshops I attended was about the neurological difference associated with ASD.  I thought it was so interesting, and I learned a lot so I wanted to share it with you.  The presenter was Brandon Condie, BCBA, LPC.

He talked about 5 main areas of the brain, including the amygdala, hippocampus, frontal lobe, corpus callosum, and cerebellum.  The thing that I found interesting was the strengths and weaknesses of each of those areas.  It just makes so much sense if you know many individuals that are affected with autism.

Here we go.

Amygdala.  In an individual with autism, this area is enlarged.

• Strengths include improved memory for interests and details.  Makes total sense for those individuals who know EVERYTHING about their special interest.  Makes sense for those who have Savant skills.
• Weaknesses include a low tolerance for stress and/or anxiety.  When I heard Temple Grandin speak last year she mentioned that her amygdala is 4 times the size of a typical brain, which meant that her fear center was 4 times as big.  We see this a lot where a situation that doesn't seem frightening to us may be completely overwhelming to an individual with autism.  This explains a lot.

Hippocampus.  This area is also enlarged in an individual with autism.

• Strengths include being logical, and is systems oriented.  Many individuals with autism excel in areas like engineering, math, etc.  We marvel at those kiddos who are unable to communicate, yet they are able to navigate things like the dvd player, ipads, computers, etc. with very little help and at a very young age.
• Weaknesses include perseveration.  We see this in a lot of individuals with autism, once they are focused on something it is difficult to change directions.  Whether it is a topic of conversation, lining things up, or making sure everything is where they feel like it needs to be.

Cerebellum.  In an individual with autism, they may have overloaded white matter.

• Strengths include a need for routine, and becoming an expert at a task.  As many parents know, routines and predictability are so important for individuals with autism.
• Weaknesses include unsteadiness, delayed physical or verbal response, and anxiety surrounding sudden change.

Frontal Lobe.  The frontal lobe is enlarged due to excessive white matter.

• Strengths include being visual learners.  Temple Grandin talks a lot about how she sees the world in pictures, and all her memories are in pictures.  That's why she's so good at what she does.
• Weaknesses include having a difficult time with abstract thought.  This may be part of why social interactions are so difficult as well because they are not concrete.  Some of our rules as pertaining to social interactions are abstract.

Corpus Callosum.   This area is undersized.  The corpus callosum links the two hemispheres of the brains and is the source for effective communication between the two hemispheres.

• Strengths include being able to hyper-focus on detail
• Weaknesses include missing the "bigger picture" and being able to bring concepts together.

Learning about this information was so eye opening for me.  I've worked with a lot of kids with autism, and I see common characteristics and I know how to work with their strengths and their areas of struggle, but learning about the brain helps me to see more of the WHY. 

Joy Mano

Utah PLAY Project Home Consultant

Early Intervention Services for Children with Autism

photo credit: Patrick Hoesly via photopin cc

Repetitive Behaviors and Autism

So I've talked about the first two areas of concern in autism, which are social interactions and communication.  The last area is repetitive behaviors.

As a recap, according to the DSM IV these are the requirements for a diagnosis of autism.

• At least two symptoms from the area of Social Interaction are present
• At least one symptom from the area of Communication is present
• At least one symptom from the area of Repetitive Behaviors is present
• A total of 6 (or more) items are present from the 3 areas listed above
• Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
• Social interaction
• Language as used in social communication
• Symbolic or imaginative play
• The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.

Ok, let's talk about Repetitive Behaviors.  Like I said above, at least one of the following is present.

• Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
• Apparently inflexible adherence to specific, nonfunctional routines or rituals
• Stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole body movements)
• Persistent preoccupation with parts of objects

What does this look like?

Restricted patterns of interest.  The key to this area is the intensity and focus.  We all have interests, but it is the intensity and focus on that interest that can become disruptive to every day life.  For some it may be a subject like trains, dinosaurs, trucks, star wars, etc.  It may become the only thing the individual will talk about and can have an effect on relationships and school depending on how focused they are on that subject.  For others it may be in lining things up, or matching objects.  This can affect ones life when the intensity is so strong that they have a meltdown every time things are not how they would like them to be lined up.  

Specific, nonfunctional routines or rituals.  Just like we have our own rules for things, and I'm sure that some individuals with autism don't understand our rules...some individuals with autism have their own rules and we just don't get it.  I had a student and his "rule" was that he had to enter the building through a certain door.  I didn't know about this "rule" and it took a while before I figured it out, but if he went through the right door instead of the left door (even if we already made it halfway down the hallway) he would have to turn around go back outside and come in through the left door.  This was a behavior that was specific, nonfunctional and turned into a ritual.

Repetitive motor mannerisms.  Many of us have little movements that we do when we are in stressful moments, or when we are trying to pay attention.  For example, when we are sitting in a meeting all day, we tend to get restless.  We start to bounce our leg, or tap our pencil on the desk.  Once again what this is looking at is the intensity and focus.  Many individuals with autism have repetitive behaviors that may begin as a coping mechanism for them but can easily turn into habit.  Some of these repetitive behaviors may be hand flapping, walking on tip toes, spinning, darting across the room, flicking their fingers in front of their eyes, etc.

Preoccupation with parts of objects.  Sometimes you will find that individuals with autism focus on parts of objects rather than looking at the object as a whole.  For example rather than playing with a toy car, the child may be overly focused on the tires.  Instead of using the toy functionally, they may only spin the tires.

Repetitive behaviors can be all consuming and may affect an individuals ability to function fully in their environment, however that information can be very useful as we learn to interact with each individual. 

If you have any concerns about your child's development, please contact your doctor.

Joy Mano

Utah PLAY Project Home Consultant

Early Childhood Autism Services

photo credit: KellBailey via photopin cc

So I've talked about the first two areas of concern in autism, which are social interactions and communication.  The last area is repetitive behaviors.

As a recap, according to the DSM IV these are the requirements for a diagnosis of autism.

• At least two symptoms from the area of Social Interaction are present
• At least one symptom from the area of Communication is present
• At least one symptom from the area of Repetitive Behaviors is present
• A total of 6 (or more) items are present from the 3 areas listed above
• Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
• Social interaction
• Language as used in social communication
• Symbolic or imaginative play
• The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.

Ok, let's talk about Repetitive Behaviors.  Like I said above, at least one of the following is present.

• Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
• Apparently inflexible adherence to specific, nonfunctional routines or rituals
• Stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole body movements)
• Persistent preoccupation with parts of objects

What does this look like?

Restricted patterns of interest.  The key to this area is the intensity and focus.  We all have interests, but it is the intensity and focus on that interest that can become disruptive to every day life.  For some it may be a subject like trains, dinosaurs, trucks, star wars, etc.  It may become the only thing the individual will talk about and can have an effect on relationships and school depending on how focused they are on that subject.  For others it may be in lining things up, or matching objects.  This can affect ones life when the intensity is so strong that they have a meltdown every time things are not how they would like them to be lined up.  

Specific, nonfunctional routines or rituals.  Just like we have our own rules for things, and I'm sure that some individuals with autism don't understand our rules...some individuals with autism have their own rules and we just don't get it.  I had a student and his "rule" was that he had to enter the building through a certain door.  I didn't know about this "rule" and it took a while before I figured it out, but if he went through the right door instead of the left door (even if we already made it halfway down the hallway) he would have to turn around go back outside and come in through the left door.  This was a behavior that was specific, nonfunctional and turned into a ritual.

Repetitive motor mannerisms.  Many of us have little movements that we do when we are in stressful moments, or when we are trying to pay attention.  For example, when we are sitting in a meeting all day, we tend to get restless.  We start to bounce our leg, or tap our pencil on the desk.  Once again what this is looking at is the intensity and focus.  Many individuals with autism have repetitive behaviors that may begin as a coping mechanism for them but can easily turn into habit.  Some of these repetitive behaviors may be hand flapping, walking on tip toes, spinning, darting across the room, flicking their fingers in front of their eyes, etc.

Preoccupation with parts of objects.  Sometimes you will find that individuals with autism focus on parts of objects rather than looking at the object as a whole.  For example rather than playing with a toy car, the child may be overly focused on the tires.  Instead of using the toy functionally, they may only spin the tires.

Repetitive behaviors can be all consuming and may affect an individuals ability to function fully in their environment, however that information can be very useful as we learn to interact with each individual. 

If you have any concerns about your child's development, please contact your doctor.

Joy Mano

Utah PLAY Project Home Consultant

Early Childhood Autism Services

photo credit: KellBailey via photopin cc

Symptoms of Autism

We are all different.  Agreed?  Yes, we may have some similarities, but we are still very different.  The person that I am probably the most like is my best friend, sometimes it's scary how much we think alike.  But, we are still very different.  One big difference is our career paths, I work with kids with autism and she is an accountant.  My sister-in-law is an identical twin, yes her and her sister look very similar, but they are very different.

What does this have to do with the symptoms of autism?  Well, I just want to emphasize that just because two people have the same diagnosis, they are individuals and are most likely very different from one another.  And although two people may have deficits in the area of communication does not mean that their deficits look the same.  It's a spectrum.  The diagnosis of autism is based on observation, and to be diagnosed with autism, the individual does not need to have 100% of the symptoms.

There are 3 common areas that are affected in individuals with autism.  They include social interaction, communication, and repetitive behaviors.  I will go into more detail about each area in upcoming posts.  If you have any concerns though, please contact your doctor.

Whether your child has a diagnosis or not, the thing that I think is important is that you find out where your child needs the most help and you put your efforts there.  I believe that individualizing the treatment is far more important than saying autism=a specific type of intervention.  There is not yet a cure for autism, BUT there are a lot of interventions that can help an individual improve and gain skills to be able to function more fully in this crazy/wonderful world we all live in.

Joy Mano

Utah PLAY Project Home Consultant

Early Intervention Services for Children with Autism

photo credit: read4thefunofit via 
photo credit: superhua via photopin cc
photopin cc photo credit: jshj via photopin cc

We are all different.  Agreed?  Yes, we may have some similarities, but we are still very different.  The person that I am probably the most like is my best friend, sometimes it's scary how much we think alike.  But, we are still very different.  One big difference is our career paths, I work with kids with autism and she is an accountant.  My sister-in-law is an identical twin, yes her and her sister look very similar, but they are very different.

What does this have to do with the symptoms of autism?  Well, I just want to emphasize that just because two people have the same diagnosis, they are individuals and are most likely very different from one another.  And although two people may have deficits in the area of communication does not mean that their deficits look the same.  It's a spectrum.  The diagnosis of autism is based on observation, and to be diagnosed with autism, the individual does not need to have 100% of the symptoms.

There are 3 common areas that are affected in individuals with autism.  They include social interaction, communication, and repetitive behaviors.  I will go into more detail about each area in upcoming posts.  If you have any concerns though, please contact your doctor.

Whether your child has a diagnosis or not, the thing that I think is important is that you find out where your child needs the most help and you put your efforts there.  I believe that individualizing the treatment is far more important than saying autism=a specific type of intervention.  There is not yet a cure for autism, BUT there are a lot of interventions that can help an individual improve and gain skills to be able to function more fully in this crazy/wonderful world we all live in.

Joy Mano

Utah PLAY Project Home Consultant

Early Intervention Services for Children with Autism

photo credit: read4thefunofit via 
photo credit: superhua via photopin cc
photopin cc photo credit: jshj via photopin cc

Eye Contact

It's really quite amazing how much we use our eyes to communicate.  We can know if someone is happy, sad, annoyed, tired, mad, etc. all by looking into someone's eyes.  We can point with our eyes, we can show interest in something (or someone), we can say "come here", we can say "help", we can say a lot with just a tiny movement of our eyes.  Our eyes are not only used to be able to see the amazing things in our world, but also to express how we are feeling about our world.

There are many individuals with autism who lack eye contact.  It can be difficult for those trying to communicate with these individuals, and they may feel that they are being ignored or that the individual is not paying attention or is distracted.  That's usually what we would think if someone is not looking at us when we are speaking to them.  There may be various reasons why someone with autism may not give eye contact, but it's not always because they're ignoring you.

So, the question is...should we force eye contact?  Should we focus on making a child give us eye contact when we're talking to them?  There may be some that disagree with me, and that's fine, but my answer would be no.  The eye contact is not the underlying issue, communication generally is.

I'm not talking about speech here, I'm not talking about being able to form words with our mouths, I'm talking about back and forth interactions, gestural communication.  

As we focus on those back and forth interactions, you will usually find that eye contact improves.  I'm not saying it's going to be perfect, but it will generally increase.  As a child starts to find you more interesting, realizes that their actions and words have power, and that they want to see your reactions, you'll see that they will look to you more often.

Need some ideas on where to start?  There are a lot of place you can start, but here's just one idea.  Try interacting using sensory motor activities.  Activities/toys that involve a lot of visual stimulation can be very difficult to compete against, you want to make the environment a place where YOU are more exciting than the flashy toys around you.

Here are 10 sensory-motor activities you can try starting with

• wrestling
• jumping together (on the trampoline, couch, bed, where ever)
• burrito wrap - get a large blanket, roll the child up, then start adding "topping" and give him/her a lot of deep pressure, then "eat" him/her up.
• bury him/her with pillows
• throw him/her onto the couch and wait for him/her to ask for more
• chase
• build a tower of pillows and run together and knock it down
• play stop and go while you spin him/her on an office chair
• swing him/her in a blanket
• crawl through a tunnel (this blocks out other distractions and they can look at you at the end of the tunnel as they crawl towards you)

Find an activity that your child will want more of. Play, play, play, and then pull back a little to see if your child will initiate more.  Don't force him/her to say more, watch their gestures and take them as cues.  Don't discount gestural communication, it's the beginning of communication skills and it's part of the foundation that they need to strengthen.

Joy Mano

Utah P.L.A.Y. Project Home Consultant

Early Childhood Autism Intervention

It's really quite amazing how much we use our eyes to communicate.  We can know if someone is happy, sad, annoyed, tired, mad, etc. all by looking into someone's eyes.  We can point with our eyes, we can show interest in something (or someone), we can say "come here", we can say "help", we can say a lot with just a tiny movement of our eyes.  Our eyes are not only used to be able to see the amazing things in our world, but also to express how we are feeling about our world.

There are many individuals with autism who lack eye contact.  It can be difficult for those trying to communicate with these individuals, and they may feel that they are being ignored or that the individual is not paying attention or is distracted.  That's usually what we would think if someone is not looking at us when we are speaking to them.  There may be various reasons why someone with autism may not give eye contact, but it's not always because they're ignoring you.

So, the question is...should we force eye contact?  Should we focus on making a child give us eye contact when we're talking to them?  There may be some that disagree with me, and that's fine, but my answer would be no.  The eye contact is not the underlying issue, communication generally is.

I'm not talking about speech here, I'm not talking about being able to form words with our mouths, I'm talking about back and forth interactions, gestural communication.  

As we focus on those back and forth interactions, you will usually find that eye contact improves.  I'm not saying it's going to be perfect, but it will generally increase.  As a child starts to find you more interesting, realizes that their actions and words have power, and that they want to see your reactions, you'll see that they will look to you more often.

Need some ideas on where to start?  There are a lot of place you can start, but here's just one idea.  Try interacting using sensory motor activities.  Activities/toys that involve a lot of visual stimulation can be very difficult to compete against, you want to make the environment a place where YOU are more exciting than the flashy toys around you.

Here are 10 sensory-motor activities you can try starting with

• wrestling
• jumping together (on the trampoline, couch, bed, where ever)
• burrito wrap - get a large blanket, roll the child up, then start adding "topping" and give him/her a lot of deep pressure, then "eat" him/her up.
• bury him/her with pillows
• throw him/her onto the couch and wait for him/her to ask for more
• chase
• build a tower of pillows and run together and knock it down
• play stop and go while you spin him/her on an office chair
• swing him/her in a blanket
• crawl through a tunnel (this blocks out other distractions and they can look at you at the end of the tunnel as they crawl towards you)

Find an activity that your child will want more of. Play, play, play, and then pull back a little to see if your child will initiate more.  Don't force him/her to say more, watch their gestures and take them as cues.  Don't discount gestural communication, it's the beginning of communication skills and it's part of the foundation that they need to strengthen.

Joy Mano

Utah P.L.A.Y. Project Home Consultant

Early Childhood Autism Intervention