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Glossary of Terms relating to Autism
and other Pervasive Developmental Disorders
by Dr Avril Brereton
Applied
Behaviour Analysis (ABA)
An intensive
intervention based on behavioural principles. In most cases a therapist
works one on one with a child on an individually written program for
between 20-40 hours each week. Its teaching methods are based on
breaking down skills into their simplest components and teaching the
components to the child using a series of trials and a system of
reinforcements.
Asperger's
Disorder (sometimes referred to as Asperger’s Syndrome)
A
developmental disorder defined by impairments in social interaction and
communication, along with restricted repetitive and stereotyped patterns
of behaviour, interests and activities. Children with Asperger’s
Disorder do not have any significant delays in early cognitive or
language development.
Attention-Deficit/Hyperactivity Disorder (ADHD)
A syndrome
with core symptoms including difficulty maintaining attention, cognitive
disorganization, distractibility, impulsivity and hyperactivity. These
symptoms may vary between children and across different situations and
times. Common secondary symptoms include perceptual and emotional
immaturity, poor social skills, disruptive behaviours and academic
problems. There are three subtypes identified in DSM-IV: ADHD, Combined
Type (where both inattention and hyperactivity-impulsivity are
significant features), ADHD, Predominantly Inattentive Type (where the
main feature is inattentiveness) and ADHD Predominantly
Hyperactive-Impulsive Type (where the main feature is hyperactivity).
Attention
Deficit Disorder (ADD)
A term that
is commonly used term despite no longer being a diagnosis in DSM-IV.
Atypical
Autism
A category
that is part of the diagnostic category PDD-NOS (see below). A general
term for conditions that are close to but do not meet the full
diagnostic criteria for autism, because of factors such as late age of
onset or atypical symptomatology.
Auditory
Integration Training (AIT)
An
intervention designed to reduce auditory sensitivity and distortions,
and to improve the quality of auditory processing. Proponents of AIT
report that it encourages the ears to work together in a coordinated
manner and can improve the ability to comprehend what is being said or
read; to follow directions; or to express thoughts and feelings in
words. This has not yet been supported by clinical trials.
Augmentative
and Alternative Communication (AAC)
The use of
visual aids (objects, photos, pictures etc.) or unaided systems (hand
signs or gestures) to help children with language difficulties
communicate more effectively. (See Makaton for an example of
augmentative communication)
Autism
A syndrome
consisting of a set of developmental and behavioural features. The core
features of autism include impairments in three main areas of
functioning: social interaction, communication and restricted,
repetitive and stereotyped patterns of behaviour, interests and
activities. Autism affects the person throughout life.
Autism
Diagnostic Interview-Revised (ADI-R)
A
standardised parent interview schedule for the diagnosis of autism (as
defined by DSM-IV criteria) developed by the Medical Research Council in
London, England. It assesses four main areas; communication, reciprocal
social interaction, play and developmental history. It can be used to
assess children and adults with a developmental age of 18 months and
over.
Autism
Diagnostic Observation Schedule-Generic (ADOS-G)
A
standardized, direct-observation measure for examining communicative and
reciprocal social interaction behaviours that are associated with
autism. Its administration involves a semi-structured play session. It
takes approximately one hour to complete.
Autistic
Savant
A person
with autism who shows an extraordinary talent or aptitude for one or two
particular skills (e.g. musical or artistic ability).
Autistic
Spectrum Disorder (ASD)
This is a
term with no formal definition or universally accepted usage. It is
used to refer to many different things throughout the world, although it
is now most commonly used in a similar way to the term PDD.
Childhood
Autism Rating Scale (CARS)
A widely
used rating scale for behaviours associated with autism. Scores on the
scale are based on direct observation by the examiner. The child is
rated in 15 areas. The scores reflect the categories of non-autistic,
mildly-moderately autistic or severely autistic, however it is NOT a
diagnostic tool. The CARS is a requirement of the Department of
Education in Victoria for funding on the grounds of autism.
Childhood
Disintegrative Disorder
A syndrome
with the core feature of a marked regression in multiple areas of
functioning after a period of 2 years of apparently normal development.
Other symptoms include difficulties with social interaction,
communication and restricted, repetitive and stereotyped patterns of
behaviour, interests and activities.
Chromosomes
Structures
in the nucleus of the body’s cells that bear an individual's genetic
information.
Co-morbid
Condition
Having more
than one concurrent diagnosis. Another term for this would be "dual
diagnosis". Many people with autism have one or more additional
diagnoses, such as ADHD, Tourette's Syndrome or Epilepsy.
COMPIC
A set of
pictographs (computer drawn line drawings) developed in Australia as a
communication resource for people with language difficulties. COMPIC
has 1670 pictographs which represent words, objects, activities and
concepts. The pictographs are accompanied by the relevant word or
phrase. The pictographs provide a visual representation of a word or
concept for use in augmentative communication programs. Other
pictograph systems are also frequently used in Victoria, e.g. Picture
Communication Symbols (PCS) and Boardmaker.
Deoxyribonucleic Acid (DNA)
The
substance contained within chromosomes which encodes an individual's
genetic information.
Developmental Behaviour Checklist (DBC)
An
instrument that assesses a broad range of behavioural and emotional
disturbances in young people (aged between 4 and 18 years) with an
intellectual disability. There are parent (primary carer) and teacher
report versions of the DBC. The DBC has five sub-scales:
Disruptive/Anti-social Behaviour, Self-absorbed, Communication
Disturbance, Anxiety and Social Relating. (Einfeld & Tonge, 2003.
Available from Centre for Developmental Psychiatry & Psychology, Monash
University. Contact Emma Lourey, PH: 03 9594 1300).
Discrete
Trial
A short,
teaching sequence which has three parts: a direction, a behaviour and a
consequence.
Diagnostic
and Statistical Manual (the most recent version is DSM-IV-R)
The official
system for classification of psychological and psychiatric disorders
produced by the American Psychiatric Association. DSM is the diagnostic
system that is most commonly used in Australia.
Early
Childhood Intervention (ECI)
ECI
describes a range of supports provided to young children with
disabilities (0-6 years) and their families. ECI aims to promote child
and family well-being and improve the development and functioning of
young children with developmental delays and disabilities.
Echolalia
The
repetition of words or phrases spoken by another person. The echoing
may occur immediately after hearing the word or phrase. This is
immediate echolalia. Delayed echolalia can occur days or weeks after
having heard the word or phrase.
Electroencephalogram (EEG)
A procedure
used to record electrical brain activity by placing electrodes on the
scalp. It is often used to diagnose seizure disorders or to look for
abnormal brain wave patterns.
Epilepsy
A brain
disorder in which clusters of nerve cells, or neurons, in the brain
sometimes signal abnormally. In epilepsy, the normal pattern of
neuronal activity becomes disturbed, causing strange sensations,
emotions, and behaviour or sometimes convulsions, muscle spasms, and
loss of consciousness. Having a seizure does not necessarily mean that
a person has epilepsy. A diagnosis of epilepsy needs to be confirmed
using an EEG or brain scan.
Expressive
Language
The use of
spoken language.
Fragile X
Syndrome
A genetic
disorder which can cause cognitive impairment and a number of other a
number of physical and behavioural characteristics. Some of these
behaviours, such as poor eye contact, hand flapping, and poor social
skills, also occur in children with autism. While most children with
Fragile X Syndrome do not have all the characteristics of autism, about
15% to 33% are diagnosed as autistic. Individuals can be tested for
"Fragile X" by having a blood test and having their chromosomes (see
above) examined by a geneticist.
Gene
Genes are
responsible for the inherited characteristics that distinguish one
individual from another. They are made of DNA. Each chromosome carries
many genes. Each human has approximately 100,000 genes.
High
Functioning Autism
Individuals
with autism who are not cognitively impaired (i.e. have an average or
higher IQ) are referred to as 'high functioning'.
Hyperlexia
A precocious
ability to read words, far above what would be expected for their
chronological age. A hyperlexic child may not understand what they are
reading and may even have significant difficulty in understanding verbal
language.
Hypotonia
Low muscle
tone.
Inclusion
The
placement of a child with a disability (physical or developmental delay)
with typically developing peers in a regular pre-school or kindergarten.
Integration
The
placement of a child with a disability (physical or intellectual) with
typically developing peers in a regular classroom at school.
Intellectual
Disability (ID)
In Victoria,
three main factors are used to define an intellectual disability. The
first is a significantly below average intelligence (that is, an IQ of
70 or less where the IQ score is obtained from a standardised
intelligence test). The second is difficulties with everyday life
skills (such as the ability to dress or bath without help or express
thoughts clearly. Tests of adaptive behaviour may be used to measure
these skills. The third is that both the above factors must be present
before the individual turns 18 years of age. More than three-quarters
of people with an intellectual disability have a mild intellectual
disability. The remainder have either a moderate, severe or profound
intellectual disabilities.
Intelligence
A broad
concept made up of a large number of widely different yet specific
skills. Its measurement through the use of intelligence tests attempts
to assess these skills in order to provide a global score representative
of an individual’s level of functioning. Scores on intelligence tests
relate a child’s performance on the test to that of other children of
the same chronological age.
Intelligence
Quotient (IQ)
A standard
score derived from intelligence tests. It represents the intellectual
age of the child (that is the age at which the average child would
perform at a given standard) divided by the child’s chronological age at
the time of testing. The scores are organised such that 100 is an
average score (i.e. when the intellectual age and chronological age are
the same) but any score between 90 and 110 is considered average.
International Classification of Diseases of the World Health
Organization (the most recent edition is ICD-10)
A system
used to classify diseases and disorders. It is the main diagnostic
system used in Europe.
Individualised Educational Plan (IEP)
A written
plan that identifies a child’s academic, physical, social and emotional
needs and sets goals for meeting these needs. Used primarily for
children with special needs. The IEP is written by the child’s teacher
in conjunction with parents, special education teachers or therapists.
Landau-Kleffner
Syndrome
A rare form
of childhood epilepsy which results in severe language disorder. It is
characterised by a progressive loss of the ability to understand
language and use speech, following a period of normal speech
development. It is usually diagnosed using an EEG taken while asleep.
The cause of the condition is unknown.
Macrocephaly
A condition
where the head circumference is two standard deviations above average
(i.e. greater than the 97th percentile).
Magnetic
Resonance Imaging (MRI)
A diagnostic
procedure that uses the magnetic qualities of chemicals in the body to
produce an image of the brain.
Makaton
A
communication system using simple hand signs. It is commonly used with
children and adults with complex communication needs. It can be used in
conjunction with other communication programs, such as PECS.
Microcephaly
A condition
where the head circumference is two standard deviations below average,
producing an abnormally small head, and a congenitally small brain.
Neuroleptics
A group of
drugs referred to as anti-psychotics or major tranquillisers (although
not all neuroleptics have a tranquillising effect). There are two broad
types: typical and atypical. Typical neuroleptics are older and have a
greater impact on positive psychotic systems (hallucinations, delusions
and thought disorder etc) while atypical neuroleptics are newer and more
likely to have an impact on both positive and negative (lack of
motivation and flat mood) psychotic symptoms. There is some evidence
that they are of use in people with developmental disorders to reduce
hyperactivity, aggressiveness, distractibility, temper tantrums and
stereotypes.
Neurologist
A doctor
specialising in medical problems associated with the nervous system,
specifically the brain and spinal cord.
Neurotypical
A term used
for neurologically and cognitively normal individuals.
Obsessive-Compulsive Disorder (OCD)
A disorder
characterised by obsessions (recurrent persistent thoughts, impulses or
images) and/or compulsions (repetitive behaviours such as checking or
mental acts such as praying, or counting). The obsessions are
distressing to the individual and often the aim of the compulsion is to
reduce this distress. For example, if the obsession is fear of germs, a
person may frequently wash their hands.
Occupational
Therapist (OT)
Health
professionals trained to assist people to overcome physical limitations
caused by injury or illness, psychological or emotional difficulties,
developmental delay or the effects of aging. Their aim is to assist
each individual to move from dependence to independence. In young
children, OT’s work with both children and families and focus on
promoting normal development and stimulating learning.
Perseveration
Repetitive
movement or speech or sticking to one idea or task, which has a
compulsive quality to it.
Pervasive
Developmental Disorder (PDD)
A term that
encompasses autism and related disorders. It specifically refers to the
following five disorders listed in the DSM-IV: Autistic Disorder,
Asperger's Disorder, Pervasive Developmental Disorder - Not Otherwise
Specified, Childhood Disintegrative Disorder, and Retts Disorder.
Pervasive
Developmental Disorder – Not Otherwise Specified (PDD-NOS)
A diagnostic
category that is used when there is a severe and pervasive impairment in
the developmental of reciprocal social interaction or verbal and
non-verbal communication skills or when stereotyped behaviours,
interests and activities are present, but the criteria are not met for a
specific Pervasive Developmental Disorder.
Picture
Exchange Communication System (PECS)
An
augmentative communication system. PECS teaches people with language
difficulties to exchange a picture of a desired item with a
teacher/parent, who immediately honours the request. Allows people with
language difficulties to initiate communication.
Positron
Emission Tomography (PET) Scan
A procedure
that uses low-dose radioactive sugar to measure brain activity.
Pragmatics
The use of
language in social contexts (for example, knowing what to say, how to
say it and when to say it).
Proprioception
The ability
to sense the position, location, orientation and movement of the body
and its parts.
Psychoeducational Profile – Revised (PEP-R)
A
standardised observational assessment instrument based on a
developmental approach. The PEP-R was specifically designed for use
with non-verbal or language delayed children. The developmental
framework of the PEP-R provides a way to describe and understand the
characteristic uneven learning patterns exhibited by children with
autism or related developmental disorders. It provides both standard
scores and age equivalencies.
Psychiatrist
A
psychiatrist is a qualified medical doctor who has obtained additional
qualifications to become a specialist in the diagnosis, treatment and
prevention of mental illness and emotional and behavioural problems. A
psychiatrist is qualified to prescribe medication because they have
completed medical training.
Psychologist
Professionals who are experts in human behaviour. Some psychologists
specialise in treating mental illness, while others help mentally
healthy people find ways of functioning better, for example, helping
people to handle stress and family problems. Psychological therapies
are also widely used by groups and organisations. Psychologists cannot
prescribe medication. Their treatments are based on changing behaviour
without medication.
Psychopathology
Clinically
significant emotional and behavioural problems.
Receptive
Language
The
understanding of language.
Rett’s
Disorder
A
disintegrative disorder where after a period of normal development,
between the ages of 5 and 48 months, head growth decelerates and there
is a loss of previously acquired skills. Other symptoms include
stereotyped hand movements, uncoordinated movement and language
difficulties. Only reported in females.
Secretin
A
neurotransmitter (chemical messenger). One of the hormones that
controls digestion, increasing the volume and bicarbonate content of
secreted pancreatic juices.
Selective
Serotonin Reuptake Inhibitors (SSRIs)
A class of
drugs used as antidepressants. They increase the levels of serotonin in
the body. These drugs should only be taken as advised by a medical
practitioner/psychiatrist as they can have some side-effects and can be
dangerous if mixed with other medications. Some examples of SSRIs are
Prozac and Zoloft.
Self-stimulation
A term for
behaviours whose sole purpose appears to be to stimulate ones senses.
Many people with autism report that some self-stimulation serves a
regulatory function for them (ie. calming, increasing concentration, or
shutting out an overwhelming sound).
Sensory
Integration (SI)
The ability
to take in information through senses (touch, movement, smell, taste,
vision, digestion and hearing), put it together with prior information,
memories, and knowledge stored in the brain and make a meaningful
response.
Serotonin
A
neurotransmitter. In conjunction with other neurotransmitters, it is
believed to be key in the control of mood and emotional behaviour. Also
implicated in the behavioural- physiological processes of sleep, pain
and sensory perception, motor function, appetite, learning and memory.
Special
Developmental School (SDS)
An
educational setting from pre-school to high school for children with IQ
of less than 50.
Special
School
An
educational setting for children and adolescents with IQ’s between 50
and 70.
Speech
Pathologist
A
professional who assesses and treats people with communication disorders
or physical problems associated with eating or swallowing.
Stim
Short for
'self-stimulation'.
T.E.A.C.C.H.
(Treatment and Education of Autistic and Related Communication
Handicapped Children)
A
therapeutic approach broadly based on the idea that individuals with
autism more effectively use and understand visual cues. It focuses on
promoting independence by using items such as picture schedules to break
down tasks step-by-step, enabling individuals to better comprehend and
perform tasks independently.
Theory of
Mind
The ability
to understand that other people have beliefs, desires and intentions
that are different from one's own.
Tourette's
Syndrome
An
inherited, neurological disorder characterised by repeated and
involuntary body movements (tics) and uncontrollable vocal sounds.
Involuntary symptoms can include eye blinking, repeated throat clearing
or sniffing, arm thrusting, kicking movements, shoulder shrugging or
jumping. In a minority of cases, the vocalisations include socially
inappropriate words and phrases - called coprolalia. These outbursts
are neither intentional nor purposeful. Onset occurs before the age of
18. The condition occurs in all ethnic groups with males affected 3 to
4 times more often than females.
Tuberous
Sclerosis
A complex
genetic disorder affecting individuals with different degrees of
severity. It derives its name from the tuber-like growths on the brain
which calcify with age and become hard or 'sclerotic'. Abnormal TS
growths can affect almost any other organ of the body (including the
skin, eyes, heart, kidneys and lungs) but they rarely cause problems.
Common symptoms include skin problems (white patches on skin or rash),
developmental delay, epilepsy and hyperactivity. It occurs in 1 in 8000
births.
Vineland
Adaptive Behavioural Scales (VABS)
A scale
designed to assess handicapped and non-handicapped persons from birth to
adulthood in their personal and social functioning. The VABS is
organised around four Behaviour Domains: Communication, Daily Living
Skills, Socialisation, and Motor Skills
Wechsler
Intelligence Scale for Children (WISC-III, also the WISC-IV has been
recently released)
An
individually administered clinical instrument for assessing the
intellectual functioning of children aged 6 to 16 years 11 months. The
individual's performance on various sub-tests is summarised in to three
main components – Verbal IQ, Performance (non-verbal) IQ and an overall
IQ score.
Wechsler
Preschool and Primary Scale of Intelligence – Third Edition (WPPSI-III)
A clinical
instrument designed to assess IQ which is similar to the WISC-III but
for children ages 2 years 6 months to 7 years 3 months.
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