Autism

Question 1

Autism Diagnostic Criteria

Answer 1

• pervasive developmental disorder in DSMIV
• based on impairment of social interaction, communication and repetitive behaviors with fixated interests
• Autism: describes a group of complex developmental brain disorders known as PDD or Autism Spectrum disorders
• Includes: PDD - Not otherwise specified, Asperger syndrome, Rett syndrome and childhood disintegrative disorder
• 3 levels of severity
• increased activation of cerebellum

Question 2

Autism Symptoms

Answer 2

• 1:88 (1:54 in boys)
• symptoms unfold between 18-24 months or as late as up to 6 mo
• head circumference is larger - brain over growth
• motor control issues
• overly focused
• poor gaze
• not imitating
• not sharing
• Postural control impairments - adaptive and anticipatory, poor stability
• imitation and praxis - orofacial, manual and postrual imitation delays, dyspraxia

Question 3

Lack of typical behaviors demonstrated in Autism

Answer 3

• Social Interaction - poor eye contact, joint attention, and inconsistent response to name
• Language - expressive and receptive
• Communication - conventional gestures - non verbal communication, pretend play and imitation
• impaired social communication - especially nonverbal gesture integration, social reciprocity, difficulty developing peer relationships
• repetitive behaviors and restricted interests - preoccupation with restricted interests, inflexible adherence to routines, repetive movements

Question 4

Diagnostic Tools for Autism

Answer 4

1. interview with family - AID
2. assessment of child -ADOS
3. ages and stages questionnaire
4. brigance screening tool
5. clinical diagnosis based on DSMIV

Question 5

THe 5 minute checklist

Answer 5

• do you know when your child is happy or upset?
• when you are not paying attenion to your child do they try to get your attention?
• does you child point to objects?
• does yourchild use sounds or words to get attention or help?
• does your child show interest in playing with a variety of objects?

Question 6

Severity and Heredity of ASD

Answer 6

• heterogenous group
• severity does not run in families
• identical twins = 60-90%
• fraternal twins and siblings = 10-20%
• increased risk w/ older parents
• parents with a child with ASD have 2-18% chance of having a 2nd child with ASD
• mutli risk dosrder - genes, environment

Question 7

Co Morbid Conditions

Answer 7

• cognitve delays
• speech and language delays
• ADHD
• OCD
• emotional, temper, tantrums, agression
• eating disorders
• anxiety disorders
• intellectual disorders
• sleeping disorders
• sensory disorders
• motor delays

Question 8

ASD vs. other disorders

Answer 8

demonstrate abnormal muscle tone, incoordination, poor balance, involuntary movements and muscle weakness

Question 9

Intervention with ASD

Answer 9

• Early is better (less effective after 5yo)
• goals individualized and monitored regularly
• intensity matter
• family participation is essential
• focus on coordination skills
• exercise will decrease self stimulation, increase academic attention, increase play response, decrease behavior issues

Question 10

Social Interactions and Communication addressed by ALL health professionals

Answer 10

• non verbal behaviors
• engaging in interaction
• sharing attention, enjoyment, interests
• social reciprocacy
• expressive and receptive language
• conversation
• repetitive use of language (stereotyped and echololia, idiosyncratic)
• make believe or social imitative play

Question 11

Repetitive Behaviors and Restricted Interests

Answer 11

• preoccupation with restricted patterns of interest
• insistence with sameness -activities, rituals, routines
• repetitive motor mannerisms
• preoccupation with parts of objects
• over-reactive or under reactive to sensory input
• unusualy sensory interest
• emotional regulation