Autism Flashcards
How does a Child get diagnosed with autism using the DSM-5?
halmark signs:
1. Impairment in social communication/interaction
Deficits in social-emotional reciprocity
Deficits in nonverbal communication
Difficulty with relationships
2. Restricted, repetitive behaviors
Stereotyped behaviors
Inflexibility with routines
Restricted interests
Sensory hyper- or hypo-reactivity
classification occurs when there is an impairment in 2 or more of these areas.
level 1= support
level 2= moderate support
level 3= substantial support
what is the M-CHAT-R?
modified checklist used for screening toddlers for autism
screen for children 16-30 months
recommended at well-baby check ups at 18 and 24 months by the AAP
what is the epidemiology and gender ratios for autism?
1 in 36 (CDC, 2020) children age 8 (11 sites), ~1.8%
1 in 150 (in 2000)
4x more common in boys than girls
Avg age of diagnosis is 3-4
All racial, ethnic groups
All social and economic groups
Not related to parenting
Not caused by MMR vaccine (Rosenberg K, 2015)
44% have average or above average IQ
https://www.cdc.gov/autism/data-research/
The study on the prevalence of autism spectrum disorder among children aged 8 years highlights what key facts of autism?
ASD might be more readily identified in high-SES communities or among populations with good access to services
For the first time since ADDM began, no statistically significant difference was found in the overall ASD prevalence among black and white children. This diminishing disparity in ASD prevalence might signify progress toward earlier and more equitable identification of ASD……black children were still less likely than white children to be evaluated by age 36 months. In addition, among children with intellectual disability, the median age at ASD diagnosis was 6 months later for black than for white children.
Hispanic children also continue to be identified as having ASD less frequently than white or black children, likely due to health inequities.
what are some reasons for the increase in diagnosis?
1) medical professionals improved/ use different diagnosis practices
2) greater public awareness
3) there is an increase of 1/3
potential causes recognition
what are some potential causes of autism both environmental and genetic
Likely genetic, family history
Viral infections, medications or complications during pregnancy
Possible air pollution exposure
May be higher risk with older parents and babies born before 26 weeks gestation
what is the neurological pathophysiology of autism?
Synapses do not undergo normal pruning during childhood and adolescence
Cerebral morphology differences in volume and geometry
Brains of individuals with autism are larger earlier, level off
Overgrowth mostly in temporal lobe, mostly before age 2 (Piven, 2011)
what are the co-morbid conditions that are associated with autism?
85% of them have comorbidities which can compound effects of ASD.
attention deficit disorder
DCD
Obsessive compulsive disorder
mood disorder
anxiety disorder
psychosis
what are some related characteristics to autism?
- eating disorders and obesity
- sleep problems
- seizures
- GI disorders
- Macrocephaly
- Sensory processing and modulation
Motor difficulties: low muscle tone, early difficulty with head control, early asymmetries in use of arms, toe walking, clumsy, decrease gross and fine motor
Is there a specific medication that can be used for autism?
NO…Medications for other symptoms like Attention Deficit Hyperactivity Disorder, GI problems or seizures
what is the medical management for a patient with autism disorder?
Management of related medical conditions and/or symptoms
Often genetic testing (many genetic conditions include ASD presentation)
Referrals to rehab team members: psychology, behavioral specialists, OT, Speech, PT
what is the prognosis for a child with autism?
childen do not outgrow autism
Prognosis depends on level of support needed and access to supports
People with Level 1 support classification may be employed and participate in typical activities
describe what the Autism Diagnostic observation schedule (ADOS) is and who can administer it?
Administered by a psychologist
Semi-structured assessment of communication, social interaction, and play (or imaginative use of materials) for individuals suspected of having autism
4 modules for children and adults
Considered gold standard test along with clinical judgement and observation
what are the two interventions provided by psychologists?
ABA therapy and Early Start Denver Model
what are the motor development differences noticed in ASD?
Delays in gross and fine motor skills (at 14 mo. slowed, at 24 mo. significant differences)
Specific deficit in gestures and motor imitation
Decreased postural control and stability (high frequency of toe-walking)
Decreased motor planning and praxis (Downey and Rapport, 2012)
86.9% at risk for motor impairment, only 31.6% receiving PT (Bhat, 2020)
what should a PT examination for the motor development differences in a child with autism include?
No PT Specific Test/Measure for Children with Autism
Movement Assessment Battery for Children, 2nd edition (MABC-2)
Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2)
The study on the associations of gross motor delay, behavior and quality of life in young children with autism spectrum disorder highlights what?
Autism Speaks, Autism network (outcomes registry) data
Children with ASD have GM delays (avg 16th percentile in children 2-6 years)
Internalizing vs. Externalizing behaviors
“Children with ASD and co-occurring “internalizing problem daytime behavior” had greater Gross motor delays than children without internalizing problem daytime behavior; therefore, these children may be most appropriate for early physical therapist evaluation.”
what are the implications for treatment in a child with autism?
If the child has appropriate cognition, consider cognitive strategies for activities similar to DCD
Consider collaboration with OT for sensory strategies
Consider activities for improved motor imitation and motor planning in goal-related context
Consider intervention for postural control as well as motor skills and fitness
what are techniques that should be used for motor learning in treatment of a child with autism?
Using ABA methods for motor skill acquisition
Discrete trials
Reinforcement
Repetitive practice across different settings
Visual supports
Task-specific training
External versus internal focus of attention inconclusive
Blocked vs. distributed practice inconclusive
Delayed feedback helpful
what is the key take away of the article Exercise activities may help other aspects of function for children with ASD (Bremer, 2016)?
Results demonstrated that exercise interventions consisting individually of jogging, horseback riding, martial arts, swimming or yoga/dance can result in improvements to numerous behavioral outcomes including stereotypic behaviors, social-emotional functioning, cognition and attention.”
what are the two additional PT interventions that can be beneficial in treating a child with autism?
1) aquatic
2) hippo therapy
what does the three tiered intervention model look like?
for behavioral management in PT
level 3: individualized and immersive interventions
Level 2: building social and communicative competencies inconsistencies with problem
level 1: building positive relationships supportive environments and optimal health
