autism Flashcards
Autism hallmark signs for diagnosis
Impairment in social communication/interaction
Deficits in social-emotional reciprocity
Deficits in nonverbal communication
Difficulty with relationships
Restricted, repetitive behaviors
Stereotyped behaviors
Inflexibility with routines
Restricted interests
Sensory hyper- or hypo-reactivity
autism classification
Classification: Described as Level 1 (support), Level 2 (mod support), Level 3 (substantial support) in the 2 areas above
pathophysiology - neurological
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)
co morbid conditions
85% have comorbidities
ADHD
DCD
OCD
mood disorder
anxiety disorder
psychosis
related characteristics
eating disorders and obesity
sleep problems
seizures
GI disorders
macrocephaly
sensory processing and modulation
motor difficulties - low tone, asymmetries, toe walking, clumsy, decreased gross and fine motor, difficulty with head control
medical management
no specific meds, children do not outgrow
autism diagnostic observation schedule (ADOS)
Semi-structured assessment of communication, social interaction, and play (or imaginative use of materials) for individuals suspected of having autism
4 modules, child to adult
considered gold standard along with clinical judgement and observation
interventions often used by psychologists: ABA therapy and Earlt Start Denver Model
Motor development differences
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)
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.”
PT exam
PT Examination:
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)
implications for treatment
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
motor learning
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
three tiered intervention model
level 3 - individualized intensive interventions
level 2 - building social and communicative competencies inconsistent with problem
level 1 - building positive relationships, supportive environments and optimal health
