Autism Flashcards
Screening tools
Autism Disorder Observation Scale (ADOS)
Modified Checklist for Autism in Toddlers (M-CHAT)
Screening Tool for Autism in Toddlers and Young Children (STAT)
DSM IV Diagnostic Criteria
Autistic Disorder
Impaired development of social interaction and communication
Markedly restricted repertoire of interests and activities
Symptoms before age 3
DSM IV Diagnostic Criteria
Asperger Syndrome
Delays in social interaction
Repetitive behaviors, interests, or activities
No delays in language, speech, cognition, or curiosity
DSM IV Diagnostic Criteria
Pervasive Developmental Disorders - Not Otherwise Specified (PDD-NOS)
Does not meet specific criteria for Autism
Differential dx
Rhett Disorder
Childhood Disintegrative Disorder
Fragile X Syndrome
Rhett Disorder
Genetic
Females with typical development
Brain growth decelerates, skills lost starting around 5 mos
Stereotypical arm movements
Childhood Disintegrative Disorder
Typical development
Sudden loss of language, bowel, and bladder control after 2 years or older
No genetic reason
If they develop typically and it drops off, it’s CDD
Fragile X Syndrome
Genetic
Males
Presentation very similar to ASD
Hearing and visual impairments
DSM V
Autism Spectrum Disorder
Autism Disorder
Asperger’s Syndrome
PDD-NOS
DSM V
Social Communication Disorder
Limitations in the social use of language
Absence of restricted interests and repetitive behaviors
DSM V Levels of Severity
Level 3 - Requires Very Substantial Support
Level 2 - Requires Substantial Support
Level 1 - Requires Support
Level 3 - Requires Very Substantial Support
Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others
Level 2 - Requires Substantial Support
Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others
Level 1 - Requires Support
Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful response to social overtures of others. May appear to have decreased interest in social interactions
Typical dx ages
May be diagnosed as early as 2 years, typically closer to 4
ASD - 4 years
PDD-NOS - 4 years 2 mos
Asperger’s - 6 years 2 mos
Signs noticed within 1st year
Vision and hearing
Social and communication
Fine motor
Potential Risk Factors
Weak link to genetic syndromes (10%)
Identical twins and siblings
46% of children with ASD have above average intellectual ability
Children born to older parents have a higher risk of being diagnosed with ASD
Exposure to prescription meds
Vaccination risk factor
NO CONNECTION
Mercury no longer used to bind medications
Prevalence in boys vs girls
Significantly more common in boys than girls
Boys 1 in 42
Girls 1 in 189
Neuropathology
Typical head circumference at birth, increases in the first 2 years
Overgrowth in frontal and temporal lobes, amygdala
…
Overconnection of “short range” neurons, underconnection of “long range”
Poor integration of areas
Ability to complete “simple” tasks is uninhibited
Attention and ASD
Preoccupations
Difficulty shifting focus
Lack of or delayed response to name
Executive functioning and ASD
Difficulty inhibiting repetitive movements
Inflexibility in patterns
Social/communication and ASD
Difficult developing social relationships
Solitary play
Lack of eye contact
Language…
Lack of language
Echolalia
Pragmatic language
Echolalia
Parent says something and the child repeats it right back to you
Motor and ASD
Communication and sensory impairments are the “hallmark” of diagnosis
Large scale studies have demonstrated deficits in... Arm movements Bilateral coordination Gait and balance Praxis/motor planning
Stereotypical motor behavior and ASD
Repetitive
Resistance to change
Impulsive behaviors
Excessive preoccupation
ASD Gait may appear…
Ataxic
Lack of alternate arm swing
Toe walking (sensation)
Deficits in feedback and feedforward
Praxis and Imitation and ASD
Impaired ability to plan, coordinate, and execute complex movements sequences
Able to perform simple motor tasks
May perform more complex tasks spontaneously
Poor imitation skills
Hypotonia, especially trunkal
Preferences
Textures
Activities
Routines
Only assessment for this population…
Movement Assessment Battery for Children (M-ABC)
Applied Behavior Analysis
Each skill broken down into component parts
Discrete trials
Intense, carryover at home needed
Developmental Individual Difference Relationship-based model (Floor Time)
Promotes social interaction
Adult follows child’s lead
Observe - Approach - Follow child’s lead - Child expresses idea
Child feels warm and connected; feels understood
Picture Exchange Communication System (PECS)
Can have multiple pages in their book
Child exchanges picture for desired object
PECS Phases
Hand over hand assistance with picture selection and exchange
Self-initiated communication
Multiple pictures to choose from
Sentence strip
Add adjectives
Going beyond basic needs: I see, I feel, I like
PT Interventions
Apraxia/motor planning
Dynamic balance
Safety awareness
Push-in to facilitated carryover
Dietary Restrictions
Gluten and dairy free
Nutritional supplements
“Hidden” food allergy testing
Detoxification of heavy metals
No scholarly evidence to support this program
In general…
Neurodevelopmental disorder in which persons present with a range of impairments in social interaction, verbal, and nonverbal communication, as well as restrictions in behaviors an interests
Additionally, the majority of children with ASDs may have significant perceptuo-motor impairments that deserve assessment and intervention
