Autism Flashcards
First documented. “Autism” is used to describe those who cannot relate to others
1940
A spectrum from Asperger → PDD → Autism is outlined in the DSM – IV
1990s
-
Impaired development of social interaction and communication:
- Inability to initiate or sustain conversation, lack of spoken language
- Repetitive speech/echolalia
- Absence of pretend or spontaneous play
- Markedly restricted repertoire of interests and activities
- Symptoms before 3
Autistic Disorder
From DSM IV: “Neurodevelopmental disorder in which persons present with a range of impairments in social interaction, verbal and nonverbal communication, as well as restrictions in behaviors and interests”
Autism Speectrum Disorder
Screening tools for Autism Spectrum Disorder:
- ADOS: Autism Disorder Observation Scale
- M-CHAT: Modified Checklist for Autism in Toddlers
- STAT: Screening Tool for Autism in Toddlers and Young Children
- Delays in social interaction
- Repetitive behaviors, interests or activities
- No delays in language, speech, cognition or
curiosity
Asperger Syndrome
(DSM IV)
- Genetic
- Females with typical development
- Brain growth decelerates, skills lost starting around 5 months
- Stereotypical arm movements
Rhett Disorder
- Genetic
- Males
- Presentation very similar to ASD
Fragile X Syndrome
- Typical development
- Sudden loss of language, bowel and bladder control after 2 years or older
Childhood Disintegrative Disorder
In the DSM V, Autism Spectrum Disorder includes which three disorders?
- Autism Disorder
- Asperger’s Syndrome
- Pervasive Developmental Disorders – Not Otherwise Specified (PDD-NOS)
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
ASD Level 3: Requires Very 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.
ASD Level 2: Requires Substantial 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.
Level 1: Requires Support
ASD parent parents often notice these signs within the first year:
- Vision and hearing
- Social and communication
- Fine motor
ASD, 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 2
- Exposure to prescription medications
_______% of children with ASD have above average intellectual ability
46%
ASD, POTENTIAL RISK FACTORS: VACCINATIONS
NO CONNECTION
- Andrew Wakefield, primary investigator, lost medical license and article retracted
- Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in
children
Currently ____ in ______ chance of having ASD, up significantly from 1 in 166 in 2000
1 in 68
ASD, higher incidence in boys or girls
- 1 in 42 for boys 1
- 1 in 189 for girls 1
ASD Neuropathology:
- Typical head circumference at birth, increases in the first 2 years
- Overconnection of “short range” neurons, underconnection of “long range”
- Impaired Mirror Neurons
in ASD, head circumference overgrowth occurs in
frontal and temporal lobes, amygdala
ASD, attention issues:
- Preoccupiations
- Difficulty shifting focus
- Lack of or delayed response to name
“hallmark” of ASD diagnosis
Communication and sensory impairments
Motor disorders in ASD:
- Stereotypical motor behavior (repetitive)
- Gait may appear “ataxic” (toe walking)
- Praxis and imitation
- Hypotonia in the trunk
STANDARDIZED ASSESSMENTS for ASD:
- Difficult to complete and interpret
- Movement Assessment Battery for Children (M-ABC)
Collaboration in ASD:
- Psyhcologists and Special Educators: Behavioral Plan
- Speech & Language Pathologists: Communication Strategies
- Occupational Therapists: Sensory needs
Applied Behavioral Analysis (Behavioral therapy):
therapy for children with ASD each skill is broken down into components parts:
- Instructions: clear and concise
- Prompt: verbal or physical
- Opportunity for response, if incorrect: start a new trial.
- immediate feedback
(carry over at home is needed)
DEVELOPMENTAL INDIVUDIAL DIFFERENCE RELATIONSHIP-BASED MODEL (“FLOOR TIME”):
- Adults following the child’s lead.
- Child feels “Warmth” and “Connectedness,” feels understood
PICTURE EXCHANGE COMMUNICATION SYSTEM (PECS)
PICTURE EXCHANGE COMMUNICATION SYSTEM (PECS):
- Child exchanges picture for desired object
Push-in to facilitate carryover at:
Treating at the:
- Classroom
- Field trips
- Playground time
PHYSICAL THERAPY INTERVENTION:
- Apraxia/Motor planning
- Dynamic balance
- Safety awareness
- Facilitate carry over
DIETARY RESTRICTIONS - DEFEAT AUTISM NOW (DAN):
- Gluten and dairy free diet
- Nutritional Supplements
- “Hidden” food allergy testing
- Detoxification of heavy metals
- No scholarly evidence to support this program
TIPS FOR ASD INTERVENTION
- Consistent treatment space
- Limit toys/materials in the treatment area
- Make sure sensory needs are met
- Incorporate communication system and behavioral approach used in classroom and home
- Use a schedule
- Stick to a routine
- Prepare for transitions
- Ensure the child is attending to you before communicating
- Allow the child to take part in session planning
- Structured breaks and rewards
- Encourage generalization to classroom and home
