Autism Spectrum Disorder Flashcards
prevalence of ASD
- 2020: 1 in 36 (2.76%) 8 year olds
- 1 in 23 males
- 1 in 88 females, partially secondary to masking in girls
- 3.34% Asian/Pacific Islander
- 3.16% Hispanic
- 2.93% Black
- 2.43% White
- 2.29% 2+ races
early signs
- no babbling or pointing by age 1
- no single words by age 16 months or 2 word phrases by age 2
- no response to name
- lack of eye contact
- excessive lining up of toys or objects
- no smiling or social responsiveness
- loss of language or social skills at any age
early signs of ASD can be identified as early as about
12 months
diagnoses for ASD are stable at about
18 months
median age of diagnosis for ASD is about
4 years
gestalt
- “form” or “shape” processing visual, auditory, linguistic information as a whole
- multi-word “chunk” that is heard, stored, and used before speaker has awareness of internal structure (delayed echolalia, scripting)
model of language acquisition
- child acquires gestalts as initial unit of language and then learns to break down (mitigate) later
- contrasted with analytic processing
neurodiverse individuals typically use a blend of
analytic processing and gestalt language processing (GLP)
4 stages of gestalt language processing (GLP)
- echolalia “Let’s get ready to rumble!”
- mitigated “Let’s get ready to eat!”
- word combinations and isolated words “Let’s get going.”
- grammatical utterances “I want to go to the park!”
interpreting echolalia
utterances may not make sense to you in the immediate context, but knowing the reason for the echolalia will help you know how to respond
utterances may not make sense to you in the immediate context
“The individual is using symbols they have in their repertoire to convey thoughts, wants, and needs”
reasons for echolalia to help SLP’s response
- supporting working memory
- want clarification or support
- like the way the sound sequence feels in their mouth
supporting GLPs: respect
- echolalia should be supported so that I can expand
- attempts to extinguish echolalia could equate to taking away an individual’s most robust form of communication
- that’s the actual opposite of what SLPs are about
supporting GLPs: respond
- individuals often expect a response and may show this using body language
- assume communicative intent and connect
supporting GLPs: know the context
get familiar with the individual’s routines and favorite down-time activities so you understand the original context of the person’s echoed utterances
supporting GLPs: keep records
- record utterances, either in writing or audio, and partner with the individual’s caregivers to figure out what they mean
- ask caregivers about frequent phrases and how they interpret them and educate staff so they can help, too!
supporting GLPs: recast
- when you know the meaning, restate and utterance
- this serves as both a response that you understood the individual and as a model for mitigated echolalia
supporting GLPs: script and sing
- support your clients’ use of their echolalic skills
- develop scripts, sing songs that relate to daily activities and interests, and use them to narrate your day
risk factors
- advanced parental age
- prenatal infections
- traumatic birth
- prenatal pharmaceutical use
- family history
co-occurring diagnoses
- motor deficits and developmental coordination disorder (DCD)
- hearing loss (HL)
- seizures
- gastrointestinal (GI) symptoms
- sleep disturbances
- intellectual disability (ID) about 38%
- sensory processing deficits (APS) about 90%
types of reasons behind dysregulation
- physical
- sensory
- emotional
physical reasons behind dysregulation
hunger, thirst, lack of sleep, illness, disorder, or infection, nutrient deficiency, lack of exercise
sensory reasons behind dysregulation
sensory overload, sensory processing challenges, sensory needs, sensory triggers
emotional reasons behind dysregulation
trauma, stress, anxiety, feeling unsafe or uncertain, change in routine, excitement, anger, other emotions, or connection needs
diagnostic criteria for ASD
- persistent deficits in social communication and social interaction across multiple contexts
- restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least 2 of the following, currently or historically
diagnostic criteria for ASD: persistent deficits in social communication and social interaction across multiple contexts
- deficits in social-emotional reciprocity, nonverbal communication used for social interaction, and/or developing, maintaining, and understanding relationships
- social pragmatic communication disorder (SPCD, formally Asperger’s syndrome)
diagnostic criteria for ASD: restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least 2 of the following, currently or historically
- stereotypes or repetitive motor movements, use of objects or speech
- insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior
- highly restricted, fixated interests that are abnormal in intensity or focus
- hyper- or hypo-reactivity to sensory input, or unusually interests in sensory aspects of the environment
child diagnosed with autism/person with autism: change in terminology
autistic person (strengths-based model)
high/low functioning/level 1, 2, or 3: change in terminology
individual’s strengths and needs (strengths-based model)
non-verbal: change in terminology
non-speaking (strengths-based model)
inflexible adherence to routines: change in terminology
security in routines (strengths-based model)
highly restricted, fixated interests: change in terminology
special interests aka: SPINs (strengths-based model)
rethinking restrictive and repetitive behaviors
- help guide typical development
- relieve sensory overload
- cope with anxiety
- express emotion
- enjoyable
- “It’s important to recognize that [repetitive behaviors are] the way autistic people move through our world and engage with it…It’s part of the way we learn and process information, and it’s a way we express our feelings and communicate.”
stimming
self-stimulating actions that are repeated to stimulate the senses
does everyone stim?
- yes
- more frequent and intense in neurodivergent individuals
stimming is a part of self-regulation ___ ___ be stopped, blocked, or discouraged (unless ___-___)
should NOT, self-injurious
types of stimming
- tactile
- auditory
- visual
- olfactory
- vestibular
- proprioceptive
- combo: hand flapping, verbal stims including echolalia)
echolalia
- repeating noises, sounds, words, and phrases
- can be a small or large part of a child’s language
- done with the same pitch/tone
- purposeful
- atypically after 2 1/2
immediate echolalia
- aides in language processing
- turn in conversation
- repeat to remember
delayed echolalia
- tied to an emotional experience
- used to communicate dysregulation
level 1 screener
- tested at the population level
- prioritize sensitivity (often over-identify)
- not effective at differentiating between children with autism and children with other developmental delays or disorders
level 1 screeners: tested at the population level
tool that doctors use for universal screenings
level 2 screeners
- tested with clinical samples
- intended to differentiate between ASD and other developmental delays or disorders (ADHDA, learning disabilities, DLD, etc.)
- prioritize specificity
level 2 screeners: tested with clinical samples
children who have pre-identified developmental delays or parental concerns
level 2 screeners: prioritize specificity
since waitlists for full evaluations are so long, level 2 screeners are used to triage who needs a full autism evaluation, and who we can clear form the waitlist
language treatment for ASD
- no “one size fits all” approach
- features that increase effectiveness
predictors for response to tx for ASD
- developmental level: fine motor, visuospatial skills, social, cognitive, and play skills
- gestural skills
- receptive language skills
- severity of ASD symptoms
language treatment for ASD: features that increase effectiveness
- more hours of treatment
- opportunities for interaction with typically developing peers
- actively engages and includes parents (decisions making and delivery)
- treatment in the natural environment
- consideration of the child’s individual characteristics, preferences, and special interests
treatment targets for ASD
- executive functions and self-regulation
- self-advocacy
- conversational skills
treatment targets for ASD: executive functions and self-regulation
- managing emotions
- deescalating
- accepting no
- planning and organization
- problem solving
treatment targets for ASD: self-advocacy
- asking for help
- identifying inappropriate, unsafe situations
- identifying preferences and interests
treatment targets for ASD: conversational skills
- turn-taking
- body language
- disagreeing
- perspective taking: empathy, apologizing
- code-switching
- initiation
