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Transcript
Autism 101:
An Introduction for Families
Lindsey Miller, ARNP
Rachel Montague, Ph.D.
June 5, 2012
Autism Center
Overview of Presentation
•
•
•
•
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What are Autism Spectrum Disorders?
Prevalence & causes
Characteristics & related issues
Treatments
Resources
Autism Center
Overview of Presentation
What Are Autism Spectrum Disorders?
• ASDs are brain-based
developmental disorders
that are present from birth
and includes presence of
• Social,
• communicative,
• and behavioral abnormalities
(Diagnostic and Statistical
Manual, IV (DSM-IV))
Autism Center
What is meant by “spectrum disorders”?
• Symptoms can occur in a variety of
combinations
• Symptoms present with varying degrees of
severity
• Two children with a diagnosis of autism can
have very different strengths and challenges
and can act completely differently from one
another
• Intellectual abilities vary
Autism Center
Autism Triad – Current Model
Autism Center
What are Autism Spectrum Disorders (ASD)?
Autism Spectrum Disorders
Autistic Disorder
Asperger's
Disorder
PDD-NOS
Autism Center
Autism – Proposed Model
Autism Center
Proposed model of ASD
Autism Spectrum Disorder
Autistic Disorder
Asperger's
Disorder
PDD-NOS
Autism Center
Prevalence of ASD
• CDC estimates that 1 in 88 children have ASD
• This is up to a 10-fold increase since 1950s
• Similar rates across different cultures, ethnicities, or
income level
• Current averages indicate
that boys are 4.4 times
more likely to be
diagnosed with ASD as
compared to girls
Autism Center
Why the increase in ASDs?
• Several reasons:
• Wider public awareness
• Better assessment tools
• We are now diagnosing kids with autism now who
present with average or above average intellectual
capabilities and more subtle social and language
delays.
• Is there a true increase?
• ASDs may have been unrecognized or misidentified
in the past
Autism Center
What causes it?
• Genetics
• Identical twin studies: 60-90% of the time that 1 twin
has ASD, the other does too.
• For sibling studies: 8-18% of the time that 1 sibling
has ASD, another sibling does too.
• Even if the other siblings don’t meet criteria for ASD,
they may have social difficulties, language
impairment or developmental delay
Autism Center
What causes it?
• Environment
• There is also likely an environmental component
• research is trying to identify specific environmental
factors
• What do we mean by “environment”?
• It’s likely a combination of genetics & environment
• The theory is that the genetic component can be
turned on by an environmental trigger.
Autism Center
What causes it?
• We know some things do NOT cause
ASD – such as vaccines or parenting
• In 2010, journal Lancet officially retracted the 1998
article that originally suggested a connection
between autism and the MMR vaccine.
• Many years ago, people believed autism was
caused by “bad parenting.” Research has shown
that is not the case.
Autism Center
When is ASD diagnosed?
• ASD can sometimes
be diagnosed as early
as age 2 by
experienced clinicians
• Some children with
ASD are diagnosed
during school-age
years.
Autism Center
How is ASD diagnosed?
• No medical test (e.g. blood test, brain scan)
• Diagnosis made using specific criteria
• Based on developmental history, direct observation
and interaction with child, clinical judgment by
qualified professionals
• Tools:
• Autism Diagnostic Observation Schedule (ADOS) often used,
but not required
• Autism Diagnostic Interview (ADI) – semi structured parent
interview about development
Autism Center
Characteristics of ASDs
Social Interaction Impairments
Communication Impairments
Restricted, Repetitive Behaviors
Autism Center
Social Interaction Impairment
• Difficulty using eye gaze, gestures, etc.
• Gestures include pointing, nodding, waving goodbye
• Few friendships
• Difficulty sharing enjoyment & interests
with others.
• Difficulty relating to others, taking
another’s perspective, and empathy
Autism Center
Communication Impairment
• Language delays
• Difficulty with back-and-forth
conversations.
• Repetitive and/or odd use of language.
Autism Center
Patterns of Behavior
• Abnormally obsessive interests
• Rigid adherence to routines
• “Stereotyped” motor movements
• Hand flapping, rocking, spinning, pacing
• Focus on the details, miss the big
pictures
• Odd play skills
Autism Center
Related Issues in ASD
•
•
•
•
•
Inattention and/or Hyperactivity (ADHD)
Anxiety
Depression/ irritability
Disruptive/ oppositional behaviors
Sensory Processing Issues
• Motor Planning Issues
• Executive Functioning
• Tic disorders
Autism Center
Common Strengths for Children with ASD
•
•
•
•
•
•
Visual learning
Concrete skills
Memory
Consistency
Following rules
Attention to detail
Autism Center
Interventions for children with ASDs
• There is no cure for ASD, but intervention
lead to improvement and development of
skills.
• Intervention is recommended as soon as
diagnosis is made.
• With intervention, progress can be made
in many areas.
• What therapy is right for your child?
Autism Center
School Services
• Children with ASD may qualify for special
education services from birth to age 21
• Birth-to-Three Services for children under 3
• Individual Education Program (IEP) for children 3 to 21
• Depending on child’s needs, extra services may include:
• speech language therapy, occupational therapy, social skills
groups, and/or academic support
• Inclusion and self-contained placements
• Behavior support or positive behavior planning
Autism Center
Special Education Resources
• WAC codes (Washington Administrative Code)
http://www.k12.wa.us/specialed/
• Wrightslaw
http://www.wrightslaw.com/
• Special Educational Ombudsman Office
http://www.governor.wa.gov/oeo/
• Autism Speaks IEP Guide:
http://www.autismspeaks.org/family-services/
community-connections/back-to-school
Autism Center
Private Therapies
•
•
•
•
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•
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Speech & Language Therapy
Occupational Therapy (sensory, fine motor)
Physical Therapy (gross motor, coordination)
Individual Therapy / Counseling
Social Skills Groups
Biomedical Treatments
Family Education & Therapy / Counseling
Parent Training & Information
Autism Center
Speech & Language Therapy
• Communication Development
• Talking and understanding what others are saying
• Production of speech sounds (articulation)
• Social Communication – “how and why we
communicate”
• Nonverbal Communication
• School-based and private speech
language pathologists
Autism Center
Occupational (OT) & Physical Therapy
(PT)
• Gross Motor Development – “large”
motor movements -- PT
• E.g., running/jumping
• Fine Motor Development – “small” motor
movements -- OT
• E.g., using utensils/tools
• Sensory Processing
• School-based and private OT/PT
Autism Center
Individual Therapy
• Common types of individual therapy:
• Cognitive Behavior Therapy (CBT)
• Child learns how thoughts, feelings and behaviors are
connected
• Child learns coping skills for anxiety, anger, teasing, etc.
• Behavior Management
• Parents learn why child has certain behaviors and learns
strategies to improve the child’s behaviors
• Applied Behavior Analysis (ABA)
• Can be provided by Masters level therapist or Ph.D.
(psychologist)
Autism Center
Social Skills Groups
• Group of approximately 4-8 children with social skills
difficulties, led by a therapist / teacher
• Focus on development of social skills
• making friends, starting and ending conversations,
etc.
• School-based and private groups
• Excellent opportunity to practice skills learned in
individual therapy!
Autism Center
Common Medical Issues in ASD
• Picky Eating
• GI (stomach, poop, etc.) Problems
• Seizures
• Sleep Disturbances
Autism Center
Biomedical
• Medications can be used to treat some
behaviors associated with ASD
• Inattention, hyperactivity, aggression, irritability,
anxiety
• Complementary & Alternative Medicine
(CAM)
• Be careful to evaluate treatments prior to beginning,
and talk to your doctor
Autism Center
Parent Support
• Parent groups
• FEAT of Washington
• http://www.featwa.org/
• Autism Society of Washington
• http://www.autismsocietyofwa.org/
• ALLY support group at Seattle Children’s Autism
Clinic
• Email [email protected] for information
• TACA of Washington
• http://www.tacanow.org/local-chapters/washington/
Autism Center
Seattle Children’s Autism Center
• How to get in:
• Talk to your Primary Care Provider for referral
• Services offered:
• Diagnosis
• Medical treatment (psychiatry, neurology,
neurodevelopmental, speech)
• Individual therapy (cognitive behavioral, behavior
management)
• Treatment planning
Autism Center
General Resources – Local
• SCH Autism Center
• Autism Blog: www.theautismblog.org
• Information and Resources:
http://www.seattlechildrens.org/clinicsprograms/autism-center/
• Autism Outreach Project
• http://www.nwesd.org/autism
• Autism Society of Washington
• http://www.autismsocietyofwa.org
Autism Center
General Resources – National and International
• Autism Speaks
• www.autismspeaks.org
• Autism Society of America:
• www.autism-society.org
• Global Autism Collaboration (Center for the
Study of Autism):
• www.autism.org
Autism Center
Government Resources
• Division of Developmental Disabilities (DDD)
• Apply for eligibility/services
• May receive services (although limited at this time)
• Important to apply now so children may receive services in
future
• http://www.dshs.wa.gov/ddd/
• Tuesdays at 11am – free DDD application help at SCAC
• Supplemental Security Income (SSI)
• May be eligible for disability income
• http://www.ssa.gov/ssi/
Autism Center
Video Recommendations
• Autism Resource
DVD, produced by
University of
Washington’s Autism
Clinic
• Watch or download at
• http://depts.washington.
edu/uwautism/resource
s/autism-resourcedvd.html
Autism Center
Book Recommendations
• Educating Children with Autism
• National Research Council
• My Social Stories Book
• Carol Gray
• More than Words
• Fern Sussman
• A Parents’ Guide to Asperger and High
Functioning Autism
• Sally Ozonoff, Geraldine Dawson, and James McPartland
Autism Center
THANK YOU!
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Autism Center