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Developmental Awareness
and Screenings
Becky LaMont MSN, APN-CNP
CDC video
CDC website
signs 1
ASD Facts
• Present at birth, with onset of symptoms
before 36 months
• Accurate diagnosis possible at 18-24 months
• Parents first voice concerns around 18
months, but diagnosis is typically not until 3
years or older
ASD Facts: Epidemiology
• Conservative prevalence: 1 in 150
• ASD more prevalent in pediatric population
– Cancer, Diabetes and Downs Syndrome
• Male to female ratio: 4 to 1
• Diagnostic rate increase 1:20 then 1:4
CDC, AAP, Autism Speaks 2007
Strike that• Since I have been giving this lecture the
prevalence of autism spectrum disorders has
changed 3 times.
• 1 in 300 to 1 in 150
• To current CDC stats of 1 in 88
• To current Easter Seals stats of 1 in 88
What is Autism?
• Neurodevelopmental disorder with a
spectrum of clinical conditions
• 3 areas of dysfunction:
– Social interaction/social relatedness difficulty
– Communication impairment
– Restrictive/repetitive behaviors and interests
Pervasive Developmental Disorder
(not otherwise
Typical Development
Joint Attention
• 2 mo.
• 9 mo.
• 12 mo.
Shared smiles
Follows a point
Point to request
Language soon follows joint attention,
No joint attention, no need to share language.
Typical Development
Social Interaction
4 mo.
9 mo.
12 mo.
15 mo.
18 mo.
24 mo.
Interest in faces, smiles shared
Orients to name
Uses gesture to get needs met
Check expressions, check this!
Pretend play, attracts attention
Enjoys playing by others, gives toys
Typical Development
Play Behavior
4-12 mo
Sensor motor
Functional Play
Symbolic Play
Imaginative Play
Language Delay:
Absolute indications for immediate evaluation
9 months:
12 months:
16 months:
24 months:
No babbling
No pointing or other gestures
No single words
No functional 2-word phrases
(not echolalic)
Any loss of language or social skills
ASD Basics Summary
• Autism is a neurodevelopmental disorder with
a broad spectrum of behavioral
• Early awareness and intervention are key.
• It’s OK to discuss concerns.
Challenging Behaviors
• Stimming: Repetitive, Stereotyped, and
Sometimes Self-Injurious Behaviors
• Restricted Interests: Obsessions, "Special
Topics", and Attention Deficits
• Insistence on Sameness
• Sensory Issues: Seeking and Avoiding
• Mood Instability and Meltdowns
• Activities of Daily Living
Myths• Refrigerator mothers
• Others?
Stir the pot
• Conflict of interest?
Final thoughts
• Autism speaks resource