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Autism Developmental Awareness and Screenings Becky LaMont MSN, APN-CNP Links • • • • CDC video CDC website signs 1 video 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 than: – 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 Autism Asperger’s Syndrome PDD – NOS (not otherwise Specified) Rett’s Syndrome Childhood Disintegrative Disorder 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 12+ 16mo 30+ 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 manifestations. • 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