Download Autistic Disorder

Autistic Disorder
What is Autism?
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Autism is a complex developmental disability
that typically appears during the first three
years of life.
It is the result of a neurological disorder that
affects the normal functioning of the brain
It impacts development in the areas of social
interaction and communication skills
What is Autism continued
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Both children and adults with autism typically
show difficulties in:
 Verbal and non-verbal communication
 Social interactions
 And leisure or play activities
Autism is a spectrum disorder that affects
each individual differently at varying degrees.
What is Autism continued
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Thus, that is why early diagnosis of Autism is
imperative
Autism is one of five disorders that falls under
the umbrella of Pervasive Developmental
Disorder (PDD).
PDD is a category of neurological disorder
that is characterized by “severe and pervasive
impairment in several areas of development.”
Signs and Symptoms of Autism
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As mentioned previously, autism is a
spectrum disorder, and although it’s defined
by a certain set of behaviors, children and
adults with autism can exhibit any
combination of these behaviors in any degree
of severity.
Two children, both with the same diagnosis,
can act completely different from one another
and have varying capabilities.
Signs and symptoms continued
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You may hear different terms used to
describe children within this spectrum such
as:
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Autistic-like
Autistic tendencies
Autism spectrum
High-functioning or low-functioning autism
More-able or less-able
Signs and symptoms continued
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More important than the term used to
describe autism is understanding that
whatever the diagnosis, children with autism
can learn and function normally and show
improvement with appropriate treatment and
education
Every person with autism is an individual and
like all individuals has a unique personality
and combination of characteristics
Signs and symptoms continued
Behavioral Indicators of Autism in Children:
 Language/Communication
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Rarely initiates communication
Uses little or no speech or is overly verbal
Uses unusual vocal intonation/rhythm
Understands and uses words literally
Relating-to people
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Doesn’t communicate with eyes
Seems content when left alone
Seeks social contact in unusual ways
Eye contact is limited and fleeting
Signs and symptoms continued
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Relating-to the environment
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Is upset or resists change
Drifts about aimlessly
Play is repetitive
Exhibits intense and obsessive interests
Responses to Stimuli
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Sometimes seems deaf
Exhibits panic related to specific sounds
Flicks fingers before eyes
Pulls away when touched
Signs and symptoms continued
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Developmental Discrepancies:
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Skills are either very good or very delayed and the child
learns skills out of the normal sequences, for example:
 Reads but doesn’t understand the meaning
 Is very good with puzzles and pegs, but is very poor with
following instructions
 Draws detailed pictures but can’t button coat
Signs and symptoms continued
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DSM-IV Criteria, Pervasive Developmental Disorders:
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A. A total of six (or more) items from (1), (2), and (3), with
at least two from (1), and one each from (2) and (3):
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(1) qualitative impairment in social interaction, as
manifested by at least two of the following:
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(a) marked impairment in the use of multiple nonverbal
behaviors, such as eye-to- eye gaze, facial expression,
body postures, and gestures to regulate social interaction
(b) failure to develop peer relationships appropriate to
developmental level
(c) a lack of spontaneous seeking to share enjoyment,
interests, or achievements with other people (e.g., by a
lack of showing, bringing, or pointing out objects of
interest)
(d) lack of social or emotional reciprocity
Signs and Symptoms continued
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(2) qualitative impairments in communication, as
manifested by at least one of the following:
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(a) delay in, or total lack of, the development of spoken
language (not accompanied by an attempt to compensate
through alternative modes of communication such as
gesture or mime)
(b) in individuals with adequate speech, marked impairment
in the ability to initiate or sustain a conversation with others
(c) stereotyped and repetitive use of language or
idiosyncratic language
(d) lack of varied, spontaneous make-believe play or social
imitative play appropriate to developmental level
Signs and symptoms continued
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(3) restricted, repetitive, and stereotyped patterns of behavior,
interests, and activities as manifested by at least one of the
following:
 (a) encompassing preoccupation with one or more
stereotyped and restricted patterns of interest that is
abnormal either in intensity or focus
 (b) apparently inflexible adherence to specific, nonfunctional
routines or rituals
 (c) stereotyped and repetitive motor mannerisms (e.g., hand
or finger flapping or twisting or complex whole-body
movements)
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(d) persistent preoccupation with parts of objects
Signs and symptoms continued
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B. Delays or abnormal functioning in at least
one of the following areas, with onset prior to
age 3 years: (1) social interaction, (2)
language as used in social communication, or
(3) symbolic or imaginative play.
C. The disturbance is not better accounted for
by Rett's disorder or childhood disintegrative
disorder.
Epidemiology
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Reported rates range from .02%-.06%
Much more common in boys than girls: 4:1
ratio.
More severe in females.
Can be identified in infancy, though most
diagnoses occur around 3-5 years of age.
Equally prevalent in all SES, race/ethnicity, all
over the world.
Autistic Savants
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Autistic child showing unreal ability in a skill
or set of skills. Called splinter skills.
Complex math, Music composition, Calendar
memorization, Counting.
Not understood; savants still show up as
mentally retarded on traditional IQ tests.
Less than 5% of all autistic individuals are
savants. (that’s 1 in 40,000)
Comorbidity
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Mental retardation is the most common disorder
comorbid with autistic disorder
Up to 70% of individuals with autism meet the
criteria for mental retardation
About 57%-70% with autism have an IQ lower than
50, 25% have an IQ between 70-90, and the
remaining 5% are of average intelligence.
Autism can also co-occur with many other conditions
and syndromes such as hearing and vision
impairments, cerebral palsy, Down Syndrome, and
seizure disorders.
Etiology of Autism
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Autism is a syndrome with many possible
causes. Anything that makes the central
nervous system develop abnormally, either
before or after birth can cause autism.
In most cases what triggers the
developmental differences occur early in the
period of fetal development.
It is vital to note that autism is not caused by
parental rejection, lack of love, or inadequate
parenting skills.
Etiology continued
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There is no single cause for autism, but it’s
generally accepted by the medical community
that it’s caused by abnormalities in brain
structure or function.
Researchers are investigating a number of
theories, including the link between heredity,
genetics and medical problems.
Etiology continued
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Some of the conditions implicated as cause:
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Viral infections:
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Metabolic Imbalances:
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Such as thyroid disease
Exposure to Alcohol and drugs:
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Such as congenital rubella
Herpes simplex infection
Cocaine-addicted babies and fetal alcohol syndrome
Exposure to environmental chemicals:
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Such as lead and other toxic chemicals
Etiology Continued
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Genetic-chromosomal factors:
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Oxygen Deprivation/over exposure during/shortly
after birth:
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Some families have more than one child with autism or other
developmental disorders. Fragile-X and Down Syndrome are
both genetic disorders that co-occur with autism.
As in retinopathy or premature birth
After severe viral infections and traumatic brain
therapy:
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As in encephalitis, spinal meningitis, or brain injury from a
fall or severe car accident. In these situations, symptoms of
autism will occur after normal age of onset.
Treatment of Autism
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Children do not “outgrow” autism, but
symptoms may lessen as the child develops
and receives treatment.
While there is no one behavioral or
communications test that can detect autism,
several screening instruments have been
developed that are now being used in
diagnosing autism.
Treatment continued
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Some of these screening instruments are:
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CARS rating system (Childhood Autism Rating Scale), that is
based on observed behavior. A 15-point scale is used to
evaluate a child’s relationships, body use, listening response,
and verbal communication.
CHAT (Checklist for Autism in Toddlers), is used for
screening at 18 months of age. This screening tool uses a
short questionnaire with two sections, one prepared by the
parents, the other by the family doctor.
Autism Screening Questionnaire, which is a 40 item
screening scale for children 4 and older to help evaluate
communication skills and social functioning.
Treatment continued
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When treating autism it requires a multidisciplinary assessment
team that consists of all or some of the following:
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Developmental pediatrician who treats health problems.
Child psychiatrist to be involved in the initial diagnosis.
Clinical psychologist who specializes in understanding the nature
and impact of developmental disabilities.
Occupational therapist who focuses on practical, self-help skills that
will aid in daily living.
Physical therapist who helps improve the use of bones, muscles,
joints, and nerves to develop coordination and motor skills.
Speech/language therapist who is involved in the improvement of
communication skills, including speech and language.
Social worker that provides counseling services or acts as a case
manager.
Treatment continued
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With appropriate services, training, and information,
children with autism will grown and can learn, even if
at the different developmental rates than others.
While there is no cure for autism, there are treatment
and education approaches that may reduce some of
the challenges associated with the disability.
Intervention may help to lessen disruptive behaviors,
and education can teach self-help skills that allow for
greater independence. But treatment must be
tailored to the child’s individual behaviors and needs.
Treatment continued
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It is important to match your child’s needs and potential with
treatments or strategies that are likely to be effective in moving
him/her closer to normal functioning.
Treatment approaches are evolving as more is learned about
autism. There are many therapeutic programs, both
conventional and complementary, that focus on replacing
dysfunctional behaviors and developing skills.
It is vital not to rush your child because he/she might have
already learned to cope with his or her current environment and
those changes could be more harm then help.
Education
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Just as there are various treatment approaches, there
are multiple educational programs that provide good
learning environments.
Educational planning for students with autism will
often address a wide range of skill development,
including academics, communication, and
language/social/self-help skills.
Most professionals agree that individuals with autism
respond well to highly structured, specialized
education programs designed to meet the individuals
needs.
Education continued
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There are areas that are important to look at when
creating a plan: social skill development,
communication, behavior, and sensory integration.
Academic goals need to be tailored to the individual’s
intellectual ability and functioning level.
It is important to note that no one program or diet is
perfect for every person or child with autism. Several
approaches should be looked at before settling on a
specific approach.