Autism spectrum disorder

  AUTISM SPECTRUM DISORDERS Day 1, ASDs and Parenting

WHAT IS AUTISM???

  

Task: Write in a sentence, what do you

think autism means or is????

AUTISM SPECTRUM DISORDER

   Autism , also termed autism spectrum disorders or ASDs

   is a wide range or spectrum of brain disorders that is usually noticed in young children that decreases

the individual's ability to communicate and relate

emotionally to others.

  

The word Autism is derived from the Greek word

“auto” which means “self”.

   First used by Austrian psychiatrist Leo Kanner in 1943.

   Usually appears during the first 3 years of life.

AUTISM SPECTRUM DISORDER

   Autism is neither Mental Retardation nor Mental Illness…

   But may come with MR, seizures, cerebral palsy and LD.

   A neuro-developmental disorder characterized by

• impaired social interaction ,
• verbal and non-verbal communication , & by - restricted and repetitive behavior .

  

Occurs about four to five times more often in boys

than girls.

   This disability may range from mild to severe.

  PREVALENCE 

  The Center for Disease Control and Prevention (CDC) reports 

  

1.5% of children in United States (one in 68)

are diagnosed with ASD as of 2014, 

a 30% increase from one in 88 in 2012(CDC,

2014).

   There is no exact data in Nepal but Autism Care Nepal Society (ACNS) estimates that there are about 250,000 to 300,000 People with Autism (PWAs) in Nepal (ACNS, 2015).

PREVALENCE CONTINUED.

   The flash report by Department of Education

indicates out of total school going children

about 1% children are with disability

   26.6% among them are intellectually disabled.

   In country report on Autism Education in Nepal, there is not exact number of students with autism but it is assumed that 14% among the intellectually disabled are with autism (Subedi, n.d).

SIGNS OF AUTISM

   No big smiles or other warm, joyful

expressions by 6 months or thereafter

  

No back-and-forth sharing of sounds,

smiles, or other facial expressions by 9 months or thereafter

   No babbling by 12 months

   No back-and-forth gestures, such as

pointing, showing, reaching, or waving

by 12 months

SIGNS OF AUTISM

   No words by 16 months

   No two-word meaningful phrases

(without imitating or repeating) by 24

months

   Any loss of speech or babbling or social skills at any age

EARLY SCREENING AND DIAGNOSTIC TOOLS FOR ASD

   Modified Checklist for Autism in Toddlers (M-CHAT)

   Many false positives; follow up with interview

   Scientifically validated for children ages 16-30 months old

   American Academy of Pediatrics recommends that all children be screened for Autism at 18 and 24 months old.

DIAGNOSING ASD

   Current Tools

   Observation—Autism Diagnostic Observation (ADOS)

   Developmental History (Parent Report)— Autism Diagnostic Interview-Revised (ADI- R)

  

Childhood Autism Rating Scale (CARS)

   Future

   Brain Imaging

   Genetic Testing

SPECTRUM OF AUTISM

   Awkw ard

  Odd

  Aggressive, _ Destructive 

   Beha vior ^

   Measure d I.Q.

   Hypersen sitive

   Hyposens itive

   Agile

   Social

   Communic ation

   Non- Verbal

   Quirky

   Self- Absorbed

   Gifted

   Profound Intellectual Disabilities

   Senso ry

   Motor

   Highly Verbal

ACCORDING TO DSM-V

  Social Communication & Interaction- A.

  Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:

1. Deficits in social-emotional reciprocity; ranging

  from abnormal social approach and failure of normal back and forth conversation through reduced sharing

of interests, emotions, and affect and response to total lack of initiation of social interaction SOCIAL COMMUNICATION & INTERACTION – (CONTINUED)

2. Deficits in nonverbal communicative

  behaviors used for social interaction;

ranging from poorly integrated- verbal and

nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication , to total lack of facial expression or gestures 3.

  Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of BEHAVIORS, INTERESTS, ACTIVITIES — B.

  Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:

  1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple

motor stereotypies, echolalia, repetitive use of

objects, or idiosyncratic phrases).

  2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).

BEHAVIORS, INTERESTS, ACTIVITIES (CONTINUED) 3.

  Highly restricted, fixated interests that are

abnormal in intensity or focus; (such as strong

attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).

4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of

  environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or

textures, excessive smelling or touching of objects, fascination with lights or spinning objects). ADDITIONAL DIAGNOSTIC CRITERIA— C.

  

Symptoms must be present in early

childhood (but may not become fully manifest until social demands exceed limited capacities).

  D.

  Symptoms together limit and impair everyday functioning.

  Severity Social Restricted Level for Communication Interests and ASD Repetitive Behaviors

  Level 1

  Without supports in place, Inflexibility of

  Requiring

  deficits in social behavior causes

  support

  communication cause significant noticeable impairments. interference with Difficulty initiating social functioning in one or interactions, and clear more contexts. examples of atypical or Difficulty switching unsuccessful response to between activities. social overtures of others. Problems of May appear to have organization and decreased interest in social planning hamper interactions. For example, a independence. person who is able to speak in full sentences and engages in communication but whose to- and-fro conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful. .

  Severity Level for ASD Social Communication Restricted Interests and Repetitive Behaviors Level 2 Requiring substantial support

  Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others. For example, a person who speaks simple sentences, whose interaction is limited to narrow special interests, and how has markedly odd nonverbal communication.

  Inflexibility of behavior, difficulty coping with change or other restricted/repetitive behaviors appears frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress and/or difficulty changing focus or action.

  Severity Social Communication Restricted Interests Level for and Repetitive ASD Behaviors

  Level 3

  Severe deficits in verbal Inflexibility of behavior,

  Requiring

  and nonverbal social extreme difficulty coping

  very

  communication skills with change, or other

  substantial

  cause severe restricted/repetitive

  support

  impairments in behaviors markedly functioning, very limited interferes with initiation of social functioning in all interactions, and minimal spheres. Great response to social distress/difficulty overtures from others. changing focus or action. For example, a person with few words of intelligible speech who rarely initiates interaction and, when he or she does, makes unusual approaches to meet needs only and responds to only very direct social approaches

MANAGEMENT APPROACHES

   Family counseling and support

   Several behavioral intervention such as-

   ABA (Applied Behavior Analysis),

   BMT or BT (Behavior Modification Techniques or Behavior Therapy),

  

  

VBA (Verbal Behavior Analysis) for language

development and communication 

  TEACCH (Treatment and Education for Autistic and Communication related handicapped CHildren) MANAGEMENT APPROACHES CONTD… 

  Sensory stimulation and integration 

  PECS (Picture Exchange Communication System) 

  Structured teaching 

  Teaching life skills, vocational skills 

  Bio-medical treatment 

  Occupational Therapy 

  Social stories 

  Music and Art therapy

   Environmental adaptation

   Making use of visual and gestural communication such as PECS, symbols, sign language etc.

   Limiting noise and visual stimuli

   Making use of visually bare work spaces and physical barriers to separate work and play areas

   Using small groups for instruction

   Developmental, Individual-differences, & Relationship-based model (DIR)

   Individual Education Plan (IEP)

ABOUT AUTISM: FACT OR MYTH???

   Caused by “cold” refrigerator mothers. 

Children with eye contact do not have Autism.



Children who are “social” do not have Autism.

 All people with Autism have extraordinary skills.  People with Autism just need love to get better. 

  People with Autism just need more discipline to get better.

   Autism can be outgrown.  There is a cure for Autism.

FACTS ABOUT AUTISM/ASD

   Multiple causes of autism: A genetic predisposition with something in the environment that triggers it.

   Genetic

   Environmental

   Every child is unique.  Children with autism are not indiscipline.  It can be compared with a culture.  Autism can take emotional and financial toll on families.  Blue color symbolize Autism. 

  April is Autism Awareness month and 2 nd

  April is World Autism Awareness Day.