Autism Spectrum Disorders (ASD)

Applied Behavior Analysis (ABA)

A structures & systematic instructional approach: - discrete trial training (DTT): (tasks are repeated until mastered) - pivotal response training (PRT): (gain & maintain child's attention - shared control over objects and materials - Verbal Behavior (VB)

Tic Disorders

A tic is a sudden, rapid, recurrent, nonrhythmic motor movement or vocalization

Most Effective Interventions of ASD?

ABA

Tourette's Disorder Criteria

*a) 2 motor & 1 or more vocal tics* b) persist for more than 1 year since first tic onset c) onset is before 18 y/o d) the disturbance is not caused to physiological effects of a substance (cocaine) or another medical condition

Persistent (Chronic) Motor or Vocal Tic Disorder Criteria

*a) single or multiple motor or vocal tics have been present during the illness, but not both motor and vocal* b) persist for more than 1 year since first tic onset c) onset age is before 18 d)the disturbance is not caused to physiological effects of a substance (cocaine) or another medical condition

Age of Onset for ASD

*prior to 3 y/o* - most often identified by parents in the months preceding child's 2nd birthday - earliest point in development for reliable detection periods is from 12-18 months

Treatment of ASD

- 400 different treatments of ASD - no known cure - engaging children in treatment - decreasing disruptive behaviors - teaching appropriate social behaviors - increasing functional, spontaneous communication - promoting cognitive skills - teaching adaptive skills to increase responsibility & independence

3 Factor's Contributing to the Spectrum of ASD

- all kids w/ autism will show intellectual delay, however not everyone will fall into the same category - language - some will show no language skills & some will show some - symptomatology will change with age

Causes of ASD

- autism is biologically based neurodevelopment disorder w/ multiple causes - prenatal complications such as low birth weight, bleeding during pregnancy, blood poisoning - genetic

Problems in Early Development of ASD

- children with ASD experience more health problems during pregnancy, at birth or immediately following birth - prenatal & neonatal complications have been identified in small percentage of kids with ASD

Prevalence & Course for Tic Disorders

- first onset will typically be between 4-6 y/o - peak in intensity & frequency between 10-12 y/o - Duration CAN be lifelong & w/o treatment you will have poor prognosis (it can get worse)

Developmental Relationship-Based Models

- floor time - Greenspan (DIR) - relationship development intervention - Gutstein (RDI)

Initial Stages of ASD Treatment

- focus on building rapport & teaching learning-readiness skills - children must learn to sit in a chair, come when called & attend to their teacher if they are to progress

SES & Gender of ASD

- found in all social classes worldwide - more common in boys

Early Intervention of ASD

- intensive 25 hours a week & 12 months a year - low student-teacher ratio (one-on-one time for specific goals) - high structure (routines) - family inclusion - peer interactions - generalization - ongoing assessment

Social Interaction Impairments of ASD

- lack of monitoring of social activities of others (can't learn from watching others) - unusual nonverbal behaviors - social imitation, sharing focus of attention, make-believe play - limited social expressiveness - atypical processing of faces & facial expression - joint attention (ability to coordinate attention to a social partner and an object or event of mutual interest)

Rett's Disorder

- normal prenatal and perinatal development, psychomotor development for first 5 months after bitch and normal head circumference at birth All of the following after the period of normal development - deceleration of head growth - loss of previously acquired hand skills (hand-writing or hand washing) - loss of social engagement - severely impaired expressive and receptive language development

UCLA Young Autism Project

- now called ABA - based on principles of applied behavior analysis, including rewards/punishments - parents are taught to act as the primary therapist for their children

Communication Impairment of ASD

- one of the first signs of language impairment is inconsistent use of early preverbal communication - if the child does not speak by 5 y/o, prognosis is not good - they will have more severe form of ASD

Core Deficits of ASD

- social-emotional development - language development - cognitive development

ASD vs. Asperger's

1) ASD have language delay or start talking later in life 2) ASD have below average IQ while Asperger's has average or above average IQ 3) Asperger's start speaking within expected age range 4) Asperger's are more aware of what they are not achieving socially

Characteristics of Effective Interventions for ASD

1) functional and spontaneous communication 2) social instruction delivered throughout the day in various settings 3) teach play skills that focus on peer interaction 4) goals for cognitive development should be carried out in the context in which the skills are expected to be used 5) teach functional academic skills - skills that they can apply to everyday life

2 Symptom Domains of ASD

1) social communication & social interaction 2) restricted, repetitive patterns of behavior, interests or activities *CHILD MUST DISPLAY SYMPTOMS IN BOTH*

Restrictive & Repetitive Behaviors Domain (ASD)

4 symptoms but ONLY 2 needed for diagnosis: 1) stereotyped or repetitive motor movements, use of objects, or speech (lining up toys) 2) Insistence of sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (extreme distress to small changes) 3) highly restricted, fixated interests that are abnormal in intensity or focus (strong attachment to unusual objects) 4) hyperactivity or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment ( apparent indifference to pain/temp., adverse response to sound or textures)

Accompanying Disorders to ASD

ID & Epilepsy others include ADHD, conduct problems, anxieties & fears, and mood problems

Social Communication & Social Interaction Domain (ASD)

Must have ALL 3 symptoms: 1) deficits in social-emotional reciprocity (failure to initiate or respond to social interactions) 2) deficits in nonverbal communication behaviors used for social interaction (lack of facial expressions) 3) deficits in developing maintaining, and understanding relationships (absence of interest in peers)

What is ASD?

a complex neurodevelopment disorder characterized by abnormalities in social behavior, language and communication skills, and unusual behaviors & interests

Medications for ASD

antidepressants, stimulants & tranquilizers/antipsychotics

Theory of Mind (ToM)

the cognition & understanding of mental states that cannot be observed directly, such as beliefs and desires, both in one's self & in others

Social (Pragmatic) Communication Disorder

those who display only deficits in social communication & interaction, BUT NOT restricted & repetitive behaviors