Autism Spectrum Disorder (ASD)

70

ASD Co-morbid Disorders: About _______% of individuals with autism spectrum disorder may have one comorbid mental disorder, and 40% may have two or more comorbid mental disorders)

behavior, activities

ASD Diagnostic Criteria B. Restricted, repetitive patterns of ______, interests, or ____________ including: Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment. Child must display TWO OUT OF THE FOUR behavior features. (1) Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases). (2) Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day). (3) Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). (4) Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

communication, interaction

ASD Diagnostic Criteria (P.50) A. Persistent deficits in social ________and social __________. Child must display ALL THREE of the social/communication features (1) Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions. (2) Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication. (3) Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

early, impairment, not

ASD MEDICAL DEFINITION cont... C. Symptoms must be present in the ______ developmental period D. Symptoms cause clinically significant __________in social, occupational, or other important areas of current functioning. E. These disturbances are _____ better explained by intellectual disability (intellectual developmental disorder) or global developmental delay.

very, support

ASD Severity level: Level 3: "Requiring ______substantial support" Level 2: "Requiring substantial support" Level 1: "Requiring _______-"

early

AUTISM Red Flag Signs and Symptoms ***_________identification is very important --No joyful expressions/large smiles by 6 months of age --No reciprocal interaction (sounds, smiles, facial expressions) by 9 months of age --No babbling by 12 months of age --No reciprocal gesturing (pointing, reaching, waving) by 12 months of age --No words by 16 months of age --No multi-word phrases (2 words or more) by 24 months --The loss of speech, babbling or social skills at any age

IDEA, 3

Under ______2004, the educational definition of ASD is: A developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age ________, that adversely affects a child's educational performance (P.L. 108-446).

genetics

(epigenetics)-combo between environment & _______

outside, OT

Assessment ______________ of OT: (See Table 27-1 in C-S text): Modified Checklist for Autism in Toddlers (MCHAT) Childhood Autism Rating Scale (CARS-2) Autism Diagnostic Observation Schedule (ADOS) ________Assessments: Sensory Profile (SP-2) Sensory Processing Measure (SPM) Pediatric Evaluation of Disability Inventory (PEDI) Adaptations maybe needed to administer standardized assessment (GOAL, PDMS, BOT-2, etc.) Clinical observations of behavior, sensory, social and play

68, males, unknown, cure

Autism Prevalence: The CDC **(2014): prevalence of autism in the US. 1 in ________ children (1 in 42 boys and 1 in 189 girls) Some question whether prevalence is related to actual increase in cases, improved diagnostic practices, greater public awareness, or more attention from medical community More common in________, however female presentation is typically more severe Specific cause is ________ Lifelong disorder with no "_________"

range, unique

Autism Spectrum Disorder: Spectrum means that there is a wide _______ of skills, abilities, and challenges No two people with autism are the same Each individual presents with his/her own set of strengths and challenges that are ________ to him/her

civil

Autism- current 2000-current "_______" rights for neurodiveristy Autism National Institute (ANI) Autreats: Retreats for autistic individuals celebrating their unique gifts- coming together with their "tribe" (neurotribe) Definition of "neurotypical syndrome": "A neurobiological disorder characterized by: preoccupation with social concerns, delusions of superiority, and obsession with conformity...There is no known cure." (Autism National Institute)

mental

Common comorbid _________ disorders include: ADHD, Anxiety, Depression, Specific Learning Disability, Developmental Coordination Disorder (Simonoff et al. 2008).

2013

DSM - 5 APA, ________ ASD: Neurodevelopmental Disorder Removed from the DSM-5 is the diagnostic category, Pervasive Developmental Disabilities including: (1) Rett's Disorder (2) Childhood Disintegrative Disorder (3) Asperger's Syndrome--***no longer used as a diagnosis (4) PDD-NOS (not otherwise specified) A controversial change

removed, aspergers

DSM - 5 APA,2013 ASD: Neurodevelopmental Disorder __________ from the DSM-5 is the diagnostic category, Pervasive Developmental Disabilities including: (1) Rett's Disorder (2) Childhood Disintegrative Disorder (3) _________ Syndrome--***no longer used as a diagnosis (4) PDD-NOS (not otherwise specified) A controversial change

1994

DSM-IV: APA, ___year?___ Disorders Diagnosed in Infancy, Childhood or Adolescence (MR, LD, Communication, Motor, PDD, Attention Deficit, Feeding/Eating, Tic, Elimination, Other) PERVASIVE Developmental Disorder (PDD) 5 diagnostic headings under PDD were identified: (1) Autistic disorder (2) Rett's Disorder (3) Childhood Disintegrative Disorder (4) Asperger's Syndrome (used to identify as high functioning autism) (5) PDD-NOS (not otherwise specified)

not, academic

Educational Definition of ASD A medical diagnosis of ASD **DOES _______ automatically make a child eligible for special education services. Instead, the IEP team must document the child's education difficulties are not the result of one of the other eligibility conditions and that the ASD is negatively impacting the child's ____________ performance (AOTA, 2016).

animal

Educational/Behavioral Intervention (cont.): ____________ Assisted Therapy Requires training of animal and therapist Animals may be calming to children with ASD May help increase language and social interaction Dogs, horses, dolphins Evidence supports efficacy

play, tone

FUNCTIONAL IMPAIRMENTS: FM skill deficits Restricted _______ Destruction due to inability to use hands in a more adaptive way Delayed development Low _________ Limited exploration (sensory hypo or hyper sensitivity)

motor, self

Functional Impairment Oral _________ skills: May be nonverbal due to oral hyper/hyposensitivity or apraxia (Avoidant or excessive drooling; mouthing) Challenges in ______-care routines Sensory hypo/hyper sensitivities contribute to difficulties with: sleeping, dressing, eating, grooming (very stressful for families)

changed

History of ASD (cont.) Theories have _______ to suit the prevailing idea of the time DSM I; DSM II, 1952 and 1968 Schizophrenic Reaction, Childhood Type; Failure to separate from mother and "refrigerator mothers" DSM-III; DSM-IV, 1987 and 1994 Infantile Autism (1987) Autistic Disorder (1994) 1991: IDEA included Autism as a disability type

applied behavior analysis

Interventions- Medical Biomedical: (medications, vitamins, minerals, diets) ____________ _____________ __________ (ABA) Discrete trial training

skills,

Interventions: Educational/Behavioral: Social _______/ Pragmatic language skills Emotional __________ strategies/programs (How Does your Engine Run; Zones of Regulation, etc.)

picture

Interventions: Educational/Behavioral: ________Exchange Communication System (PECS) Exchange a picture for something they want Child initiated, helps improve communication Symbols: Board Maker, Rebus, etc.

stories, sensory

Interventions: Sensory SI therapy (occupational therapy utilizing sensory integration treatment): Sensory _______: Similar to Social Stories, but with sensory interventions ________ diets: Sensory "snacks": short term, immediate (air cushion, wt'd vest, "chewies") Vs. Sensory "meals": long term (effect lasts for hours such as S.I. tx, exercise, yoga, etc.)

short, hours

SENSORY DIETS Sensory "snacks": _______ term, immediate (air cushion, wt'd vest, "chewies") Vs. Sensory "meals": long term (effect lasts for _______ such as S.I. tx, exercise, yoga, etc.)

general, sensory

Signs and Symptoms No two children are alike ________ signs/symptoms may include: Difficulty relating to others May not speak or difficulty communicating functionally May not sustain eye contact Difficulty reading social cues Prone to repetitive behaviors Hand flapping Rocking Echolalic/perseverative speech ___________sensitivities Hypersensitive to noise Vision well developed Seek deep pressure Sensitive to light touch

mystery, interplay

What Causes Autism? Cause remains a ________ Increased rates have been attributed to pollution, antibiotics, vaccines Andrew (Wakefield's study, 1998) about vaccine-autism link retracted in 2011 Research indicates some genetic basis Not all cases can be attributed to genetics alone Current science suggests it is an ________ of genetics and the environment Do environmental features/exposures trigger genetic changes-"turn on" genes? (epigenetics)-combo between environment & genetics

medical

____________ conditions commonly associated with autism spectrum disorder include: epilepsy, sleep problems, feeding problems and constipation. (Baird et al. 2011).

interoception

_____________- the "8th sense" Receptors located within body "Feel" conditions in ones body (heart rate, breathing, bowel/bladder, muscle tension, stomach) Connected to self-regulation/emotion Autistic individuals have less developed interoception systems (Mahler, 2015) Close your eyes and feel...

neurodevelopmental

_______________ DISORDERS Intellectual disability Communication disorders Autism spectrum disorder (p. 50) Attention deficit hyperactivity disorder Neurodevelopmental motor disorders Specific learning disorders

History

__________of ASD History reference: Neurotribes , Steve Silberman (2015) 1911 - Eugen Bleuler Swiss psychiatrist who first used the word "autism" 1920s - Carl Jung Swiss psychiatrist- analytical psychiatry and used word autism with introvert schizophrenia 1943 - Dr. Leo Kanner American child psychiatrist- Described a group of 11 children-severe behavior/development issues Used the words autism and autistic 1944 - Dr. Hans Asperger (Asperger's Syndrome) Germany; WWII Described similar characteristic, but a wider range, including some near "normalcy" Also used the terms autism and autistic to describe presentation of symptoms Noted adult like speech and motor clumsiness Called the subjects "little professors"

neurodevelopmental disorders

a group of conditions with onset in the developmental period" DSM-5, APA (2013) p.31