AUTISM SPECTRUM
DISORDERS
WHAT IS AUTISM???
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.
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.
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).
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%
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
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
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
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
SPECTRUM
OF AUTISM
Social
Communic ation Motor
Senso
ry
Profound
Intellectual
Disabilities
Gifted
Self-Absorbed
Quirky
Non-Verbal
Highly
Verbal
Awkw
ard
Agile
Hyposens
itive
Hypersen
sitive
Measure
d I.Q.
Beha
vior
Aggressive,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
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
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,
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
Severity Level for ASD Social Communication Restricted Interests and Repetitive Behaviors Level 1 Requiring support
Without supports in place, deficits in social
communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful response to social overtures of others. May appear to have
decreased interest in social interactions. For example, a 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. .
Inflexibility of behavior causes significant
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
Severity Level for ASD
Social Communication Restricted Interests
and Repetitive Behaviors Level 3 Requiring very substantial support
Severe deficits in verbal and nonverbal social communication skills cause severe
impairments in
functioning, very limited initiation of social
interactions, and minimal response to social
overtures from others. 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
Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interferes with
functioning in all spheres. Great distress/difficulty
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
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
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)
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.
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
ndApril is World
