autism overview what is autism? is there more than one type of autism? how is autism diagnosed? what...

Autism

Overview

What is Autism?Is there more than one type of Autism?How is Autism diagnosed?What are the characteristics of Autism?

WHAT IS AUTISM?Very complex, often baffling developmental disabilityFirst described by Leo Kanner in 1943 as early infantile autism“Auto” – children are “locked within themselves”For next 30 years, considered to be an emotional disturbance

WHAT IS AUTISM?Today, autism is a severe form of a broader group of disordersThese are referred to as pervasive developmental disorders Autism typically appears during the first 3 years of life

WHAT IS AUTISM?Very likely neurological in origin Prevalence figures vary widely, recent data suggests as high as 1/150 births s (Centers for Disease Control Prevention, 2007)

4 times more prevalent in boysNo known racial, ethnic, or social boundariesNo relation to family income or lifestyle

WHAT IS AUTISM?Autism impacts normal development of the brain in areas of social interaction and communication skills.Individuals with autism find it difficult to communicate with others and relate to the outside world.Occasionally, aggressive and/or self-injurious behavior may be present.

WHAT IS AUTISM?Repeated body movements (hand flapping, rocking)Unusual responses to peopleAttachment to objectsResistance to change in routineSensory sensitivities

WHAT ARE THE TYPES?Actually, the “umbrella” heading is Pervasive Developmental Disorder (PDD).Autism is one of the 5 PDDs.They all have commonalities in communication and social deficits.They differ in terms of severity.

1. Autistic DisorderImpairments in social interaction, communication, and imaginative play.Apparent before age 3

2. Asperger’s DisorderImpairments in social interactions, and presence of restricted interests and activitiesNo clinically significant general delay in languageAverage to above average intelligence

3. Pervasive Developmental Disorder – Not Otherwise Specified

(PDD-NOS)

Often referred to as atypical autismUsed when a child does not meet the criteria for a specific diagnosis, but there is severe and pervasive impairment in specified behaviors

4. Rett SyndromeProgressive disorder which typically occurs in girlsPeriod of normal development and then the loss of previously acquired skillsAlso loss of purposeful use of hands, which is replaced by repetitive hand movementsBeginning at age of 1-4 years

5. Childhood Disintegrative Disorder

Normal development for at least the first 2 yearsThen significant loss of previously acquired skills

Conclusions on TypesAutism is a spectrum disorderThis means that symptoms and characteristics can present themselves in wide variety of combinations, from mild to severeAutistic individuals can be very different from each other“Autism” is still commonly used to refer to any of the 5 PDDs

How is Autism Diagnosed?No definitive medical testTeam uses interviews, observation, and specific checklists developed for this purposeTeam might include neurologist, psychologist, developmental pediatrician, speech/language therapist, learning consultant, etc.Must rule out MR, hearing impairment, behavior disorders, or eccentric habits

CHARACTERISTICS1. Communication/Language2. Social Interaction3. Behaviors4. Sensory and movement disorders5. Resistance to change (predictability)6. Intellectual functioning

1. Communication/languageBroad range of abilities, from no verbal communication to quite complex skillsTwo common impairments:A. Delayed languageB. Echolalia

A. Delayed languagePronoun reversal: “You want white icing on chocolate cake.”Difficulty in conversing easily with othersDifficulty in shifting topicsLooking away; poor eye contact

B. EcholaliaRepeating words or phrases made by another personCommon in very young children (Age 3)Immediate repetition or delayed repetition (even years later)May or may not be communicative

2. Social InteractionOne of hallmarks of autism is lack of social interaction1. Impaired use of nonverbal behavior2. Lack of peer relationships3. Failure to spontaneously share enjoyment, interests, etc. with others4. Lack of reciprocity (all one-sided, no give and take)

3. BehaviorsRepetitive behaviors, including obsessions, tics, and perseveration

( (repeating a response at a later time when not appropriate)

Impeding behaviors (impede their learning or the learning of others)Will need positive behavior supports

A. Self-injurious behaviorB. Aggression

4. Sensory and movement disorders

Very commonOver- or under-sensitive to sensory stimuliAbnormal posture and movements of the face, head, trunk, and limbsAbnormal eye movementsRepeated gestures and mannerismsMovement disorders can be detected very early – perhaps at birth

5. PredictabilityChange in routine is very stressfulMay insist on particular furniture arrangement, food at meals, TV showsSymmetry is often importantInterventions need to focus on preparing students for change if possible

6. Intellectual functioningAutism occurs in children of all levels of intelligence, from those who are gifted to those who have mental retardationIn general, majority of individuals with autism are also identified as having mental retardation – 75% have below 70 IQVerbal and reasoning skills are difficult

InterventionsInclude life skills, functional academics, and vocational preparationPositive behavior supportSocial storiesIndividualization and early intervention are the keys!!

American Academy of Pediatrics

Recommendations

All children should be screened for autism by their family pediatrician twice by the age of 2, at 18 months and again at 24 months. Treatment should be started when an autism diagnosis is suspected rather than waiting for a formal diagnosis.

Resources

Autism Society of AmericaCenter for Disabilities: Autism Spectrum Disorders Programhttp://health.pppst.com/autism.html