Final Autism Ppt

7/27/2019 Final Autism Ppt

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UNDERSTAND THE AUTISM


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DEFINITION

ITS A developmental disability significantly affecting

Verbal

nonverbal communication

social interaction

generally evident before age three


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CHARACTERSTICS

engagement in repetitive activities

stereotyped movements

resistance to environmental change

change in daily routines

unusual responses to sensory experiences


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Sensory issues

Over or under-sensitivity to noises,lighting, odors, tastes, textures, pain

Sensory over-selectivity

Failure to respond

Hidden senses

vestibular(movement and balance)

proprioceptive (feedback on how much

force or pressure to apply when picking

up something or holding an item)


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Cognitive issues

Difficulty drawing conclusions Difficulty with incidental learning

Often excellent rote memory

Slower at retrieving information Slowerprocessing speed

Problems with working memory

Trouble predicting outcomes (e.g.,peoples reactions)

Often do not see cause-effect


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Cognitive issues continue

Problems with executive function Issues with shift: moving freely from one

activity/situation to another, transitions, flexible

problem solving

Issues with initiation; cant begin tasks

Issues with planning, organizing, sequencing,

setting goals/objectives

Issues with seeing big picture or main idea Issues with evaluating activity; pace, completion,

Issues with modulating emotional response

Issues with controlling impulses


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History of Autismo Term autism originally used by Bleuler (1911)

o To describe withdrawal from social relations into a rich fantasy life seen in

individuals with schizophrenia

o Derived from the Greek autos (self) and ismos (condition)

o Leo Kanner 1943

o Observed 11 children

o Inattention to outside world: extreme autistic aloneness

o Similar patterns of behavior in 3 main areas:

1. Abnormal language development and use

2. Social skills deficits and excesses

3. Insistence on sameness


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History of Autism

oPsychiatrist Hans Asperger (1944) - describes little professor

syndrome

o Eisenberg and Kanner (1956)o Added autism onset prior to age 2

o Further refined definition of autism

o Creak (1961)

o Developed 9 main characteristicso Believed they described childhood schizophrenia

o Incorporated into many descriptions of autism and commonly used

autism assessment instruments today


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History of Autismo Rutter (1968)

o Said the term autism led to confusion!

o Argued autism was different than schizophrenia

o Higher M:F ratio

o Absence of delusions & hallucinations

o Stable course (not relapse/marked improvement)

o Further defined characteristics (for science, research)

o National Society for Autistic Children

o One of the 1st & most influential parent groups for children with autism in U.S.

o Wrote separate criteria (for public awareness, funding)

o Added disturbances in response to sensory stimuli & atypical development

o Did not include insistence on sameness


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Myths

Individuals with autism never makeeye contact

Autism is a mental illness.

Individuals with autism do not speak.Autism can be outgrown.

Individuals with autism cannot learn

autistic children are retarded. Autismcan be completely cured.

Autistics have no sense of humour.


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Myths

inside a child with autism is a genius. Individuals with autism are very

manipulative.

Individuals with autism cant smile; cannot show affection

do not want friends

do not learnAutism is caused by poor parenting

and a lack of initial bonding.


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Prevalence of Autism

2-6 cases per 1,000 growing at a rate of 10-17 percent per year

diagnostic boundaries have changed inclusion of spectrum Increasing recognition of comorbidity (e.g.

Downs, Tourette syndrome, cerebral palsy) Improvements in case-finding methods Populations sampled Increased public awareness Introduction of the MMR vaccine

boy:girl- 4:1(more severe in girls) Usually identified before 30 months

No racial or socioeconomic differences


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CAUSES

Monozygotic vs. dizygotic twin studieshave shown that if 1 identical twin has

autism, the chance that the other twin

has autism is 10 times higher than thatof fraternal twins


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Neurotransmitters

Serotonin Some studies have found higher levels

in children with ASD

Opioids Display properties similar to morphine Administration can result in stereotypy,

insensitivity to pain, reduced

socialization Some studies have found higher levels

in children with ASD


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CAUSES

Other Theories: Heavy metals

Pollutants

Toxins

Vaccines

Chemicals

Pesticides

Gastrointestinal issues *none of these have been empirically

proven to cause autism*


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high risk parameters

Siblings of children with ASD: 10 x increased risk Premature Infants

Comorbid Genetic Syndromes: e.g. Fragile Xsyndrome, Tuberous Sclerosis

Prenatal Exposures e.g. Valproic acid


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Early Development

communication andrelating to other people

followed by social-

emotional development ofbaby is key to form strong

relationships and

continued learning which

starts from the birth itself


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By the end of 3 months

Begin to develop a socialsmile

Enjoy playing with otherpeople and may cry when

playing stops Become more expressive

and communicate morewith face and body

Imitate some movementsand facial expressions


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Smile back at another person Respond to sound with sounds

Enjoy social play

By the end of 12 months Use simple gestures (pointing,

showing, waving bye,) Imitate actions in their play

Respond when told no

Start babbling mama, dada, baba


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Do simple pretend play

Point to interesting objects

Use several single words unprompted

By the end of 2 years(24 months)

Use 2- to 4-word phrases

Follow simple instructions

Become more interested in other children

Point to object or picture when named


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Role of physician/ Counselor

Early recognition based on Knowledge of signs and symptoms

Developmental surveillance and

screening

Guiding families to diagnosticresources and intervention services

Conducting a medical evaluation Providing ongoing health care

Supporting and educating families


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DIAGNOSIS

Major areas

Communication

Socialization

Behavior


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Communication

Delay in, or complete lack of, verbalcommunication

Difficulty in initiating or sustaining

conversations Stereotyped or idiosyncratic use of

language (echolalia, jargon)

Inability to engage in spontaneous,make- believe, or imitative play at theappropriate developmental level


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Socialization

Difficulty developing peer relationshipsappropriate to developmental level

Impaired use of nonverbal behaviors

(e.g., eye contact, facial expressions,and gestures)

Lack of spontaneous seeking to shareenjoyment, interests, or achievements

with other people (joint attention) Lack of social or emotional reciprocity


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Behavior

Preoccupation with an activity orinterest that is abnormal either in

intensity or focus

Inflexible adherence to nonfunctionalroutines or rituals

Repetitive or stereotyped movements

(e.g., hand flapping) Persistent preoccupation with parts of

objects


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Treatment

Goals

Minimize core features and associated deficits

Maximize functional independence

Alleviate family stress


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Speech and language therapy

Redesign of education pattern

Educate the parents/ guardian/

siblings

Conduct applied behavioral analysis

(ABA) and treat according to the score

ABA : It is the repetitive use of positivereinforcement to teach specific skills and

decrease inappropriate behaviors.


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Son-Rise Program encourages providers and parents to teach with

enthusiasm and to employ a non-judgementalattitude.

floor time treatment Floor Time is simply the idea that a childs

communication skills can be improved bybuilding on his/her strengths while playingtogether on the floor.

Pivotal Response Treatment

to teach language, decrease inappropriatebehaviors, and increase social skills andacademics.


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Symptoms/ Disorders Freq TreatmentsAttentional, impulsivity,hyperactivity

59% Behavioral interventionPsychopharmacotherapy stimulants, atomoxetine,

alpha agonists, anti-anxiety

Anxiety 43-84% Behavioral treatment relaxation, cognitive

Psychopharmacotherapy SSRI, alpha agonist

Depression 2-30% Psychotherapy

Medication anti-depressants

Obsessive compulsive

symptoms

37% Behavioral treatment, supportive counseling;

Medication SSRI, others

Disruptive, irritable or

aggressive behavior

8-32% Behavioral intervention

Medication atypical neuroleptics (risperidone,

arapiprazole, others)

Self-injurious behavior 34% Behavioral intervention

Medication (e.g., naltrexone, risperidone, others)

Tics 8-10% Medications; Alpha agonist (clonidine, guanfacine),

others

Sleep disruption 52-73% Sleep diary; sleep hygiene; behavioral supports;

investigate possible medical comorbidity/ies as

cause(s)

Psychopharmacology

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Final Autism Ppt

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