HP 252 - Autism/Developmental Disabilities in Early Childhood

Developmental Disabilities

umbrella term including intellectual disabilities & others that have effect on person’s ability to independently complete major life activities in 3 or more areas

Types of Developmental Disabilities (4)

1. Intellectual Disability (most common)

2. Cerebral Palsy

3. Autism

4. Others: ADHD, Down syndrome, Expressive Language Disorder, Fragile X syndrome, Hearing Loss, Learning Disabilities, Neural Tube Defects, Seizure Disorders, Tourette syndrome, Visual impairment…

Causes of developmental disabilities

• genetic factors

• prenatal factors

Intellectual Disabilities

significant limitations in both intellectual functioning & adaptive behavior

Types of Intellectual Disabilities

1. Down syndrome

2. Fragile X syndrome

3. FASD

4. PKU

5. Klinefelter syndrome

6. Prader-Willi syndrome

3 Causes of intellectual disabilities

1. Genetic cause

2. External trauma/toxins (teratogens)

3. Unknown

Difference between DD & ID

DD diagnosed before 22 & from functional limitations in 3 or more major life activities while ID diagnosed before 18 & IQ score less than 70

Major life activities that can be impacted by developmental disabilities (7)

1. Self Care – can they bathe themselves? (daily living activities)

2. Learning – school

3. Receptive & Expressive Communication – can’t communicate their needs

4. Mobility – can they move around?

5. Self-Direction – can they obtain a specific career? (designing support/services they want in their lives

6. Capacity for Independent Living – being able to live on their own

7. Economic Self-Sufficiency – capacity to sustain work & understand finances

What are examples of intellectual disabilities? (6)

Down syndrome, fragile X syndrome, FASD, PKU, Klinefelter syndrome, Prader-Willi syndrome

Cause & General Traits of Down syndrome

1. Cause — most commonly occurring chromosomal condition

2. General traits —

3. Low muscle tone

   Small stature

   Upward slant to eyes

   Single deep crease across palm center

   Mild to moderate ID range

Cause & General Traits of Fragile X syndrome

1. Cause — FMR1 gene on X chromosome doesn’t make protein needed for normal brain development

2. General Traits — Large ears

   Elongated Facial appearance

   Flexible joints

   Flat Feet

   Macroorchidism (testicular enlargement)

   Social anxiety & avoidance

   ID may worsen w/ age

   Learning difficulties

   Speech delay

Cause & General Traits of Fetal Alcohol Spectrum Disorder

1. Cause — exposure to alcohol

2. General Traits — ID

Sleep Disturbances

Motor dysfunctions

Problems w/ attention & hyperactivity

Hyper irritability

Aggression

Conduct problems

Cause & General Traits of Phenylketonuria (PKU)

1. Cause — Born without enzyme needed to break down amino acid phenylalanine to tyrosine resulting in brain damage & physical disabilities (genetically inhibited metabolic disorder)

2. General Traits — Severe ID

Aggressiveness

Hyperactivity

Cause & General Traits of Klinefelter syndrome (47-XXY)

1. Cause — chromosomal condition affecting male physical & cognitive development + born with at least 1 extra X chromosome

2. General Traits — Sterility

Underdevelopment of male sex organs

Abnormal body proportions

Less body hair

Tall height

Gynecomastia (breast development)

Mild ID

Problems in social skills, auditory perception, language

Cause & General Traits of Prader-Willi syndrome

1. Cause — most commonly known genetic cause of obesity (chronic hunger w/ lower metabolism; deletion of portion of chromosome 15)

2. Genetic Traits — Small hands & feet

   Short stature (if not treated w/ growth hormone)

   Incomplete sexual development

   Mild ID

   Learning difficulty

   Impulsivity

   Aggressiveness

   Temper Tantrums

   Obsessive-compulsive behavior (skin picking)

   Delayed Motor skills

Autism & Diagnostic Criteria (4)

A: persistent deficits in social communication & social interaction across contexts

B: restricted, repetitive patterns of behavior, interests, or activities as manifested by at least 2/4 symptoms

C: symptoms present in early childhood

D: symptoms together limit & impair everyday functioning

What’s the difference between DSM-IV & DSM-5?

• DSM IV – category of pervasive developmental disorders including autism, aspergers and & PDD

• DSM-5 – aspergers & PDD grouped as autism

Difference between medical & social model of autism

1. Medical — fitting individuals into symptom categories

2. Social — strengths based

What are examples of social model of autism?

Preference for solitary, predictable, play

May not respond to verbal cues

Strengths in processing visual info

Difficulty w/ abstract concepts

Develops speech later

Challenges w/ eye contact

Difficulty expressing needs + emotions

Repetition in language or movement

Characteristics vary widely

Echolalia

Person repeats word or phrases that they hear others say (functional or unintentional (shown in 75% of verbal autistic individuals)

What’s the difference between immediate & delayed echolalia?

• Immediate — repeats what is just heart

• Delayed — repeats something heard in past from long-term memory retrieval

What are early signs of ASD? (5)

1. Lack of eye contact

2. Lack of joint attention

3. Lack of reciprocal conversation (delayed babbling)

4. Atypical sensory/motor processing

5. Other signs – Sleep disturbance, feeding problems, preference for consistency, focus on objects, reluctance to share activities with others, fascination with sensory experiences, failure to imitate others’ actions

General trends in autism over time & prevalence rates by sex

Higher rates in boys & black individuals

Why are there higher rates of autism? (4)

Higher rates now due to….

• Broader diagnostic criteria – more people fall into category

• Greater awareness of diagnostic criteria – more people seek out diagnosis

• Improved diagnostic practices

• Misinterpretation of IDEA Child Count data – autism not a category