Autism Spectrum disorder

prevalence of autism in children

About 1 in 44 children has been identified with autism spectrum disorder (ASD) in 2021

demographics

occurs in all racial, ethnic, and socioe=conomic groups, more common in boys than in girls

3 hypothoses about etiology

1. genetic

2. prenatal

3. combo of genetic and environemntal factors

genetic etilogy

• genetic susceptibility for autism

• more common in boys than girls

prenatal etiology

Low birth weight, maternal smoking, maternal age >35, paternal age >40

food allergy etiology

• Many children with ASD have food sensitivities/allergies that may exacerbate symptoms

ASD and the brain

Abnormalities in neural networking between areas of the brian

• Larger head size and brain volume at 3-4 years

• Reduced activation of the frontla lobe

• Amygdala and hippocampus abnormalities (limbic system)

• Cerebrallar dysfunction

how does the limbic system affect ASD

• Abnormal in persons with ASD- reduced volume in amygdala in MRI studies, enlarged hippocampus (which regulates emotions and fear)

cerebellum cells important to ASD

purkinje celss- receives sensory info from brain and spinal cord and relays them to the cerebellum

purkinje fibers in ASD

postmortem brains show increase in purkinje fibers, but fewer neuronal connections.

these have a role in sensory discrimination, attention, and emotions

method of diagnsosis

• by developmental pediatrician, neurologist or child psychology

• onset before age 3

• based on screening tools as well as parent report

3 main diagnostic tools

• Autism diagnostic observation schedule gold standard

• Autism diagnostic interview-revised

• Gilliam autism rating scale (GARS)

DSM V ASD

the criteria will incorporate several disagnoses from DSM-IV including autistic disorder, asperger's disorder, childhood disintegrative disorder and PDD_NOS into the diagnosis of autism spectrum disorder for DSM 5 to help more accurately and consistently diagnose children with autism

domains of ASD DSMV

• social communication and intervention

• restricted interest and repetitive behaviors

levels of securtiy ASD

• Requiring support

• Requiring substantial support

• Requiring very substantial support

level 1 autism

• needs support

• patients social and communication skills and repetive behaviors are only noticeable without support

level 2 autism

need substantial support patient’s social and communication skills and repetive behaviors are still obvious to the causal observer, even with support in place

level 3 autism

needs very substantial suport. patients social and communication skills and repetitive behaviors severly impair every day life

ASD and intellecutal ability

IQ can range from profound intellectual disability to genius

ASD learning style

1. more concrete

2. mental snapshots represent eent

3. difficult to understand chagnes

2 differential diagnoses

childhood disintegrative disorder and rhett’s syndrome

childhood disintegrative disorder

marked by normal development until age 3-4, loss of bowel/bladder control, potential seizures, low IQ

characteristic s of hellers syndrom

has features of autism but represents with global developmental deficts and follows regression after typical development

rhetts syndrom

normal development until 6-18 months, decline in social interaction, speech. Develops hand wringings, loss of LE control

• predominantly female

role of OT- early intervention

• Early Intervention: Ideal from 0-3 years of age.

• Evaluation: Assess performance skills, limitations, and participation in play, ADLs, and school tasks.

• Direct Intervention: Providing hands-on therapy.

• Consultation/Education: Train caregivers, teachers, etc., in developmentally supportive play and activities to enhance social interaction and communication.

Role of OT- adaptability and menaingful interventions

• Foster Adaptability:

  • Develop strategies for transitions (settings, people, life phases).

  • Collaborate with family and individual to identify safe community mobility methods.

• Meaningful Activities: Identify, develop, or adapt daily activities and work tasks to enhance the individual’s quality of life.

what should OT in adults focus on

1. the individuals’s unique abilities. and limitations

2. access to services

3. quality of services

cranio-sacral therapy

based on belief that children may have experienced birth trauma and this therapy can restore normal bone motion and fluid circulation therefore improving CNS function