ASD (Autism Spectrum Disorder)

Spectrum

It depicts category or level.

Autism Spectrum Disorder

1. High-Functioning Autism

2. Autism

3. Severe Autism

Level 1: High-Functioning Autism

Needs support. Patient’s social and communication skills and repetitive behaviors are only noticeable without support.

Hindi mo ito agad mapapansin lalo na kung hindi mo nasubaybayan yung milestones ng isang individual.

Level 2: Autism

Needs substantial support. Patient’s social and communication skills and repetitive behaviors are still obvious to the causal observer, even with support in place.

Level 3: Severe Autism

Needs very substantial support. Patient’s social and communication skills and repetitive behaviors severely impair daily life.

Kailangan talaga ng monitoring at kasa-kasama palagi.

Autism Spectrum Disorder (ASD)

It is characterized by persistent deficits in social communication and social interaction across multiple contexts, including deficits in social reciprocity (kapag tinawag mo yung pangalan niya is lilingon siya sayo), nonverbal communicative behaviors used for social interaction (kapag nagtaas ka ng kilay is matic dapat alam niya na ang ibig sabihin), and skills in developing, maintaining, and understanding relationships.

DIAGNOSTIC CRITERIA (A)

Persistent deficits in social communication and social interaction across multiple contexts, as manifested by all of the following, currently or by history:

1. Deficits in social-emotional reciprocity.

   Example is kapag masaya ang lahat tapos siya parang wala lang.

2. Deficits in nonverbal communicative behaviors used for social interaction.

   Example is kapag yung mother is may pinapakuha sayo at tinuturo nito gamit ang nguso, hindi ito magge-gets ng bata.

3. Deficits in developing, maintaining, and understanding relationships

   Usually early development pa lang ay makakakitaan mo na siya ng mga symptoms.

DIAGNOSTIC CRITERIA (B)

Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history:

1. Stereotyped or repetitive motor movements, use of objects, or speech.

   Example is kapag paulit-ulit niya lang sinasabi yung “LA LA LA” or kapag yung nagha-hand flapping siya.

2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior.

   Example is kapag yung tinuturo mo is hindi niya magets, possible na magtantrums siya for how many minutes.

3. Highly restricted, fixated interests that are abnormal in intensity or focus.

   Example is okay na siya sa panonood ng tv kahit pa 3 hours siyang ganon or isang laruan lang yung hawak-hawak niya sa buong araw — kapag kinuha mo ito ay magtatantrums siya.

4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment.

   Nagkakaroon siya ng certain fixation sa isang object or ayaw niya talaga makita and mahawakan at all yung isang bagay.

DIAGNOSTIC CRITERIA (C)

Symptoms must be present in the early developmental period.

At the age of 2 years old is nakikita mo na yung mga symptoms.

DIAGNOSTIC CRITERIA (D)

Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

DIAGNOSTIC CRITERIA (E)

These disturbances are not better explained by intellectual developmental disorder (intellectual disability) or global developmental delay.

Ibig sabihin yung nakikitang communication skills/social skills ay hindi pasok sa criteria ng IDD and global developmental delay.

6 months

No big smiles or other warm, joyful expressions.

9 months

No back-and-forth sharing of sounds, smiles, or other facial expressions.

12 months

• No consistent rresponse to own name.

• No babbling.

• No back-and-forth gestures, such as pointing, showing, reaching, waving, or three-pronged gaze (e.g., child looks at adult, looks at toy to indicate interest in it, looks back at adults to communicate something about the toy).

16 months

No words.

24 months

No two-word meaningful phrases (without imitating or repeating).

Early Signs of Autism

Any loss of speech or babbling or social skills at any age.

Specifiers:

• Requiring support.

• Requiring substantial support.

• Requiring very substantial support.

• With or without accompanying intellectual impairment.

• With or without accompanying language impairment.

• Associated with a known genetic or other medical condition or environmental factor.

• Associated with a neurodevelopmental, mental, or behavioral problem.

• With catatonia.

  Hindi nagre-respond sa mga tao or environment.

Causes of Autism

• Genetic Factors

• Neurological Causes

Genetic Factors

• no single “autism gene” exists; multiple genes are involved.

• if a child has ASD, the chance of their sibling having ASD is about 15%.

• when a monozygotic twin has autism, the chances are much greater that the other twin will also have autism than is the case with dizygotic twins.

• family members of those with autism are more likely to exhibit autistic-like characteristics at a subclinical level, such as a lack of close friends, a preoccupation with narrow interests, and a preference for routines.

Neurological Causes

• the brain cells of individuals with autism exhibit deficient connectivity that disrupts the cells’ ability to communicate with each other.

• the brains and heads of young children with autism tend to grow suddenly and excessively then followed by a deceleration.

  Maggo-grow/magde-develop, but eventually magde-decline.

• high levels of androgen in their mothers’ amniotic fluid are more likely to exhibit autistic traits as children (extreme male brain).

EDUCATIONAL CONSIDERATIONS

• Applied Behavior Analysis (ABA)

• Instruction in Natural Settings

• Functional Behavioral Assessment (FBA)

• Positive Behavioral Intervention and Support (PBIS)

• Picture Exchange Communication System (PECS)

• Social Stories

• Pivotal Response Teaching (PRT)

• Service Delivery Models

Applied Behavior Analysis (ABA)

• focuses on teaching functional skills and continuous assessment of progress.

• emphasizes positive reinforcement or rewarding of desired behaviors.

Instruction in Natural Settings

• use of the natural interactions by which children normally learn language and other social skills.

Importante sa kanilla na magkaroon ng play stage. For example, a child may pretend to be a doctor or a teacher during playtime.

Functional Behavioral Assessment (FBA)

• involves determining the consequences, antecedents, and setting events that maintain such behaviors.

Positive Behavioral Intervention and Support (PBIS)

• finding ways to support positive behaviors of students rather than punishing negative behaviors.

If ang bata kasi is may ASD, hindi naman nila agad maco-comprehend kung bakit sila pina-punish.

Picture Exchange Communication System (PECS)

• involves the use of pictures to help students initiate and maintain functional communication.

For example kapag pinakita ang pictures ng baso at water — that is their way of communicating na sila ay nauuhaw.

Social Stories

• for students who are more verbal but who have problems with interpreting social cues and interaction.

Pagbabasa ng story book, which may mga kwento na natuturuan sila to say ‘thank you’ and ‘sorry’.

Pivotal Response Teaching (PRT)

• that some skills are critical, or pivotal, for function in other areas such as motivation, self-management, initiations and responding to multiple cues.

Ito yung mga programs and therapies for children with ASD.

Service Delivery Models

• self-contained classroom

  15 or less lang yung kini-cater na students.

• general education classroom

  Kapag nakitaan na kaya na ni student ay pwede na siyang isama sa typical classroom.

• resource rooms

  Eto yung mga facilities and playgrounds.

• residential facilities

  Kapag severe cases ay maaari silang pumasok sa residential facilities.

ASSESSMENT OF PROGRESS

• MacArthur-Bates Communicative Development Inventory Second Edition

• Clinical Evaluation of Language Fundamentals-4

• PDD Behavior Inventory (PDDBI)

• The Social Responsiveness Scale (SRS)

• Autism Social Skills Profile (ASSP)

• The Childhood Autism Rating Scale

MacArthur-Bates Communicative Development Inventory Second Edition

• monitor the progress of language development of very young.

May checklist if naiintindihan niya ba yung specific na nakalagay doon (basic sounds/language).

Clinical Evaluation of Language Fundamentals-4

• measures receptive, expressive, grammatical, and semantic skills for individuals ages 5 to 21.

Checklist and scoring din for language, example is car and shoes — if kaya ba niyang sabihin.

PDD Behavior Inventory (PDDBI)

• designed to monitor progress in social/adaptive behavior of students 2 to 12 years old.

Ito yung ginagamot to see if delay lang ba yung napapansin niya sa anak niya or disorder na.

The Social Responsiveness Scale (SRS)

• evaluates the severity of social impairment of individuals with autism spectrum disorders between the ages of 4 to 18.

To see if saan ba magfa-fall ang kanyang condition — if high-functioning autism, autism, or severe autism ba.

Autism Social Skills Profile (ASSP)

• social skills of children and adolescents with autism spectrum disorder (6-17 years old).

Tinitingnan here how often niya ginagawa yung isang bagay, like if he/she joins activities with peers.

The Childhood Autism Rating Scale

• focuses on behaviors that deviate from children developing typically and is appropriate for children over 2 years old.

Ito yung initial na binibigay if may early symptoms of autism ba ang isang bata.

EARLY INTERVENTION

Early Intensive Behavioral Interventions (EIBI) Program

Here sa Philippines, kailangan niya munang umattend sa therapy school/session, then sila rin yung magre-recommend sa bata if pwede na ba siya mag-enroll sa general education.

Early Intensive Behavioral Interventions (EIBI) Program

• help young children with developmental delays to acquire adaptive and functional skills in the areas of communication, play, and social, emotional, cognitive, and self-help skills.

TRANSITION TO ADULTHOOD

• person-centered planning

• community residential facilities

• supported living settings

• supported competitive employment

person-centered planning

• the person with the disability is encouraged to make their own decisions as much as possible.

Kailangan siya maturuan na magdecide on his/her own since need niya rin matutong tumayo sa sarili niyang mga paa.

community residential facilities

• people with autism are being integrated into the community.

If severe yung condition is kadalasan ganito ang nangyayari.

supported living settings

• own homes or apartments.

Cerebral Cortex

• A thin layer of gray matter on the surface of the cerebral hemispheres. Two-thirds of its area is deep in the fissures or folds. Responsible for the higher mental functions, general movement, perception, and behavioral reactions.

Amygdala

• Responsible for emotional responses, including aggressive behavior.

Hippocampus

• Makes it possible to remember new information and recent events.

Basal Ganglia

• Gray masses deep in the cerebral hemisphere that serve as a connection between the cerebrum and cerebellum. Helps to regulate automatic movement.

Brain Stem

• Located in front of the cerebellum. Serves as a relay station, passing messages between various parts of the body and the cerebral cortex. Primitive functions essential to survival (breathing and heart control) are located here.

Corpus Callosum

• Consists primarily of closely packed bundles of fibers that connect the right and left hemispheres. Allows for communication between the hemispheres.

Cerebellum

• Located at the back of the brain. Fine tunes motor activity. Regulates balance, body movements, coordination, and the muscles used in speaking.

Example of Teaching a Child with ASD

Trial 1:
Pinakita mo kung paano magclap—ginaya niya—sinabihan mo siya ng ‘nice try’.

Trial 2:
Ikaw mismo nagguide sa kamay niya to clap—ginawa niya mag-isa—sinabihan mo siya ng ‘great job’.

Trial 3:
Nung sinabihan mo siya na magclap is nagawa niya na agad ito mag-isa—sinabihan mo siya ng ‘very good clapping’.

Pinapakita lang na kailangan talaga ng mahabang pasensya sa pagtuturo since hindi naman agad mage-gets ng bata yung pinapagawa.

supported competitive employment

Dito sa Philippines is may mga companies na naga-accept ng exceptional inviduals since may batas na nagsasabing hindi tayo pwede magdiscriminate.