Week 1

ableism

discrimination or prejudice against individuals with disabilities

person-first language

believes people are people first; they may have a disorder, but the disorder doesn’t define them; “person with autism”

identity first language

believe autism is part of who they are; it isn’t something to be ashamed of

1 in 31

what is the prevalence of autism according to the 2022 CDC?

boys (1 in 20) compared to 1 in 93 girls

is autism more common in boys or girls?

9-18-24-30

screening for autism for all children during wellness visits of ages ___ months

Modified Checklist for Autism in Toddlers (M-CHAT and M-CHAT-F)

what is the most common screening practice that physicians use with children 16 to 30 months when they use an autism specific screening?

-20

-5-10

-social interaction, communication, play

M-CHAT consists of a ___ item questionnaire that parents can complete in ___; questions focus on various aspects of a child’s behavior, including ___

-less

-fail

-diverse and rural

screening practices:

-the younger the ___ sensitive

-people with sensory impairments were more likely to ___

-not internally consistent among ___ families

-health, developmental, behavior

-physical

-developmental and psychological

-DSM-5

-parent

-comorbid

diagnostics guidlines (AAP):

-general ___ history

-___ examination

-___ evaluation

-___ criteria

-___ understanding

-lab of any ___ conditions suspected

-genetic testing

-selective metabolic testing

-EEG

diagnositic guidelines for additional evals if warrented:

-___ if intellectual challenges suspected for family history

-___ if lethargy, cyclic vomiting, early seizures, or dysmorphic features

-___ is seizures suspected

-name

-interest or joint attention

-symbolic play

-Systematic Observation of Red Flags (SORF)

what are early indicators of autism:

-inconsistent response to ___ (most robust)

-failure to show ___ for pleasure of connection with another

-failure to demonstrate ___

-great tool =

Communication and Symbolic Behavior Scales-Developmental Profile (CSBS-DP)

which screening tool is used for infants and toddlers with a functional communication age of 6 to 24 months?

a team including a physician (psychiatrist, developmental pediatrician, pediatric neurologist), clinical psychologist, SLP, behavior specialist, and social worker

who are the professionals typically qualified to diagnose autism?

autism

a neurodevelopmental disorder caused by interactions or mutations of many genes affecting genetic coding during development; changes exist at birth and occur on a continuum

-restricted, repetitive patterns of behavior, interests, or activities

-social communications

what are the two major parts of the DSM-5 diagnostic checklist?

you must have all three characteristics in Social Communication and at least two characteristics in Restricted/Repetitive patterns

according to the DSM-5, how many characteristics are required in each of the two major categories for a diagnosis?

restricted, repetitive patterns of behavior, interests, or activities

-repeating or nonfunctional use of motor movements (rocking, head banging, hand flapping), speech (repeating memorized speech or repeating things over and over), or objects (lining up, spinning wheels)

-needing routines more than normal, using speech in odd ways, insisting on sameness, trouble with change

-strong focus on interest that is abnormal in intensity or focus, sometimes ignoring other things

-different reactions to sensory input (visual, hearing, touch, taste, knowledge of body in space); this can be sensitivity or lack of reaction or both

social communication

-challenges in developing social and emotional relationships (joint attention, expressing feelings, two-way interactions)

-challenges in nonverbal communicative behaviors used for social interaction (understanding and using gestures and facial expressions)

-challenges in developing and maintaining relationships, appropriate to developmental level and beyond those with caregivers

severity

judged by how much support is needed in either social communication or behavior/interests that interfere with independent function (requiring minimal support, requiring substantial support, and requiring very substantial support)

-minimal

-substantial

-very substantial

3 levels of support:

-i’m not immediately identified as “different'“ = ___

-people usually recognize a difference in me = ___

-people recognize a difference upon sight = ___

broadly affected autism

defined by developmental delays, difficulty not only with social interaction but broader communication issues; has repetitive behaviors that are pervasive; about 10% of autistic group

mixed autism with developmental delay

defined by developmental delays and social/repetitive behaviors; anxiety, depression, and disruptive behaviors mild or absent; lot of variation due to presentation of social/repetitive behaviors being individualized; about 19% of autistic group

moderate challenges autism

defined by basic characteristics (social communication/restrictive interests) but in more subtle ways and developmental delays were absent; about 33% of autistic group

social and/or behavioral autism

defined by developmental milestones met but later on struggle with ADHD, anxiety, depression, or OCD; about 37% of autistic group

asperger’s disorder

term used for children with autism who do well on intellectual testing; no longer a diagnosis but can be added to the description

-Autism Diagnostic Observation Schedule (ADOS)

-Autism Diagnostic Interview-Revised (ADI-R)

what are the "Gold Standard" diagnostic tools for autism?

-2-12

-40 mins

-90%

-80-90%

Autism Diagnostic Observation Schedule (ADOS):

-ages ___

-administration about ___

-sensitivity in uper ___

-specificity in upper ___ to lower ___ range

-2 1/2hr

-research

-trained

-96%

-92%

Autism Diagnostic Interview-Revised (ADI-R):

-administration about ___

-mostly used in ___

-must be ___

-sensitivity = ___

-specificity = ___

social (pragmatic) communication disorder (SPCD)

persistent difficulties with the use of verbal and nonverbal language for social purposes; social communication without repetitive characteristics

specific language impairment

many children with ASD have this in addition to SPCD, but children don’t have the gesture and joint attention issues nor the repetitive behaviors

obsessive-compulsive disorder (OCD)

uncontrollable, recurring thoughts and repetitive behaviors that consume significant time; often part of the repetitive behaviors found in ASD but part of that diagnosis; have typical language and social disorders

attention deficit/hyperactivity disorder (ADHD)

differentiate between focus on narrow restricted interests and focus on other things; co-occurence frequent

schizophrenia

childhood onset doesnt occur until ages 7-12; adult onset extremely unusual; ASD sometimes thought as part of a continuum but less in later years

fragile X syndrome

genetic condition, developmental problems (learning disabilities, cognitive impairment, ADHD, anxiety, impulsiveness, sleep problems) 1 in 4000 males; 1 in 8000 females

langau kleffner

begins between 2 and 8yo, progressive loss of language abilities after normal development, seizures in 3 out of 4 kids, many during sleep; boys and girls are equally affected

prader willi syndrome

genetic chromosomal disorder syndrome, physical, mental, and behavioral problems, constant hunger (hyperphagia)

rett syndrome

genetic disorder, present at birth, slowed growth, jerky limb movement, communication delay or loss, agitation, irritability, seizures, scoliosis, muscle stiffness, small head, deterioration; mostly in females

williams syndrome

genetic disorder, elfin facial features, ADHD, lack or delay in communication, fairly normal life span

angelman syndrome

genetic disorder, developmental disabilities, neurological problems, smile and laugh frequently, have happy, excitable personalities

-problems with genetic code development

-brain development differences

-some structural and functional differences

-cognitive and neurological differences

-behavior differences

neurological overview:

-___ = many genes involves; many parts of the brain involved particularly frontal, anterior temporal and cerebellum

-___ = neuronal migration is disrupted; accelerated growth of white matter

-___ = different growth patterns; increased columns with smaller cell bodies

-___ = language areas are not well synchronized; less connections; reading at lower cortical level

-___ = the effects of autism are occurring before behavior is seen; the way the brain responds to environment is altered; early detection is so important

1. structural changes in the brain

2. neural connectivity disruption

3. dysregulation in neurotransmitters

4. familial inheritance patterns

5. gene and environment interactions

what five biological/neurological changes are associated with autism?

pervasive developmental disorder

what major diagnostic umbrella term was replaces by ASD in the DSM-5?

asperger’s disorder, pervasive developmental disorder, and childhood disintegrative disorder

which specific subtypes were eliminated and absorbed into the single diagnosis of ASD in the DSM-5?

traditional behavioral approach

practitioners teach skills one-to-one with a predetermined correct response and a highly prescribed teaching structure (high structure, adult-led, repetitive trials)

social-pragmatic developmental approach

interventionist follows the child’s lead, fosters initiation and spontaneity, and reinforces contingent responses

contemporary behavioral interventions

gives children choices, provides shared teaching opportunities between interventionist and child, and incorporates the child’s preferred activities and materials

1) Individualized supports/services, 2) Systematic instruction, 3) Structured learning environments, 4) Specialized curriculum content, 5) Functional approach to problem behavior, and 6) Family involvement

list the six key educational practices identified for school-age children with ASD

National Autism Center (NAC) National Standards Project (NSP)

what major project evaluates the effectiveness of ASD interventions?

established (proven effective), emerging (some evidence), and unestablished (little to no evidence)

what are the three categories of evidence defined by the National Standards Project?