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Autism

• complex neurobehavioral condition that includes impairments in social interaction and developmental language and communication skills combined with rigid, repetitive behaviors.

• result of a neurological disorder that has an effect on normal brain function, affecting development of the person's communication and social interaction skills

• Social communication & Social interaction

• Social imagination & Flexibility of thought

• Restricted, repetitive interests or activities

• Restricted, repetitive patterns of behavior

• Unusual sensory responses

Autistic people have differences in what following areas? (5)

Epidemiology

• Every 20 minutes, a child is diagnosed

• Autism affects four times as many boys as girls

• An estimated 50,000 children and 150,000 adults in Canada have autism

• The diagnosis rate in North America is currently 1 in 88 children

Prevalence of Autism in the Philippines

• According to the Autism Society of the Philippines, the country has a prevalence of 1 in every 100 individuals.

• Approximately 1.2 million Filipinos are living with autism

• Causes of Autism

• inherited genetically

• result of environmental toxins (heavy metals, chemicals, pesticides, viruses)

MRI studies

• rapid overgrowth in the first year and minimal growth after age 2 until approx. age 4 and lack of overgrowth

Frontal Cortex

• rapid overgrowth until age 4 (cognitive language functions, social-emotional processing)

Visual Cortex

Relatively intact

• Advanced parental age at the time of conception

• Prenatal exposure to air pollution or specific pesticides

• Maternal conditions such as obesity, diabetes, or immune system disorders

• Extreme prematurity or very ow birth weight

• Birth complications that result in periods of oxygen depriva

What are the 5 Environmental Factors that may be associated with Autism?

Possible signs of Autism in Babies and Toddlers

• By 6 months, no social smiles or other warm, joyful expressions directed at people

• By 6 months, limited or no eye contact

• By 9 months, no sharing of vocal sounds, smiles or other nonverbal communication

• By 12 months, no babbling

• By 12 months, no use of gestures to communicate (e.g. pointing,

• reaching, waving etc.)

• By 12 months, no response to name when called

• By 16 months, no words

• By 24 months, no meaningful, two-word phrases

• Any loss of any previously acquired speech, babbling or social skills

Red Flags

• Does not babble or coo by 12 months

• Does not gesture (point, wave, grasp) by 12 months

• Does not say single words by 16 months

• Does not say two-word phrases on his or her own by 24 months

• Has any loss of any language or social skill at any age

Early signs of Autism

• No babbling or pointing by 12 months

• Doesn’t like to be cuddled

• Not responding to sounds, voices, or name

• Avoids eye contact & doesn’t smile back

• Doesn’t show any sharing interest

• No two-word phrases by 24 months

• Tendency to stare at lights, ceiling fans or hands

• Spins or lines object or self

Poor Social Communication and Social Interaction (ASD)

• Usually quiet and alone

• Lack social reciprocity

• Lost in their own world

• Reduced eye contact and lack facial expression

• Lack of response to their name

• Does not express feelings and emotions.

• Appear unaware of others feelings

• Abnormal tone and rhythm (singing or robot like voice)

• Fails to respond and appears not to hear you

• Resists cuddling and holding

• Prefers solitary activities and plays alone

• Inability to start or sustain the communication

• Inability to use or understand social cues

Restricted and Repetitive Patterns of Behaviors, Interests, or Activities

Repetitive movements such as spinning, rocking, or hand flapping

Get disturbed with changes in routine or environment

Indifferent to pain and temperature

Fixation to an object, toy or activity

Has specific food preference

Problems with coordinated movements

Impacts on Day to Day Life

• Often find these difficult to understand

• May be perceived as rude because they avoid eye contact

• Their tone of voice may not always reflect the way they are feeling

• May not be able to use gestures or interpret other people’s gestures

• May interpret language literally and so may misunderstand idioms

• May fins it difficult to instigate or join in play with other children

• May find it difficult to tale turns and share; Can cause problems with friendships

• May not engage in conversation in the same way and enjoy discussing factual issues rather than small talk; Have to be specific when you want to bring the convo to end

• May have difficulty in understanding the rules of social relationships; May cause many issues including them offering truthful opinion rather than a tactful one

1. tactile

2. vestibular

3. proprioceptive

4. visual

5. auditory

6. olfactory

7. gustatory

What are the 7 Unusual Sensory Responses?

Unusual Sensory Response Impacts on day to day life

• Sensory joy from certain colors

• Sensory joy from the feel of certain materials - “stimming”

• Decreased feelings of pain

• Sensitivity to lighting in shops

• Dislike of certain colors

• Difficulties around noisy traffic

• Inability to tolerate certain smells

• Distress/ anxiety in busy environments

• Sensitivity to touch

1. Asperger’s Disorder

2. Kanner’s Syndrome

3. Pervasive Development Disorder

4. Rett’s Syndrome

5. Childhood Disintegrative Disorder

What are the 5 types of Autism Spectrum Disorders?

Asperger’s Syndrome

• Children are unskilled in communication and any type of social interaction.

• Carry repetitive motions and are fixated on patterns of all types.

• Often clumsy due to their under developed motor skills.

• They carry a talent that they focus specifically on and are thought to be very skilled at.

• It is claimed that Albert Einstein may have carried this characteristic

Asperger’s Syndrome

Most common type of Autism?

Asperger’s Syndrome

What is usually misdiagnosed as Obsessive-Compulsive Disorder and Attention Deficit Disorder?

Classic Autistic Disorder

Kanner’s Sydrome AKA what?

Kanner’s Syndrome

Named after Dr. Leo Kanner who described and studied it in the 1930s – 40s.

• Carry very limited emotional connection with anyone.

• Very routine-based – wants everything to be the same including: clothing, food, music, and TV shows.

• Deeply affected by noise, bright lights and smells.

• Generally considered to be low-functioning, but how well their mind works is unknown due to their poor social and communication skills

Pervasive Development Disorder

• Used to describe children who have most of the same symptoms as classic autism.

• They require the same interventions and treatments.

• Differences between PDD-NOS and autism are minor. Only doctors and researchers are able to differentiate

Rett’s Syndrome

Rare type of autism and appears to only happen to girls.

First discovered by Dr. Rett.

Patients often have muscle atrophy and carry repetitive hand motions.

Very low-functioning and will require care for most of their lives.

This type of autism has been diagnosed since the 60s, but in the 1990s, the gene that was said to have caused this condition was found

Childhood Disintegrative Disorder

• Very rare and strikes children who appear to have normal development from birth.

• Changes usually take place between 2-4 years of age.

• Do not potty train, will lose the ability to interact with other children and will lose

• interest in play.

• They will regress and eventually lose the motor skills they had once mastered.

• Communication skills will disappear and will even stop talking at one point

Developmental Screening & Comprehensive Diagnostic Evaluation

Two steps in diagnosing ASD?

Developmental Screening

All children should be screened for developmental delays and disabilities during regular well-child doctor visits at:

• 9 months

• 18 months

• 24 or 30 months

Additional screening might be needed if a child is at high risk for developmental problems due to preterm birth, low birth weight or other reason

In addition, all children should be screened specifically for ASD during regular well-child doctor visits at:

• 18 months

• 24 months

Additional screening might be needed if a child is at high risk for ASD (e.g., having a sister, brother or other family member with an ASD) or if behaviors sometimes associated with ASD are present

Comprehensive Diagnostic Evaluation

• Developmental Pediatricians (doctors who have special training in child development and children with special needs)

• Child Neurologists (doctors who work on the brain, spine, and nerves)

• Child Psychologists or Psychiatrists (doctors who know about the human mind)

• General Clinical Management

• Early Interventions

• Behavioral and Developmental Interventions

• Pharmacological Treatment Options

Treatment/ Management for Autism? (4)

Applied Behavior Analysis & Verbal Behavior Therapy

Two types of Behavioral Therapies?

Applied Behavior Analysis

teaches play, communication, self-care, academic and social living skills, and reduces problematic behavior

Verbal Behavior Therapy

seeks to move children beyond labeling, a first step of learning language, and gesturing to vocalizing their requests – “I want a cookie.”

Cognitive Behavioral Therapy

focus more on developing skills a child already has and working on their deficiencies

Developmental and Individual Differences Relationship

(also called Floortime) motivation to engage and interact with others.

The therapist follows a child’s lead in working on new skills

Relationship Development Intervention

breaks its various objectives down into step-by-step paths adults use to prompt development, such as building eye contact or back- and-forth communication.

Treatment and Education of Autistic and Related Communication Handicapped Children

is a classroom-based program that customizes academic instruction and social development to a child’s strengths.

Social Skill Groups

help children engage in pragmatic language and manage real-world difficulties with peers

Various Forms of the Therapy

Music Therapy

Auditory Therapy

Vitamin/Mineral Therapy

Holding Therapy

Daily Life Therapy

Picture Exchange Communication System (PECS)

Speech –Language Therapy

Occupational Therapy

Swimming Therapy

Animal Therapy

Ways to help

Being aware of Autism and the differences experienced by autistic people is key.

Ask the autistic person, carers or seek advice from others

Be understanding, people with autism have a lot to offer but may need support.

Consider how you can adapt the environment to decrease sensory issues (decrease noise, dim lighting, find a quiet space etc.)

Adapt your communication style

Communication

Speak slowly and clearly

Don’t use idioms or metaphors

Allow time for the person to process information

Keep instructions short

Avoid relying on gesture, facial expression or tone of voice