Autism spectrum disorder

Autism spectrum disorders

What is Autism???

Task: Write in a sentence, what do you think autism means or is????

Autism spectrum disorder

Autism, also termed autism spectrum disorders or ASDs
is a wide range or spectrum of brain disorders that is usually noticed in young children that decreases the individual's ability to communicate and relate emotionally to others.
The word Autism is derived from the Greek word “auto” which means “self”.
First used by Austrian psychiatrist Leo Kanner in 1943.
Usually appears during the first 3 years of life.

Autism Spectrum Disorder

Autism is neither Mental Retardation nor Mental Illness…
But may come with MR, seizures, cerebral palsy and LD.
A neuro-developmental disorder characterized by
- impaired social interaction,
- verbal and non-verbal communication, &
by - restricted and repetitive behavior.
Occurs about four to five times more often in boys than girls.
This disability may range from mild to severe.

Prevalence

The Center for Disease Control and Prevention (CDC) reports
1.5% of children in United States (one in 68) are diagnosed with ASD as of 2014,
a 30% increase from one in 88 in 2012(CDC, 2014).
There is no exact data in Nepal but Autism Care Nepal Society (ACNS) estimates that there are about 250,000 to 300,000 People with Autism (PWAs) in Nepal (ACNS, 2015).

Prevalence continued.

The flash report by Department of Education indicates out of total school going children about 1% children are with disability
26.6% among them are intellectually disabled.
In country report on Autism Education in Nepal, there is not exact number of students with autism but it is assumed that 14% among the intellectually disabled are with autism (Subedi, n.d).

Signs of Autism

No big smiles or other warm, joyful expressions by 6 months or thereafter
No back-and-forth sharing of sounds, smiles, or other facial expressions by 9 months or thereafter
No babbling by 12 months
No back-and-forth gestures, such as pointing, showing, reaching, or waving by 12 months

Signs of Autism

No words by 16 months
No two-word meaningful phrases (without imitating or repeating) by 24 months
Any loss of speech or babbling or social skills at any age

Early screening and diagnostic tools for Asd

Modified Checklist for Autism in Toddlers (M-CHAT)
Many false positives; follow up with interview
Scientifically validated for children ages 16-30 months old
American Academy of Pediatrics recommends that all children be screened for Autism at 18 and 24 months old.

Diagnosing ASD

Current Tools
Observation—Autism Diagnostic Observation (ADOS)
Developmental History (Parent Report)—Autism Diagnostic Interview-Revised (ADI-R)
Childhood Autism Rating Scale (CARS)
Future
Brain Imaging
Genetic Testing

Spectrum of Autism

According to DSM-V

Social Communication & Interaction-
Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:
Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction

Social Communication & Interaction – (continued)

Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures
Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of interest in people

Behaviors, Interests, Activities —

Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).

Behaviors, Interests, Activities (continued)

Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

Additional Diagnostic Criteria—

Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities).
Symptoms together limit and impair everyday functioning.

Management approaches

Family counseling and support
Several behavioral intervention such as-
ABA (Applied Behavior Analysis),
BMT or BT (Behavior Modification Techniques or Behavior Therapy),
VBA (Verbal Behavior Analysis) for language development and communication
TEACCH (Treatment and Education for Autistic and Communication related handicapped CHildren)

Management approaches contd…

Sensory stimulation and integration
PECS (Picture Exchange Communication System)
Structured teaching
Teaching life skills, vocational skills
Bio-medical treatment
Occupational Therapy
Social stories
Music and Art therapy

Environmental adaptation
Making use of visual and gestural communication such as PECS, symbols, sign language etc.
Limiting noise and visual stimuli
Making use of visually bare work spaces and physical barriers to separate work and play areas
Using small groups for instruction
Developmental, Individual-differences, & Relationship-based model (DIR)
Individual Education Plan (IEP)

about autism: fact or myth???

Caused by “cold” refrigerator mothers.
Children with eye contact do not have Autism.
Children who are “social” do not have Autism.
All people with Autism have extraordinary skills.
People with Autism just need love to get better.
People with Autism just need more discipline to get better.
Autism can be outgrown.
There is a cure for Autism.

Facts about autism/ASD

Multiple causes of autism: A genetic predisposition with something in the environment that triggers it.
Genetic
Environmental
Every child is unique.
Children with autism are not indiscipline.
It can be compared with a culture.
Autism can take emotional and financial toll on families.
Blue color symbolize Autism.
April is Autism Awareness month and 2nd April is World Autism Awareness Day.

Thank you