autism dr - autism

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  • 1. Autism Dr. Kline FSU-PC

2. What is Autism? A disorder largely characterized by deficits in social interaction. Symptoms of disorder & as well as its severity differ from child to child. 3. Symptoms of Autism 1. Failure to Develop Normal Socialization: Hallmark of autism is the inability of child with this disorder to develop normal social skills. -Do not interact with others like normal kids, if they interact at all -Seem to prefer their own company -Have difficulty expressing/showing emotion -few signs of normal attachment -Avoid eye contact with otherseven caregivers -They dont notice & respond to normal social cues produced by others (a smile, nod, wave, etc.) -May use others like tools to get what they want (leading you by the hand to the frig for food, water). 4. 2. Disturbances in speech, language, & communication A profound problem, children with autism are usually late to talk or regress after what looks like normal speech development (40% dont talk at all). Many that talk, echo others around them, show little spontaneous speech. Improper use of pronouns (saying you instead of I. Speech may not be for communication, but for self stimulation. When speaking, often its impaired in social interactions (may stand to close to others when talking, may fail to recognize topic is over, etc.) Speech may be flat/monotone with no intonation. 5. 3. Abnormal Relationships to Objects & Events: Children with autism usually do not play with toys the way the toys are intended to be played with (child may lift toy car upside down & spin wheels). Routines are important to kids with autism, objects may need to be displayed in a familiar placement. There may be no pretend play or it may be very rudimentary focusing on one object. Good news-ABA can teach these kids to play with objects appropriately & to develop some pretend play. 6. 4. Abnormal Responses to Sensory Stimulation Unlike normal individuals, autistic children have difficulty filtering out extraneous stimuli from their environment (sounds, lights, and skin sensations may be overwhelming for them). --kids may throw tantrums to sounds, or try to repeat sounds as if enthralled with them. --certain tactile sensations may be perceived as painful or itchy to the skin (tactile aversions). Young autistic children appear to use senses of smell & taste, more than auditory or visual modalities to explore their world. --Pain thresholds will vary, being very insensitive one minute to vary sensitive the next. 7. 5. Developmental Delays & Differences: Rate of development in communication, social, & mental processes is varied & almost nearly always delayed compared to normal children. --Interestingly, motor development (ability to use hands, to craw, walk, & run, climb stairs, manipulate objects, may be only slightly delayed if at all. Sequence of development in any of these domains may be unusual (child may be able to read or say complex words torch, but have no understanding of the individual vowel & consonant sounds). 8. 6. Onset of disorder Autism begins in infancy or early childhood. It is generally believed to be a lifelong disorder that a child is born with. Although parents may get a firm diagnosis by 36 mos., it is usually common for such a diagnosis to occur later. 9. Types of Autism: The symptoms of autism are categorized under a broad diagnostic rubric called Pervasive Developmental Disorders or PDD. According to the DSM-IV, PDD includes the following conditions: Autistic Disorder Aspergers Disorder Retts Disorder Childhood Disintegrative Disorder (CDD) Pervasive Developmental Disorder: Not Otherwise Specified (PDD:NOS) 10. Regardless of which type of PDD a child has the 3 primary symptoms they all share are: 1. Impaired social interaction 2. Impaired communication 3. Characteristic behavior patterns (stereotyped behaviors, etc.) 11. How do you know which type of PDD a child has? The specific type of PDD a child has is determined by: *when the symptoms began to appear *how quickly or slowly the symptoms appeared *the severity of the symptoms *the exact nature or character of the symptoms The conditions that fall under the umbrella category of PDD are called, Autistic Spectrum Disorders. 12. Autistic Disorder Three major symptoms of PDD: 1. Impaired social interaction- child may live in own world May not seek out company of others May relate to parents & family as objects or tools 13. 2. Impaired Communication Does not communicate with others often or does so in unusual/non-typical ways. *May answer a question with a question. *May invent words or phrases for things. *When they do communicate, they often try to bring conversation to a topic (s) they can relate to & understand. * Are very unaware of other persons lack of interest in their favorite topics of conversation. 14. 3. Repetitive, Stereotypic, or Odd Patterns of Behavior, Unusual Interests, or Responses to the Environment. Kids with autism have intense interests & preferences that are different from typical children. Many prefer the predictability of routines. They like structure. May show odd stereotyped behaviors in response to distressing events (hand flapping, self stimulation with verbal play). 15. Making an Autistic Disorder Diagnosis Frequently used criteria to make a diagnosis are: Absence or impairment of imaginative and social play Impaired ability to make friends with peers Impaired ability to initiate or sustain a conversation with others Stereotyped, repetitive, or unusual use of language Restricted patterns of interests that are abnormal in intensity or focus Apparently inflexible adherence to specific routines or rituals Preoccupation with parts of objects 16. Aspergers Disorder: In 1944, Dr. Hans Asperger described a group of 4 children ages 6-11 with typical communication & cognitive skills, but who had significant problems with social interactions. Several symptoms were observed from these children. 17. Symptoms of Aspergers Disorder *intense, but very narrow interests. *speech that was unrelated to the conversations topic *interest in letters & numbers at a very young age. *poor empathy. *clumsiness *difficulty controlling volume of voice when speaking *trouble adjusting to school. 18. How is Aspergers Disorder different from Autistic Disorder? 1. Children with Aspergers dont have the same level of communication problems that kids with autistic disorder do. Nearly all kids with Aspergers develop speech & language skills roughly when typical children do. 2. Arent diagnosed until much later than kids with autistic disorder, since speech isnt usually delayed. 19. 3. Children with Aspergers usually dont score in range of mental retardation compared with many autistic kids who do. 4. Kids with Aspergers have verbal abilities (vocabulary, facts) that are generally better than their non-verbal abilities. This is the reverse for kids with Autistic Disorder. 5. Socially, kids with Aspergers have interest in other people, compared with the solitary existence of most kids with autistic disorder. 20. Retts Disorder Is a genetic condition affecting only females in which normal brain development simply stops. Its rare-affecting only 1 in every 15,000 children. Growth & development appear normal until 5 mos. of age, when the head growth appears to slow through about 48 mos. of age. Overall kids with Retts disorder have similar social & mental impairments of autistic disorder, but are much worse & more significantly impaired. 21. Childhood Disintegrative Disorder A very rare PDD occurring in one in 100,000 children in which. Is striking because it emerges after an extended period of typical development which often lasts for several years. There is a marked regression in language skills, communication, social interactions, play, & motor behaviors. Decline may occur over several weeks to several months. In as many as 75% of the reported cases, the developmental deterioration was dramatic with little recovery of lost abilities. 22. PDD: NOS Prevalence: 1 in 500 children Is an autistic spectrum disorder in which some of the symptoms of autism are present, but not the four traditional required to fit into one of the other four categories (autistic disorder, Aspergers disorder, Retts Disorder, Childhood Disintegrative Disorder). Fits children with a unique mixture of symptoms that fall under the PDD umbrella, but dont specifically fit into one of the four distinct diagnoses discussed above. The heterogeneity of symptoms among children with PDD: NOS & its similarity to other PDDs has made it difficult for parents to get clear information about their childs condition or a diagnosis for their child. 23. What is the prevalence of Autism? It is estimated that in the US, 400,000 people have autism. It appears to be on the rise & is one of the most common developmental disabilities with only mental retardation, epilepsy, & cerebral palsy occurring more frequently. Autism appears to occur 3-4 times more often in boys than in girls. Girls when affected, usually have significantly more debilitating symptoms. 24. What causes Autism? Its unclear what causes autism, although a number of theories have been proposed. 1. In the 1960s psychologists blamed it on so-called, refrigerator mothers, who were supposedly cold & indifferent to their children. This was dismissed years ago. 2. Another view was environmental toxins, which is still being debated. 25. Causes (contd.) 3. The MMR vaccine has been argued to be linked to autism. It has been speculated that thermarasol, the mercury preservative in the MMR vaccine, may cause someone with a diathesis for autism, to develop the disorder. The most current research does


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