Autism in Early Childhood:Identification and Supports

Tammi PoppeB.S. ECE

Autism SpecialistC.H.A.S.A.E.R. LLC

Oct. 10, 2007

Life on the Spectrum

• Autism is one of five major disorders that fall on the Pervasive Developmental Disorder (PDD) spectrum.

Pervasive Developmental Disorders

• Autism

• Asperger’s Syndrome

• Childhood Disintegrative Disorder

• Rhett’s

• Pervasive Developmental Disorder Not Otherwise Specified (PDD/NOS)

Autistic Disorders

• “Autism is a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction, and communicative skills.”

» Autism Society of America

Autism

• Leo Kanner – 1943– No language– “autism” formerly used by Blueler in 1912 to

mean “escape from reality”, which he ascribed to schizophrenia.

– Previously diagnosed as emotionally disturbed and/or mentally retarded.

Asperger’s

• Hans Asperger- Austria 1944

• Higher functioning population

• Language developed

• Believed in biological rather than psychological cause.

• WW2

Childhood Disintegrative Disorder

• Heller 1908

• Onset between ages 2-4 in children who previously exhibit normal development.

• More boys than girls diagnosed

• 10 x less common than Kanner’s Infantile Autism

Rhett’s Syndrome

• Andreas Rhett – Austria, 1966

• Almost exclusively affects girls

• Brief period of normal development followed by multiple areas of deterioration

• Characteristics include mental retardation, small brain and head size, seizures and hand wringing.

• 4-Stage deterioration, early death

Pervasive Developmental DisorderNot Otherwise Specified

“Subthreshold” diagnosis used when a person has many traits of another PDD, but not enough to meet DSM criteria for a diagnosis of another PDD.

What causes autism?

• Genetics– Autism Genome Project

• Neurexin 1 located on chromosome2– Glutomate functioning

• Sequence swath on chromosome 11

What causes autism?

• Environment– Mercury toxicity

• Immunizations• fish

– Pollutants• Hydrogen sulfide• Water

What are the odds?

• 1 in 150 – This number DOES NOT

include Asperger’s, PDD/NOS or other spectrum disorders!!!

• Every 20 minutes a child is diagnosed with autism!

• When we add other spectrum disorders the numbers are more like1 in 98!!!

What are the cost?

• Currently more than $90 billion annually to the U.S. and expected to more than double in the next decade.

• Wisconsin– 1 Intensive waiver child =

$44,000/yr NOT including medical and educational expenses!

– 1 Post-Intensive child = apx $11,000/yr NOT including medical and educational cost!

What does autism look like?

• While there is a set of basic diagnostic criteria; no two children present the same.– This creates a

challenge in diagnosing, treating and educating the ASD (autism spectrum disorder) population.

Infants

ColickyThrushSleep IssuesSocial Delays

Eye contactSmileResponse to play

Toddlers

Language delay50-200 words by age 2ApraxiaEcholalia

RitualsFoodPlay

Toddlers Continued

Social deficits Parallel play Modeling Joint attention

PhysicallyFrequent ear infectionsYeast issuesToe walkingSkin issues

Pre-School

Continued echolaliaDisney/PixarRepetitive viewingObsession w/movie/TV characters

Social deficits

Preschool Continued

May have lost earlier language acquisitionsAggressionSelf abuseShows little to no interest in peers, or peers on his/her termsAversion to changePoor/no play skills

Physical Bowel/toiletSkin sensitivity Stomach issues

KindergartenReceptive/expressive language

issuesPECSingingV.O.D. ( voice output device)

Sensory IssuesAuditoryTactileVisualOral Olfactory

Increased behaviorsOver stimulating environmentChange in routineProcessing issues

Kindergarten Continued

MedicationWhat will it controlDanger to self and others

Social Inappropriate response to stimuliRule bound Right vs. Wrong or Fair vs. equalTeam sport/multi player gamesPersonal cares

Children’s Long Term Support

• Funding Source– Diagnosis– Referral to County– CLTFS– Waiver Application– MA– Wait List– 250 slots per year on 3

year cycle

Autism Waiver

• Intensive– 20-35 hours per week of intensive in home

therapeutic services.– $44,000/yr

Post Intensive Services

Family Direct

$11,000/yr

RESOURCES

• Reproduction of graphs with the permission of the Kennedy Krieger Institute, Baltimore, MD.

• Wisconsin Department of Public Instruction

• www.dpi.state.wi.us/sped/autdata.html

• Autism Genome Project