Autism

Question 1

First documented. “Autism” is used to describe those who cannot relate to others

Answer 1

1940

Question 2

A spectrum from Asperger → PDD → Autism is outlined in the DSM – IV

Answer 2

1990s

Question 3

• Impaired development of social interaction and communication:
  
  • Inability to initiate or sustain conversation, lack of spoken language
  • Repetitive speech/echolalia
  • Absence of pretend or spontaneous play
• Markedly restricted repertoire of interests and activities
• Symptoms before 3

Answer 3

Autistic Disorder

Question 4

From DSM IV: “Neurodevelopmental disorder in which persons present with a range of impairments in social interaction, verbal and nonverbal communication, as well as restrictions in behaviors and interests”

Answer 4

Autism Speectrum Disorder

Question 5

Screening tools for Autism Spectrum Disorder:

Answer 5

• ADOS: Autism Disorder Observation Scale
• M-CHAT: Modified Checklist for Autism in Toddlers
• STAT: Screening Tool for Autism in Toddlers and Young Children

Question 6

• Delays in social interaction
• Repetitive behaviors, interests or activities
• No delays in language, speech, cognition or
  curiosity

Answer 6

Asperger Syndrome

(DSM IV)

Question 7

• Genetic
• Females with typical development
• Brain growth decelerates, skills lost starting around 5 months
• Stereotypical arm movements

Answer 7

Rhett Disorder

Question 8

• Genetic
• Males
• Presentation very similar to ASD

Answer 8

Fragile X Syndrome

Question 9

• Typical development
• Sudden loss of language, bowel and bladder control after 2 years or older

Answer 9

Childhood Disintegrative Disorder

Question 10

In the DSM V, Autism Spectrum Disorder includes which three disorders?

Answer 10

• Autism Disorder
• Asperger’s Syndrome
• Pervasive Developmental Disorders – Not Otherwise Specified (PDD-NOS)

Question 11

Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others

Answer 11

ASD Level 3: Requires Very Substantial Support

Question 12

Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others.

Answer 12

ASD Level 2: Requires Substantial Support

Question 13

Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful response to social overtures of others. May appear to have decreased interest in social interactions.

Answer 13

Level 1: Requires Support

Question 14

ASD parent parents often notice these signs within the first year:

Answer 14

• Vision and hearing
• Social and communication
• Fine motor

Question 15

ASD, potential risk factors:

Answer 15

• Weak link to genetic syndromes (10%)
• Identical twins and siblings
• 46% of children with ASD have above average intellectual ability
• Children born to older parents have a higher risk of being diagnosed with ASD 2
• Exposure to prescription medications

Question 16

_______% of children with ASD have above average intellectual ability

Answer 16

46%

Question 17

ASD, POTENTIAL RISK FACTORS: VACCINATIONS

Answer 17

NO CONNECTION

• Andrew Wakefield, primary investigator, lost medical license and article retracted
• Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in
  children

Question 18

Currently ____ in ______ chance of having ASD, up significantly from 1 in 166 in 2000

Answer 18

1 in 68

Question 19

ASD, higher incidence in boys or girls

Answer 19

• 1 in 42 for boys 1
• 1 in 189 for girls 1

Question 20

ASD Neuropathology:

Answer 20

• Typical head circumference at birth, increases in the first 2 years
• Overconnection of “short range” neurons, underconnection of “long range”
• Impaired Mirror Neurons

Question 21

in ASD, head circumference overgrowth occurs in

Answer 21

frontal and temporal lobes, amygdala

Question 22

ASD, attention issues:

Answer 22

• Preoccupiations
• Difficulty shifting focus
• Lack of or delayed response to name

Question 23

“hallmark” of ASD diagnosis

Answer 23

Communication and sensory impairments

Question 24

Motor disorders in ASD:

Answer 24

• Stereotypical motor behavior (repetitive)
• Gait may appear “ataxic” (toe walking)
• Praxis and imitation
• Hypotonia in the trunk

Question 25

STANDARDIZED ASSESSMENTS for ASD:

Answer 25

* Difficult to complete and interpret * **Movement Assessment Battery for Children (M-ABC)**

Question 26

Collaboration in ASD:

Answer 26

1. Psyhcologists and Special Educators: Behavioral Plan 2. Speech & Language Pathologists: Communication Strategies 3. Occupational Therapists: **Sensory needs**

Question 27

**Applied Behavioral Analysis (Behavioral therapy):**

Answer 27

therapy for children with ASD each skill is broken down into components parts: 1. Instructions: clear and concise 2. Prompt: verbal or physical 3. Opportunity for response, if incorrect: start a new trial. 4. immediate feedback (carry over at home is needed)

Question 28

DEVELOPMENTAL INDIVUDIAL DIFFERENCE RELATIONSHIP-BASED MODEL (“FLOOR TIME”):

Answer 28

* Adults following the child's lead. * Child feels “Warmth” and “Connectedness,” feels understood

Question 29

Answer 29

PICTURE EXCHANGE COMMUNICATION SYSTEM (PECS)

Question 30

PICTURE EXCHANGE COMMUNICATION SYSTEM (PECS):

Answer 30

* Child exchanges picture for desired object

Question 31

Push-in to facilitate carryover at:

Answer 31

Treating at the: * Classroom * Field trips * Playground time

Question 32

PHYSICAL THERAPY INTERVENTION:

Answer 32

* **Apraxia/Motor planning** * Dynamic balance * Safety awareness * Facilitate carry over

Question 33

DIETARY RESTRICTIONS - DEFEAT AUTISM NOW (DAN):

Answer 33

* Gluten and dairy free diet * Nutritional Supplements * “Hidden” food allergy testing * Detoxification of heavy metals * No scholarly evidence to support this program

Question 34

TIPS FOR ASD INTERVENTION

Answer 34

* Consistent treatment space * Limit toys/materials in the treatment area * Make sure sensory needs are met * Incorporate communication system and behavioral approach used in classroom and home * Use a schedule * Stick to a routine * Prepare for transitions * Ensure the child is attending to you before communicating * Allow the child to take part in session planning * Structured breaks and rewards * Encourage generalization to classroom and home