What are red flags that may be noticed in infants that indicate autism?
- being an easy baby (like being able to sit for long stretches without interaction, soothing or human interaction)
- watching hands at different orientations (like out of corner of eyes)
- low interest in faces or tracking adult movement in a room
- low interest in social games like peek-a-boo (may react but won’t initiate or simply a complete lack of interest)
according to the DSM, what are the five criteria for a diagnosis of ASD?
1) social communication deficits
2) restricted repetitive and stereotyped patterns of behavior, interests and activities
3) symptoms must be present in early development
4) clinically significant impairment
5) not better explained by intellectual disability or growth and development disorders - though they can co-occur
one diagnostic criteria for ASD is deficits in social communication.
what are the three parts of this criteria that must be met currently or by history?
- deficits in social-emotional reciprocity
- deficits in nonverbal communication behaviors (like eye contact, body language, gestures, facial expressions)
- deficits in developing, maintaining, and understanding relationships
all three must be met currently or by history
how may facial expressions be different from that of normal children in an individual with ASD?
- individuals with ASD may have a absent facial expressions or may have over exaggerated
- may have a clear happy or sad, but other expressions may be absent
one diagnostic criteria for ASD is restricted repetitive and stereotyped patterns of behavior, interests or activities.
what are the four parts of this criteria and how many must be met currently or by history?
-two must be met currently or by history
- stereotyped and repetitive motor movements, use of objects, or speech
- insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or non-verbal behavior
- highly restricted, fixated interests that are abnormal in intensity or focus
- hyper or hypo reactivity to sensory input or unusual sensory aspects of the environment
what are some of the impairments that may or may not accompany ASD?
- impaired intellectual functioning
- impaired language
- medical or genetic conditions
- avoidant-restrictive food disorder
- sleep disorder
- constipation
Of those with ASD, which gender is more likely to have accompanying intellectual disorder?
females
what is the approximate incidence of ASD
1% in general population
however 1 in 70 live births
-not as common in older generations
more than 80% of those with ASD have complex selective feeding, what are some examples of this?
- don’t like meat and alternatives or vegetables
- restricted range of foods they find acceptable (example only white foods)
- often prefer breads and cereals
- often prefer processed and predictable
- low fluid intake
more than 66% of those with ASD have severe sleep disturbance, what are some examples of this?
- difficulty falling asleep
- waking in a fully alert state for over an hour in the middle of the night
- early waking
approximately how many of those with ASD have motor coordination problems?
- up to 80%
- this often improves as children grow into school age, but can be quite noticeable during preschool years
approximately 70% of children with ASD have additional mental health conditions, what are the three most common?
- social anxiety (this is often related to perfectionism)
- ADHD
- oppositional defiance disorder
what is oppositional defiance disorder?
a pattern of negativistic interaction, with the core being refusal to do what is asked
what is typically involved in making a ASD diagnosis?
- an interdisciplinary team
- analysis of if individual meets DSM or ICD criteria
- thorough developmental history
- 1 standardized parent report measure
- 1 standardized behavioral observation measure
- assessment of cognitive and developmental level
- multiple sources of information
what are some red flags of ASD that may be noted in a toddler or preschool aged child?
-low or absent eye contact
-not responding to name or social smile
-delayed or absent language at age greater than 2
-echolalia (echoing language)
-regression of language (starts using and then stops using words, when language returns, word choices may be odd with more normal words missing)
-in “own world”
-not pointing
-using hand as a tool (leading adult by hand to get what they need)
-unusual emergence of language (obscure first words)
-pronoun errors (may refer to self as “you” or flip genders even with people they know well)
-reading or counting before speaking (hyperlexia or hypernumeracy)
-repetitive play
fixation on unusual objects or parts of objects
what kind of treatments may be appropriate for ASD?
- behavior therapy (to work on social skills. taught like a playbook)
- speech, language and communication therapy
- social stories and visual schedules
- feeding therapy if required
- sensory integration
- fine/gross motor skill therapy
- biomedical strategies may be used (though not as well supported by research at this time)
- prescription medication
what are some sensory differences that may occur in those with ASD?
-over or under reaction to sensory input
- most common is oversensitivity to sound
- second most common is oversensitivity to touch
what kinds of sounds are commonly problematic for children with ASD?
-hand dryers, alarms, vacuums
these are most common, but all children are different
what are types of sensory processing sensitivities
- may be over or under responsive to:
- sound
- smell
- sight
- touch
- tast
- vestibular
- proprioceptive
what are some dangers associated with having low register sensory processing issues?
- may not respond to pain, hunger or temperature
- this can lead to injury or other issues
what are some pointers to have clarity of communication with those who have ASD?
- avoid sarcasm, idioms or sayings, homonyms that could be ambiguous, rhetorical questions, watered down rules of life
- avoid saying can you ___ instead say you can ___
- use short, simple sentences
- give specific instructions
- say what you want
- limit number of choices
- get attention first and reduce distratctions
what are some commands that can be useful for children with ASD as well as other children?
- say less
- stress what is important
- show what you want
- keep it simple and emphasize key words
what are appropriate commands for 1 year olds?
- one direction at a time
- yes/no questions
- simple where questions that can be answered with pointing
- questions of what is this when talking about familiar objects
what are appropriate commands for 2 year olds?
-2 word commands
-1-2 step instructions
-avoid first __, then___
-can ask basic questions about own wants and needs
-can answer longer questions like where, what, who is
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prep for quiz 1133
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Midterm Prep121
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Autism39
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Pain & Palliative Care41
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Neural Tube Defects & Neuro Concerns51
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textbook questions for obstetrics29
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childhood cancer55
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alterations in GI functions46
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fluid resuscitation4
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pediatric obesity33
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growth and development64
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pediatric cardiac issues52
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respiratory concerns89
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Mental Health Disorders38
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Meningitis and Seizures84
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Genetic Disorders20
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Pharmacotherapy in Children2
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Cariology11
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health challenges in labour and birth43
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health challenges in the newborn63
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postpartum health challenges24
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health challenges in pregnancy53
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Infant Nutrition33
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intimate partner violence15
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food security0
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pain measures during labour10
