What are the 3 core impairments that characterize autism spectrum disorder?
- Social communication/ interaction
- Restricted and repetitive behaviors, interest, and activities
- Abnormal language development and usage.
How is social communication and interaction impairment characterized?
- Poor imitation skills
- Difficulty in developing age appropriate peer relationships
- Lack of spontaneous seeking to share enjoyment interest or achievement w/others
- Lack the ability to reciprocate socially and emotionally
- May seek additional personal space
What are characteristics of restricted, repetitive patterns of behavior, interests and activities?
- Early in development toys and object may not be used typically instead are manipulated in ritualistic manner
- Do not show imitative or abstract play that other children their age exhibit
- Activities and play are more rigid, repetitive and monotonous than their peers
What are frank compulsive behaviors?
You will see a child with autism lining up objects rather than “playing” with them
Some children with Autism spectrum disorder will have abnormal language development what are some common characteristics of that?
- Difficulty putting meaningful sentences together even if they have a large vocabulary
- A child may use a word once and then not use if for weeks to yrs
- Echolalia
- Hyperlexia
- Pronoun reversal
What is Echolalia?
Echoing/repeating what they hear
What is Hyperlexia?
Able to read at advanced stages
Some children with Autism spectrum disorder will have intellectual disability what are some common characteristics of that?
- Verbal sequence and abstract skills are the most severe problem
- Strength is visuospatial or memory skills
Some children with Autism spectrum disorder will demonstrate irritability what are some common characteristics of that?
- Aggression
- Severe temper tantrums
- Lower function and intellectual deficits
- Self-injurious behaviors
How is lower function and intellectual deficits defined?
Aggression may emerge unexpectedly w/o obvious trigger or purpose
What are examples of self-injurious behaviors?
- Head banging
- Skin picking
- Biting
Some children with Autism spectrum disorder will have insomnia what are some treatment options for that?
- Behavioral interventions: include modifications of parental behavior before and at bedtime and providing routines that remove reinforcers for remaining awake
- Medications: melatonin
Some children with Autism spectrum disorder will have epilepsy what are some common characteristics of that?
Increased incidence of febrile seizure
How does acute illness differ in a child with autism compared to a child w/o autism?
- Some do not show temperature elevations with minor infectious illness and may not show the typical malaise of ill children
- In some children behavior problems and relatedness seem to improve noticeable during a minor illness and in some such changes are clue to a physical illness
What is the screening tool used for autism spectrum disorder?
M-CHAT
- Modified checklist for Autism in Toddlers (up to age 5)
What is the M-CHAT and what is it useful for?
- Screening tool not diagnostic but can be a spring board for referring evaluations
- Online tool
- Designed to be administered w/o training
- Catches children w/ autism and developmental disorders earlier
What is a con with the M-CHAT?
Can miss children-not all inclusive (false negatives/positives)
What is a diagnostic tool used for autism spectrum disorder?
A-DOS
- Autism Diagnostic Observation Schedule (gold standard)
What is the A-DOS and what is it useful for?
- A play based evolution for toddlers and children and question based with young adults and adults
- Scored to look at specific areas of autism related to the diagnostic criteria
- A certified physician will also complete a parent interview to look at early developmental milestones and current functioning
Who do you refer for dx and tx in a pt that you suspect has autism spectrum disorder?
- Pediatric neurologist
- Developmental Pediatrician (Dr. Liebe)
- Seattle children’s Hospital
- Child Psychiatrist (FWC)
- Child Psychologist
What resources are available to families with a child with autism?
- ARCH
- Parent to patent groups
- Holland center
- Animated explanation for autism - good video for family and class
