AUTISM SPECTRUM DISORDER?

• Autism Spectrum Disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges (CDC, 2016).
• Group of complex neurodevelopmental disorders of the brain. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors (Autism Speaks, 2016).

Types of Autism

• Autism Disorder - "Classic Autism"
• Aspergers Syndrome
• Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS)
• Childhood Disintegrative Disorder

AUTISM Spectrum disorder

• Affects how one communicates with and relates with others & affects how they make sense of the world around them.
• Learning, thinking, & problem-solving abilities can range from very gifted to severely challenged.
• The term “spectrum” refers to the wide range of symptoms, skills, and levels of disability in functioning that can occur in people with ASD.

COMMON CO-OCCURiNG DIAGNOSES

• Attention Deficit Hyperactivity Disorder (ADHD)
• Obsessive-Compulsive Disorder (OCD)
• Learning Disabilities
• Intellectual Developmental Disorder
• Certain genetic and chromosomal conditions (Fragile X Syndrome, Rett Syndrome)
• Sensory Processing Disorder (SPD)

Incidence of ASD

• 1 in 68 children has been identified with autism spectrum disorder (ASD) in the United States, (CDC, 2014).
• Boys (1 in 42) are 4.5 times more likely to have autism spectrum disorder as girls (1 in 189), (CDC, 2014).
• Affects all racial, ethnic & socioeconomic groups and growing at a faster rate than any other developmental disability (CDC, 2014).

causes

• There is no known cause of ASD & there is no known cure.
• Current research points to both genetic & environmental factors.
• Researchers have identified a number of genes associated with the disorder.

CAUSES

• Studies suggest a disruption in normal brain growth very early in development. These disruptions may be the result of mutations in genes that control brain development and regulate how brain cells communicate with each other (NIH, 2016).

RISK FACTORS

• Advanced parental age
• Sibling is diagnosed with ASD
• Bacteria or viral infections during pregnancy
• Exposure to toxic chemicals during pregnancy
• Multiple studies have shown that vaccination to prevent childhood infectious diseases do not increase the risk of developing autism.

Early Signs

• No babbling or pointing by 1 year of age
• No single words by 16 months or two-word phrases by age 2
• No response to name
• Loss of language or social skills previously acquired
• Excessive focus on or lining up of toys/objects
• No smiling or social responsiveness

Social challanges

• Difficulty maintaining & establishing eye contact
• Difficulty reading facial expressions & emotional signals
• Difficulty understanding others feelings
• Lack of or poor reciprocal exchanges & reciprocal play (back & forth, peek-a-boo).
• Often dislike being comforted by touch

CommuNication Challenges

• Impaired verbal & non-verbal communication skills
• Difficulty taking turn & staying engaged in conversation
• May repeat words, phrases - Echolalia
• Tend to be concrete
• Often focus on self needs

BEHAVIor challenges

• Preoccupations
• Focus on parts & pieces vs the whole
• High need for sameness & routines
• Stereotypical behaviors - hand flapping, head shaking, rocking
• Sensory processing challenges - may be hypersensitive or lack awareness

Functional Challenges

• Sleep disruptions
• Difficulty with eating
• May have high levels of anxiety or depression
• Activities of Daily Living interrupted

Diagnosis

• Children are screened for developmental delays and disabilities during regular well-child doctor visits at: 9,18, 24 & 30 months of age
• Additional screening may be needed if a child is at high risk for ASD (e.g., having a sibling or family member with ASD)
• A reliable diagnosis can be made at 2 yrs old

SCREENING & EVALUATION

• Parent questionnaires & screening instruments are used to gather information about a child’s developmental history and behavior.
• Comprehensive Evaluation often includes information gathered from a multidisciplinary team that may include: Developmental Pediatrician, Child Psychologist, Neurologist, Psychiatrist, or Speech Therapist.

INTERVENTIONS

• Early Intervention (birth to 3 yrs) is critical
• Speech, Occupational, Physical therapies
• Sensory Integration Therapy
• Behavior and Communication Approaches
• Medication
• Dietary Approaches

CoMMON MOTOR CHALLENGES

• Delayed gross motor and fine motor skills
• Difficulties initiating, planning, and sequencing movements
• Difficulty processing sensory information for movement
• Decreased balance or postural insecurity
• Challenges navigating the community

CONSIDERATIONS

• Communication needs
• Play Skills
• Interests and motivators
• Motor skills & postural patterns
• Sensory needs
• Environmental factors

CASE STUDY

• Observations?
• Questions?
• Considerations?
• Accommodations?

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