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DEFINITION
nonverbal communication
social interaction generally evident before age three
CHARACTERSTICS
engagement in repetitive activities
stereotyped movements
resistance to environmental change
Sensory issues
Over or under-sensitivity to noises, lighting, odors, tastes, textures, pain Sensory over-selectivity Failure to respond Hidden senses
vestibular (movement and balance) proprioceptive (feedback on how much force or pressure to apply when picking up something or holding an item)
Cognitive issues
Difficulty drawing conclusions Difficulty with incidental learning Often excellent rote memory Slower at retrieving information Slower processing speed Problems with working memory Trouble predicting outcomes (e.g., peoples reactions) Often do not see cause-effect
History of Autism
o Term autism originally used by Bleuler (1911) o To describe withdrawal from social relations into a rich fantasy life seen in individuals with schizophrenia o Derived from the Greek autos (self) and ismos (condition) o Leo Kanner 1943 o Observed 11 children
History of Autism
o Psychiatrist Hans Asperger (1944) - describes little professor syndrome o Eisenberg and Kanner (1956)
o Added autism onset prior to age 2 o Further refined definition of autism o Creak (1961) o Developed 9 main characteristics
History of Autism
o Rutter (1968) o Said the term autism led to confusion! o Argued autism was different than schizophrenia o Higher M:F ratio o Absence of delusions & hallucinations
Myths
Individuals with autism never make eye contact Autism is a mental illness. Individuals with autism do not speak. Autism can be outgrown. Individuals with autism cannot learn autistic children are retarded. Autism can be completely cured. Autistics have no sense of humour.
Myths
inside a child with autism is a genius. Individuals with autism are very manipulative. Individuals with autism cant smile; cannot show affection do not want friends do not learn Autism is caused by poor parenting and a lack of initial bonding.
Prevalence of Autism
2-6 cases per 1,000 growing at a rate of 10-17
diagnostic boundaries have changed inclusion of spectrum Increasing recognition of comorbidity (e.g. Downs, Tourette syndrome, cerebral palsy) Improvements in case-finding methods Populations sampled Increased public awareness Introduction of the MMR vaccine
boy:girl- 4:1(more severe in girls) Usually identified before 30 months No racial or socioeconomic differences
CAUSES
Monozygotic vs. dizygotic twin studies have shown that if 1 identical twin has autism, the chance that the other twin has autism is 10 times higher than that of fraternal twins
Neurotransmitters
Serotonin Opioids
CAUSES
Other Theories: Heavy metals Pollutants Toxins Vaccines Chemicals Pesticides Gastrointestinal issues *none of these have been empirically proven to cause autism*
Early Development
communication and relating to other people followed by socialemotional development of baby is key to form strong relationships and continued learning which starts from the birth itself
Use simple gestures (pointing, showing, waving bye,) Imitate actions in their play Respond when told no Start babbling mama, dada, baba
Guiding families to diagnostic resources and intervention services Conducting a medical evaluation Providing ongoing health care Supporting and educating families
DIAGNOSIS
Major areas Communication Socialization Behavior
Communication
Delay in, or complete lack of, verbal communication Difficulty in initiating or sustaining conversations Stereotyped or idiosyncratic use of language (echolalia, jargon) Inability to engage in spontaneous, make- believe, or imitative play at the appropriate developmental level
Socialization
Difficulty developing peer relationships appropriate to developmental level Impaired use of nonverbal behaviors (e.g., eye contact, facial expressions, and gestures) Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (joint attention) Lack of social or emotional reciprocity
Behavior
Preoccupation with an activity or interest that is abnormal either in intensity or focus Inflexible adherence to nonfunctional routines or rituals Repetitive or stereotyped movements (e.g., hand flapping) Persistent preoccupation with parts of objects
Treatment
Goals
Speech and language therapy Redesign of education pattern Educate the parents/ guardian/ siblings Conduct applied behavioral analysis (ABA) and treat according to the score
ABA : It is the repetitive use of positive reinforcement to teach specific skills and decrease inappropriate behaviors.
Son-Rise Program encourages providers and parents to teach with enthusiasm and to employ a non-judgemental attitude.
Psychopharmacology
Symptoms/ Disorders Attentional, impulsivity, hyperactivity Anxiety Depression Obsessive compulsive symptoms
Freq
59%
Treatments
Behavioral intervention Psychopharmacotherapy stimulants, atomoxetine, alpha agonists, anti-anxiety Behavioral treatment relaxation, cognitive Psychopharmacotherapy SSRI, alpha agonist Psychotherapy Medication anti-depressants Behavioral treatment, supportive counseling; Medication SSRI, others
8-32%