Post on 29-Dec-2015
What is Autism?Shirley Alleyne M.B.B.S
Paediatric & Adult Psychiatrist
What is Autism Spectrum Disorder?
Autism Spectrum Disorder(Objectives)
Define Autism Spectrum Disorder (ASD)
Review Epidemiology & Aetiology
Discuss early signs and symptoms
Autism Spectrum Disorder(Objectives)
Review: The diagnostic process Evidence based intervention
in 2015 Resources for the management
of ASD
Autism Spectrum Disorder(Definition)
Abnormalities In:
Social Interaction Communication Restricted interest Stereotyped behaviour
Autism Spectrum Disorder(Demographics-International)
Medium prevalence of ASD 1.3/1000
M:F = 4:1 No socioeconomic bias More common in children of
older PARENTS
Autism Spectrum Disorder(Demographics- Caribbean)
Aruba prevalence 5.3/ 1000 children
(Balkom et al 2009)
Jamaica- mean age of parental concern 21+months/+/-10 months.
Jamaica-mean age of accessing intervention 44 months.
Jamaica-% of teachers and medical providers who referred on first contact 5.6% & 4.6% respectively.
(Samms-Vaughan et Franklin-Benton 2015)
Autism Spectrum Disorder(Etiology)
Unknown Genetics-5% common & rare
variant 18.7% recurrence rates
Autism Spectrum Disorder(Early Intervention-Screening)
Routine assessment of communication and social relatedness
Use of screeners- M-CHAT at 18 and 24 months
Autism Spectrum Disorder(Diagnosis)
Based on knowledge of typical development
Based on clinical history Based on clinical observations May include the use of
diagnostic tools (ADOS, ADI etc) Genetic testing is recommended
Autism Spectrum Disorder(Diagnotic Criteria)
PERSISTENT deficits in:
Social CommunicationPoor eye contactOne sided conversationsLimited facial expression & use of
gestures
Autism Spectrum Disorder(Diagnotic Criteria)
PERSISTENT deficits in:
Social Interaction Unable to initiate or maintain social
interactions Poor interest in others Inability to read nonverbal cues Inability to adjust to changes in the
social environment
Autism Spectrum Disorder(Diagnotic Criteria)
Restricted, Repetitive Behaviours,Interests or Activities Stereotyped motor movements, use
of objects or speech Insistence on sameness Highly restricted fixation interests Hypo or hyperactivity to sensory
inputs
Autism Spectrum Disorder(Early Intervention & Outcomes)
Early Intervention Capitalizes on increase brain
plasticity in early childhood Proven to improve long-term
prognosis Proven to improve
communication and social skills Proven to improve intelligence
Autism Spectrum Disorder(Management)
Communication Intervention Educational Intervention Behavioural Interventions Pharmacotherapy Alternative/Complimentary
treatments Supportive Psychotherapy-
Family
Steve Wiltshire- renown Artist, person with ASD.“Hope is being able to see that there is light despite all of the darkness”- Desmond Tutu
Autism Spectrum Disorder(Resources on Island)
The Albert C. Graham Development Centre
Sunshine Early Stimulation Centre The John Payne School
Schoolhouse for Special Needs The Learning Centre The Derrick Smith Secondary School The Autism Association of Barbados Spectrum Possibilities Charity
Autism Spectrum Disorder(Resources)
www.cdc.gov www.babycenter.com www.autismspeaks.org www.autismsource.org www.aacap.org www.aap.org www.healthychildren.org www.autism.kennedykrieger.org
Autism Spectrum Disorder(References)
Tchaconas, A., & Adesman, A. (2013). Autism spectrum disorders: a pediatric overview and update. Current opinion in pediatrics, 25(1), 130-143.
Volmar, Fred et Al.Practice Parameter for the Assessment and Treatment of Children and Adolescents with Autism Spectrum Disorder www.aacap.org (JAACAP Vol 53 2014)
van Balkom, I. D., Bresnahan, M., Vogtländer, M. F., van Hoeken, D., Minderaa, R. B., Susser, E., & Hoek, H. W. (2009). Prevalence of treated autism spectrum disorders in Aruba. Journal of neurodevelopmental disorders, 1(3), 197-204.
Samms‐Vaughan, M., & Franklyn‐Banton, L. (2008). The role of early childhood professionals in the early identification of autistic disorder. International Journal of Early Years Education, 16(1), 75-84.
Autism Spectrum Disorder(References)
Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23.
Wetherby, A. M., Guthrie, W., Woods, J., Schatschneider, C., Holland, R. D., Morgan, L., & Lord, C. (2014). Parent-Implemented Social Intervention for Toddlers With Autism: An RCT. Pediatrics, 134(6), 1084-1093.
Kasari, C., Gulsrud, A., Paparella, T., Hellemann, G., & Berry, K. (2015). Randomized Comparative Efficacy Study of Parent-Mediated Interventions for Toddlers With Autism.