Autism Spectrum Disorder• severe and pervasive impairment in development•Impaired ability to communicate•presence of stereotyped behavior, interests, and activities

Impairments in social relatedness underlie and define autism

lack of awareness of the feelings of others, an impaired capacity to imitate and express

emotion absence of capacity for social and symbolic

play.

Communication deficits

non-verbal communication seen in 50% of clients

Echolalia repetition of words or phrases

abnormal prosody atypical speech rhythm, stress, intonation,

and loudness pronoun reversal

the person refers to “you” as him or herself, and the other person as “me”

Higher-functioning formerly known as Asperger's disorder early development (both cognition

and language) is apparently normal, but the child often has unusual interests that are pursued with great intensity

Social deficits become more prominent as the child enters preschool and is exposed to peers.

Prevalence 1 per 88 children in the United States

(CDC) increase in prevalence

changing diagnostic criteria service eligibility regulations knowledge about intervention political advocacy the increase in diagnosis of very young

children High co-morbidity – maybe up to 80%

Causes Neuro-biological causation assumed Certain clusters of genes may be

associated Brain abnormalities Neurotransmitter systems - serotonin

Diagnosis Medical diagnosis inter-professional collaboration

(psychiatry, medicine, psychology, social work, speech/language/communication therapy, occupational therapy, and physical therapy).

Assessment involves: Information from parents

Child’s deveopmental history child’s prior response to any educational

programs or behavioral interventions. Direct observations in structured (school) and

unstructured settings (home) and in interactions with peers, parents, and siblings.

A medical evaluation, which includes information about possible seizures, visual and hearing examinations for possible sensory problems, and testing for lead levels if the child has had exposure.

Cognitive assessment (IQ) Adaptive functioning and social skill

development Speech and language assessment Assessment with standardized scales

“gold standards” (clinician administered) the Autism Diagnostic Interview-Revised Autism Diagnostic Observation Schedule

Course variable results depending on the

severity of the condition and timing of identification, but are associated with poor outcomes regarding quality of social functioning.

one-third of children with autism ultimately achieve some level of independence and self-sufficiency in adulthood with 2/3 requiring intensive care

Interventions special education

Federal law family support

Education, support, parent training behavioral management

Applied behavior analysis social skills training Medications implemented cautiously

Almost 1/3 take at least one medication Risperidone and stimulants are common

Families like complementary and alternative interventions

For adolescents adaptive and vocational skills to prepare

for independent living. Sexual development which may be

addressed using education and behavioral techniques.

Adults identification of community resources

and supports for long-term care planning.

Options include foster homes, semi-independent living situations, living with parents who may qualify for income supplements and insurance, and supervised group living.

Critique Continued delays in identification of

autism spectrum Concern from consumer advocacy

groups about DSM 5 taking away Aspergers