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.

Shirley Alleynecpapsclinic@gmail.comwww.cpapsclinic.com

THANK-YOU