Unraveling the Intricacies of Autism Spectrum Disorder Dr. Ryan Plosker New England Academy

Defining Developmental Disabilities How do we define developmental disabilities? What are some of the common characteristics in developmentally delayed children? What are some examples of developmental disabilities and where does Autism Spectrum Disorders fit?

Defining Developmental Disabilities Overlap of the term developmental disability and intellectual disability. Similarities and differences between the two. Quantitative approach versus Qualitative approach to understanding Understanding the Spectrum

The “Spectrum” – Previous Diagnosis Pervasive Developmental Disorder Autism Asperger’s C.D.D. Rett’s

The “Spectrum” What is P.D.D. NOS? Understanding the Spectrum Areas of development that are assessed to determine delays

DSM - V The term “Asperger’s Syndrome” has been replaced by “Autism Spectrum Disorder”. Neurodevelopmental Disorder It looks at a continuum ranging from “mild” to “severe”.

DSM – V Diagnosis A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: 1. Deficits in social-emotional reciprocity; 2. Deficits in nonverbal communicative behaviors used for social interaction; 3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers).

DSM – V Diagnosis B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following: 1. Stereotyped or repetitive speech, motor movements, or use of objects; 2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change 3. Highly restricted, fixated interests that are abnormal in intensity or focus; 4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment

DSM – V Diagnosis C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities) D. Symptoms together limit and impair everyday functioning.

Autism Spectrum The “Spectrum”

DSM – V P.D.D. Comparison/Common Characteristics: 1. Qualitative Impairment in Social Functioning and Communication 2. Repetitive/Stereotyped patterns of Behavior 3. Age

History and Background The word "autism," which has been in use for about 100 years, comes from the Greek word "autos," meaning "self." The term describes conditions in which a person is removed from social interaction -- hence, an isolated self.

History and Background Eugen Bleuler, a Swiss psychiatrist, was the first person to use the term (1911) He also referred to it as “Schizophrenia” In the 1940s, researchers in the United States began to use the term "autism" to describe children with emotional or social problems.

History and Background Leo Kanner, a doctor from Johns Hopkins University, used it to describe the withdrawn behavior of several children he studied. At about the same time, Hans Asperger, a scientist in Germany, identified a similar condition that’s now called Asperger’s syndrome.

History and Background Hans Asperger (1944) “children who are quite unusual in their social, linguistic and cognitive abilities.” He studied 4 boys “odd development” Autistic Psychopathology

History and Background Asperger saw a pattern of “a lack of empathy, ability to form friendships, one- sided conversations, intense interests and clumsy movements.” Asperger opened a school towards the end of world war II.

History and Background We are convinced, then, that autistic people have their place in the organism of the social community. They fulfill their role well, perhaps better than anyone else could, and we are talking of people who as children had the greatest difficulties and caused untold worries to their care-givers. (Hans Asperger, 1944)

History and Background Lorna Wing (1981) Described children with a poverty of social interaction, failure of communication, and the development of special interests. Asperger and Wing described children who were more able.

Current Statistics About 1 in 68 children has been identified with autism spectrum disorder (ASD). ASD is reported to occur in all racial, ethnic, and socioeconomic groups. ASD is almost 5 times more common among boys (1 in 42) than among girls (1 in 189).

Current Statistics Within 10 years ( ), there has been an increase in diagnosis from 1 in 150 children to 1 in 68. Prevalence of autism in U.S. children increased by percent!! 30% increase over the past 2-years.

Early Childhood “Developing Autism” Non-Verbal Social difficulties apparent Enter into structured setting (Kindergarten)

Early Childhood Rapid change before age 5 Case of Billy

Early School Years Classroom behaviors Peer Avoidance Odd Behaviors Known as the “strange kid” Behavioral Melt down’s

Early School Years Often kept home by parents Hyper focus impacts learning Story of Scott

Middle School Years Social issues are exacerbated Teacher Changes Classroom Changes Schedules

Middle School Years Lockers Dating Increase of Organizational Skills Jesse

High School Years Hope in the future Failure and frustration Odd Man Out! Teasing/bullying The finding of a friend Academics