2. www.RCMAutismNotebook.com (c) 2007 1 The Study of Special Needs in Infancy and Early Childhhod Pervasive Developmental Disorders and Autism Spectrum Disorders: Rosa C. Martinez, Ph.D., BCBA

3. www.RCMAutismNotebook.com (c) 2007 2 INTRODUCTION: This mini presentation will focus on “AUTISM”

4. www.RCMAutismNotebook.com (c) 2007 3 Part 1 Definitions Etiology of autism Symptoms Prevalence Diagnosis Treatment approaches

5. www.RCMAutismNotebook.com (c) 2007 4 Frequently Used Acronyms in Relation to Autism: in Relation to Autism: ABA: Applied Behavior Analysis ABC: Applied Behavior Consultants ABC: Autism Behavior Checklist ABC: Antecedent, Behavior, Consequence ADA: American w/ Disabilities Act ADD: Attention Deficit Disorder ADHD: Attn Deficit Hyperactivity Dis ADI: Autism Diagnostic Interview ADOS: Autism Diagnostic Observation Scale AIA: Autism, Intolerance

6. www.RCMAutismNotebook.com (c) 2007 5 More Acronyms: AIT: Auditory Integration Training ANC: Autism National Committee ANDI: Autism Network for Dietary Intervention ARI: Autism Research Institute ARRI: Autism Research Review International AS: Asperger’s Syndrome ASA: Autism Society of America ASD: Autism Spectrum Disorders

7. www.RCMAutismNotebook.com (c) 2007 6 ASL: American Sign Language AUTCOM: Autism National Committee CAN: Cure Autism Now CARS: Childhood Autism Rating Scale CBCL: Achenbach Childhood Beh Checklist CF: Casein free CHAT: Checklist for Autism in Toddlers DAN: Defeat Autism Now DAS: Developmental Apraxia of Speech FC: Facilitated Communication More Acronyms:

8. www.RCMAutismNotebook.com (c) 2007 7 FEAT: Families for Early Autism Treatment GARS: Gilliam Autism Rating Scale GF: Gluten Free HFA: High Functioning Autistic LFA: Low Functioning Autistic NAS: National Autistic Society NLP: Natural Language Paradigm NOS: Not Otherwise Specified OCD: Obsessive Compulsive Disorder ODD: Oppositional Defiant Disorder More Acronyms:

9. www.RCMAutismNotebook.com (c) 2007 8 PDD: Pervasive Developmental Disorder PDD-NOS: PDD Not Otherwise Specified PECS: Picture Exchange Comm System PEP: Psycho-Educational Profile POAC: Parents of Autistic Children PRT: Pivotal Response Training RCMPHD: ME SI: Sensory Integration SIB: Self Injurious Behavior More Acronyms:

10. www.RCMAutismNotebook.com (c) 2007 9 More Acronyms: TEACCH: Treatment & Education of Autistic & Related Communication Handicapped Children TOM: Theory of Mind TS: Tourette’s Syndrome

11. www.RCMAutismNotebook.com (c) 2007 10 NO NEED TO REMEMBERTHESE!

12. www.RCMAutismNotebook.com (c) 2007 11 THE MOST IMPORTANT ACRONYMS: ASD: Autistic Spectrum Disorder PDD: Pervasive Developmental Disorder RCMPHD: Rosa C. Martinez, PhD., BCBA

13. www.RCMAutismNotebook.com (c) 2007 12 Part I DEFINITIONS:

14. www.RCMAutismNotebook.com (c) 2007 13 P ervasive D evelopmental D isorders PDD is a category designated by the American Psychiatric Association PDD is NOT a disorder PDD is a behavioral diagnoses

15. www.RCMAutismNotebook.com (c) 2007 14 P ervasive D evelopmental D isorders 1.Autism Disorder 2.Asperger’s Disorder 3.Rett’s Disorder 4.Childhood Disintegrative Disorder 5.PDD-NOS

16. www.RCMAutismNotebook.com (c) 2007 15

17. www.RCMAutismNotebook.com (c) 2007 16 What Is ASD? ASD and PDD are synonymous Autism is often referred to as a spectrum disorder, meaning that the symptoms and characteristics of autism can present themselves in a wide variety of combinations, from mild to severe. (Two children both with a diagnosis of autism, can act very differently from one another.)

18. www.RCMAutismNotebook.com (c) 2007 17 What is Autism? A developmental disability …affects the processing, integrating, and organizing of information …significantly impacts communication, social interaction, functional skills, and educational performance A neurological disorder (abnormalities in the CNS) …affects functioning of the brain

19. www.RCMAutismNotebook.com (c) 2007 18 AUTISM is on the rise!

20. www.RCMAutismNotebook.com (c) 2007 19

21. www.RCMAutismNotebook.com (c) 2007 20 What Is the Difference Between PDD-NOS and Autism? PDD-NOS: Behavioral diagnoses No medical test No brain scan Same educational approach Very mild autistic symptoms Some autistic symptoms w/ other severe neurological problems AUTISM: Behavioral diagnoses No medical test No brain scan Same educational approach Severe autistic symptoms Neurological problems

22. www.RCMAutismNotebook.com (c) 2007 21 PDD is synonymous with ASD. PDD is not synonymous with Autism. Why not?

23. www.RCMAutismNotebook.com (c) 2007 22 PDD: Category of various disorders Not itself a diagnoses PDD-NOS: Features that resemble autism but may not be as severe or extensive PDD-NOS is a diagnosis (NOS: Not Otherwise Specified) AUTISM: The most severe of the pervasive developmental disorders Autism is a diagnosis

24. www.RCMAutismNotebook.com (c) 2007 23 AUTISM: A developmental disability (affect’s a person’s ability to communicate, understand language, play, and interact.) Autism is a behavioral syndrome (which means that the definition is based on patterns or behaviors emitted.) Autism is a neurological disability (presumed to be present at birth and is usually apparent before the age of 3. Specific cause is unknown. (It is widely assumed that there are multiple causes, each of which manifests subtypes.)

25. www.RCMAutismNotebook.com (c) 2007 24 Asperger’s: Deficits in social interaction Unusual responses to the environment (similar to those in autism) however: cognitive and communicative development are within the normal or near normal range in the first years of life and verbal skills are usually an area of strength.

26. www.RCMAutismNotebook.com (c) 2007 25 DISORDERAUTISMASPERGER’SPDD-NOS DIAGNOSES15-18 months Onset 0-3 Diagnosed over age 3 15-18 months Atypical autism after 3 years old DSM – IV A)Social B)Communication C) Behavior At least 1 sign from A, B, and C, plus 6 overall. Does not include communication re: verbal speech skills Fewer criteria are diagnosable as PDD-NOS Spectrum of severity determines diagnoses Severely disordered verbal and non-verbal language, unusual behaviors Relatively good language, mild non- verbal language deficits, restricted range of interests and relatedness Severe impairments but strict criteria for other PDD disorders not met.

27. www.RCMAutismNotebook.com (c) 2007 26 ETIOLOGY OF AUTISM No specific cause has yet been identified. Theories: Biological Neurological MRI (Magnetic Resonance Imaging) PET (Positron Emission Tomography) Genetic Environmental

28. www.RCMAutismNotebook.com (c) 2007 27 SYMPTOMS OF AUTISM Problems using and understanding language Difficulty relating to people, objects, and events Unusual play with toys and other objects Difficulty with change in routines Repetitive body movements

29. www.RCMAutismNotebook.com (c) 2007 28 SYMPTOMS

30. www.RCMAutismNotebook.com (c) 2007 29 SYMPTOMS

31. www.RCMAutismNotebook.com (c) 2007 30 EARLY DETECTION AND EARLY INTERVENTION

32. www.RCMAutismNotebook.com (c) 2007 31 Red Flag Criteria for diagnosis prior to 3 years old At 6 months not making eye contact with parent during interaction Not cooing or babbling Not smiling when parents smile Not participating in vocal turn-taking Not responding to peek-a-boo game

33. www.RCMAutismNotebook.com (c) 2007 32 At 14 months No attempts to speak Not pointing, waving or grasping No response when name is called Indifferent to others Repetitive body motions Fixation on a single object Oversensitivity to textures, smells, sounds Strong resistance to change in routine

34. www.RCMAutismNotebook.com (c) 2007 33 At 24 months Does not initiate 2-word phrases (doesn’t just echo words) Any loss of words or developmental skill

35. www.RCMAutismNotebook.com (c) 2007 34 Persons with AUTISM may possess the following characteristics in various combinations and in varying degrees of severity:

36. www.RCMAutismNotebook.com (c) 2007 35 Inappropriate laughing or giggling No real fear of dangers!

37. www.RCMAutismNotebook.com (c) 2007 36 Apparent insensitivity to pain May not want cuddling

38. www.RCMAutismNotebook.com (c) 2007 37 Sustained unusual or repetitive play; Uneven physical or verbal skills May avoid eye contact

39. www.RCMAutismNotebook.com (c) 2007 38 May prefer to be alone Difficulty in expressing needs; May use gestures

40. www.RCMAutismNotebook.com (c) 2007 39 Inappropriate attachments to objects Insistence on sameness

41. www.RCMAutismNotebook.com (c) 2007 40 Echoes words or phrases Inappropriate response or no response to sound

42. www.RCMAutismNotebook.com (c) 2007 41 Spins objects or self Difficulty in interacting with others

43. www.RCMAutismNotebook.com (c) 2007 42

44. www.RCMAutismNotebook.com (c) 2007 43

45. www.RCMAutismNotebook.com (c) 2007 44

46. www.RCMAutismNotebook.com (c) 2007 45

47. www.RCMAutismNotebook.com (c) 2007 46 PREVALENCE

48. www.RCMAutismNotebook.com (c) 2007 47 PREVALENCE 166 / 150 /

49. www.RCMAutismNotebook.com (c) 2007 48 PREVALENCE Over one half million people in the U.S. have some form of ASD

50. www.RCMAutismNotebook.com (c) 2007 49 PREVALENCE Autism is the 3rd most common Developmental disability

51. www.RCMAutismNotebook.com (c) 2007 50 PREVALENCE Autism has no racial, ethnic, or social boundaries

52. www.RCMAutismNotebook.com (c) 2007 51 PREVALENCE

53. www.RCMAutismNotebook.com (c) 2007 52 DIAGNOSES OF AUTISM No medical tests for diagnosing autism Behavioral diagnoses ABC ADI CARS ADOS

54. www.RCMAutismNotebook.com (c) 2007 53 DIAGNOSIS: DSM-IV SOCIALCOMMUNICATIONBEHAVIOR NONVERBAL BEHAVIOR SPOKEN LANGUAGE RESTRICTED PATTERNS OF INTEREST PEER RELATIONSHIPS INITIATING CONVERSATION COMPULSIVE ROUTINES SPONTANEOUS SHARING IDIOSYNCRATIC LANGUAGE STEREOTYPIES SOCIAL RECIPROCITY MAKE BELIEVE IMITATIVE PLAY OBJECT PREOCCUPATION

55. www.RCMAutismNotebook.com (c) 2007 54 TREATMENT APPROACHES Clinical Practice Guideline Report of the Recommendations: Autism/Pervasive Developmental Disorders Assessment and Intervention For Young Children (Age 0-3 Years) Sponsored by New York State Department of Health Early Intervention Program

56. www.RCMAutismNotebook.com (c) 2007 55 TREATMENT

57. www.RCMAutismNotebook.com (c) 2007 56 DO: Refer the parent to their pediatrician! Give them a brochure to take to their pediatrician… “Identifying Children with Autism Spectrum Disorder” Information for Physicians and Primary Health Care Providers Provide Resources

58. www.RCMAutismNotebook.com (c) 2007 57 Communication: Does not respond to own name Cannot tell me what he/she wants Language is delayed Doesn’t follow directions Appears deaf at times Seems to hear sometimes but not others Doesn’t point or wave bye-bye

59. www.RCMAutismNotebook.com (c) 2007 58 Social: Doesn’t smile socially Seems to prefer to play alone Has poor eye contact In his own world Tunes others out Not interested in peers

60. www.RCMAutismNotebook.com (c) 2007 59 Behavioral: “Tantrums” “Hyperactive”, “uncooperative” or “oppositional” Doesn;’t know how to play with toys Repeats things over and over Toe walks Has unusual attachments to toys Lines things up Appears oversensitive to certain textures or sounds Has odd movement patterns

61. www.RCMAutismNotebook.com (c) 2007 60 INDICATIONS FOR IMMEDIATE FURTHER EVALUATION No babbling by 12 months No gesturing by 12 months No single words by 16 months No 2-word spontaneous phrases by 24 months (not echolalic vocalizations) ANY loss of ANY language or SOCIAL SKILLS at any age

62. www.RCMAutismNotebook.com (c) 2007 61 TREATMENT

63. www.RCMAutismNotebook.com (c) 2007 62 www.RCMAutismNotebook.com Thank you for your participation! For more resources on Autism visit....