1. Chapter 21 Autism Spectrum Disorders
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

2. Introduction ASDs Class of neurodevelopmental disorders Impairments in
Social reciprocity
Communication
Repetitive behaviors
Neurologically based
Have genetic predisposition
Gene–environment interaction plays a role
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

3. Diagnostic Categories within the Autism Spectrum
Autistic Disorder
Defined by a pattern of at least six symptoms distributed across three domains
At least two symptoms must be in social reciprocity
Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)
Child without prerequisite number/distribution of symptoms for another diagnosis within the ASDs or atypical presentation with functional impairments in the relevant areas
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

4. Diagnostic Categories within the Autism Spectrum (continued)
Asperger’s Disorder
Diagnosed if three symptoms (two related to social reciprocity and one to habitual behaviors) are present
Early language development typical, but pragmatic language impairments common
Adaptive behaviors may be delayed
Overlap between diagnosis of high-functioning autism and Asperger’s Disorder
Often not diagnosed until school age
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

5. Diagnostic Features of Autism Spectrum Disorders
Qualitative impairments in social reciprocity
Inability to read and comprehend feelings, experiences, and motives of others
Difficulties interacting with peers
Diminished use of eye contact and facial expression
No Theory of Mind
Atypical communication development
Atypical development in receptive and expressive language
Early language often characterized by imperative labeling, echolalia, atypical prosody, and improper use of pronouns
May have a basic impairment in nonverbal communication behaviors
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

6. Diagnostic Features of Autism Spectrum Disorders (continued)
Atypical behavior
Repetitive, perseverative, and stereotyped behaviors
Strict adherence to routines
Young children may have attachments to unusual things
Stereotyped movements (e.g., pacing, spinning, running in circles, drumming, rocking, arm flapping, toe walking)
Unusual responses to sensory input (e.g., overreaction to environmental noises, touch, or odors)
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

7. Causes of Autism Spectrum Disorders
The genetics of autism
Family studies
Candidate gene studies
Association with genetic disorders of known etiology
Brain structure and function in ASDs
Obstetric complications
An increased risk for ASD has been reported among premature infants
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

8. Causes and Epidemiology of Autism Spectrum Disorders
Environmental exposures
Teratogens
Vaccinations (no scientific evidence of connection)
Infections
Gender and ASDs
More boys than girls, gender ratios range from 2:1 to 5:1
Epidemiology of ASDs
Prevalence approximately 1 in 110 children
Reported rate in 2011 is tenfold that of a generation before
Advanced maternal and paternal ages have been associated with increased risk for ASD diagnosis
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

9. Early Identification of Autism Spectrum Disorders
Early diagnosis
Atypical development of pretend play, pointing, use of eye gaze, and social interest distinguish toddlers at high risk
Screening tools
Evaluation of the child with an ASD
Multidisciplinary assessment
Diagnostic measures
Laboratory testing and neuroimaging
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

10. Associated Conditions
Intellectual disability
Learning disabilities
Especially specific impairments in executive function
Epilepsy
Reported in about 25% of people with ASDs
Tic disorders
Up to 9% of children with ASDs have motor tics
Sleep disorders
50%–70% of children with ASDs
Gastrointestinal symptoms
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

11. Associated Conditions (continued)
Psychiatric conditions
Greater risk for depression, mood disorders, attention-deficit/hyperactivity disorder, and anxiety
Associated genetic disorders
Tuberous sclerosis
Fragile X syndrome
Chromosome 15 deletion
Other syndromes: Moebius syndrome, Joubert syndrome, Down syndrome, phosphatase and tensin homolog mutation, CHARGE syndrome, and Smith-Lemli-Opitz syndrome
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

12. Treatment Approaches
Early educational programs focus on teaching social language and enhancing appropriate behaviors
Educational approaches
Preschool programs vary
Generally include structured teaching periods, reinforcement of spontaneous communication, instruction of specific skills using principles of reinforcement, and incidental learning
K–12 involves individualized education program
Specific academic goals should relate to cognitive and functional level
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

13. Treatment Approaches (continued)
Behavioral approaches
Applied behavior analysis (ABA)
Developmental, Individual-Difference, Relationship-Based (DIR) Model
Relationship Development Intervention (RDI)
Management of maladaptive behaviors
Pragmatic language and social skills training
Medication
Stimulant medications
Selective serotonin reuptake inhibitors
Atypical neuroleptics
Mood stabilizers and other medications
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

14. Treatment Approaches (continued)
Complementary and alternative therapies
Dietary manipulation, vitamin supplements, and non–FDA-approved use of prescription medication most common
Family support
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

15. Outcome
IQ scores that fall in the average range and presence of language that can be used in conversation predict best outcomes
More than half of children diagnosed with autism acquire language that can be used for communication
In some cases, intervention leads to child no longer meeting diagnostic criteria by school age
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

16. Summary
ASDs are neurodevelopmental disorders with a genetic basis, potentially affected by environmental factors
Characterized by impairments in communication, social interaction, and repetitive interests and behaviors
Advances in early recognition and intervention have had a positive impact
Chapter 21 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.