Autism Spectrum Disorders

Autism Spectrum Disorders
By Amber, Laura, and Ross

Everyone Stand Up, It’s Game Time!!!
Everyone will start in the middle of the room. We are going to ask a series of questions. Then you will choose your answer from the letters listed.

Question 1 A student with Autism would not typically exhibit which behavior: Throw a crying tantrum on the floor. Be outgoing and talking to everybody. Ability to memorize important dates. Repetitive hand flapping.

Question 2 Childhood Disintegrative Disorder(CDD) typically develops at what age? 2-3 years 5-6 years 12-13 years 18-21 years

Question 3 Children with Asperger Syndrome are able to develop what skill at the same level as students without disabilities? Speech and Language Skills Social Skills Common Sense Skills Gross-motor Skills

Question 4 True or False: Rett Syndrome is most common in boys. True

Question 5 Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS) displays all impairments except: A.Communication B. Social skills C. Ability to persuade others D. Unusual behaviors including a restrictive range of interests

Question 6 In DSM-V the symptoms for ASD are typically present in:
Newborn Period Early Developmental Period School-Age Period Adolescent Period

Question 7 True or False: Severity Levels examine social communication and restricted interests/repetitive behaviors. A. True B. False

Question 8 Example of a repetitive behaviors include all except:
Fixated rituals Constantly flipping a light switch Sitting in a different spot every morning for circle time Snapping over and over

Question 9 An ASD early diagnose indicator is: Cannot read by age 3
Trouble with homework Cannot spell name in preschool Does not speak single words by 16 months

Question 10 Other ASD early diagnosis indicators includes all except:
Does not respond to name Has poor eye contact Shares toys with peers Does not smile or understand expressions

DSM-IV

Autism Impairments Communication Social skills
Restricted and repetitive behavioral patterns or range of interests. Approximately 50% of individuals with autism also have an Intellectual Disability

Autism Skills Different levels of intellectual functioning
Exhibit a range of symptoms Ex:) Some individuals can instantly count the number of matches that have fallen on the ground.

Childhood Disintegrative Disorder (CDD)
Impairments similar to autism (communication, social skills, restricted and repetitive behavioral patterns or range of interests) Children develop typically until age 5 or 6 Long-term outcomes are much worse than children that have autism

Asperger Syndrome Behavioral Characteristics Social skills
Restricted or unusual behaviors or interests Communication Ex: some individuals can take language quite literally which cause misunderstood jokes or gestures.

Asperger Syndrome Skills
They can learn and develop speech and language skills at the same level as students without disabilities. Unlike kids with other ADS conditions, the majority have normal intelligence.

Rett Syndrome Also called Rett Disorder More common in girls
Early development appears normal Repeated, sterotypical hand wringing Communication and social deficits Lack of muscle control Most children with Rett syndrome also have an intellectual disability

Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS)
Impairments in all 3 areas (communication, social skills, and unusual behaviors including a restrictive range of interests) Disorder is pervasive and severe

Characteristics All children with ASD display deficits in:
Social interaction Verbal and nonverbal communication Repetitive behaviors or restricted interests

ADS Early Diagnosis Indicators
Do not babble or point by 1st birthday Do not speak single words by 16 months Do not combine 2 words by 2nd birthday Do not respond to name Lose language ability Have poor eye contact Do not play with toys but attach to one subject Do not smile or understand expressions Repeat actions that have little purpose Appear to have impaired hearing

DSM-V Released May 2013 Diagnostic criteria looks at 5 sub-categories
Persistent deficits in social communication and social interaction across multiple contexts Restricted, repetitive patterns of behavior, interests, or activities Symptoms must be present in the early developmental period Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning These disturbances are not better explained by intellectual disability or global developmental delay

Sub-Category 1 Persistent deficits in social communication and social interaction across multiple contexts, are manifested by the following Deficits in social-emotional reciprocity Deficits in nonverbal communicative behaviors used for social interaction Deficits in developing, maintaining, and understanding relationships

Sub-Category 2 Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following: Stereotyped or repetitive motor movements, use of objects, or speech Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior Highly restricted, fixated interests that are abnormal in intensity or focus Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment

Sub-Category 3 Symptoms must be present in the early developmental period (approximately before 8 years old).

Sub-Category 4 Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning Severity Level Social Communication Restricted Interests and Repetitive Behaviors

Severity Level 3

Severity Level 2

Severity Level 1

Sub-Category 5 These disturbances are not better explained by intellectual disability or global developmental delay.

Eligibility example from a three year reevaluation - Do you see these categories?

Differences between DSM-IV & DSM-V

Diagnostic Subcategories: In DSM-5 there are no diagnostic subcategories.
Requirement for Diagnosis: A historical report maybe be used to meet behavioral criteria. Specific Behavioral Criteria (SBC) - Social: Social communication and social interaction are combined into one category (1)Reflecting research indicating a lack of reliability across clinicians in assigning subcategories. ASD encompasses {Autistic Disorder, Asperger’s Disorder, and PDD-NOS} Rett’s Disorder and CDD are no longer included in the ASD diagnosis. (2) DSM5: all 3 from A & 2 from B vs DSM4: 6 total, 2 from A1, 1 from A2, 1 from A3

Specific Behavioral Criteria (SBC) DSM-V (All 3 in A) (≥2 in B) DSM-IV
Social Social Communication & Social Interaction (Category A) Social Interaction (Category A.1) Communication N/A Communication (Category A.2) Restricted/ Repetitive Activities Restricted, repetitive behavior, interests, activities (Category B) Restricted repetitive & stereotyped patterns of behavior (Category A.3)

SBC: LANGUAGE/ COMMUNICATION: (A) Language impairment is now considered a specifier, not a diagnistic criteria (B) Impaired conversation is considered an aspect of social-emotional reciprocity (C ) Stereotyped language is considered an aspect of restricted/repetitive behaviors. (D) Social and imaginative play are incorporated into A.3 SBC: Restricted/ Repetitive Activities: In DSM-5: Sensory issues are now included as a behavioral symptom (B.4) (A.3) = Deficits in developing, maintaining, and understanding relationships

Age of Onset: In DSM-5: Symptoms do not have to be apparent before age 3 Level of Impairment: In DSM-5, Functional impairment must be present for a diagnosis. Rule-Outs: Social (Pragmatic) Communication Disorder (SCD) is presented as an alternative (new) diagnosis Comorbidities: In DSM-5: Comorbidities with other conditions are recognized (LOI) Severity levels for behavioral criteria A and B must be specified (R-O) ...for individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for ASD (Co) Specifiers are used to further describe the symptomatology

IDEA Definition & DSM-5 Diagnostic Criteria
Similarities: Include symptoms in the areas of: -social interactions -nonverbal communication -repetitive activities -stereotyped movements -resistance to change -unusual sensory responses indicate that symptoms need not be apparent before age 3.

IDEA Definition & DSM-5 Diagnostic Criteria
Classification: IDEA: “Autism” DSM-5: “Autism spectrum disorder (ASD)” DSM-5 provides an algorithm for how many symptoms in each behavioral domain are required for a diagnosis. IDEA specifies that the symptoms must adversely affect the child’s educational performance DSM-5 requires impairment in social, occupational, or other important areas of functioning

Time For Round 2-Everyone to the Middle!