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AutiSM A GROWING CONCERN. Robyn Smith Department of Physiotherapy UFS 2012. Learning outcomes. After this module the learner is to be able to: Be able to define and understand what autism is Be able to identify the key areas of development that are affected by autism

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autism a growing concern

AutiSMA GROWING CONCERN

Robyn Smith

Department of Physiotherapy

UFS

2012

learning outcomes
Learning outcomes

After this module the learner is to be able to:

  • Be able to define and understand what autism is
  • Be able to identify the key areas of development that are affected by autism
  • Be able to identify autistic spectrum characteristics in a child
  • Be able to identify the possible causes of autism
  • Be able to provide a brief overview of treatment options available and used in the child with autism
  • Understand the role of the physiotherapist, and therapy approach to be used the child with autism
how common is autism
How common is Autism?
  • Autism is on the increase
  • Incidence 1/110 children Statistics are of concern
  • Boys: 1/70

Autism is not going away and is going to have a huge impact on society in future years

autism awareness
Autism Awareness
  • Little known about autism
  • World Autism day 2 April to raise awareness
  • Lack of treatment facilities
  • Lack of trained persons to help autistic children, burden often falls solely on parents
what is autism
What is autism?
  • Grouped as part of the Autistic Spectrum Disorders (ASD)
  • Also including Asperger’s Syndromes
  • A complex neurodevelopmental disorder, that is present from early on in life
  • Involving the impairment of social interaction as well as deficits in language and communication
  • Also often accompanied by rigid and repetitive behaviours
  • Development of the child with autism is frequently uneven with areas of strength alongside areas of difficulty.
what is autism1
What is autism?
  • Other conditions may be present in addition to the ‘core features’ of autism. These are numerous and commonly include sensory processing problems, seizures, physical disorders, sleep problems, depression and high levels of anxiety, which may give rise to behavioural or other problems.
  • May have difficulties in forming and maintaining friendships and in realising their academic and employment potential.
  • The child and their families are also at high risk of social exclusion.
causes of autism
Causes of Autism
  • Caused by abnormalities in brain structure or function. Brain scans show differences in the shape and structure of the brain in autistic versus non-autistic children
  • The exact cause of autism has not been established to date.
causes of autism1
Causes of autism
  • Epigenetic – disorder has a strong genetic link. Abnormalities of chromosome 5 have now been linked to an increased risk for autism

strong familial genetic disposition with one autistic child has a 1/20 chance of having another, one twin is autistic 90% chance other is

  • Has been linked to the Measles-Mumps & rubella vaccination may be contributing factor
  • ???? Environmental factors
socialisation
Socialisation

Impaired social interaction is the hallmark of autism

  • Do not make eye contact
  • Fail to respond to their names
  • Appear not to hear you at times
  • Resist cuddling or holding
  • Unaware of other peoples feelings
  • Prefer to play alone and retreat into their “own world”
communication
Communication
  • Start talking later than others, some children are non-verbal
  • Often loose previously acquired sentences and words
  • Never make eye contact when asking for something
  • Abnormal articulation and voice often singsong or robotic like
  • Cannot initiate or continue a conversation
  • Repeat words or sentences verbatim without understanding how to use them
behaviour
Behaviour
  • Repetitive movements e.g. rocking, spinning and hand flopping
  • Develops routines and rituals
  • Become upset at the slightest change in routine or ritual
  • Constantly moving
  • Fascinated by parts of objects e.g. spinning of wheels of a toy car
  • Overly sensitive to light, touch and sound –have lot of sensory integration problems
treatment of autism
Treatment of Autism

There is no cure for autism

Therapies and behavioural intervention are aimed at addressing specific symptoms with the hope of brining about an improvement

treatment options
Treatment options

More than 700 treatment options

Good to use various treatment options but most importantly do not forget about reaching the child

educational and behavioural therapies
Educational and behavioural therapies
  • Children often need a very structured learning environment and often cannot be mainstreamed.
  • How one teaches is more important than what one teaches
  • Need to teach them to interact socially, emotional regulation and different ways of finding a route through activities
  • Various educational programmes used with success e.g. SNAP programme, TEACCH, PECS, SCERTS model
  • Appropriate school placements
  • Appropriate vocational placements
  • If acting out in a group revert to activities in isolation
  • Make use of reward system
  • Can make use of their obsessions during therapy
educational aspects to focus on
Educational aspects to focus on
  • Try and teach child to concentrate -go back to basics . Break tasks down into its simplest components to limit anxiety and stress
  • Tell them when an activity is over
  • Social stories
  • Visual timetable –breakdown of activities and must run in order
  • Objects of reference
  • First and then boards
  • Zoning of areas
  • Communication books, boards and devices
speech and language therapy
Speech and language therapy
  • To address language and communication skills
occupational therapy
Occupational therapy
  • Address sensory integration problems
  • Cognitive stimulation very important
  • Perceptual activities

SENSORY ISSUES !!!!

  • Deep pressure and brushing with a soft brush often work well to calm children down
  • “Bear Hug”
  • Unrolling ear
  • Blowing things e.g. Whistle, bubbles etc
physiotherapy
Physiotherapy
  • Not always referred to physiotherapy

Due to the core nature of their problems the physical aspects may be overlooked

  • Many of these children also have:
    • Developmental delays
    • Low muscle tone
    • Co-ordination and balance problems
medication
Medication
  • Various medications can be used in the treatment of Autism
  • Mood stabilising medications e.g. Tegretol, Lithium
  • Antipsychotic medications e.g. Risperdal
  • Antidepressant andAntianxietyMedications e.g. Prozac
  • Stimulant medications for ADHD e.g. Ritalin
  • Non Stimulant medications for ADHD e.g. Strattera
alternative therapies
Alternative therapies
  • Stem Cell therapy

Controversial therapy. Value of stem cell therapy in autism still under investigation. Stem cell therapy illegal in most countries.

  • HBOT

Remains controversial, efficacy has not been proven in the case of autism

references
References
  • Smith, R. 2010. Paediatric dictate, UFS (unpublished).
  • Griesel, D. 2010. PANDA autism seminar (unpublished)
  • List of Autism medications for children . Available online at http://www.child-autism-parent-cafe.com/autism-medication.html

Retrieved on 18/03/10

  • Research autism available online at http://www.researchautism.net/pages/autism/index

Retrieved on the 18/03/10

  • Autism fact sheet. 2010. available online at http://www.ninds.nih.gov/disorders/autism/detail_autism.htm