AUTISM And autism spectrum disorders
What is autism? • Autism Spectrum Disorder is a term used to describe a subset of the PDDs. This subset includes Autistic Disorder (autism), PDD-NOS, and Asperger's Disorder/Syndrome (AS). These disorders are characterized by: • Communication • Behaviour • Social interactions • These common characteristics are often referred to as the "triad of impairments“ • Often these are associated challenges related to sensory, anxiety, motor skills and learning. • The term "spectrum" refers to a continuum of developmental severity ranging from Autistic Disorder to AS.
AUTISM SPECTRUM DISORDERS:Possible Cause • There are several theories. Researchers are exploring various explanations but, to date, no definitive answers or specific causes have been found. • Current research studies say it may be inherited genetically • May also be a result of environmental toxins (heavy metals, chemicals, pesticides, viruses) • Ongoing research is being done
AUTISM SPECTRUM DISORDERS:Neurological Implications • Neurological Implications • MRI studies have suggested - rapid overgrowth in the first year and minimal growth after age 2 until approx. age 4 and lack of overgrowth • Frontal Cortex - rapid overgrowth until age 4 (cognitive language functions, social-emotional processing) • Visual cortex - relatively intact.
Terminology • The terms "autism”, "Pervasive Development Disorder (PDD)”, and Autism Spectrum Disorder (ASD)" have been used, sometimes interchangeably, over time. • PDD (Pervasive Development Disorder) is the term used in Diagnostic and Statistical Manual to describe a class of disorders that share areas of concern in social interactions, communication and repetitive patterns of activities and restricted interests • Five disorders encompass this area
AUTISM SPECTRUM DISORDERS: Types of autism • Five disorders in this category • Autism • Asperger syndrome • Rett syndrome • Childhood Disintegrative Disorder • PDD-NOS (Pervasive Developmental Disorder) • Two of these disorders are very rare, Rett's disorder and CDD
AUTISM SPECTRUM DISORDERS: Types of autism • Autism Disorder • Autism Disorder, commonly known as Autism, is the most commonly diagnosed disorder within the Autism Spectrum. While severity of symptoms varies, those with autism are less likely to develop functional speech (about 50%) • may either be completely non-verbal or echolalic (the immediate or delayed repetition of words of phrases) • Individuals with Autism are also more likely to demonstrate repetitive, unusual or stereotypical behaviour (e.g., tantrums, hand flapping, self injury, lining up toys) • Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS) • has common challenges, however, this diagnosis is given when some, but not all, of the features of autism (or another PDD) are present • Those with PDD-NOS are diagnosed later due to the wider variability of symptoms
AUTISM SPECTRUM DISORDERS: Types of autism • Asperger Syndrome • Within this diagnosis individuals have average to above average intelligence • difficult to diagnose before school age because of their advanced vocabulary and reading skills • they have challenges understanding the "hidden curriculum", which includes rules regarding how to behave, when to speak, and what to talk about • they may capture only what the person is saying and may miss what is communicated through tone, body language and facial expressions • They may have special interests that they are passionate about • e.g. vaccuum cleaners, dinosaurs, road maps, solar system etc. • They may be able to tell you every detail about a topic • They may also experience motor clumsiness and sensory differences
AUTISM SPECTRUM DISORDERS:Types of autism • Rett Syndrome • Can be caused by mutation in the sequence of a single gene • relatively rare condition that almost exclusively affects females • Occurs in one out of every 10,000 to 15,000 people • Initially go through a period of normal development that lasts between 6 and 18 months • followed by rapid regression in motor and language skills • stereotypic repetitive hand movements (hand wringing, hand mouthing) • severe to profound intellectual disability • epilepsy and scoliosis • Some associated problems can be treated • Physical, occupational, and speech therapy can help with problems of coordination, movement, and speech
AUTISM SPECTRUM DISORDERS:Types of autism • Childhood Disintegrative Disorder • Very few children meet the criteria for this particular disorder • Loss of vocabulary is more dramatic in this condition than in classical autism • Rare form of autism spectrum disorder • Far more common in males than in females • Symptoms may appear by age 2, but the average age of onset is between 3 and 4 years of age • Until this time, the child has age-appropriate skills in communication and social relationships • Long period of normal development before regression helps differentiate this disorder from Rett Syndrome • Loss of vocabulary is more dramatic in CDD than in classical autism • Extensive and pronounced losses involving motor, language, and social skills • Also accompanied by loss of bowel and bladder control, oftentimes seizures and a possibility of becoming completely non-verbal
AUTISM SPECTRUM DISORDERS:SYMPTOMS • EARLY SIGNS (12 to 24 months) • Often begin to develop language then lose it or don’t acquire language at all • May appear deaf, respond unevenly or not at all to sounds • Difficulty consoling during transitions (tantrums) • Difficulty sleeping/waking up at night • Fail to "point and look” • Fail to bond • (e.g. child is indifferent to parents' presence • Have reactions to vaccines • Self restricted/selected diet • Limited imaginative play • Not interested in playing with other children • Chronic gastrointestinal problems • Repeated infections
AUTISM SPECTRUM DISORDERS:SYMPTOMS • Autism is NOT a mental illness nor does it only apply to kids who misbehave
AUTISM SPECTRUM DISORDERS:DETECTING AUTISM – how? • Children who have or may have autism tend to do things differently than other children around them • Autistic children tend to be more independent and enjoy playing alone • Children with autism have a hard time explaining what they want or even communicating with language in general • Also have a hard time moving on from one activity to another
AUTISM SPECTRUM DISORDERS:DETECTING AUTISM – how? • characteristics may apply to many children and to determine whether a child has autism is the job of a specialized doctor • however, these symptoms are worth looking out for in children
AUTISM SPECTRUM DISORDERS:DETECTING AUTISM – WHEN? • Children may show signs of autism at as young as 18 months • Things to look out for in a child at this age is poor eye contact, difficulty imitating others, delayed ability to communicate • Average age of diagnosis is typically age 3
Autism SPECTRUM DISORDERS:challenges • The stress of living with an autistic individual can affect the psychological well being of family members as well as generate conflicts among them • Parents have a hard time managing a child that has autism, especially in public • problems that manifest in public encounters cannot be handled the same way they are in a closed, comfortable environment • Families with autistic children find that public reaction to them is stereotypical and negative
Autism SPECTRUM DISORDERS:challenges • number of challenges faced by South Asians that are impacted by ASD: • Lack the necessary English language skills to communicate effectively with healthcare and educational professionals • The South Asian community in Ontario lacks an ongoing, open dialogue regarding ASD. This leaves members of the community who are impacted ASD unable to turn to community institutions and members for support • Culturally specific stigmas and misinformation surrounding ASD forces many families to remain silent and not seek out the necessary treatments and interventions.
AUTISM SPECTRUM DISORDERS:South Asian Statistics • In Sri Lanka there are a reported 39,000 Autistic children with no continuing data collection or improvements in screening tools • this figure is most likely an underestimate • In India - 1:500 • Autism Resource Centre in Tamil Nadu reports ~ 1 in 150 children affected • Bangladesh: 282,680 • India: 2,130,141 • Pakistan: 318,392 • Relative to the entire population of persons with autism, Asians and Hispanics increased the most in the 15-year interval between 1987 and 2002 – doubled**
AUTISM SPECTRUM DISORDERS:Facing the numbers • Every 20 minutes, a child is diagnosed • Autism affects four times as many boys as girls • An estimated 50,000 children and 150,000 adults in Canada have autism • The diagnosis rate in North America is currently 1 in 88 children.
AUTISM SPECTRUM DISORDERS:Treatments • Educational/Behavioural interventions • Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as Applied BehavioralAnalysis(ABA) and Intensive Behaviour Intervention (IBI) • Medications • Doctors may prescribe medications for treatment of specific autism-related symptoms such as anxiety, depression, ADHD, ADD or obsessive-compulsive disorder • Other therapies • There are a number of controversial therapies and interventions available, but few, if any, are supported by scientific studies • Parents should use caution before adopting any unproven treatments • Although dietary interventions have been helpful in some children, parents should be careful that their child’s nutritional status is carefully followed • The child can have IBI as the #1 therapy
AUTISM SPECTRUM DISORDERS:Treatments • The most important therapy is Intensive Behaviour Intervention (IBI) • It is the only therapy funded by the government and is evidence based • These play a great deal of improvement in behaviour • Various therapy and treatment methods • Drug Treatment • Music Therapy • Auditory Therapy • Vitamin/Mineral Therapy • Holding Therapy • Daily Life Therapy • Picture Exchange Communication System (PECS) • Speech –Language Therapy • Occupational Therapy • Swimming Therapy • Animal Therapy
AUTISM SPECTRUM DISORDERS:Treatments Children who receive early interventiontend to have better brain function, communication skills and overall social behavior than children with no early intervention
AUTISM SPECTRUM DISORDERS:How can parents cope with having a child with autism? • Children with autism need special care and attention, special kinds of treatment, and class education • Enroll in special therapy classes that enable progress in child’s development disorder • The earlier the child is enrolled, the better the chances that they will get better • Hundreds of therapies are available • Each and every parent can decide upon which treatment is best for their child
Impact on families • Causes emotional, physical, and financial distress, just to name a few • Compared to other diagnosis, autism adds on the most stress to families due to: • Difficulty of diagnosing • exhaustion of advocating on intervention programs in community • Time consuming process
AUTISM SPECTRUM DISORDERS:Tips from parents of children with asd • Home Safety Issues • Arrangement of Furniture • Tall furniture objects (ex. Bookcases, dressers, etc) can be screwed directly to walls to prevent them from tipping over when child tries to climb on them • Locks, gates, barriers • Help prevent falling down steps, escaping from the house, or climbing out a window, and can limit access to dangerous areas • Order and structure in the child’s environment • Can reduce frustration levels • Some use visual labels (symbols or photos) on everyday items like rooms or cabinets • Mealtime • Eating utensils may need to be tied to string and attached to the chair or table so that if thrown, they remain attached preventing unintentional injuries • Car safety • Best to wear soft footwear so a shoe or a boot will not hurt the driver if kicked off or thrown
AUTISM SPECTRUM DISORDERS • Autism is a disorder that doesn’t affect just one culture, background and society. It is a worldwide problem that knows no limits nor understands social status. That is why it is important for parents to cup up with the stress and pressure of having a child with autism.
Videos • Documentary – “My Autism and Me” • http://www.youtube.com/watch?v=FeGaffIJvHM • Documentary – "We Thought You'd Never Ask“ • http://www.youtube.com/watch?v=dKj9NDHo8bg
AUTISMSPECTRUM DISORDERS:RESOURCES • Autism Ontario • http://www.autismontario.com • Autism Canada Foundation • http://www.autismcanada.org/ • Autism Society Canada • http://www.autismsocietycanada.ca/ • Autism Research Institute • http://www.autism.com/ • Autism Speaks Canada • http://www.autismspeaks.ca/ • Autism Web • http://www.autismweb.com/ • Temple Grandin • http://www.templegrandin.com/
AUTISMSPECTRUM DISORDERS:RESOURCES • Geneva Centre for Autism • http://www.autism.net/ • South Asian Autism Awareness Centre • http://saaac.org/ • Autism Awareness Centre Inc. • http://www.autismawarenesscentre.com/ • Surrey Place Centre • http://www.surreyplace.on.ca/ • Ministry of Children and Youth Services • http://www.children.gov.on.ca/htdocs/English/topics/specialneeds/autism/programs.aspx • Snoezelen Room - Agincourt Community Center