Introduction to Autism Final - Amazon S3and+… · • Diagnostic and statistical manual of mental...
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Introduction to Autism Spectrum Disorder Ashley McGinn Ph.D., HSPP
Transcript of Introduction to Autism Final - Amazon S3and+… · • Diagnostic and statistical manual of mental...
IntroductiontoAutismSpectrumDisorderAshleyMcGinn Ph.D.,HSPP
Agenda• DiagnosticCriteriaforAutismDSM-5• ChangesfromDSM-IV• VideoofTempleGrandin• AutisminIDEA• AutismStatistics• CommonComorbidities• OpportunitiesforIntervention
DSM-VCriteriaforAutismSpectrumDisorder
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Persistentdeficitsinsocialcommunicationandsocialinteractionacrossmultiple
contexts,asmanifestedbythefollowing,currentlyorbyhistory:
Deficitsinsocial-emotionalreciprocity,ranging,forexample,fromabnormalsocialapproachandfailureofnormalback-and-forthconversation;toreducedsharingofinterests,emotions,oraffect;tofailureto
initiateorrespondtosocialinteractions
Deficitsinnonverbalcommunicativebehaviorsusedforsocialinteraction,ranging,forexample,from
poorlyintegratedverbalandnonverbalcommunication;toabnormalitiesineyecontactandbodylanguageordeficitsinunderstandinganduseof
gestures;toatotallackoffacialexpressionsandnonverbalcommunication.
Deficitsindeveloping,maintaining,andunderstandingrelationships,ranging,forexample,fromdifficultiesadjustingbehaviortosuitvarioussocialcontexts;todifficultiesinsharingimaginativeplayorinmakingfriends;toabsenceofinterestin
peers.
Restricted,repetitivepatternsofbehavior,interest,oractivities,asmanifestedbyatleasttwoofthefollowing,currentlyorbyhistory:
Stereotypedorrepetitivemotormovements,useofobjects,orspeech(e.g.,simplemotorstereotypies,lining
uptoysorflippingobjects,echolalia,idiosyncraticphrases).
Insistenceonsameness,inflexibleadherencetoroutines,orritualizedpatternsofverbalornonverbalbehavior(e.g.,
extremedistressatsmallchanges,difficultieswithtransitions,rigidthinkingpatterns,greetingrituals,needto
takesamerouteoreatsamefoodeveryday).
Highlyrestricted,fixatedintereststhatareabnormalinintensityorfocus(e.g.,strongattachmenttoorpreoccupationwithunusualobjects,excessively
circumscribedorperseverativeinterests).
Hyper- orhypo-reactivitytosensoryinputorunusualinterestinsensoryaspectsoftheenvironment(e.g.,apparentindifferencetopain/temperature,adverse
responsetospecificsoundsortextures,excessivesmellingortouchingofobjects,visualfascinationwithlightsor
movement)
SocialCommunication• Persistentdeficitsinsocialcommunicationandsocialinteraction
acrossmultiplecontexts,asmanifestedbythefollowing,currentlyorbyhistory:• Deficitsinsocial-emotionalreciprocity,rangingfromabnormalsocialapproachand
failureofnormalback-and-forthconversation;toreducedsharingofinterests,emotions,oraffect;tofailuretoinitiateorrespondtosocialinteractions
• Deficitsinnonverbalcommunicativebehaviorsusedforsocialinteraction,rangingfrompoorlyintegratedverbalandnonverbalcommunication;toabnormalitiesineyecontactandbodylanguageordeficitsinunderstandinganduseofgestures;toatotallackoffacialexpressionsandnonverbalcommunication.
• Deficitsindeveloping,maintaining,andunderstandingrelationships,rangingfromdifficultiesadjustingbehaviortosuitvarioussocialcontexts;todifficultiesinsharingimaginativeplayorinmakingfriends;toabsenceofinterestinpeers.
SeverityLevel:SocialCommunication
Level1- RequiringSupportWithoutsupportsinplace,deficitsinsocial
communicationcausenoticeableimpairments.Difficultyinitiatingsocialinteractions,andclearexamplesofatypicalorunsuccessfulresponsestosocialoverturesofothers.Mayappeartohavedecreasedinterestinsocialinteractions.Forexample,apersonwhoisabletospeakinfullsentencesandengagesincommunicationbut
whoseto-and-fromconversationswithothersfails,andwhoseattemptstomakefriendsareoddand
typicallyunsuccessful.
Level2- RequiringSubstantialSupportMarkeddeficitsinverbalandnonverbalsocial
communicationskills;socialimpairmentsapparentevenwithsupportsinplace;limitedinitiationofsocialinteractions;andreducedorabnormalresponsestosocialoverturesfromothers.For
example,apersonwhospeakssimplesentences,whoseinteractionislimitedtonarrowspecialinterests,andwhohasmarkedlyoddnonverbal
communication.
Level3- RequiringVerySubstantialSupportSeveredeficitsinverbalandnonverbalsocial
communicationskillscausesevereimpairmentsinfunctioning,verylimitedinitiationofsocialinteractions,andminimalresponsetosocial
overturesfromothers.Forexample,apersonwithfewwordsofintelligiblespeechwhorarelyinitiates
interactionand,whenheorshedoes,makesunusualapproachestomeetneedsonlyand
respondstoonlyverydirectsocialapproaches.
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RestrictedandRepetitiveBehavior• Restricted,repetitivepatternsofbehavior,interest,oractivities,asmanifestedbyat
leasttwoofthefollowing,currentlyorbyhistory:
• Stereotypedorrepetitivemotormovements,useofobjects,orspeech(e.g.,simplemotorstereotypies,lininguptoysorflippingobjects,echolalia,idiosyncraticphrases).
• Insistenceonsameness,inflexibleadherencetoroutines,orritualizedpatternsofverbalornonverbalbehavior(e.g.,extremedistressatsmallchanges,difficultieswithtransitions,rigidthinkingpatterns,greetingrituals,needtotakesamerouteoreatsamefoodeveryday).
• Highlyrestricted,fixatedintereststhatareabnormalinintensityorfocus(e.g.,strongattachmenttoorpreoccupationwithunusualobjects,excessivelycircumscribedorperseverativeinterests).
• Hyper- orhypo-reactivitytosensoryinputorunusualinterestinsensoryaspectsoftheenvironment(e.g.,apparentindifferencetopain/temperature,adverseresponsetospecificsoundsortextures,excessivesmellingortouchingofobjects,visualfascinationwithlightsormovement).
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SeverityLevel:
Level1: RequiringSupportInflexibilityofbehaviorcausessignificantinterferencewithfunctioninginoneormorecontexts.Difficultyswitchingbetweenactivities.Problemsof
organizationandplanninghamperindependence.
Level2: RequiringSubstantialSupportInflexibilityofbehavior,difficultycopingwithchange,orotherrestricted/repetitivebehaviorsappearfrequentlyenoughtobe
obvioustothecasualobserverandinterferewithfunctioninginavarietyof
contexts.Distressand/ordifficultychangingfocusoraction.
Level3:RequiringVerySubstantialSupportInflexibilityofbehavior,extremedifficulty
copingwithchange,orotherrestricted/repetitivebehaviorsmarkedlyinterferewithfunctioninginallspheres.Greatdistress/difficultychangingfocusor
action.
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TempleGrandin
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ChangesfromDSM-IV-TRtoDSM-5
AutismSpectrumDisorder(ASD)
PDD-NOS
Asperger’sDisorder
AutisticDisorder
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ChangesfromDSM-IV-TRtoDSM-5
• Socialcommunicationandsocialinteractionarecombinedintoonecategory.
• Sensoryissuesarenowincludedasabehavioralsymptom.• Symptomsdonothavetobeapparentbeforeage3.• Functionalimpairmentmustbepresentfordiagnosis.Severity
levelsmustbespecified.• Comorbiditieswithotherconditionsarerecognized&
Specifiers areusedtodescribesymptomatology.
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IDEADefinitionofAutism• Autismmeansadevelopmentaldisabilitysignificantlyaffectingverbaland
nonverbalcommunicationandsocialinteraction,generallyevidentbeforeagethree,thatadverselyaffectsachild’seducationalperformance.Othercharacteristicsoftenassociatedwithautismareengagementinrepetitiveactivitiesandstereotypedmovements,resistancetoenvironmentalchangeorchangeindailyroutines,andunusualresponsestosensoryexperiences.Achildwhomanifeststhecharacteristicsofautismaftertheageofthreecouldbeidentifiediftheaforementionedcriteriaaresatisfied.Autismdoesnotapplyifachild’seducationalperformanceisadverselyaffectedprimarilybecausethechildhasanemotionaldisturbance,asdefinedinparagraph(c)(4)ofIDEA.
AutismStatistics
• ArethenumberofindividualsidentifiedwithASDincreasingordecreasing?
• IsASDmoreprevalentinboysorgirls?• IfafamilyhasonechilddiagnosedwithASD,dotheyhaveagreaterlikelihoodofhavinganotherchildwithASD?
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Autism&CommonComorbidities
• IntellectualDisability• Speech/LanguageDisorders• Attention-Deficit/HyperactivityDisorder• AnxietyDisorders• SeizureDisorders
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OpportunitiesforIntervention• FamilySupport&Resources• AppliedBehaviorAnalysis(ABA)• P.L.A.YProject• Speech/LanguageTherapy• OccupationalTherapy• SocialThinking• Parent-ChildInteractionTherapy(PCIT)
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References• AutismSpeaks.(2008,September8) IntroductiontoAppliedBehavior
Analysis.Retrievedfromhttps://www.youtube.com/watch?v=iyCx-OLzgJw.• Autismspectrumdisorder:Anoverviewforeducators.(2014).TheIRIS
Center.Retrievedfromhttps://iris.peabody.vanderbilt.edu/module/asd1/.• DiagnosticandstatisticalmanualofmentaldisordersDSM-5.(2013).
Arlington,VA:AmericanPsychiatricAssociation.• Saulnier,C.&Ventola,P.(2012)EssentialsofAutismSpectrumDisorders
Evaluation&Assessment,NJ:JohnWiley&Sons.• Strombo.(2013,September14)TempleGrandin TalksToGeorge
Stroumboulopoulos.Retrievedfrom:https://www.youtube.com/watch?v=mb7Y7ueMBmg.
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ContactInformation
AshleyMcGinn,Ph.D.,HSPPEastersealsCrossroads4740KingswayDriveIndianapolis,IN46205317-466-1000,ext.3801
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