Overview of AutismMonica Blondin RN

Objectives: After reviewing this power point, you should be

able to: Describe what autism is. Describe the history of the term autism. Describe the signs and symptoms of autism. List co-morbid conditions associated with autism. Provide a description of who can diagnose autism. Be able to describe some traditional and alternative

therapies for those with autism. Describe what makes early intervention important for

those with autism. List some of the unmet needs found in families living

with autism.

What is Autism: Autism is a neurological disorder that affects the normal functioning of the

brain. ("What is Autism?" 2005) Impacted areas include:

Social interaction and communication skills. ("Definition of Autism," n.d.)

Autism is a developmental disability that typically appears in the first three years of life. ("Definition of Autism," n.d.)

Autism is one of five disorders that falls under the umbrella of Pervasive Developmental Disorders (PDD). ("Definition of Autism," n.d.)

PDD is also referred to as Autism spectrum disorders (ASD). (Boyse, 2008) Under the PDD umbrella, all disorders are characterized by severe impairment in

several areas of development. ("Definition of Autism," n.d.) The five disorders under the included in PDD are:

Autistic Disorder Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) Asperger Syndrome Childhood Disintegrative Disorder (CDD) Rett Syndrome (Boyse, 2008)

History of the Term Autism:

A Swiss psychiatris, Paul Eugen Bleuler coined the term Autism.

The term autism dates back to 1912. He also coined the term schizophrenia.

The Term Autism is Greek. “Autos” meaning self, and “ismos” meaning state

of being. This translates to the meaning of autism today,

since those with autism seem to be lost in themselves at times.

("History of Autism, From Way Back to Today," 2011)

Term Changed in Meaning:

In 1938 Hans Asperger used the term “autistic psychopaths” when referring to child psychology. High functioning autistics are now referred to

having Asperger’s Syndrome. ("History of Autism," n.d.)

In 1943 Leo Kanner used the term as it is know today. He is the one normally given the credit for the

term.

Autism was recognized to be a disorder in the 60’s. Up to this point, autistics were medically

treated in the same way as schizophrenia and retardation. ("History of Autism," n.d.)

Diagnosis of Autism: There is no valid diagnostic medical test for autism today.

The diagnosis of autism is based on behavioral observation in accordance with educational and psychological testing.

If a parent suspects their child has a developmental disability, a referral to an Early Intervention program and specialist should be acquired from a doctor. A hearing evaluation, lead exposure and an autism-specific

screening tool should be used to assess the child. At times, parents concerns are not taken seriously by doctors, so

diagnosis may be delayed.

Those that are able to make the diagnosis of autism include either/or a: Developmental Pediatrician, Neurologist, Psychiatrist, Or a Psychologist.

("Diagnosis of Autism," 2011)

Causes of Autism:

The subject itself is highly controversial.

There is no know completely blamable cause of autism.

There are many myths about what causes Autism. Some of those myths consist of:

Thimerosal in vaccines ("Autism and Vaccines," 2011) Television watching (Wallis, 2006) Genetic predisposition (Hincha-Ownby, 2008) Environmental pollutants (Hincha-Ownby, 2008).

Co-morbid Conditions Associated with

Autism: Co-morbid medical and psychological conditions

are found to occur at high rates in those with ASD.. Common medical conditions include:

Hypothyroidism Seizure disorder Tuberous sclerosis Fragile X syndrome Visual impairments Hearing impairments Sleep disorders.

Common psychological conditions include: Social anxiety Phobias Depression Obsessive compulsive disorder Attention Deficit/Hyperactivity Disorder.

(Hess, 2009)

Autism Rates: In 2009 it was found that 1% of children in the United

States were affected by ASD. This is based on statistics collected in 2006. It was found that 1 in 110 children were affected by ASD

at this time. Four years prior to this, it was found that only 1 in 150

children in the U.S. were affected by ASD. This is a 57% increase in just four years.

ASD is four times more common in boys than girls.

In 2006, it was found that 1 in 70 boys met the criteria for ASD.

("The Year of Autism Epidemiology," 2011)

Signs and Symptoms of Autism:

With Autism, three areas of development can be challenging.

Those areas include: Social skills Language Behavior

The symptoms of autism can very greatly.

It is important to note that two persons with the same diagnosis can act extremely different.

("Autism: Symptoms," 2011)

Common Social Skill Findings:

Autistic individuals may: Fail to respond to his or her name Have poor eye contact Resist cuddling or holding Loose previously acquired verbal

skills Appear to not hear you at times Appear unaware of others’ feelings Seem to prefer to play alone.

("Autism: Symptoms," 2011)

Common Language Findings:

Autistic individuals may: Begin to talk later than 2 years of age; Have other developmental delays prior to 30

months of age; Not make eye contact when making requests; Speak in an abnormal tone or rhythm,

Such as talking in a singsong or robot voice; Not be able to start a conversation or keep one

going; Repeat words or phrases word for word,

without understanding the usage.

("Autism: Symptoms," 2011)

Common Behavioral Findings:

Autistic individuals may: Have specific routines or rituals that must be followed; Become disrupted if the routines are not followed or

have the slightest change; Move constantly; Perform repetitive movements,

Such as rocking or spinning; Be extremely sensitive to light, sound, and touch; Be insensible to pain; Be spellbound by parts of an object,

An example of this could include turning the wheel of a toy car.

("Autism: Symptoms," 2011)

When to Seek a Physician for

Guidance: Verbalize to your doctor if the following are

observed, further testing may be needed. Your child:

Doesn’t babble or coo by 12 months Doesn’t use gestures by 12 months

Such as pointing or waving Doesn’t say single words by 12 months Doesn’t say two-word phrases by 24 months Or loses previously acquired language or

social skills. ("Autism: Symptoms," 2011)

Treatments for Autism: Treatments are should be initiated based on the individual child’s symptoms.

To have the greatest success with each treatment type it is important to not only have it individually tailored, but to make sure the treatment starts early.

It is also important to have the treatments involve the parents or primary caregivers. (Schoenstadt, 2009) More common potential treatments include:

Medication Medications may reduce unwanted behaviors or lengthen the attention span.

Long term usage is not desirable because of the side effects that coincide with their usage.

(Schoenstadt, 2009) Speech therapy

The goal of speech therapy is to improve useful communication. This may be by means of verbal communication or picture boards. (Schoenstadt, 2009)

Occupational Therapy The focus of occupational therapy includes enhancing the performance of activities of:

Daily living Education Work Leisure Play Social participation. (Scott, 2011)

Diet as a Therapy for Those with Autism:

One diet said to help reduce issues with speech and behaviors in autism is the gluten-free, casein-free (GFCF) diet Gluten is a protein found wheat and other grains. Casein is a protein found in milk and foods containing milk.

According to one theory, gluten and casein can not be digested properly by those with autism.

GFCF diet has not gained total acceptance in the medical community.

It is important to consult your physician prior to beginning this diet. This must be done to assure that a healthy diet is provided

with needed supplementation. Doctors can order medical tests to determine if your child is

sensitive or has an allergy to gluten or casein.

(Seroussi, 2011)

Potential Vitamin Treatment:

Vitamins Vitamin Treatment for those with autism is meant to treat the whole

body. Some children with autism have a specific taste for particular foods.

Because of this, they may be lacking some of their nutritional requirements.

Possible vitamin deficiencies or needed supplements include: Vitamins A, B1, B2, B3, B6, B12, C, D, E, and K

Folic Acid Zinc Magnesium Calcium Selenium Molybdenum Omega Fatty Acids And essential Amino Acids.

Each deficiency causes different bodily malfunctions.

Vitamin therapy, just like medication therapy, must be tailored with the assistance of a physician.

(Crow, 2008)

http://special-needs.families.com/blog/why-kids-with-autism-need-vitamin-supplements

Assistive Computer Devices:

There are multiple programs that can be found on the internet to assist persons with developmental disabilities.

The programs and software can be found be completing a search on “autism programs” in any internet search engine.

The programs are used as teaching methods in the following areas: Listening Identifying Naming Skills Matching Auditory Processing Memory Enhancement Computer usage Fine Motor Skills Reading Vocabulary Language Increasing Attention Span Keyboard Usages. ("Special Needs Software," 2008)

Assistive Communication

Devices: There are many alternative communication devices that can assist an autistic

individual to communicate.

The most important objectives of an Alternative and Augmentive Communication (AAC) device is that it says precisely what the person wants and it says it quickly. ("AAC Devices," 2011)

One AAC device that can be purchased is called the RJ Cooper Auggie. This device has a touch screen display the can generate voice by touching the screen. The device costs $1,149.00 to $2,995. ("RJ Cooper Auggie," n.d.) There are many devices similar to this that can be purchased on-line.

Two of the products can be utilized with Apple products, such as IPod or IPad. TapToTalk

An assistive communication device. Free from the Apple app store. ("TapToTalk," 2008)

Proloquo2Go Alternative communication or assistive communication aid for those with difficulty

speaking. Now offered for 189.99 at the Apple app store. ("Proloquo2Go," 2008)

Assistive PECS Board: Picture Exchange Communication System (PECS) is another form

of AAC that uses pictures to communicate. The PECS system consists of actual pictures or drawings on a Velcro

board. When the person using the board desires to communicate

something, they take a picture off the board and hand it to the person they are wishing to communicate with. ("Picture Exchange Communication System (PECS) for Children with Autism," 2009)

In order to obtain the most desirable results for the PECS system, an applied behavioral analysis approach is used when training individuals to use the system. The teaching approach usually occurs in six steps. It gives the user positive results for using the pictures to

communicate. ("Picture Exchange Communication System (PECS) for Children with Autism," 2009)

The PECS system is fairly inexpensive and can be made at home to for more personalized communication cards. (Lisalyn, 2011)

There has been some evidence that utilization of the PECS system can enhance the development of speech. (Wallin, 2004)

Sensory Integration Therapy:

Sensory Integration Therapy is performed by an Occupational Therapist.

This therapy occurs in a room that is designed to simulate and challenge the senses.

Some of the activities that could be in the room include: Swinging in a hammock Dancing to music Playing in boxes filled with beans Hitting a ball that is in motion Spinning in a chair Balancing on a beam Crawling through a tunnel.

The goal of this therapy is to help the child move in different ways and feel different things. This is thought to assist them in responding to different stimuli

in their everyday surroundings.

("Autism Therapy: Sensory integration," 2009)

Possible Symptoms with Included Treatments:

Importance of Early Intervention:

Early intervention is extremely important for all disabilities.

Education is the single most effective treatment for the ASD. (Vines, 2001)

It was found that, since the brains grows quickest from 0-3 years, early intervention is key to optimal outcomes with autism. ("Is Early Intervention Important for Children with Autism?" 2007)

It is important to understand that the results of the intervention is dependant upon the type. One study analyzed the 2 year results comparing community intervention versus the Early Start Denver

Program (ESDM). Those who received community intervention raised 7.0 standard score points. Those who underwent ESDM raised 17.6 standard score points.

The ESDM had a more intensive, individualized approach to therapy. The ESDM group were reported to more likely have a change in diagnosis from autism PDD-NOS.

(Dawson et al., 2009)

In 2001, authorities were suggested to promote early intervention because of the assistance which it provides.

Recommendations in providing effective interventions include: A minimum of 25 hours of planned educational activities weekly. Daily individual attention to allow time to address objectives adequately. Ongoing assessment Successful interactions with typically developing children. Instruction in the areas of communication, social interaction, play and cognitive skills.

http://ici.umn.edu/products/impact/193/over9.html

Unmet Needs of those with Autism:

There are multiple unmet needs that affect those with disabilities.

It has been reported that some of the needs consist of: Vision care Communication aids Therapy services Mobility aids. (Dusing, Skinner & Mayer, 2004)

A survey on unmet needs for those living with autism reports: Unmet health-care needs Obstacles in getting referrals, coordinating care, and family support

systems. Financial difficulties

Parents need to decrease or stop working to care for the autistic individual. (Mozes, 2008)

Those personally living with autism blogged, when asked specifically, that the greatest unmet needs of autistic individuals includes: Support Flexibility Acceptance and understanding Potential school budget and service cuts Time, care, patience, understanding and willingness to look at things

from a different point of view. Structure of daily living activities. No support structure after schooling is completed.

References: Autism: Symptoms. (2011). Retrieved from

http://www.mayoclinic.com/health/autism/DS00348/DSECTION=symptoms

Boyse, K. (2008, December). Autism, Autistic Spectrum Disorders (ASD) and Pervasive Developmental Disorders (PDD). Retrieved from http://www.umich.edu/yourchild/topics/autism.htm

Crow, K. (2008). Why Kids with Autism May Need Vitamin Supplements. Retrieved from http://special-needs.families.com/blog/why-kids-with-autism-need-vitamin-supplements

Dawson, G., Rogers, S., Munson, J., Winter, J., Greenson, J., Donaldson, A. et al. (2009, November 30). Randomized, Controlled Trial of an Intervention for Toddlers With Autism: The Early Start Denver Model. Pediatrics. Retrieved March 12, 2011, from http://pediatrics.aapublications.org/cgi/content/abstract/peds.2009-0958v1

Definition of Autism. (n.d.). Retrieved from http://www.definitionofautism.com/

Diagnosis of Autism. (2011). In Autism Speaks. Retrieved from http://www.autismspeaks.org/diagnosis/index.php

Dusing, S., Skinner, A., & Mayer, M. (2004, September). Unmet Need for Therapy Services, Assistive Devices, and Related Services: Data From the National Survey of Children With Special Health Care Needs. Academic Pediatrics, 4(5), 448-454. Retrieved from http://www.ambulatorypediatrics.org/article/S1530-1567(05)60340-1/abstract

Hess, J. (2009, December). Gender Differences in Children with Autism Spectrum Disorders and Co morbid Psychopathology. Retrieved from http://etd.Isu.edu/docs/available/etd-10212009-091310/unrestricted/JulieHiss_Thesis.pdf

References Continued: Hincha-Ownby, M. (2008, January 15). Causes of Autism: Environmental Exposure, Genetic Predisposition,

or Vaccine-Induced. Retrieved from http://www.suite101.com/content/causes-of-autism-a41696

History of Autism, From Way Back to Today. (2011).

Is Early Intervention Important for Children with Autism? (2007, August 18). Retrieved from http://autism.about.com/od/childrenandautism/a/Ellmportant.htm

Lisalyn. (2011). How to Create an Inexpensive Visual Schedule Activity Board for Your Preschooler with Autism. Retrieved from http://www.brighthub.com/education/early-childhood/articles/47054.aspx

Mozes, A. (2008, December 1). Health Needs of Autistic Children Often Unmet. Retrieved from http://www.stemcellschina.com/index.php/fr/news-fr/autism/1024-health-needs-of-autistic-children-often-unmet

n.d. History of Autism. Retrieved from http://www.colour-se7en.co.uk/autism.html

Picture Exchange Communication System (PECS) for Children with Autism. (2009, November 6). Retrieved from http://autism.healingthresholds.com/therapy/picture-exchange-communication-system-pecs

Proloquo2Go. (2008). In AppShopper. Retrieved from http://appshopper.com/education/proloquo2go

RJ Cooper Auggie. (n.d.). In Enablemart. Retrieved from http://www.enablemart.com/Catalog/Speech-Generating-Devices/Auggie

References Continued: Schoenstadt. (2009, January 14). Autism Speech Language Therapy. Retrieved from

http://autism.emedtv.com/autism/autism-speech-language-therapy.html

Scott, J. B. (2011). Occupational Therapy's Role with Autism. Retrieved from http://www.aota.org/Consumers/professionals/WhatisOT/RDP/Facts/38517.aspx

Seroussi, K. (2011). The GFCF (Gluten-Free, Casein-Free) Diet for Autism Spectrum Disorders. Retrieved from http://www.autismweb.com/diet.htm

Special Needs Software. (2008). In BloomingKids. Retrieved from http://www.bloomingkids.com/kids.asp

TapToTalk. (2008). In AppShopper. Retrieved from http://appshopper.com/education/taptotalk

Vines, V. (2001, Winter). Early Intervention Is Key to Easing Autism's Effects. IN Focus, 1(2). Retrieved March 23, 2011, from http://www.infocusmagazine.org/1.2/autism.html

Wallin, J. M. (2004). Visual Supports. Retrieved from http://www.polyxo.com/visualsupport/pecs.html

Wallis, C. (2006, October 20). Does Watching TV Cause Autism? Retrieved from http://www.time.com/time/health/article/0,8599,1548682,00.html

What is Autism? (2005, n.d.). Retrieved from http://www.autism-pdd.net/what-is-autism.html

The Year of Autism Epidemiology. (2011). In Autism Speaks. Retrieved from http://www.autismspeaks.org/science/science_news/top_ten_autism_research_events_2009_prevalence.php