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  2. 2. Autism in IDEA <ul><li>Autism is defined under IDEA as </li></ul><ul><li>a developmental disability significantly affecting verbal and nonverbal communication and social interaction, usually evident before age 3 that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences.” </li></ul>
  3. 3. Autism in DSM IV-TR <ul><li>In the Diagnostic and Statistical Manual used by mental health professionals, Autism falls under the category called Pervasive Developmental Disorders (PDD) </li></ul>
  4. 4. Autism Spectrum Disorders <ul><li>Sometimes in the literature you will see the PDD disorders categorized under Autism Spectrum Disorders ASD </li></ul>
  5. 5. Autism Spectrum Disorders <ul><li>an increasingly popular term that refers to a broad definition of autism including the classical form of the disorder as well as closely related disabilities that share many of the core characteristics. </li></ul>
  6. 6. Autism Spectrum Disorders <ul><li>ASD includes the following diagnoses and classifications: </li></ul>
  7. 7. Autism Spectrum Disorders <ul><li>(1)Autistic Disorder also referred to as Classic Autism </li></ul><ul><li>(2) Pervasive Developmental Disorder—Not Otherwise Specified (PDD-NOS), which refers to a collection of features that resemble autism but may not be as severe or extensive; </li></ul>
  8. 8. Autism Spectrum Disorders <ul><li>(3) Rett's syndrome, which affects girls and is a genetic disorder with hard neurological signs, including seizures, that become more apparent with age; </li></ul>
  9. 9. Autism Spectrum Disorders <ul><li>(4) Asperger syndrome, which refers to individuals with autistic characteristics but relatively intact language abilities, </li></ul>
  10. 10. Autism Spectrum Disorders <ul><li>(5) Childhood Disintegrative Disorder, which refers to children whose development appears normal for the first few years, but then regresses with the loss of speech and other skills until the characteristics of autism are conspicuous </li></ul>
  11. 11. Autism Spectrum Disorders <ul><li>Although the classical form of autism can be readily distinguished from other forms of ASD, the terms autism and ASD are often used interchangeably. </li></ul>
  12. 12. Incidence <ul><li>10 years ago Autism and PDD occured in approximately 5 to 15 per 10,000 births. These disorders were four times more common in boys than girls. </li></ul><ul><li>Today, the Centers for Disease Control believe that the incidence may be as great as 1 in 166 for those diagnosed with autism, Asperger’s syndrome, and other pervasive developmental disorders. </li></ul>
  13. 13. Incidence <ul><li>In the past 10 years, California has had a 273% increase in the number of children with autism who enter the developmental services system---1,685 new cases last year alone&quot; </li></ul>
  14. 14. Incidence <ul><li>Rise in incidence from Change in Criteria </li></ul><ul><li>&quot;It would be very surprising indeed if the broadening of the criteria for autism weren't the major part of the explanation,&quot; says Michael Rutter of the Institute of Psychiatry in London. </li></ul>
  15. 15. Incidence <ul><li>Increased public recognition of the disorder is also likely to have contributed to the apparent epidemic. As parents and doctors have become more familiar with the disease, the chances that they will identify potential cases and refer them to psychiatrists have increased. </li></ul>
  16. 16. Causes <ul><li>Medical researchers are exploring different explanations for the various forms of autism. Although a single specific cause of autism is not known, current research links autism to biological or neurological differences in the brain </li></ul>
  17. 17. Causes <ul><li>In 1998, Andrew Wakefield, a gastroenterologist at University College London, proposed a novel and terrifying connection between autism and the combination measles–mumps–rubella (MMR) vaccine. </li></ul>
  18. 18. Causes <ul><li>He described the cases of 12 children who appeared to be developing normally until they received their MMR shot between the ages of 15 and 18 months. Soon after, the children developed a kind of inflammatory bowel disease, began losing basic speech and social skills, and were subsequently diagnosed with autism. </li></ul>
  19. 19. Causes <ul><li>Subsequent studies have failed to find a link between MMR and autism 12-14 . On closer analysis, the data from several parts of the world show that the rise in autism actually started before MMR, Rutter explains. </li></ul>
  20. 20. Causes <ul><li>But just as the MMR controversy is dying down, another potential vaccine-related cause for autism has been highlighted. Many vaccines use a mercury-containing preservative called thiomersal. Fears that vaccinations may be exposing children to dangerous levels of mercury have led the US Institute of Medicine to schedule a meeting for next month to discuss possible links between thiomersal and autism. </li></ul>
  21. 21. Causes <ul><li>Despite lingering fears over the safety of vaccines, many researchers believe that the real key to understanding autism lies in sufferers' genes. </li></ul>
  22. 22. Causes <ul><li>One study found that if one identical twin has autism, the other twin has a 60% chance of developing the condition, and a 92% chance of having a condition within the DSM 's spectrum of related disorders. </li></ul>
  23. 23. Causes <ul><li>But the fact that the identical twin of a child with autism may not develop the condition suggests that environmental factors are also involved. Mutations to one or more autism genes may, for instance, increase a child's vulnerability to an unknown environmental trigger encountered during early infancy or in the womb. </li></ul>
  24. 24. General Characteristics <ul><li>Communication problems (e.g., using and understanding language); </li></ul><ul><li>Difficulty in relating to people, objects, and events; </li></ul>
  25. 25. General Characteristics <ul><li>Unusual play with toys and other objects; </li></ul><ul><li>Difficulty with changes in routine or familiar surroundings; </li></ul><ul><li>Repetitive body movements or behavior patterns. </li></ul>
  26. 26. General Characteristics <ul><li>Children with autism or PDD vary widely in abilities, intelligence, and behaviors. </li></ul>
  27. 27. General Characteristics <ul><li>Some children do not speak; others have limited language that often includes repeated phrases or conversations. </li></ul>
  28. 28. General Characteristics <ul><li>People with more advanced language skills tend to use a small range of topics and have difficulty with abstract concepts . </li></ul>
  29. 29. General Characteristics <ul><li>Repetitive play skills, a limited range of interests, and impaired social skills are generally evident as well. </li></ul>
  30. 30. General Characteristics <ul><li>Unusual responses to sensory information -- for example, loud noises, lights, certain textures of food or fabrics -- are also common. </li></ul>
  31. 31. Asperger's Syndrome <ul><li>Asperger Syndrome (AS) is a neurobiological disorder, which most researchers feel falls at the &quot;high-end&quot; of the Autistic Spectrum. </li></ul>
  32. 32. Asperger’s Syndrome <ul><li>AS is a relatively new term in the United States, having only recently being officially recognized as a diagnosis by the medical community </li></ul>
  33. 33. Asperger’s Syndrome <ul><li>Because of their high degree of functionality and their naivete, those with AS are often viewed by their peers as odd, and are frequently a target for bullying. </li></ul>
  34. 34. Asperger’s Syndrome <ul><li>socially awkward and clumsy in relations with other children and/or adults </li></ul><ul><li>naive and gullible </li></ul><ul><li>often unaware of others' feelings </li></ul>
  35. 35. Asperger’s Syndrome <ul><li>unable to carry on a &quot;give and take&quot; conversation </li></ul><ul><li>easily upset by changes in routines and transitions </li></ul><ul><li>literal in speech and understanding </li></ul>
  36. 36. Asperger’s Syndrome <ul><li>overly sensitive to loud sounds, lights or odors </li></ul><ul><li>fixated on one subject or object </li></ul><ul><li>physically awkward in sports </li></ul>
  37. 37. Asperger’s Syndrome <ul><li>unusually accurate memory for details </li></ul><ul><li>sleeping or eating problems </li></ul><ul><li>trouble understanding things they have heard or read </li></ul><ul><li>inappropriate body language or facial expression </li></ul><ul><li>unusual speech patterns (repetitive and/or irrelevant remarks) </li></ul>
  38. 38. Asperger’s Syndrome <ul><li>stilted, formal manner of speaking </li></ul><ul><li>unusually loud, high or monotonous voice </li></ul><ul><li>tendency to rock, fidget or pace while concentrating </li></ul>
  39. 39. Rett Syndrome <ul><li>a neurological disorder seen almost exclusively in females </li></ul><ul><li>found in a variety of racial and ethnic groups worldwide </li></ul>
  40. 40. Rett Syndrome <ul><li>The child with RS usually shows: </li></ul><ul><li>an early period of apparently normal or near normal development until 6-18 months of life </li></ul>
  41. 41. Rett Syndrome <ul><li>A period of temporary stagnation or regression follows during which the child loses communication skills and purposeful use of the hands. </li></ul>
  42. 42. Rett Syndrome <ul><li>Soon, problems with hand movements, gait disturbances, and slowing of the rate of head growth become apparent. </li></ul>
  43. 43. Rett Syndrome <ul><li>The characteristic hand movements begin to emerge during this stage and often include wringing, washing, clapping, or tapping, as well as repeatedly moving the hands to the mouth. </li></ul>
  44. 44. Rett Syndrome <ul><li>Hands are sometimes clasped behind the back or held at the sides, with random touching, grasping, and releasing. </li></ul>
  45. 45. Rett Syndrome <ul><li>Some girls also display autistic-like symptoms such as loss of social interaction and communication. </li></ul>
  46. 46. Rett Syndrome <ul><li>Rett syndrome is caused by mutations (structural alterations or defects) in the MECP2 (pronounced meck-pea-two ) gene, which is found on the X chromosome </li></ul>
  47. 47. CHILDHOOD DISINTEGRATIVE DISORDER <ul><li>Childhood Disintegrative Disorder (also known as Heller's Syndrome) is a condition in which a child develops normally for 2 years, then begins to lose ground. </li></ul>
  48. 48. CHILDHOOD DISINTEGRATIVE DISORDER <ul><li>Previous gains in language and social skills, motor abilities, play, and even in continence are eroded.  </li></ul>
  49. 49. Classic Autism <ul><li>Classic autism is the best known subtype of this disorder (PDD) and involves severe qualitative deficits in social interaction, language communication and play and is associated with stereotypic and perseverative behavior. </li></ul>
  50. 50. High Functioning Autism <ul><li>Symptoms include delayed or absence of speech, the inability to appropriately relate to others, repetitive movements, such as hand flapping, and an insistence of a routine. </li></ul><ul><li>Pervasive Developmental Disorder:   Not otherwise specified - (commonly referred to as atypical autism) a diagnosis of PDD-NOS may be made when a child does not meet the criteria for a specific diagnosis, but there is severe and pervasive impairment in specified behaviors. </li></ul>