This document discusses autism spectrum disorder (ASD) and provides information about diagnosis, causes, treatment, oral health findings, and challenges with dental care for autistic children. Some key points: - ASD is defined by difficulties with social interaction, communication, and restricted/repetitive behaviors. Males are 4 times more likely than females to have ASD. - Severity is classified by the Childhood Autism Rating Scale from mild to severe. Diagnosis involves formal evaluation plus this scale. - Causes are believed to include genetic and environmental factors like heavy metal exposure. Having a first autistic child increases the risk of another child with ASD. - Treatment focuses on intensive therapy sessions

1. Prof Dr Hussein Abdeldayem
Prof of Ped Neurology, Alex University
Member of AAN, AAP, ICNA
AUTISMAUTISM
FOR PEDOFOR PEDO

2. Autism Spectrum DisorderAutism Spectrum Disorder
ASDASD
They are defined as a group of biologically based
neurodevelopment disorders that share two
common areas of concern
Qualitative
impairments in
social interactions
Qualitative
impairments in
social interactions
Restricted and
repetitive
interests or
behaviors
Restricted and
repetitive
interests or
behaviors
Qualitative
impairments in
communication
Qualitative
impairments in
communication

3. ASD
male 4/ 1 female

4. ASD

5. DSM-V
No pervasive developmental
disorder term
But
ASDMild Severe

6. SEVERITY According to CARS
 15 and less. Normal
 16 – 29. Risky
 30 – 33. mild autism
 34 – 36 moderate autism
 37 – 60. severe autism

7. 1 child in every 150. - - 88 68
2007 2012 2014

8. please refer
 Failure to Attend to human voices
 Failure to Look at face and eyes of others
 Failure to Orient to name
 Failure to Demonstrate interest in other children
 Failure to imitate
 NO babbling, pointing or gesturing by 12 mo
 NO single words by 16 mo
 NO 2 words spontaneous phrases by 24 mo
 Any loss of language or social skills at any age
Auditory assessment is needed (ABR)
Screening for autism: M-CHAT

9. So…What causes autism?
Genetic Factors
Factors that affect the
capacity for methylation
(including gender)
Factors that affect
metal handling
Environmental Factors
Vaccine AdditivesEnvironmental Exposure
To Heavy Metals
Brain Differences
Effect or cause

10. Is there an increased risk
of having another child
with autism (recurrence)?
 The incidence of
autism in the general
population is 0.2-1%,
but the risk of having
a second (or
additional) autistic
child increases almost
50-fold to
approximately 10 to
20%.

12. Formal diagnosis
+

13. CARS
 To assess severity
 60 questions
 For the mother or
caregiver and noticed by
the examiner
 <15 normal
 15-30 : risky
 30-37: mild ,moderate
 >37: severe

14. Treatment
AUSTISM IS A TREATBLE DISEASE
SESSIONS ,SESSIONS , SESSIONS ,
SESSIONS
SESSIONS
SESSIONS

15. AUTISM IS A TREATABLE DISEASE

16. Oral Findings
 Higher risk of dental caries :
In a study to describe the caries status of
children with autism it was found that children
with autism are often cited as having certain
behaviors as:
 Taking Medications xerostomia
 Preferring sweetened foods.
 Poor oral hygiene
 Inability of brushing and flossing

17. Oral Findings
3. Tooth eruption .. May be
delayed due to phenytoin
induced gingival hyperplasia.
4. Trauma and injury.. To the
mouth from falls or accidents in
case of seizure disorders and
SIB (self-injurious behaviors).

18. Autistic child and Dental Problems
 15%-20% of ASD children
 Include
1. Decayed teeth
2. Gum disorder
3. Bruxism
4. Trauma
5. Abnormal alignment
6. SIB/ pica

19. Etiology
 Poor oral hygiene
 Not cooperative with brushing and flossing
for decayed teeth and gum disease
 Emotional troubles as anxiety for bruxism
 Tongue thrusting for alignment
 Hyperactive and clumsy for teeth or jaw trauma
 SIB for trauma
 Hypersensitivity to sensory stimuli can also interfere
with oral hygiene

20. Problems in Pedro Clinic
1- no verbal or non verbal communication
2- hyperactive
3. Easily distracted and impulsive
4. Easily agitated
5. Can ‘ t his turn
6. Hypersensitive to sensory stimuli either dental set or
its sound

21. Role in the Pedro Clinic
1- first appointment of the day
2- allow to tour in the clinic before first appointment
3- be quick as possible
4- try to explain simply and to be friendly with the child
5- might use sedation as choral hydrate
6- parents especially loved by the child should come
inside the clinic
7- using the same assisting dental stuff, nurse, for every
visit

22. Parent’s Advices
 For brushing
1- modeling
2- routine time
3- video films or photos of interest
4- use toothpaste of acceptable odor
• Not allow or decrease chewable candies or gums
• Drink water after drinking milk or juice especially
before sleep

23. SIB
SIB TREATMENT
 1- RESPERIDONE
 2- ARIPIPRAZOLE
 3- HALOPERIDOL

25. AUTISM IS NOT MENTAL RETARDATION
 AUTISTIC CHILD IS USUALLY TALENT IN
MATH
MUSIC
ART
Einstein , Newton , Messi