The project I have chosen to radically revise my second paper about Autism and Education. I plan on making an informative power point based on the researched information from my paper. In the power point, I will discuss the different options available to the parents of children with autism. The different options I will discuss include enrolling a child in a private school, the process of enrolling a child in public school, and enrolling a child in an alternative school. For each option, I will discuss the pros and cons, advantages and disadvantages of each choice. The objectives of my power point include informing parents of autism more about the disorder, outlining the step by step process of enrolling a child into a special education program in a public school, outlining the different laws associated with how the public school systems and special education, discuss the advantages and disadvantages of each option, and give references for more information on Autism and how to help out the cause. The goal of the power point overall is to inform parents of children with autism of their different options, and hopefully it will become an aid in their decision when it comes time to decide how they want to educate their child. I also plan on providing more information on Autism, so they will be able to learn more about the disorder and have some references to find more information about it.
As for the interface, I will be using Microsoft Powerpoint. In the program there is an option to ‘Publish as a Webpage”, which is how I am going to publish my work. I will be posting the link to the webpage I created with the power point to a blog I created so it will be accessible to a wide audience. By using a blog as well I give the audience a chance to provide feedback on my website, or a forum to post more information. Parents can post their opinions, choices, or provide advice for each other.
A selective overview of highlights from the amazing people who highjacked Twitter for a day to function as an autism awareness and advocacy tool, and the amazing experience that was Autism Twitter Day.
Autism 101 by ASNV (Last updated June 2015)AutismNOVA
Want to know more about autism? This presentation gives parents, educators, service providers, and the general public a brief overview of autism signs & symptoms, and considerations and best practices when interacting with a child or adult who is on the autism spectrum.
This presentation is a Grand Rounds for the Dept. of Pediatrics at Mt. Sinai Hospital in Chicago. Presented by child psychiatrist, Daniel B. Martinez, M.D. February 9, 2011
The project I have chosen to radically revise my second paper about Autism and Education. I plan on making an informative power point based on the researched information from my paper. In the power point, I will discuss the different options available to the parents of children with autism. The different options I will discuss include enrolling a child in a private school, the process of enrolling a child in public school, and enrolling a child in an alternative school. For each option, I will discuss the pros and cons, advantages and disadvantages of each choice. The objectives of my power point include informing parents of autism more about the disorder, outlining the step by step process of enrolling a child into a special education program in a public school, outlining the different laws associated with how the public school systems and special education, discuss the advantages and disadvantages of each option, and give references for more information on Autism and how to help out the cause. The goal of the power point overall is to inform parents of children with autism of their different options, and hopefully it will become an aid in their decision when it comes time to decide how they want to educate their child. I also plan on providing more information on Autism, so they will be able to learn more about the disorder and have some references to find more information about it.
As for the interface, I will be using Microsoft Powerpoint. In the program there is an option to ‘Publish as a Webpage”, which is how I am going to publish my work. I will be posting the link to the webpage I created with the power point to a blog I created so it will be accessible to a wide audience. By using a blog as well I give the audience a chance to provide feedback on my website, or a forum to post more information. Parents can post their opinions, choices, or provide advice for each other.
A selective overview of highlights from the amazing people who highjacked Twitter for a day to function as an autism awareness and advocacy tool, and the amazing experience that was Autism Twitter Day.
Autism 101 by ASNV (Last updated June 2015)AutismNOVA
Want to know more about autism? This presentation gives parents, educators, service providers, and the general public a brief overview of autism signs & symptoms, and considerations and best practices when interacting with a child or adult who is on the autism spectrum.
This presentation is a Grand Rounds for the Dept. of Pediatrics at Mt. Sinai Hospital in Chicago. Presented by child psychiatrist, Daniel B. Martinez, M.D. February 9, 2011
A presentation on Steve Jobs's early life, past, inventions, products, apple products like Iphone, Ipad and Mac, the Next Computers, Pixar animations etc. The slide/ ppt also includes what we learn from steve jobs as a dropout, a lover who lost and about death. It also contains slides for the next big thing i.e. Apple Watch.
Understanding Autism: UT Arlington New Teacher Webinar
This slideshare gives key points about the crucial topic of “Understanding Autism.” and is geared for educators. Learn more about teaching and locating resources to better help students on the autism spectrum. Learn how to build on strengths of students!
The link to the recording is here: https://elearn.uta.edu/webapps/bb-collaborate-bb_bb60/recording/launchGuest?uid=ac9763c6-c090-42a0-985d-fc26e5e231b3
The YouTube channel is here: YouTube [video]: http://www.youtube.com/utanewteachers
Like us on Facebook: Facebook Page [interaction/updates]:
https://www.facebook.com/UTANewTeacherProject
Lola Nasretdinova talks about autism for the international conference on child disability issues, Bishkek, 1-3 March 2011, Kyrgyzstan.
Лола Насретдинова о спектре аутистических нарушений (на англ.) для международной конференции в Бишкеке 1-3 марта 2011 г.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
3. 3/30/2014
ASDs are a range of neurological
disorders marked by impairment
in social functioning,
communication,
and repetitive and unusual patterns of behavior.
(Autism Society of America, 2008)
4. 3/30/2014
Leo Kanner, in 1943 described 11
children with
―Autistic disturbances of affective contact‖
Poor social skills
Quantitative and qualitative defects of
communication
Professional, high achieving parents
Coined the term, Refrigerator mother
Hans Asperger, in 1944, described ―autistic psychopathy‖
Poverty of social interaction
Failure of communication
Oddities of non-verbal communication – gaze aversion, prosody
Attractive appearance
Similarities between the parents and children
Resistance to change
HISTORY
7. 3/30/2014
• Communication is defined as:
According to the Webster Dictionary
communication is defined as a
act of connecting with
or
conveying either by verbal or non verbal.
Webster Dictionary, Published 1997, Landoll. Inc
8. 3/30/2014
Verbal Communication
• Language, we all have a gift of speaking
• Using the right words at the right time.
• Account for all the words you say and
meaning.
• Saying the right thing at the wrong time.
9. 3/30/2014
Non-Verbal
• Body Language
• What message are you giving by your
Expressions
• Judging by visual expressions
• Saying a positive thing with a negative
expression
10. 3/30/2014
Pervasive Developmental
Disorders" (PDD)
• Biologically based
neurodevelopmental disorders
characterized by impairments in
three major domains:
• Socialization,
• Communication,
• And behavior.
Pervasive Developmental Disorders. In:
American Psychiatric Association.
Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, Text
Revision (DSM-IV-TR®). American
Psychiatric Association, Washington, DC
2000. p. 70.
14. 3/30/2014
Prevalence
• The majority of studies conducted from the
mid-1990s indicates a prevalence of
approximately 1 in 1000 for autism and 2 in
1000 for ASD, compared to 0.4 to 0.5 per
1000 in previous decades
• NOW::::::2009 __________ 1 IN 91
•
• 100,000 saudi child has autism in 2008
• Now: in saudia arabia 1 every 144 is autistic
• Four times more prevalent in boys than in
girls
National Autism Association
Article Date: 07 Oct 2009 - 2:00 PDT
15. 3/30/2014
These disorders include
Autistic disorder (classic autism, sometimes called
early infantile autism), Childhood Autism, or
Kanner's autism)
Rett’s disorder
Childhood disintegrative disorder
Asperger’s disorder (also known as Asperger
syndrome)
Pervasive Developmental Disorder, Not Otherwise
Specified (Pdd-nos), Including Atypical Autism
17. 3/30/2014
Diagnostic criteria for autistic disorder
A B C
1. Qualitative impairment in social interaction, as manifested by
at least two of the following:
a. Marked impairment in the use of multiple nonverbal behaviors
such as eye-to-eye gaze, facial expression, body posture, and
gestures to regulate social interaction
b. Failure to develop peer relationships appropriate to
developmental level
c. A lack of spontaneous seeking to share enjoyment, interests, or
achievements with other people (e.g , by a lack of showing,
bringing, or pointing out object of interest)
d. Lack of social or emotional reciprocity
A. A total of 6 or more items from 1., 2., and 3., with at least two from 1.,
and one each from 2. and 3.:
Cnt.
18. 3/30/2014
• 2. Qualitative impairments in communication as
manifested by at least one of the following:
a. Delay in, or total lack of, the development of
spoken language (not accompanied by an attempt
to compensate through alternative modes of
communication such as gesture or mime)
b. In individuals with adequate speech, marked
impairment in the ability to initiate or sustain
conversation with others
c. Stereotyped and repetitive use of language
or idiosyncratic language
d. Lack of varied, spontaneous make-believe
play or social imitative play appropriate to
developmental level
Cnt.
19. 3/30/2014
• 3. Restricted repetitive and stereotyped patterns
of behavior, interests, and activities, as
manifested by at least one of the following:
a. Encompassing preoccupation with one
or more stereotyped and restricted patterns of
interest that is abnormal either in intensity or
focus
b. Apparently inflexible adherence to specific,
nonfunctional routines or rituals
c. Stereotyped and repetitive motor
mannerisms (eg hand or finger flapping or
twisting, or complex whole-body movements
d. Persistent preoccupation with parts of
objects
Cnt.
21. 3/30/2014
Screening tools for autism
spectrum disorders
• Screening is defined as a brief, formal,
standardized evaluation, the purpose of
which is the early identification of
patients with unsuspected deviations
from normal.
• A screening instrument enables detection of conditions/concerns
that may not be readily apparent without screening.
• Screening does not provide a diagnosis; it helps to determine
whether additional investigation (e.g, a diagnostic evaluation) by
clinicians with special expertise in developmental pediatrics is
necessary
22. 3/30/2014
Several screening tools have been
developed for use in children younger than
three years of age
• Checklist for Autism in
Toddlers (CHAT)
• Quantitative Checklist for
Autism in Toddlers (Q-CHAT)
• Modified Checklist for Autism
in Toddlers (M-CHAT)
• Checklist for Autism in
Toddlers-23 (CHAT-23)
• Pervasive Developmental
Disorders Screening Test II,
Primary Care Screener
(PDDST-II PCS)
• Screening Tool for Autism in
Two-Year-Olds (STAT)
Johnson, CP, Myers, SM. Identification and evaluation of children
with autism spectrum disorders. Pediatrics 2007; 120:1183.
23. 3/30/2014
Checklist for Autism in Toddlers (CHAT <18m
• Section A - Ask Parent:
• Yes or No?
• ____ 1) Does your child enjoy being swung( , bounced on
your knee, etc?
• ____ 2) Does your child take an interest in other children?
• ____ 3) Does your child like climbing on things, such as up stairs?
• ____ 4) Does your child enjoy playing peek-a-boo /hide-
and-seek?
• ____ *5) Does your child ever pretend , for example, to make a
cup of tea using a toy cup and teapot, or pretend other things?
• ____ 6) Does your child ever use his/her index finger to point, to ask
for something?
• ____ *7) Does your child ever use his/her index finger to point, to
indicate interest in something?
• ____ 8) Can your child play properly with small toys (e.g. cars or
bricks ) without just mouthing, fiddling , or dropping them?
• ____ 9) Does your child ever bring objects over to you, to show you
something
24. 3/30/2014
• Section B - GP's observation
• Yes or No?
• ____ i) During the appointment, has the child made eye contact with you?
• ____ *ii) Get child's attention, then point across the room at an interesting object and
say "Oh look! There's a (name a toy)!" Watch child's face. Does the child look across
to see what you are pointing at?
• NOTE - to record yes on this item, ensure the child has not simply looked at your
hand, but has actually looked at the object you are pointing at.
• ____ *iii) Get the child's attention, then give child a miniature toy cup and teapot and
say "Can you make a cup of tea?" Does the child pretend to pour out the tea, drink it
etc?
• NOTE - if you can elicit an example of pretending in some other game, score a yes
on this item
• ____ *iv) Say to the child "Where's the light?" or "Show me the light". Does the child
point with his/her index finger at the light?
• NOTE - Repeat this with "Where's the teddy ?" or some other unreachable
object, if child does not understand the word "light". To record yes on this item, the
child must have looked up at your face around the time of pointing.
• ____ v) Can the child build a tower of bricks ? (If so, how many?) (Number of
bricks...)
• * Indicates critical question most indicative of autistic characteristics
Cnt.
British Journal of Psychiatry (1996), 168, pp. 158-163
Psychological markers in the detection of autism in infancy in a large population. AUBaron-Cohen S; Cox A; Baird G;
32. 3/30/2014
I.Q. in autism
50 IN 50%
50-70 in 20%
70-100 in 30%
the last is the BEST
BUT IN ONE SIDE OF ART
High functioning autism is the term used to
describe individuals with intelligence quotient
(IQ) >70 (ie, borderline and above
intelligence).
35. 3/30/2014
• Medical conditions associated with autism
.
• Between 45 and 60 percent of children with autism are
mentally retarded.
• Seizures occur in 11 to 39 percent of children with
ASD. The risk of seizures is higher in individuals with
more severe intellectual disability (mental retardation).
• A minority (fewer than 10 to 25 percent) of cases of
ASD are associated with a medical condition or
syndrome, such as phenylketonuria, fetal alcohol
syndrome, tuberous sclerosus, fragile X syndrome, or
Angelman syndrome. These syndromes are usually
diagnosed at or shortly after birth.
36. 3/30/2014
The pathogenesis of ASD is
incompletely understood
• There is increasing evidence for the role of genetic
factors in the etiology of autism
• Evidence for the strong genetic contribution to
development of ASD is derived from the following
observations
• Unequal sex distribution, with 4:1 male predominance
• Increased prevalence in siblings of patients with ASD
compared to the general population
• High concordance rate among monozygotic twins
Pediatrics. 2007 Nov;120(5):1183-215. Epub 2007
Oct 29.
37. 3/30/2014
• Neuroimaging and autopsy studies in patients
with autism suggest that brain abnormalities play
an important role
• These abnormalities include diffuse differences
in total and regional gray and white matter
volumes, sulcal and gyral anatomy, brain
chemical concentrations, neural networks, brain
lateralization, and cognitive processing
compared to individuals without autism
Cnt.
NA-MIC AHM Salt Lake City, UT Jan 11, 2007
MRI findings in 77 children with non-syndromic autistic
disorder.. 2009;4(2):e4415. Epub 2009 Feb 10.
38. 3/30/2014An Autistic Brain: result or cause
of autism?
Larger frontal lobes due to excess
white matter
• Corpus Collosum is undersized
• Amygdala is enlarged
10% larger hippocampus.
This region is responsible for
memory.
ASD patients rely on
memory to interpret situations
• Cerebellum is larger also due to
excess white matter
Too many cables within local areas
but not enough linking different
regions
Cnt.
39. 3/30/2014
• Parental age — Advanced parental age
(both paternal and maternal) have been
associated with an increased risk of
having a child with ASD
• . This is perhaps related to de novo
spontaneous mutations and/or alterations
in genetic imprinting.
Advancing paternal age and autism. Gen Psychiatry. 2006 Sep;63(9):1026-32.
Arch Pediatr Adolesc Med. 2007 Apr;161(4):334-40.
Advanced parental age and the risk of autism spectrum disorder. J Epidemiol. 2008 Dec
1;168(11):1268-76. Epub 2008 Oct 21.
Cnt.
40. 3/30/2014
• Lack of association with
immunizations — Some authors have
attributed regressive autism to vaccine
exposure (particularly measles vaccine
and thimerosal [a mercury preservative
used in vaccines]). However, the
overwhelming majority of epidemiologic
evidence does not support an association
between immunizations and autism
. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data.
Pediatrics 2003; 112:604.
AUTISM AND VACCINES:the TRUTH beyond the CONTROVERSY
Pediatrics on the Parkway November 15, 2008
Cnt.
42. 3/30/2014
Possible Red Flags for Autism
• The child does not respond to
his/her name.
• The child cannot explain what
he/she wants.
• The child’s language skills are
slow to develop or speech is
delayed.
• The child doesn’t follow
directions.
• At times, the child seems to be
deaf.
• The child seems to hear
sometimes, but not other times.
• The child doesn’t point or wave
―bye-bye.
• The child seems to prefer to
play alone.
• The child gets things for
him/herself only
The child used to say a few words
or babble, but now he/she doesn’t.
The child throws intense or violent
tantrums.
The child has odd movement
patterns.
The child is overly active,
uncooperative, or resistant.
The child doesn’t know how to
play with toys.
The child doesn’t smile when
smiled at.
The child has poor eye contact.
The child gets ―stuck‖ doing the
same things over and over and
can’t move on to other things.
43. 3/30/2014
• The child is very independent for his/her age.
• The child does things ―early‖ compared to other children.
• The child seems to be in his/her ―own world.‖
• The child seems to tune people out.
• The child is not interested in other children.
• The child walks on his/her toes.
• The child shows unusual attachments to toys, objects, or schedules
(i.e., always holding a string or having to put socks on before pants).
• Child spends a lot of time lining things up or putting things in a
certain order.
•
Cnt.
The National Institute of Child Health and Human
Development (NICHD),
Autism Overview: What We Know ,2005
44. 3/30/2014
Asperger syndrome
• First identified by Hans Asperger in 1944
• unusual social styles, even lack of eye contact in
interactions, or poor social skills.
• Difficulty making friends.
• Difficulty reading or communicating through non verbal
social cues, such as facial expressions. Cannot read
body language.
• Have difficulty introducing themselves into groups of
people or conversations.
• Obsessive focus on a narrow interest
different way of thinking and interacting with their
environment
45. 3/30/2014
Where Asperger’s Syndrome
Differs from Autism
Autism Asperger’s Syndrome
Severe problems with
language
No significant language
delay or problems with
structure
Significant learning
difficulties
Learning difficulties less
severe
47. 3/30/2014
• Individuals with AS have low-IQ.
• Effect of bad parenting
• Person should be able to control their behavior
Strengths
Individuals with AS are quirky but are also
creative and intelligent.
Can be successful in “narrow” careers, IT,
Engineering
Have a unique perspective
Common
Misconception
s
48. 3/30/2014
• Rett’s disorder
• It was described in 1966 by Andreas Rett, an Austrian
neuropediatrician
• It's quite rare with only one affected out of every ten to fifteen thousand children.
•
• a neurodevelopmental disorder that occurs almost exclusively in
females.
• Affected patients initially develop normally
• , then gradually lose speech and purposeful hand use sometime
after 18 months of age.
• Most cases result from mutations in the MECP2 gene.
• Characteristic features include:
• deceleration of head growth (in contrast to acceleration of head
growth, which occurs in other ASD),
• stereotypic hand movements,
• Dementia seizures, autistic features, ataxia, and breathing abnormalities
subsequently develop
49. 3/30/2014
• Deceleration of brain growth begins after birth
• . In a postmortem study of 39 patients 3 to 35 years
old, most RETT’S brains were smaller than normal and
did not grow after age four years
• In contrast, the heart, kidneys, liver, and spleen grew
at a normal rate until 8 to 12 years of age. At that time,
their growth rate decelerated, but continued so that
organ weights were appropriate for height, which was
also reduced. Adrenal organ weights were normal.
Armstrong, DD, Dunn, JK, Schultz, RJ, Herbert, DA.
Organ growth in Rett syndrome: a postmortem
examination analysis. Pediatr Neurol 1999; 20:125.
52. 3/30/2014
Exclusion Criteria
• Evidence of intrauterine growth retardation
• Organomegaly or other signs of storage disease
• Retinopathy or optic atrophy
• Microcephaly at birth
• Evidence of perinatally acquired brain damage
• Existence of identifiable metabolic or other
progressive neurological disorder
• Acquired neurological disorders resulting from
severe infections or head trauma
Cnt.
53. 3/30/2014
DSM-IV: Diagnosis of Rett’s Disorder
• A. All of the following:
– (1) apparently normal prenatal and perinatal development
– (2) apparently normal psychomotor development through the first 5
months after birth
– (3) normal head circumference at birth
• B. Onset of all of the following after the period of
normal development:
– (1) deceleration of head growth between ages 5 and 48 months
– (2) loss of previously acquired purposeful hand skills between ages
5 and 30 months with the subsequent development of stereotyped
hand movements (e.g., hand-wringing or hand washing)
– (3) loss of social engagement early in the course (although often
social interaction develops later)
– (4) appearance of poorly coordinated gait or trunk movements
– (5) severely impaired expressive and receptive language
development with severe psychomotor retardation
55. 3/30/2014
• Rett’s Disorder
– Mostly females
– Deterioration in developmental
milestones, head
circumference, overall growth
– Loss of purposeful hand
movements
– Stereotypic hand movements
(hand-wringing, hand washing,
hand-to-mouth)
– Poor coordination, ataxia,
apraxia
– Loss of verbalization
– Respiratory irregularity
– Early seizures
– Low CSF nerve growth factor
• Autistic Disorder
– Mostly males
– Abnormalities present from
birth
– Stereotypic hand movements
not always present
– Little to no loss in gross motor
function
– Aberrant language, but not
complete loss
– No respiratory irregularity
– Seizures rare; if occur, develop
in adolescence
– Normal CSF nerve growth
factor
56. 3/30/2014
Childhood Disintegrative Disorder
• is a regressive disorder.
• This favors boys and does not begin to show symptoms
before three to four years.
• By this time the child has meet many of their early milestones. They are
walking, potty trained, affectionate and will be speaking. They'll enjoy
playing with their peers.
• Then it will begin without warning and over the space of
just a few months all this progress will stop. The child will
lose whatever language they have and will no longer be
able to control their bowel or bladder. They may begin to
have seizures and will usually have a low IQ. This is the
most dramatic of all the types of autism as the once
sunny smiling child will turn sullen, uncommunicative and
lose all they have learned.
57. 3/30/2014
Pervasive Developmental Disorder not
Otherwise Specified PDD -NOS
• is the name used for people who have
many of the symptoms of autism but not
enough of one kind to be labeled with it
and so they are put in this general
category. The person may have most of
the symptoms, a very few or almost none.
It is not a diagnosis of a disorder but
merely a term to cover off the symptoms of
an unknown neurodevelopmental disorder
62. 3/30/2014
More references
• Edelson, M. (2006). Are the Majority of Children With Autism Mentally Retarded?
A Systematic Evaluation of the Data. Focus on Autism and Other Developmental
Disabilities. 21, (2),66-83.
• Bellini, S,. And Hopf, A. (2007). The Development of the Autism Social Skills
Profile: A Preliminary Analysis of Psychometric Properties. Focus on Autism and
Other Developmental Disabilities. 22, (2), 80-87.
• Koegel, R,. And Koegel L. (1995). Teaching Children with Autism. Baltimore: Paul
H. Brookes Publishing Co., Inc.
• Murdock, L., Cost, H., and Tieso, C. (2007). Measurement of Social
Communication Skills of Children With Autism Spectrum Disorders During
Interactions With Typical Peers. Focus on Autism and Other Developmental
Disabilities. 22 (3), 160-172.
• Myles, B., Lee, H., Smith, S., Tien, K., Chou, Y., Swanson, T., and Hudson, J.
(2007). A large-Scale Study of the Characteristics of Asperger Syndrome.
Education and Training in Developmental Disabilities. 42 (4), 448-459.
• Richard, G. (1997).The Source for Autism. Illinois: LinguiSystems, Inc.
• Sewell, K. (1998). Breakthroughs: How to Reach Students with Autism.
Wisconsin: Attainment Publication.
• Simons, J., and Oishi, S. (1987). The Hidden Child: The Linwood Method for
Reaching the Autistic Child. Maryland: Woodbine House.
• Tyron, P., Mayes, S., Rhodes, R., and Waldo, M. (2006). Can Asperger’s Disorder
be diffrentiated from Autism Using DSM-IV Criteria? Focus on Autism and Other
Developmental Disabilities. 21, (1).pp. 2-6.
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