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Autism Center
Autism 101:An Introduction for Families
Lindsey Miller, ARNPRachel Montague, Ph.D.
June 5, 2012
Autism Center
• What are Autism Spectrum Disorders?• Prevalence & causes• Characteristics & related issues• Treatments• Resources
Overview of Presentation
Autism Center
What Are Autism Spectrum Disorders?• ASDs are brain-based
developmental disorders that are present from birth and includes presence of • Social,• communicative, • and behavioral abnormalities
(Diagnostic and Statistical Manual, IV (DSM-IV))
Overview of Presentation
Autism Center
• Symptoms can occur in a variety of combinations
• Symptoms present with varying degrees of severity
• Two children with a diagnosis of autism can have very different strengths and challenges and can act completely differently from one another
• Intellectual abilities vary
What is meant by “spectrum disorders”?
Autism Center
Autism Spectrum Disorders
Autistic Disorder Asperger's Disorder PDD-NOS
What are Autism Spectrum Disorders (ASD)?
Autism Center
Autism Spectrum Disorder
Autistic Disorder Asperger's Disorder PDD-NOS
Proposed model of ASD
Autism Center
• CDC estimates that 1 in 88 children have ASD• This is up to a 10-fold increase since 1950s
• Similar rates across different cultures, ethnicities, or income level
• Current averages indicate
that boys are 4.4 times
more likely to be
diagnosed with ASD as
compared to girls
Prevalence of ASD
Autism Center
Why the increase in ASDs?
• Several reasons:• Wider public awareness• Better assessment tools• We are now diagnosing kids with autism now who
present with average or above average intellectual capabilities and more subtle social and language delays.
• Is there a true increase?• ASDs may have been unrecognized or misidentified
in the past
Autism Center
What causes it?
• Genetics• Identical twin studies: 60-90% of the time that 1 twin
has ASD, the other does too.
• For sibling studies: 8-18% of the time that 1 sibling has ASD, another sibling does too.
• Even if the other siblings don’t meet criteria for ASD, they may have social difficulties, language impairment or developmental delay
Autism Center
What causes it?
• Environment• There is also likely an environmental component
• research is trying to identify specific environmental factors
• What do we mean by “environment”?
• It’s likely a combination of genetics & environment• The theory is that the genetic component can be
turned on by an environmental trigger.
Autism Center
What causes it?
• We know some things do NOT cause ASD – such as vaccines or parenting• In 2010, journal Lancet officially retracted the 1998
article that originally suggested a connection between autism and the MMR vaccine.
• Many years ago, people believed autism was caused by “bad parenting.” Research has shown that is not the case.
Autism Center
When is ASD diagnosed?
• ASD can sometimes be diagnosed as early as age 2 by experienced clinicians
• Some children with ASD are diagnosed during school-age years.
Autism Center
How is ASD diagnosed?
• No medical test (e.g. blood test, brain scan)• Diagnosis made using specific criteria • Based on developmental history, direct observation
and interaction with child, clinical judgment by qualified professionals
• Tools:• Autism Diagnostic Observation Schedule (ADOS) often used,
but not required• Autism Diagnostic Interview (ADI) – semi structured parent
interview about development
Autism Center
Characteristics of ASDs
Social Interaction Impairments
Restricted, Repetitive Behaviors
Communication Impairments
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Social Interaction Impairment
• Difficulty using eye gaze, gestures, etc.• Gestures include pointing, nodding, waving goodbye
• Few friendships• Difficulty sharing enjoyment & interests
with others.• Difficulty relating to others, taking
another’s perspective, and empathy
Autism Center
Communication Impairment
• Language delays• Difficulty with back-and-forth
conversations.• Repetitive and/or odd use of language.
Autism Center
• Abnormally obsessive interests• Rigid adherence to routines• “Stereotyped” motor movements
• Hand flapping, rocking, spinning, pacing
• Focus on the details, miss the big pictures
• Odd play skills
Patterns of Behavior
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Related Issues in ASD
• Inattention and/or Hyperactivity (ADHD)• Anxiety• Depression/ irritability • Disruptive/ oppositional behaviors• Sensory Processing Issues
• Motor Planning Issues
• Executive Functioning
• Tic disorders
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• Visual learning• Concrete skills• Memory• Consistency• Following rules• Attention to detail
Common Strengths for Children with ASD
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• There is no cure for ASD, but intervention lead to improvement and development of skills.
• Intervention is recommended as soon as diagnosis is made.
• With intervention, progress can be made in many areas.
• What therapy is right for your child?
Interventions for children with ASDs
Autism Center
• Children with ASD may qualify for special education services from birth to age 21• Birth-to-Three Services for children under 3• Individual Education Program (IEP) for children 3 to 21• Depending on child’s needs, extra services may
include:• speech language therapy, occupational therapy, social
skills groups, and/or academic support• Inclusion and self-contained placements• Behavior support or positive behavior planning
School Services
Autism Center
Special Education Resources
• WAC codes (Washington Administrative Code) http://www.k12.wa.us/specialed/
• Wrightslawhttp://www.wrightslaw.com/
• Special Educational Ombudsman Office http://www.governor.wa.gov/oeo/
• Autism Speaks IEP Guide: http://www.autismspeaks.org/family-services/ community-connections/back-to-school
Autism Center
Private Therapies
• Speech & Language Therapy• Occupational Therapy (sensory, fine motor)• Physical Therapy (gross motor, coordination)• Individual Therapy / Counseling• Social Skills Groups• Biomedical Treatments• Family Education & Therapy / Counseling• Parent Training & Information
Autism Center
Speech & Language Therapy
• Communication Development• Talking and understanding what others are saying• Production of speech sounds (articulation)• Social Communication – “how and why we
communicate”• Nonverbal Communication
• School-based and private speech language pathologists
Autism Center
Occupational (OT) & Physical Therapy (PT)
• Gross Motor Development – “large” motor movements -- PT• E.g., running/jumping
• Fine Motor Development – “small” motor movements -- OT• E.g., using utensils/tools
• Sensory Processing• School-based and private OT/PT
Autism Center
Individual Therapy
• Common types of individual therapy:• Cognitive Behavior Therapy (CBT)
• Child learns how thoughts, feelings and behaviors are connected
• Child learns coping skills for anxiety, anger, teasing, etc.
• Behavior Management• Parents learn why child has certain behaviors and learns
strategies to improve the child’s behaviors• Applied Behavior Analysis (ABA)
• Can be provided by Masters level therapist or Ph.D. (psychologist)
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• Group of approximately 4-8 children with social skills difficulties, led by a therapist / teacher
• Focus on development of social skills• making friends, starting and ending conversations,
etc.• School-based and private groups• Excellent opportunity to practice skills learned in
individual therapy!
Social Skills Groups
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Common Medical Issues in ASD
• Picky Eating
• GI (stomach, poop, etc.) Problems
• Seizures
• Sleep Disturbances
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Biomedical
• Medications can be used to treat some behaviors associated with ASD• Inattention, hyperactivity, aggression, irritability,
anxiety
• Complementary & Alternative Medicine (CAM)• Be careful to evaluate treatments prior to beginning,
and talk to your doctor
Autism Center
Parent Support
• Parent groups• FEAT of Washington
• http://www.featwa.org/
• Autism Society of Washington• http://www.autismsocietyofwa.org/
• ALLY support group at Seattle Children’s Autism Clinic• Email [email protected] for information
• TACA of Washington• http://www.tacanow.org/local-chapters/washington/
Autism Center
Seattle Children’s Autism Center
• How to get in:• Talk to your Primary Care Provider for referral
• Services offered:• Diagnosis• Medical treatment (psychiatry, neurology,
neurodevelopmental, speech)• Individual therapy (cognitive behavioral, behavior
management)• Treatment planning
Autism Center
General Resources – Local
• SCH Autism Center• Autism Blog: www.theautismblog.org• Information and Resources:
http://www.seattlechildrens.org/clinics-programs/autism-center/
• Autism Outreach Project• http://www.nwesd.org/autism
• Autism Society of Washington• http://www.autismsocietyofwa.org
Autism Center
General Resources – National and International
• Autism Speaks• www.autismspeaks.org
• Autism Society of America:• www.autism-society.org
• Global Autism Collaboration (Center for the Study of Autism):• www.autism.org
Autism Center
• Division of Developmental Disabilities (DDD)• Apply for eligibility/services• May receive services (although limited at this time)• Important to apply now so children may receive services in
future• http://www.dshs.wa.gov/ddd/• Tuesdays at 11am – free DDD application help at SCAC
• Supplemental Security Income (SSI)• May be eligible for disability income• http://www.ssa.gov/ssi/
Government Resources
Autism Center
Video Recommendations
• Autism Resource DVD, produced by University of Washington’s Autism Clinic
• Watch or download at• http://
depts.washington.edu/uwautism/resources/autism-resource-dvd.html
Autism Center
Book Recommendations
• Educating Children with Autism• National Research Council
• My Social Stories Book• Carol Gray
• More than Words• Fern Sussman
• A Parents’ Guide to Asperger and High Functioning Autism• Sally Ozonoff, Geraldine Dawson, and James McPartland