St C C Ed Asst 08 02 webweb4.uwindsor.ca/users/m/mgragg/main.nsf... · Autism Spectrum Disorders ... Early Diagnosis of Autism Why? • early intervention better prognosis ... •

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www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 1

Autism Spectrum Disorders Autism Spectrum Disorders (ASD)(ASD)

Welcome!Welcome!

You can download this handout from www.uwindsor.ca/autism under “Workshops”

Email [email protected]


What are ASD’s?What are ASD’s?

Behaviour Communication

Social

difficulty with changeintense interestsrepetitive

“sticky”

low social interest� friendships for level

not reciprocalweak sharingeye contact

weak nonverbal

no/delayed speech� 2-way conversation

not reciprocalweak nonverbal

weak play

and

SensoryIssuesAnxiety


Autism is…Autism is…

� a spectrum disorder• from very delayed to above average

abilities

• from mild to moderate to severe autistic behaviours

�developmental• abilities & symptoms may improve

with good programming


Autism: Associated FeaturesAutism: Associated Featuresmay occur, not required for diagnosismay occur, not required for diagnosis

• cognitive; deficits, strengths & weaknesses(50-70% intellectual impairment)

• unusual motor behaviours

• unusual sensory behaviours

• eating, sleeping, drinking

• attention; joint, shifting, focus

• mood; anxieties & fears

• medical conditions, seizures

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Early Signs of ASDEarly Signs of ASD


Red Flags Red Flags immediate evaluation ifimmediate evaluation if

• no babbling by 12 months

• no gesturing by 12 months

• no single words by 16 months

• no 2-word phrases by 24 months (not just echolalic)

• any loss of any language or social skills at any age (30%)

Filipek et al, Amer. Acad. Neurology, 2000


First Signs of Autism: BehaviourFirst Signs of Autism: BehaviourAt 12 months of age, may see unusualAt 12 months of age, may see unusual

•eye contact

•visual tracking

•disengagement of visual attention

•orienting to name

•imitation

•social smiling

•reactivity, social interest & affect

•sensory behaviorsZwaigenbaum, Bryson, Rogers, Rogerts, Brian & Szatmari, 2005


First Signs of Autism: OtherFirst Signs of Autism: Other

Temperament: • 6 months, marked passivity & low activity level

• 12 months, extreme distress, fixating on particular objects, & rarely in a positive mood

Delayed expressive & receptive languageZwaigenbaum, Bryson, Rogers, Rogerts, Brian & Szatmari, 2005

Challenging behaviours may be the firstsign of high functioning autism

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Early Diagnosis of AutismEarly Diagnosis of Autism

Why?

• early intervention � better prognosis

• so parents know

• connect to autism community

• support for families


Ontario Parents’ ExperiencesOntario Parents’ ExperiencesA. Spadafora, M.A., 2005A. Spadafora, M.A., 2005

• 78 parents of 80 children with PDDs

• median birth year of 2000 (1968-2001)

• average age of diagnosis ~ 51 months51 months

(early intervention best before 42 months)(early intervention best before 42 months)

• age at first concern ~ 19 months (1–48 mo.); approx. 34 months before diagnosis!


Early IdentificationEarly Identification

What we are doing

already is

NOT good enough

for

EARLY identification

& intervention!


Causes of AutismCauses of Autism

• neurological disorder

• 4.6 boys to every girl

• genetic susceptibility

• environmental triggers?

• not related to parenting or learning

• not related to MMR vaccine or preservatives in vaccines

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More Children with Autism?More Children with Autism?

� 67 per 10,000 children (CDC, 2007)

• 1 in every 150 children• 1 in every 100 boys

� more children identified now??? – better identification?

- better public awareness- wider definition

- misdiagnoses?•increased prevalence, incidence?


Families and Families and their Children’s ASD Diagnoses?their Children’s ASD Diagnoses?

denial?

anger?

bargaining?

depression?

acceptance?


Acceptance SpiralAcceptance Spiral

It’s a process - it takes time!www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 16

Families: Research Shows Families: Research Shows Social SupportSocial Support

� helps parents of children with autism

� helps siblings of children with autism

AND

� helps children with autism make more progress

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AutismAutismbrings strong families closer

can drive distant families apart


InterventionIntervention


Basic Supports for All ChildrenBasic Supports for All Children

Supportive Environment

� basic needs: food, shelter, medical care, nurturance

� access to preferred toys, activities, interests & friends

� opportunities for success at the child’s level


Basic Supports for All ChildrenBasic Supports for All Children

Supportive Caregivers

� parents and teachers need to be supported too!

� staff & parent relationships

� professionals; attitude is more than half the battle.

� don’t take things personally, avoid power struggles

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Autism Spectrum Disorders (ASD)Autism Spectrum Disorders (ASD)

Children with ASD learn differently.

They need different supports to help them learn & maintain behavioural control.


General Helpful Supports for General Helpful Supports for Children with Autism/PDDChildren with Autism/PDD

1. Make things predictable

2. Reduce language

3. Use visual supports

4. Broaden preoccupations

5. Reduce anxiety


1. Make Things Predictable1. Make Things Predictable

• develop routines so the child can predict what will happen next e.g. work, homework, bedtime and chores

• teach the child to use a schedule(picture, word, object), calendar

• prepare in advance for transitions & unexpected events, e.g. when playtime is over

• clear expectations


2. Reduce Language2. Reduce Language

• use clear simple language, even if the person talks a lot

• avoid slang, metaphorical language, sarcasm, rhetorical questions, etc

• develop cue phrases.; talk less when he is excited or upset

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3. Use Visual Supports3. Use Visual Supports

• use pictures, videos, drawings, & manipulatives

• visually organize materials clearly, e.g. baskets, colour coding, tape on floor

• visual strategies e.g. Triangle of Choices

• written language is visual for people who can read


4. Broaden Preoccupations4. Broaden Preoccupations

• use intense narrow, intereststo teach & motivate

• getting rid of preoccupationsrarely works in the short term

• schedule specific times for his interests e.g. dinosaur time, Dracula time


5. Reduce Anxiety5. Reduce Anxiety

• use above strategies (make things predictable, reduce language, make things visual)

• allow the person time -- to process, to cope, to be alone

• try relaxation training, vigorous rhythmic exercise, medication


Intervention ComponentsIntervention Components

• earliest age (as soon as autism is suspected)

• active engagement in intensive, 5 full-days, min. 25 hrs/wk, full-year, 1 on 1

• teach social, communication, cognitive development, & play skills

• systematic, individualized

• generalization

• parent involvement National Research Council, 2001

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Community Resources for ASDCommunity Resources for ASD


Community Resources listCommunity Resources list

4 page list of Windsor resources for children with autism

�good resource to give to parents

www.summitcentre.org

�click on “Local Autism Services”


The Summit Centre for The Summit Centre for Preschool Children with AutismPreschool Children with Autism

affiliated with U of W!


UNITY: 3 Month Intensive UNITY: 3 Month Intensive ABA Parent TrainingABA Parent Training

atThe Summit Centre for Preschool Children

with Autism

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PurposePurpose

�� to provide highto provide high--quality intensive quality intensive Applied Behaviour Analysis (ABA)Applied Behaviour Analysis (ABA)training to selected parents training to selected parents of children with autismof children with autism

�� to enable parents to provide ABA home to enable parents to provide ABA home programming for their childrenprogramming for their children

based on the model of the HOPE Center, based on the model of the HOPE Center, Beaumont Hospital, Berkley, MIBeaumont Hospital, Berkley, MI


All About AutismAll About AutismIntroductory workshops

• for parents of children with a diagnosis or suspicion of autism

• 3rd Wed. of month (except July & Aug)• different speakers & topics

Sponsored by: � Dedicated Parents, � Autism Society Ontario Windsor/Essex Chapter, � Autism Services Inc., � Children First, � Children’s Rehabilitation Centre, � Ontario Early Years Centres, � Talk to Me (Essex Preschool Speech & Language) � The Summit Centre for Preschool Children with Autism, � Thames Valley Children’s Centre The Autism Program South West Region


Autism Resource LibraryAutism Resource Library

Autism Services Incorporated

• books, videos, DVD’s on autism

• will loan via school courier

• online catalog of what is available!

www.autismservicesinc.com


“Even the smallest footsteps can cross great distances.”“Even the smallest footsteps can cross great distances.”

Documents

St C C Ed Asst 08 02 webweb4.uwindsor.ca/users/m/mgragg/main.nsf... · Autism Spectrum Disorders ... Early Diagnosis of Autism Why? • early intervention better prognosis ... •