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Autism Spectrum Disorders: Diagnosis & Treatment

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Autism Spectrum Disorders: Diagnosis & Treatment Presented by: Andrew Bailey MA, MFT Founder/Executive Director The Anova Center for Education ... – PowerPoint PPT presentation

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Title: Autism Spectrum Disorders: Diagnosis & Treatment


1
Autism Spectrum Disorders Diagnosis Treatment
  • Presented by Andrew Bailey MA, MFT
  • Founder/Executive
    Director
  • The Anova Center for Education - ACE School
  • Santa Rosa, San Rafael Concord California
  • ACE School Staff Development Series
  • Autumn 2012

2
What is an Autism Spectrum Disorder?
  • Autism Spectrum Disorder is a neurodevelopmental
    disorder whose manifestations occur in great
    variation in severity,
  • or across a Spectrum. The essential
    features are
  • Markedly abnormal development in social
    interaction and communication
  • Markedly restricted repertoire of activities
    and interests
  • Marked impairment in the use of multiple
    nonverbal behaviors (e.g. eye-to-eye gaze, facial
    expression, body postures)
  • to regulate social interaction and
    communication.
  • Failure to develop peer relationships
    appropriate to developmental level (takes
    different forms at different ages)
  • Younger individuals may have little or no
    interest in establishing friendships, whereas
    older individuals may have an interest but lack
    understanding of the conventions of social
    interaction.
  • Lack of joint attention with others (e.g.
    not sharing objects or experiences) or awareness
    of others feelings or needs.
  • Impairment in communication is marked and
    sustained and affects both verbal and nonverbal
    skills. There may be a delay in, or total lack
    of, the development of spoken language.
  • Delays in social interaction, language, and
    symbolic play must be apparent prior to 3 years
    of age.

3
What Causes Autism?
  • Autism Spectrum Disorders have no known causes
    and no known cures.
  • Some researchers believe autism is not a single
    phenomenon but rather a collection of similar
    conditions or autisms
  • Most theories have focused on the interaction
    between a genetic susceptibility or
    predisposition toward autism and environmental
    triggers such as environmental toxins. Prenatal
    or childhood injury?
  • Some cases are clearly genetically transmitted
    twin studies
  • and others are not so clear. Vaccines?
  • Environmental toxins including chemicals,
    viruses, and bacteria can potentially cause
    genetic changeswhen and how remains unclear.
  • Visit the website for the MIND Institute at the
    University of California at Davis for the most
    current resources and research

4
What is the Prevalence of Autism?
  • Autism has evolved from a relatively rare
    phenomenon to a commonly diagnosed childhood
    condition over the last twenty years.
  • 1 in every 100 children born in the United States
    today will eventually receive an autism
    diagnosis. (1 in every 88 boys)
  • Autism is the fastest growing childhood
    disability and is more common than pediatric
    AIDS, juvenile diabetes, and childhood cancer
    combined.
  • Please visit the Website for the California State
    Senate Select Committee on Autism and Related
    Disorders for the most recent statistics.

5
What are the Treatments for Autism?
  • Can Autism be cured? Jenny McCarthy and many
    others think so.
  • However
  • Most scientists do not believe a cure currently
    exists, but that treatment can significantly and
    permanently reduce symptoms.
  • Contemporary autism treatment takes many forms
    including some that are controversial, unproven
    and expensive. The average individual with autism
    will require 3-5 million dollars of care/services
    in their lifetimea figure that is likely to
    skyrocket.
  • The most common treatments seek to teach
    developmental skills that the child is missing
    (especially language, social, and behavioral) in
    clinical or naturalistic environments, using a
    wide variety of techniques and philosophies.

6
What are the Treatments for Autism?
  • The most effective treatments will produce
    measurable results for only 60 of the
    recipients.
  • The following is a list of the most commonly used
    treatments
  • Applied Behavior Analysis (ABA) Is the most
    commonly used and empirically proven set of
    techniques for symptom reduction. Includes a
    large number of sub headings and strategies such
    as Pivotal Response Training, PECS, and TEACCH.
    Can be implemented by anyone under the direction
    of a trained Behavior Analyst
  • Floortime Is a widely used technique for
    language and social development that is child
    centered and relationship driven. Unlike ABA it
    is not structured and therapist directed and does
    not rely on data to make decisions.
  • Speech Therapy Is delivered by trained speech
    therapists and lay people and seeks to teach
    communication and social skills. A wide variety
    of specialized techniques are utilized.
  • Occupational Therapy Is delivered by trained
    Occupational Therapists and lay people and seeks
    to teach self regulation and motor skills. A wide
    variety of specialized techniques are utilized.

7
What are the Treatments for Autism?
  • The following are medical or biological
    interventions that are mostly unproven but are
    commonly delivered
  • Dietary restrictions or changes especially
    those eliminating dairy, gluten, and artificial
    flavors or colorings. There is some evidence to
    support the idea that autism is a metabolic
    disorder that affects brain functioning.
  • Hyperbaric Oxygen is an expensive but
    relatively safe treatment involving the
    individual receiving oxygen at high pressures.
  • Chelation Therapy involves injections of
    certain substances into the body that are
    intended to bond with and remove the heavy metals
    (mercury et al) that are suspected of causing the
    autism.
  • Pharmaceutical interventions involve the
    ingestion or application of a potentially large
    number of substances or compounds that are
    intended to cure or treat symptoms of autism.
    The compounds and substances are formulated and
    delivered based on a particular hypotheses about
    the cause of autism (mercury, fungus, allergy,
    genes, etc)

8
Neurodevelopmental Impairments and School
Performance
  • Sensory integration difficulties
  • Specific learning disabilities
  • Behavioral excesses or deficits
  • Impairments in social cognition

9
Anova Method of Education - AME
  • AME is an intensive educational and
    treatment program designed for a rapidly growing,
    poorly understood, and acutely underserved
    population of school age children and young
    adults.
  • Simultaneous application of treatment modalities
    is essential Four primary components of AME
  • Social Cognition Therapy/Speech Therapy
  • Highly Individualized Academic Instruction
  • Occupational Therapy/Sensory Integration
  • Behavior Analysis/Positive Behavior Support
  • Customized classroom and therapy environments
    with extensive specialized equipment/technology.
  • Highly trained team of teachers and therapists

10
Treatment Fundamentals
  • Consistency and structure in the classroom and on
    campus
  • Posted schedule of daily school activities
  • Simple and redundant classroom rules - posted
  • Consistent expectations among all teaching staff,
    SLP, OT, APE, administration.
  • Imminent reinforcers in place
  • Staff use consistent therapeutic vocabulary
  • for prompting and error correction

11
Teaching Strategies for Success
  • Teaching adaptive skills as effective replacement
    behaviors
  • Teach students pivotal replacement behaviors that
    can be used in a variety of situations and
    community settings (e.g. asking questions,
    seeking out help, recognizing their own sensory
    overload).
  • Teach students appropriate escape behaviors such
    as asking for a break when overwhelmed.

12
Pediatric Occupational Therapy
  • Specialized treatment to address complex sensory
    and motor difficulties in children, including
  • Sensory Integration Dysfunction
  • Sensory defensiveness
  • Impaired visual perceptual skills
  • Impaired visual-motor integration
  • Impaired fine or gross motor coordination
  • and planning.
  • Auditory processing difficulties

13
Occupational Therapy Behavior
  • Defensiveness
  • Outbursts
  • Self-injury
  • Avoidance responses
  • Hypervigilance
  • Modulation problems
  • Distractibility
  • Self-stimulation
  • Difficulty with transitions
  • Shutting down

14
Occupational Therapy Behavior
  • Registration problems
  • Delayed responses
  • Heightened auditory visual sensitivity
  • Sluggish proprioceptive system
  • Impaired integration
  • Poor motor planning
  • Impaired balance
  • Poor protective responses
  • Inadequate sense of own body

15
Occupational Therapy Interventions
  • The OT perspective
  • Sensory Integration is involved in every
    human behavior, including the complex sequences
    of verbal and motor behaviors that are required
    to succeed in school.
  • Assessing behavior from a sensory integration
    perspective helps to identify sensory needs that
    drive behavior, including maladaptive responses
    that interfere with educational performance.

16
Occupational Therapy Interventions
  • The OT perspective
  • Improved sensory processing results in improved
    behavior, social interaction, and learning
  • Certain strong sensations can be used to
    influence the efficiency of sensory processing.
    These sensations may include spinning, brushing,
    swinging, and many others.

17
Occupational Therapy Clinic
  • Specialized swings and suspension hooks
  • Ball pools
  • Scooterboard ramp
  • Foam crash pits
  • Weighted vests, blankets and gloves
  • Theraballs
  • Adjustable lighting and music

18
Social Cognition Deficits
  • Our students experience profound deficits in
    social cognition that limit their ability to
    take the perspective of others in social
    situations. The combination of a bright and
    verbally expressive child with social cognition
    impairments can lead to serious emotional and
    behavioral problems, particularly around school
    environments.

19
Social Cognition Deficits
  • Often viewed as eccentric, odd or manipulative
  • Frequently become the victims of teasing and
    bullying
  • Display deficits in language pragmatics and
    prosody
  • Can be extremely literal and have difficulties
    utilizing language in a social context

20
Social Cognition Abilities
  • Intra-personal abilities include
  • an individuals affective range and intensity
  • the ability to discriminate among emotions
  • the ability to label their emotions appropriately
  • the ability to use them to guide their actions
  • Interpersonal abilities include
  • the ability to decode the underlying feelings,
    intentions, and motivations of others
  • to recognize specific characteristics of others
    (e.g., age, gender, and ethnicity)
  • to influence others to behave in desired ways.

21
Social Cognition Therapy
  • The ACE School utilizes Social Cognition
    Therapy in assisting students to understand the
    internal world of others. Complex and nuanced
    social issues are broken down and made more
    concrete to increase student comprehension for
    use in their daily lives. A specific vocabulary
    is used throughout the day to reinforce or
    correct various social behaviors (see charts).
    Compassionate nagging and other real-time
    interventions are used to allow students to see
    the immediate effects of their social behaviors
    on others. Individual and group treatment is
    delivered in the classroom, clinic, and across
    the school milieu to promote skill retention and
    generalization.
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