Autism Spectrum

Disorders
Jessie Bradshaw & Anna Krasno
CALM
March 21, 2012

Definition of Autism
Red Flags
Assessments & Screeners
Cultural Considerations
Trauma & Autism
Referrals & Community Resources
Treatment

Autism
Developmental Disability
Autism
Asperger Syndrome
Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)

Three categories for a diagnosis

Social difficulties
Communication impairments
Restricted and repetitive behaviors

1 in 110
Children with Autism also commonly diagnosed with another DD

Mental Retardation: 19.2%

ADD/ADHD: 41.8%
Learning Disability: 60.7%
Other developmental delay: 79.5%

Most heritable neurodevelopmental

disorder
20% of siblings
(Boulet et al., 2009)

Associated Features
Cognitive Delays
Digestive
Disorders
Seizures
Sleep disturbances
Anxiety
Depression

Early Red Flags

Infants and Toddlers
Rare eye contact
Lack of social smiling by
6 months
No back and forth babbling or facial
expressions by 9 months
No babbling or gestures by 12
months
No words by 16 months
Under or over emotionally reactive
Not orienting to name
Would rather play with objects

http://www.autismspeaks.
org/what-autism/videoglossary

Later Red Flags

Preschool and School Age
Little interest in other
children
No pretend play
Odd or delayed speech
Very few friends
Behaviors
Strong preference for
routine
Difficulty with transitions

Assessment Measures
Child Behavior Checklist (CBCL)
1 to 5
Withdrawal Subscale
Pervasive Developmental Problems DSM Scale

6-18
Withdrawn
Social Problems
Thought Problems

Ages and Stages Questionnaire (ASQ)

Social-Emotional
Language
Ooi, Rescorla, Ang, Woo, Fung (2011)

Screeners
M-CHAT
Modified Checklist for Autism in Toddlers
16-30 months of age
23 Questions
Pass/Fail

CSBS-ITC
Communication and Symbolic Behavior Scales
Infant Toddler Checklist
6-24 months
24 Questions
Social, Speech, and Symbolic Subscales

Cultural Variables
Autism found across cultures
Children of minority status and low
SES take longer to be diagnosed
(Mandell et al., 2005; 2008)

Take an ecological approach with

families
Understand what disability means to the
family
Gain knowledge of cultural
routines/practices

Symptoms of Trauma and

Autism
Can look similar
Coping mechanisms
Repetitive behaviors
Low levels of eye-contact
Social isolation
Disruptive behaviors
Inflexibility, maintaining control

Referrals
Tri-Counties Regional Center
Any person believed to have a developmental disability,
and any person believed to have a high risk of becoming
the parent of a developmentally disabled infant, is eligible
for initial intake and assessment services.
At the conclusion of the assessment process, eligibility for
services is determined. If the person is eligible for
services through the Regional Center, then the planning
team needs to develop a plan for service delivery.

Koegel Autism Center

Infant Program
Research studies
education.ucsb.edu/autism

Resources
STAR
starautism.com

Alpha Resource Center

Early Start Program
First Five Program
Autism Speaks
Learn the signs

How to Talk to Families

1. Bring up your observations with the parent
2. Wait for agreement
3. Evaluations are free and can give families
great feedback
4. Early intervention is key
5. Early intervention is key
6. Early intervention is key
7. Follow up and offer help with
interpretation and support

Treatment
Early intervention is essential
Younger siblings

Use evidence based practice

(Simpson,

2005)

Skill-based behavioral interventions

work
Discrete Trial Training
Pivotal Response Treatment (Koegel &
Koegel, 2006)

Pivotal Response Treatment

Uses behavior management
principles
Implemented in the natural
environment
Increases motivation for social
interaction
Includes parent education
component
Can be used for all ages

Pivotal Response Treatment

Key components
Child Choice
Direct, natural, contingent reinforcers
Reinforces attempts

Promotes inclusion of individuals with

autism in all realms of life

Examines Function of
Behaviors
Functional Behavior Assessment
(FBA)
Not all behaviors serve the same
function
Across settings
Informs treatment planning

Antecedent-Behavior-Consequence
Positive Behavioral Support
Strength-based approach
Clinical significance

Other Treatments
Limited support
Music Therapy
Art therapy
Gluten/Casein free diet (can be harmful)

Not recommended
Hyperbaric chamber (can be harmful)
Chelation (can be harmful)
Facilitated communication
Auditory Integration Training

Take Home Message

Early identification
Knowledge of evidence based
treatment

Thank you!
Jessie Bradshaw:
jbradshaw@calm4kids.org
Anna Krasno:
akrasno@calm4kids.org