Autism Spectrum Disorder

Is defined by the American

Psychiatric Associations Diagnosis
of Manual of Mental Disorders
(DSM-5) as a single disorder that
includes
disorders
that
were
previously considered separate
autism,
Aspergers
syndrome,
childhood
disintegrative
developmental
disorder
not
otherwise specified.

Checklist for signs of autism

Social
interactions
Children with autism might:
seem to be in their own
world
show little eye contact for
example, during interaction,
or to draw attention to
something
not use gestures for
example, lifting arms to be
picked up
not share enjoyment or
interests for example, they
might not point to an object
or event to share it
show
little
emotion
or
empathy
not respond to their names
show no interest in other
children or peers.
Communication
Children with autism might:
have little or no babble
have little or no spoken
language
not engage in pretend play
for example, they wont feed
a baby doll
have
echolalia,
which
means they echo or mimic
words or phrases without
meaning or in an unusual
tone of voice
have difficulty understanding
and
following
simple
instructions for example,
Give me the block might be
difficult for them.
Repetitive or persistent behaviours
Children with autism might:

have intense interest in

certain objects theyll get
stuck on one particular toy
or object
focus narrowly on an object
for example, on a detail like
opening and closing the door
on a toy bus rather than
pretending to drive it
insist on following routines
and be easily upset by
change
show
repetitive
body
movements or unusual body
movements for example,
back-arching, hand-flapping
or walking on toes.
Sensory
issues
Children with autism might:
be extremely sensitive to
sensory experiences for
example, they might be
easily upset by certain
sounds, or only eat foods
with a certain texture
seek sensory stimulation
for example, they might like
deep pressure touch or
vibrating objects like the
washing machine
like to flutter their fingers at
the side of their eyes to
watch the light flicker.
Changes to diagnosis of autism
spectrum disorder
In May 2013, the criteria used to
diagnose children with autism
spectrum disorder (ASD) changed.
Previously,
the Diagnostic
and
Statistical
Manual
of
Mental
Disorders (4th edition) (DSM-IV)
categorised children with ASD as
having
either
autistic
disorder, Aspergers
disorder or PDD-NOS.
The
new
version of the Manual, DSM-5,
combines these three categories
into one, which is simply referred to
as autism spectrum disorder (ASD).
What Causes Autism?
Genetic problems:
Over the last five years, scientists have
identified a number of rare gene changes,
or mutations, associated with autism.

Research has identified more than a

hundred autism risk genes. In around 15
percent of cases, a specific genetic cause
of a persons autism can be identified.
However, most cases involve a complex
and variable combination of genetic risk
and environmental factors that influence
early brain development.
Environmental Factors:
parental age at time of conception
(both mom and dad)
maternal illness during pregnancy
extreme prematurity and very low
birth weight and certain difficulties
during birth(periods of oxygen
deprivation to the babys brain)
Mothers exposed to high levels of
pesticides and air pollution may
also be at higher risk of having a
child with ASD

theres a lack of evidence.

combination

autism.
with

Rather,
genetic

strategies.

risk

increase risk.

but no real consensus on what is

most effective.

Went from 1 in 2500, to 1 in 1000,

to 1 in 166 over the past decade.
Autism is now more common than
childhood

cancer,

downs

syndrome, spina bifida or cystic

fibrosis.

Because there is a wide variability

in people with Autism there is a
need

to

develop

an

individual

treatment and management plan.

6 Steps To Success For Autism
Step 1: Educate Yourself.
Step 2: Reach Out to the Parents.

Prevalence Of Autism

Range of therapies and treatments

in

factors, they appear to modestly

But people with Autism often make

good progress and develop coping

these factors, by themselves, do

cause

Some suggest otherwise but

It is important to keep in mind that

not

No it is a lifelong disorder.

Boys are affected 4 times as often

Step 3: Prepare the Classroom.

Step 4: Educate Peers and Promote
Social Goals.
Step

5:

Collaborate

on

the

Implementation of an Education Plan.

Step 6: Manage Behavioral Challenges.

as girls but unknown as to why.

1 out of 68 families will have a

child with autism.

Is There A Cure For Autism?

1. Autism
Spectrum
Disorder/
Autistic
Disorder
A collection of developmental
disorders in which a child engages

in repetitive behaviors and has

trouble
communicating
and
connecting with others. It's usually
diagnosed around age 2 or 3,
although some signs show up
earlier.
Symptoms can be mild to severe.
Children who meet more rigid
criteria for a diagnosis of autism
have autistic disorder. They have
more severe impairments involving
social and language functioning as
well as repetitive behaviors. Often,
they also have mental retardation
and seizures.

DSM IV/ICD-10 Diagnostic Criteria for Autism Spectrum Disorder

Autistic Disorder
Age of Onset

Delays or abnormal
functioning in social
interaction, language
or play by age 3.

Social
Interaction

Qualitative Impairment
in social interaction, as
manifested by at least
two of the ff:
a. marked impairment
in the use of multiple
nonverbal
behaviors
i.e., eye to eye gazed;
b. Failure to develop
peer
relationships
appropriate
to
developmental level;
c. Lack of spontaneous
seeking
to
share
enjoyment with other
people;
d. Lack of social or
emotional reciprocity.

Retts
Disorder
Apparently
normal
prenatal
development;
apparently
normal motor
development
for
first
5
months;
deceleration
of
head
growth
between ages
5
and
48
months .

Loss of social
engagement
early in the
course
(although
often
social
interaction
develops
later).

Child
Disintegrative
Disorder
Apparently
normal
development
for at least
the first two
years of birth;
clinically
significant
loss
of
previously
acquired skills
before
age
10.

Aspergers
Disorder

Same
with
Autistic
disorder along
with loss of
social
skills
(previously
acquired).

Same
Autistic
disorder.

PDD-NOS

NO
clinically
significant
delay
in
language,
cognitive
development,
or
development
of
age
appropriate
self-help skills,
adaptive
behavior and
environment in
childhood.

as

This category
is to be used in
cases
of
pervasive
impairment in
social
interaction and
communication
with presence
of stereotyped
behaviors
of
interests when
criteria are not
met
for
a
specific
disorder.

Communicati
on

Behavior

Qualitative
impairments
of
communication
as
manifested by at least
one of the ff:
a. delay in, or
total lack of,
the
development
of
spoken
language;
b. Marked
impairment in
initiating
or
sustaining
a
conversation
with others, in
individuals with
adequate
speech;
c. Stereotyped
and repetitive
use
of
language
or
idiosyncratic
language;
d. Lack of varied,
spontaneous
make-be;ieve
or
imitative
play
Restricted, repetitive,
and
stereotyped
patterns of behavior,
as manifested by one
of the ff:
a. preoccupation
with one or
more
stereotyped or
restricted
patterns
of
interest;
b. adherence
to
nonfunctional
routines
or
rituals;
c. stereotyped
and repetitive
motor
mannerisms;
d. persistent
preoccupation

Severely
impaired
expressive
and receptive
language
development
and
severe
psychomotor
retardation.

Same
as
Autistic
disorder,
along
with
loss
of
expressive or
receptive
language
previously
acquired.

NO
clinically
significant
delay
in
language.

Loss
of
previously
acquired
purposeful
hand
movements;
appearance
of
poorly
coordinated
gait or trunk
movements.

Same
as
Autistic
disorder,
along
with
loss of bowel
or
bladder
control, play,
motor
skills
previously
acquired.

Same
Autistic
Disorder.

as

with parts
objects.
Exclusions

Autism

of

Disturbance not better

accounted for by Retts
or CDD.

Characteristics

Disturbance
not
better
accounted for
by
another
PDD
or
schizophrenia.

Symptoms/Indicators

Criteria are not

met
for
another
PDD
or
Schizophrenia.

Treatment/Intervention

Asperger's
Syndrome

- also called Asperger's

disorder, is a type of
pervasive
developmental disorder
(PDD). PDDs are a
group of conditions that
involve delays in the
development of many
basic
skills,
most
notably the ability to
socialize with others, to
communicate, and to
use imagination.
Children
with
Asperger's
syndrome
typically function better
and
generally
have
normal intelligence and
near-normal language
development, although
they
may
develop
problems
communicating as they
get older.
named
for
the
Austrian doctor, Hans
Asperger, who first
described the disorder
in
1944.
However,
Asperger's
syndrome
was not recognized as a
unique disorder until
much later.

The symptoms of
Asperger's syndrome
vary and can range
from mild to severe.
Common symptoms
include:

Problems
with social skills:
Children
with
Asperger's syndrome
generally
have
difficulty interacting
with others and often
are
awkward
in
social
situations.
They generally do
not make friends
easily. They have
difficulty
initiating
and
maintaining
conversation.

Eccentric or
repetitive
behaviors: Children
with this condition
may develop odd,
repetitive
movements, such as
hand wringing or
finger twisting.

Unusual
preoccupations or
rituals: A child with
Asperger's syndrome
may develop rituals
that
he
or
she
refuses to alter, such
as getting dressed in
a specific order.

Communication
difficulties: People
with
Asperger's
syndrome may not
make eye contact

Right now, there is no

cure for Asperger's
syndrome,
but
treatment
may
improve
functioning
and
reduce
undesirable behaviors.
Treatment may include
a combination of the
following:

Special
education: Education
that is structured to
meet
the
child's
unique
educational
needs.

Behavior
modification:
This
includes strategies for
supporting
positive
behavior
and
decreasing
problem
behaviors.

Speech,
physical,
or
occupational
therapy:
These
therapies are designed
to increase the child's
functional abilities.

Social
skills
therapies: Run by a
psychologist,
counselor,
speech
pathologist, or social
worker,
these
therapies
are
invaluable
ways
to
build social skills and
the ability to read
verbal and non-verbal
cues that is often
lacking in those with
Asperger's.

Medication:
There
are
no

when speaking with

someone. They may
have trouble using
facial
expressions
and gestures, and
understanding body
language. They also
tend
to
have
problems
understanding
language in context
and are very literal
in
their
use
of
language.

Limited
range of interests:
A
child
with
Asperger's syndrome
may
develop
an
intense,
almost
obsessive, interest in
a few areas, such as
sports
schedules,
weather, or maps.

Coordination
problems:
The
movements
of
children
with
Asperger's syndrome
may seem clumsy or
awkward.

Skilled
or
talented:
Many
children
with
Asperger's syndrome
are
exceptionally
talented or skilled in
a particular area,
such as music or
math.
Pervasive
Development
Disorder-Not
Otherwise
Specified
(PDD-NOS),

- PDD NOS is also

being referred to as
'atypical personality
development,' 'atypical
PDD,' or 'atypical

- Children with PDD

NOS have some
symptoms similar to
those associated
with Autistic

medications to treat
Asperger's syndrome
itself, but drugs may
be
used
to
treat
specific
symptoms
such
as
anxiety,
depression,
hyperactivity,
and
obsessive-compulsive
behavior.

Treatment
for
a
diagnosis of PDD-NOS
is the same as the
treatments used to
treat the other PDD.
Each
child
will

defined
Autism'.
- PDD-NOS can be
thought of as a
'diagnosis of exclusion'.
It is used for children
who share some, but
not all, of the traits of
autistic disorder and/or
Asperger syndrome.

disorder and Asperge

r syndrome. Usually,
these involve delays
in the development
of many basic skills
concerned with
understanding the
social world; the
ability to socialize, to
communicate, to
empathize in the
right way and at the
right moment, and to
use imagination.

demonstrate individual
and unique needs, and
therefore,
treatment
will
be
determined
accordingly.

- Most children with

PDD-NOS have
milder symptoms
than children with
autistic disorder, but
they do not share
the above-average
intelligence
associated with
Asperger syndrome.

Aspergers syndrome has similar symptoms to

early childhood autism, but with normal
language development and IQ. PDD-NOS is the
mildest form and is often referred to as
atypical autism or sub-threshold autism

Image courtesy of Andreas Chiocchetti

Social level Impaired

Impaired

two of
these
Language

Impaired

Not impaired

level
Early childhood Aspergers
(or classical)

At least

three are
affected

PDD-NOS

syndrome

autism

Behavioural Impaired

Impaired

level
Onset

Early childhood

Usually later

Not

onset

specified

IQ

High functioning: IQ > 70

IQ > 70; low

IQ > 35

Provide a Well-Structured, Consistent

Environment

functioning: IQ
< 70

Have a seating plan in place.

Table 1: Differences between the three subtypes of autism spectrum disorders

Educational Strategies for Asperger

Syndrome
Assist
the
Student
Communication Skills

in

Developing

Have patience.
Listen to all attempts made by the student.
Allow extended time for processing after a
questions has been asked to the student;
refrain from rephrasing the question or
interrupting.
Accept the childs language pattern and word
choice; refrain from correcting the childs
speech.
Continually model appropriate and correct
format of speech.
In conversation, listen for message behind
the words and not how the message was
conveyed. Ignore peculiarities in the volume of
speech, intonation, and inflection of the childs
voice.
Encourage continued communication through
positive and accepting responses.
Be concise, concrete, and specific with the
language that you use.
Avoid using vague terms such as maybe,
later, or perhaps.
Specifically state questions (e.g., Why did
you get out of your chair? rather than, Why
did you do that?).
Specifically state requests (e.g., Please sit
with all four legs of your chair on the floor,
rather than, Please dont do that.).

Post the class schedule either in the

classroom, or if the student with AS is different
than the rest of the class, post the schedule on
the students desk or notebook planner.
Post classroom rules either in the classroom,
or if the student with AS is different than the
rest of the class, post the rules on the students
desk or notebook planner.
Inform the student if a change is coming in
the seating plan or class schedule.
Provide prior notification for any change in
the normal school day, such as special events,
vacation dates, lyceums, or days when a
substitute teacher may be in the classroom.
Promote Self-Confidence
Encourage students to assist other students
in academic areas.
Highlight students areas of strengths in
cooperative learning situations; in return, foster
respect among the peer group.
Other
Accommodations
Classroom

inside

the

Present assignments visually and verbally.

Provide copies of teacher notes.
Tape/ record the lecture.
Provide headphones or earplugs in the
classroom to reduce noises.
Allow homework to be typed rather than
handwritten.
Allow students to tape record answers to
written examinations.

Rett Syndrome

is a unique neurodevelopmental disorder

which begins to show its affects in infancy or early childhood. It is seen
almost exclusively in females. It was identified by Dr. Andreas Rett, an
Austrian physician who first described it in a journal article in 1966.
Although Rett syndrome is a genetic disorder, less than 1 percent of
recorded cases are inherited or passed from one generation to the
next.

Symptoms

A deceleration of
head growth
between ages 5
and 48 months
Loss of previously
acquired
purposeful hand
skills between
ages 5 and 30
months with the
subsequent
development of
stereotyped hand
movements.
Loss of social
Engagement early
in the course.

Cause
Is caused by
mutations on the X
chromosome on a
gene called MECP2.

Treatment

Appearance of
poorly coordinated
gait or trunk
movements

Severely impaired
expressive and
receptive language
development with
severe

1. Physical
Therapy/Hydrothe
rapy
Improves or maintains
mobility and balance
Reduces misshapen back
and limbs
2. Occupational
Therapy
Improves or maintains use
of hands
Teaches self-directed
activities like dressing and
feeding
3. Speech-Language
Therapy
Teaches nonverbal
communication
Improves social interaction
4. Medication
To reduce breathing
problems
To eliminate problems with
abnormal heart rhythm
To relieve indigestion and
constipation
To control seizures

psychomotor
retardation

5. Feeding
Assistance
Supplements calcium and
minerals to strengthen
bones and slow scoliosis
High-calorie, high-fat diet
to increase height and
weight.

STAGES of RETT Syndrome

STAGES

Stage I- early onset

Ages

(6 and 18 months of age)

Characteristics and
Behavior

Stage
IIThe
destructive stage

rapid (1-4 yrs old)

May demand less

attention or be
irritable
and
restless
May begin to show
less eye contact
and have reduced
interest in toys
Delays in gross
motor skills such
as
sitting
or
crawling
Hand-wringing and
decreasing
head
growth may occur,
but not enough to
draw attention
Hand movements
such as wringing,
washing, clapping,
or tapping, as well

Stage III- the plateau or

pseudo-stationary stage

(2 to 10 yrs old)

Stage IV- The Late Motor

deterioration stage

Can last
decades

for

years

or

as
repeatedly
moving the hands
to the mouth.
Some
display
symptoms that are
like autism such
as loss of social
interaction
and
communication.
Breathing
irregularities such
as
episodes
of
apnea
and
hyperventilation
may occur.
Slowed
head
growth is usually
noticed during this
stage.
Apraxia,
motor
problems,
and
seizures
are
prominent during
this stage
May show more
interest
in
surroundings and
alertness, attention
span,
and
communication
skills may improve.
Improvement
in
such
as
less
irritability,
crying
and
autistic-like
features.
Prominent features
include
reduced

mobility, curvature
of
the
spine
(scoliosis)
and
muscle weakness,
rigidity, spasticity,
and
increased
muscle tone with
abnormal
posturing of an
arm, leg, or top
part of the body
Repetitive
hand
movements
may
decrease and eye
gaze
usually
improves.

Childhood Disintegrative Disorder

(CDD) Also known as

Heller's syndrome and it is a progressive neurological condition which results in a
continuous loss of skills over the duration of a childs life. NO specific medical or
neurological cause was found to account for all occurrences of the disorder.

Characteristics

Limited
social
interactions
for
instance
lack
of
mutual emotion

avoids eye contact

unable to develop
social relationships
with peers
the
same age

Changes in pattern

Symptoms
Delay or loss of
spoken language.
Impaired nonverbal behaviors
such as body
language or facial
expressions.
Cannot start nor
converse
normally.
Inability to form
relationships with

Treatment
While there is no known
cure for Childhood
Disintegrative Disorder
there are strategies that
have a positive impact.
Educating the
parents so that
they can support
the child's
treatments at
home
Speech and

of active play likes

lining up toys and
has no imaginative
play
Social and gross
motor
traits
or
mannerisms
such
as tip toe walking,
looking
in
short
glances,
looking
through fingers and
looking sideways.

friends and family.

Loss of motor
skills.
Loss of language.
Loss of bladder
and bowel
movement.

language therapy,
occupational
therapy, social
skills
development, and
sensory
integration
therapy.
Support of the
family