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Often unrecognized and undiagnosed until or after late pre school age Appropriate tools for routine developmental screening and screening specifically for autism very limited
Abnormal development of social skills (withdrawal, lack of interest in peers) Limitations in the use of interactive language (speech as well as non verbal communication), and Sensorimotor deficits (inconsistent responses to environmental stimuli)
Early identification and early intervention during the toddler and preschool years
NO NO NO NO
NO NO NO NO
..Chat in toddler
SECTION B: GP or HV observation i. During the appointment, has the child made eye contact with you? ii. Get childs attention, then point across the room at an interesting object and say Oh look! Theres a [name of toy]! Watch childs face. Does the child look across to see what you are pointing at? iii. Get the childs attention, then give child a miniature to cup and teapot and say Can you make a cup of tea? Does the child pretend to pour out tea, drink it, etc?b iv. Say to the child Wheres the light? or Show me the light. Does the child POINT with his/her index finger at the light? v. Can the child build a tower of bricks? (If so, how many?) (Number of bricks:---------)
YES YES
NO NO*
YES YES
NO# NO+
YES
NO
RISK ASSIGNMENT
High risk for autism group Fail A5, A7, Bii, Biii, Biv Medium risk for autism group Fail A7, Biv (but not in maximum risk group) Low risk for autism group Not in other two risk group
The CHAT is designed to be administered by primary healthcare workers or clinician in childrens services
As a screening tool, it is convenient to administer at the eighteen-month development check-up
Those child who failed this CHAT were rescreened about one month later with the same questioner A second CHAT is advisable so as to check that a fail on a key item occurs for valid reasons Any child failing the CHAT a second time should however be referred to a specialist clinic for diagnosis
ASSESSMENT
The purpose of assessment is to confirm the diagnosis; seek an underlying cause; assess strengths and weaknesses in the child and associated developmental and mental health impairments (comorbodities); assess family needs; and identify the resources to meet the needs
The use of DSM-IV and any of the several autism-specific diagnostic inventories substantially increases diagnostic reliability
DIFFERENTIAL DIAGNOSIS
Other pervasive development disorders - Retts syndrome - Childhood disintegrative disorders - Aspergers disorders Disorders of infancy, childhood, and adolescence - Selective mutism - Stereotypic movement disorder Schizophrenia with childhood onset Mental retardation or general learning disability Language disorder
MANAGEMENT
The general goals of treatment for autistic patients are to improve language and social skills, decrease problem behaviors, support parents and families in their adjustment to and education of autistic children, and foster independence
No drug or other treatment cures autism, and many patients do not require medication. However, psychotropic drugs that target specific symptoms may help substantially
CONCLUSION
When an autistic disorder is suspected, referral should be made for further developmental evaluation and cognitive testing Although there is currently no cure for autism, early diagnosis and intervention can significantly enhance functioning in later life