Autism Lisa A. Tobler, MS

Reading Visual Impairments in Infancy, p. 178 Developmental Delay, p. 226 Autism, p. 289 ADHD, p Eating Disorders, p. 499 Depression, p

Autism Complex neurobehavioral disorder characterized by: Impairment in social interaction Impairment in communication Restricted, perseverative behaviors, interests, and activities

Diagnostic Criteria for Autistic Disorder (299.00) To receive a diagnosis of Autism, a child must have at least 6 of the characteristics in the 3 areas (note minimums in each area) In one of the areas, onset must be before age 3

Autism: DSM-IV Qualitative impairment in social interaction as shown by at least two (2) of the following: Marked impairment in nonverbal behaviors Failure to form developmentally appropriate relationships Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people Lack of social or emotional reciprocity

Autism: DSM-IV Qualitative Impairment in communication as manifested by at least one (1) of the following: Spoken language or gesture Ability to initiate or sustain a conversation Stereotyped and repetitive use of language or idiosyncratic language Lack of varied make-believe play or social imitative play appropriate to developmental level.

Autism: DSM-IV Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one (1) of the following: Stereotyped and restricted patterns of interest Adherence to specific, nonfunctional routines or rituals Stereotyped and repetitive motor mannerisms Preoccupation with parts of objects

Causation? Genetic influences are the most likely cause. Several research studies have been published in the last 5 years pointing to genetic causation. Chromosome 16 was recently implicated. Environmental factors Toxins?

Pervasive Developmental Disorders Autistic Disorder (299.00) Asperger’s Disorder (299.80) Pervasive Developmental Disorder, NOS (299.80) Rett Syndrome (299.80)

Autism Spectrum Disorders – confusing terminology PDD vs. PDD, NOS Asperger’s vs. High Functioning Autism Autism with or without mental retardation Autism Spectrum Disorder (ASD)

DSM-IV-TR Criteria for PDD-NOS Severe and pervasive impairment in the development of reciprocal social interaction along with Communication skills OR Presence of stereotyped behavior, interests, and activities But criteria are not met for any other PDD

Rett’s Disorder

CDC Statistics Occur in all racial, ethnic, and socioeconomic groups Four times more likely to occur in boys than in girls Parents who have a child with an ASD have a 2%–8% chance of having a second child who is also affected.

What are the Symptoms? Atypical use of non-verbal behaviors Eye gaze Gestures Facial expression

What are the Symptoms? Impaired Spontaneous seeking to share enjoyment Joint Attention

What are the Symptoms? Restricted interests, stereotypies, and repetitive behaviors

What are the Symptoms? Atypical development of spoken language Language regression Echolalia Not turning to name

What are the Symptoms? Atypical social and emotional reciprocity Responding to name Orient toward people

Things to Note Does the child respond to parental attention Does the child watch the parent for social cues Does the child respond to his/her name

1992 Baseline year

0-30% % % >1000% % 1996

% % % >1000% %

Why the Increase in Cases? The increase in the rate of autism is because of better diagnosing. In 1999, the rate of autism was 1 in 10,000 births. In 2009, it was 1 in 110 according to the CDC. This is a 5,000% increase in 10 years.

Ask Yourself??? If this increase is because of better diagnosing, where are the thousands and thousands of adults with autism who should have received a diagnosis 10, 20 or 30 years ago?