Wednesday, November 30, 2022

Is Autism A Developmental Disorder

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Comprehension Of Nonverbal Facial Cues

Telemedicine-Aided Therapy Helps Parents of Children With Developmental Disorders, Including Autism

A byproduct of the work of the Pittsburgh/Yale/Ohio State team was an investigation of the role of nonverbal facial cues in heterosexual nondate rape. Males who were serial rapists of adult women were studied for nonverbal receptive abilities. Their scores were the highest of any subgroup. Rape victims were next tested. It was reported that women who had been raped on at least two occasions by different perpetrators had a highly significant impairment in their abilities to read these cues in either male or female senders. These results were troubling, indicating a predator-prey model. The authors did note that whatever the nature of these preliminary findings the responsibility of the rapist was in no manner or level diminished.

The final target of study for this group was the medical students they taught. Medical students at Ohio State University, Ohio University and Northeast Ohio Medical College were invited to serve as subjects. Students indicating a preference for the specialties of family practice, psychiatry, pediatrics and obstetrics-gynecology achieved significantly higher levels of accuracy than those students who planned to train as surgeons, radiologists, or pathologists. Internal medicine and plastic surgery candidates scored at levels near the mean.

Screening For Asd In Children

There is emerging research indicating that timely diagnosis and intervention can benefit children with ASD and other developmental disorders. Timely diagnosis is important as it is a necessary step in terms of identifying appropriate intervention.

When performing a preliminary assessment for ASD, a health professional or team of professionals will determine a childs level of risk. They will use a combination of standardized questionnaires or tools and their clinical judgment.

Some more familiar screening tools in Canada include the:

  • Infant Toddler Checklist
  • Autism Observation Scale for Infants
  • Autism Diagnostic Observation Schedule Toddler Module
  • Modified Checklist for Autism in Toddlers: Revised with Follow-Up

The first signs of ASD usually present in very early childhood. ASD can be detected through screening in children as young as 12 months old. However, parents are often the first to notice unusual development in their child.

Children with ASD demonstrate areas of concern that help to indicate when an assessment should be done. Not all signs are necessary for a child to receive a diagnosis of ASD.

Table 1: Symptoms of ASD and age when symptoms may be apparent.

Symptoms
X X

ASD develops differently in each individual. Unlike other conditions, there is no typical person with ASD. The term spectrum is used because symptoms can occur in combination or in degrees of intensity. Symptoms can also vary widely from relatively mild to debilitating.

The Neurology Of Communication By Transfer Of The Dynamics And Form Of Intentions And Feelings In Movement

New data from social neuroscience confirm the common sense that we are aware of other person’s states of mind by immediate or direct engagement with the Other’s motor intentions, by whatever modality or movement these intentions are expressed, matching them by instantaneous affect attunement to the animation by which we generate intentions of our own Self . Sensitivity for the intentions, interests and feelings of other individuals, for the social affordances of their behaviors, must depend upon matching regulatory processes that govern the rhythm or pulse and expressive tonality or quality of movements of the human body as well as by mirroring their body-related form .

Direct resonance between preparation, execution, observation and thought in action depends on motor images , which underpin perception, observation, and planning of goal-directed action, and also integrate Self-related experience . An amodal perception-action system is also the means by which complex embodied human intentions may be communicated between agents across many channels of expression, in a consensuality, which, when further elaborated and mediated by language, becomes a tool for sharing abstract concepts and plans .

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Level : Requiring Very Substantial Support

The communication issues a person with Level 3 ASD may face include:

  • severe issues in both verbal and nonverbal social communication, which severely impair functioning
  • very limited initiation of social interactions
  • minimal response to social interaction from others
  • using few words of intelligible speech
  • unusual methods of meeting social needs and responding to only very direct approaches

The repetitive behavioral issues a person with Level 3 ASD may face include:

  • inflexible behavior

The levels of ASD correspond to the severity of the autism symptoms described above and the degree of support required.

In addition, it is important to keep in mind that the amount of support an autistic person needs can vary according to different ages or situations.

Signs Symptoms And General Diagnostic Issues

Developmental testing for Autism ADHD Learning Disorders

Although individuals with ASD are very different from one another, the disorder is characterised by core features in two areassocial communication and restricted, repetitive sensorymotor behavioursirrespective of culture, race, ethnicity, or socioeconomic group. ASD results from early altered brain development and neural reorganisation., However, because there are no reliable biomarkers, the diagnosis must be made on the basis of behaviour. The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders -5 criteria, published in 2013, were intended to make the diagnosis of ASD more straightforward. There is now a single ASD spectrum based on the two domains . Subtypes such as Aspergers disorder and pervasive developmental disorder not otherwise specified, which were unreliably used by clinicians, are now consolidated under the single diagnosis of ASD. In addition, DSM-5 explicitly recognises that ASD can be accompanied by other disorders, including genetic disorders and psychiatric conditions .

To be diagnosed with ASD, a person must show evidence of difficulties, past or present, in each of three social communication subdomains, and must have or have had difficulty in two of the four different restricted, repetitive sensorymotor behaviours . There are also newly proposed levels of severity in DSM-5 based on the need for support, which so far have shown dubious validity, although the concept of functionality is in itself very important.

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Signs And Symptoms Of Autism Spectrum Disorders

Autism spectrum disorder is a developmental disability caused by differences in the brain. Some people with ASD have a known difference, such as a genetic condition. Other causes are not yet known. Scientists believe there are multiple causes of ASD that act together to change the most common ways people develop. We still have much to learn about these causes and how they impact people with ASD.

There is often nothing about how people with ASD look that sets them apart from other people. They may behave, communicate, interact, and learn in ways that are different from most other people. The abilities of people with ASD can vary significantly. For example, some people with ASD may have advanced conversation skills whereas others may be nonverbal. Some people with ASD need a lot of help in their daily lives others can work and live with little to no support.

ASD begins before the age of 3 years and can last throughout a persons life, although symptoms may improve over time. Some children show ASD symptoms within the first 12 months of life. In others, symptoms may not show up until 24 months or later. Some children with ASD gain new skills and meet developmental milestones, until around 18 to 24 months of age and then they stop gaining new skills, or they lose the skills they once had.

How Mental Illness Is Diagnosed And Treated

Diagnosis

Because of the wide range of mental illnesses in the books, along with the fact that many people have one or more co-occurring mental illnesses, diagnosing mental health problems can be challenging. Diagnosis of mental illnesses is made using specific criteria found in the Diagnostic and Statistical Manual for Mental Disorders. In general, mental illness can be classified as mild, moderate or severe. If more than one mental illness is present, mental health professionals will try to determine whether one led to or influenced another. For example, someone with social anxiety may also experience depression as a result of feeling isolated.

Treatment

For someone who is on the autism spectrum and also has a mental illness, treating the mental illness in the context of the developmental disorder is essential for success. People with autism should find a mental health provider who is experienced in treating people who are on the spectrum.

Treating mental illness, like treating autism, requires a highly individualized treatment plan. Ideally, treatment will include both medication and therapy, along with lifestyle changes that support good mental health.

Medication

Therapy

Some of the therapies used to treat mental illness include:

Cognitive Behavioral Therapy

Helps individuals identify and change dysfunctional thought patterns and develop skills for coping with negative thoughts and emotions

Interpersonal Therapy

Acceptance and Commitment Therapy

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How Is Asd Diagnosed

ASD symptoms can vary greatly from person to person depending on the severity of the disorder. Symptoms may even go unrecognized for young children who have mild ASD or less debilitating handicaps.

Autism spectrum disorder is diagnosed by clinicians based on symptoms, signs, and testing according to the Diagnostic and Statistical Manual of Mental Disorders-V, a guide created by the American Psychiatric Association used to diagnose mental disorders. Children should be screened for developmental delays during periodic checkups and specifically for autism at 18- and 24-month well-child visits.

Very early indicators that require evaluation by an expert include:

  • no babbling or pointing by age 1
  • no single words by age 16 months or two-word phrases by age 2
  • no response to name
  • excessive lining up of toys or objects
  • no smiling or social responsiveness

Later indicators include:

  • impaired ability to make friends with peers
  • impaired ability to initiate or sustain a conversation with others
  • absence or impairment of imaginative and social play
  • repetitive or unusual use of language
  • abnormally intense or focused interest
  • preoccupation with certain objects or subjects
  • inflexible adherence to specific routines or rituals

How Is Autism Treated

Autism Spectrum Disorder and DSM-5 with Martin Lubetsky, MD | UPMC Video Rounds

There is no cure for ASD. Therapies and behavioral interventions are designed to remedy specific symptoms and can substantially improve those symptoms. The ideal treatment plan coordinates therapies and interventions that meet the specific needs of the individual. Most health care professionals agree that the earlier the intervention, the better.

Educational/behavioral interventions: Early behavioral/educational interventions have been very successful in many children with ASD. In these interventions therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as applied behavioral analysis, which encourages positive behaviors and discourages negative ones. In addition, family counseling for the parents and siblings of children with ASD often helps families cope with the particular challenges of living with a child with ASD.

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What Are The Types Of Autism

In the past, doctors diagnosed autism according to four different subtypes of the condition. However, healthcare professionals now classify autism spectrum disorder as one broad category with three different levels to specify the degree of support an autistic person needs.

Before 2013, healthcare professionals defined the four types of autism as:

  • childhood disintegrative disorder
  • pervasive developmental disorder-not otherwise specified

However, the American Psychiatric Association revised their Diagnostic and Statistical Manual of Mental Disorders in 2013, which did not include these four subtypes of autism. They now all fall under the one umbrella term of ASD.

Keep reading to learn more about how we categorize ASD, including the various levels, and how doctors diagnose the condition.

ASD is now the umbrella term for the group of complex neurodevelopmental disorders that make up autism. It is a condition that affects communication and behavior.

The autism spectrum refers to the variety of potential differences, skills, and levels of ability that are present in autistic people.

According to the Centers for Disease Control and Prevention , around in the United States are on the autism spectrum.

The differences in autistic people are often present from early childhood and can impact daily functioning.

Autistic people can experience the following challenges:

According to the National Institute of Mental Health, early signs of ASD can

Possible Causes And Risk Factors

The cause of autism remains unclear. However, it appears that both genetic and environmental factors contribute to the disorder. A study published in 2011 that assessed pairs of twins in which at least one twin was affected by an ASD suggested that, while genetic factors contribute moderately to susceptibility, environmental factors contribute to a greater degree. Other research has indicated that genetic vulnerability to autism differs between males and females, with more mutations being needed to produce the condition in females compared with males. Increased genetic resiliency to autism in females lends support to the so-called female protective model, which attempts to explain the increased prevalence of autism in males. Interactions between genes and the environment likely play an important role in influencing susceptibility to autism.

An environmental risk factor that has been proposed for autism and other ASDs is maternal infection during pregnancy. Indeed, certain maternal infections have been associated with an increased incidence of neurodevelopmental disorders in offspring. Infection with agents such as the rubella virus activate the mothers immune system, and such immunological activity in the early stages of pregnancy has been linked with damage to the developing brain of the embryo or fetus.

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What Type Of Reports Or Recommendations Might I Expect

Upon assessment and feedback, your clinical psychologists will provide you with an assessment report that outlines the results of the assessment and provides a full and thorough list of recommendations to support you to address areas of concern. Recommendations are tailored to the individual and typically address any supports that may be required for the individual at home, school/work, and in the community.

Autism As A Developmental Disorder

Keyfindings: Using Diagnostic Intruments

Since autism was first described more than 60 years ago , researchers have been trying to pinpoint the underlying basis of the disorder. Yet autism still continues to perplex, even though the need for an understanding of the disorder is clear. We know, after all, that autism is a life-long disorder that has a substantial effect on the individual, their family, and society. And recent UK estimates indicate that the prevalence of autism is high: 38.9 per 10,000 for autism and 116.1 per 10,000 for the entire autism spectrum . My research has concentrated largely on the underlying cognitive abnormalities in autism, and how these might manifest themselves over time. In this article, I illustrate the complexity of the disorder at the level of cognition, and stress the need to understand the underlying cause by situating the study of autism within a developmental context.

We know from twin and family studies that autism is largely genetic, though the identification of specific genes is proving more difficult than originally anticipated, largely due to the disorders heterogeneity. Research suggests that there are multiple, interacting genes involved in its inheritance , and that the neurobiological abnormalities are pervasive and not confined to any one particular region of the brain .

Weblinks

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Diagnosis In Older Children And Adolescents

ASD symptoms in older children and adolescents who attend school are often first recognized by parents and teachers and then evaluated by the schools special education team. The schools team may perform an initial evaluation and then recommend these children visit their primary health care doctor or doctors who specialize in ASD for additional testing.

Parents may talk with these specialists about their childs social difficulties including problems with subtle communication. These subtle communication issues may include problems understanding tone of voice, facial expressions, or body language. Older children and adolescents may have trouble understanding figures of speech, humor, or sarcasm. Parents may also find that their child has trouble forming friendships with peers.

Treatment Modes And Modalities

Treatment modes and modalities are technologies or other support systems that the SLP can use in conjunction with, or during implementation of, various treatments. For example, the SLP can use video-based instruction in peer-mediated interventions to address social skills and other target behaviors.

A number of treatment modes and modalities are described below. When selecting a mode or modality, the SLP considers the intervention goal and the individual’s developmental stage. For example, a mode or modality that is appropriate for an individual who is at the emerging language stage may not be appropriate for an individual who is at the prelinguistic stage. The list below is not exhaustive, and inclusion does not imply an endorsement from ASHA.

An AAC system is an integrated group of componentsâincluding symbols, selection techniques, and strategiesâused to enhance communication. AAC uses a variety of techniques and toolsâincluding picture communication systems, line drawings, photographs, video clips, speech-generating devices , tangible objects, manual signs, gestures, and finger spellingâto help the individual express thoughts, ideas, wants, needs, and feelings. AAC can be used to supplement existing expressive verbal communication or with individuals who are unsuccessful at learning expressive verbal communication.

Activity Schedule and Visual Supports

Computer-Based Instruction

Video-Based Instruction

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Diagnosis Of Autism In Adults

It is not unusual for autistic people to have reached adulthood without a diagnosis.

Sometimes people will discover some information about autism that makes them think That sounds like me. They may then choose to talk to a health professional for a diagnosis, or they may not.

You may choose to seek a diagnosis for suspected autism if:

  • you have been diagnosed with a mental health condition and/or intellectual disability during childhood or adolescence, but think that you may have autism
  • you have struggled with feeling socially isolated and different
  • your child or another family member has been diagnosed with autism and some of the characteristics of autism sound familiar to you.

If you wish to seek an assessment for autism, you can:

  • talk to your GP who may refer you to a psychologist or psychiatrist with experience in the assessment and diagnosis of autism
  • talk to a psychologist or psychiatrist with experience in the assessment and diagnosis of autism .

A psychologist or psychiatrist with experience in the assessment and diagnosis of autism will ask you about your childhood, and experiences at school and as an adult. They may also do some psychological or psychiatric testing. A speech therapist may also be consulted to assess your social communication skills. All of this information will be used to help make a diagnosis.

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