Treatment Considerations: Asha’s Position
Several treatment options and approaches lack scientific evidence of validity and are not endorsed by ASHA. They are Auditory Integration Training , Facilitated Communication , and Rapid Prompting Method . Below are brief descriptions of these treatments, along with ASHA’s position on each. Click on the hyperlinks provided to read ASHA’s full position statements.
Auditory Integration Training
Auditory Integration Training is a type of sensory integration treatment that involves exercising the middle ear muscles and auditory nervous system to treat a variety of auditory and nonauditory disorders, including auditory processing problems, dyslexia, learning disabilities, attention-deficit disorders, and ASD. The treatment typically involves listening to specially filtered and modulated music for two 30-minute sessions per day for 10 consecutive days. The objective is to reduce distortions in hearing and hypersensitivity to specific frequencies so that the individual will be able to perceive soundsâincluding speechâin a normal fashion.
According to ASHA’s position statement titled, Auditory Integration Training, “The 2002 ASHA Work Group on AIT, after reviewing empirical research in the area to date, concludes that AIT has not met scientific standards for efficacy that would justify its practice by audiologists and speech-language pathologists” .
Rapid Prompting Method
What Are Startup Costs
Startup costs are costs paid or incurred in connection with investigating the creation or acquisition of an active trade or business or creating an active trade or business. To be a startup cost, the expenditure must have otherwise been deductible as an ordinary and necessary business expense under Sec. 162.
So How Should I Describe My Child Or Someone Else’s Diagnosis
If you don’t know which description to use, don’t worry, it’s taken a while but I’ve figured out what works for us and I promise you will too.
There are two main approaches:
- Person-first : The argument for this approach is that it doesn’t define someone by their diagnosis. It’s not labelling somebody.
- Identity-first : The argument for describing someone as autistic is that it’s an inherent part of their identity and something to be proud of.
Last year autistic speaker Chris Bonnello, through his website Autistic Not Weird, asked 11,000 people how they describe a diagnosis.
Just over half of autistic respondents said they only use “autistic person” while 11 per cent preferred “person with autism”. About a quarter of people were happy to use either.
Almost half of the non-autistic people with no autistic relatives said they only use “person with autism”.
“This does seem to back up the experience of many of us in the autism community, that professionals are taught to use person-first language but those on the spectrum themselves are more willing to claim the word autistic as their identity,” Mr Bonnello says.
“I see the arguments for ‘person with autism’ but I feel tempted to give the comeback that I don’t see my autism as something that is so terrible that it has to be pushed to the end of the sentence as if it’s not part of the real me.”
Mr Bonnello also flags the danger of becoming too caught up in the debate.
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How Do You Speak Up As A Parent
I’ve lost count of the number of times I want to call someone out on the language they’ve used around autism or disability.
How do you do this calmly and politely, especially if they’re talking about your child?
Shannon Des Roches Rosa has been writing about autism since her son Leo was diagnosed on the autism spectrum in 2003 and she is the senior editor of The Thinking Person’s Guide to Autism.
Shannon says it’s hard for anyone to change habits, especially when it comes to language.
“If people don’t know any better and you say ‘Did you know that this is considered harmful?’ and they say ‘I am so sorry I will try and change my usage’, even if they make a couple of mistakes because it does take time, I understand,” she says.
“I only have a problem with people who have been told that specific words are harmful and then they insist on using them anyhow because then they are disrespecting Leo and his community.”
The flip side of that is that through Patch and autistic community I’ve learnt some beautiful words which are important to them words that celebrate difference, like neurodiverse and neurodivergent.
I use them loudly and often in public, in the hope others adopt them too.
Treatment Considerations: Transitioning Youth And Adults
The core challenges associated with ASD can have an impact on the ability to succeed in postsecondary educational programs, employment, and social relationships, and to acquire the skills needed to live independently .
Individuals with ASD who are transitioning to young adulthood experience high rates of unemployment and underemployment and may have difficulty maintaining employment once secured . Socially, they may discontinue friendships, participate in fewer social activities , and experience social isolation .
These findings highlight the need for continued support to facilitate a successful transition to adulthood. SLPs are involved in transition planning in high school and may be involved, to varying degrees, in other support services beyond high school.
Transition planning for individuals with ASD may include
- determining the need for continued therapy, if appropriate
- identifying career goals and educational needs
- providing academic or career counseling
- providing opportunities for work experience
- discussing housing options and
- facilitating community networking .
Effective transition planning involves the student as an active and respected member of the team as well as their family, who can provide valuable information about the student’s needs. See ASHA’s resource on transitioning youth.
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How Does A Kid Get Autism
Genetics. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes may increase the risk of autism spectrum disorder.
Political Correctness And The Euphemism Treadmill
The language of disability has gone through many iterations on the path to political correctness. Terms used to refer to people have included crippled, handicapped, handicapable, disabled, special needs and differently-abled. The concept of the euphemism treadmill refers to this iterative selection of terminology. Currently, disabled is the term most favored by disabled people.
- While cripple is practically universally deprecated, the derivative crip is in-group slang used among mobility impaired groups as a self-identification label. Insiders may use crip, but outsiders and formal writing â including Wikipedia articles â should not. The process of using an otherwise negative term as an in-group marker is known as reappropriation.
- Cripple is used as a metaphor in contexts unrelated to disability. It seems to be particularly used in business/economics and sports news writing: “Franklin’s suspension is a crippling blow to the struggling team”, and “Global platinum shortage may cripple motor industry”.
Role Of The Slp In Diagnosis
Interdisciplinary collaboration in assessing and diagnosing ASD is important due to the complexity of the disorder, the varied aspects of functioning affected, and the need to distinguish ASD from other disorders or medical conditions.
Ideally, the SLP is a key member of an interdisciplinary team with expertise in diagnosing ASD. When there is no appropriate team available, an SLPâwho has been trained in the clinical criteria for ASD and who is experienced in diagnosing developmental disordersâmay be qualified to diagnose these disorders as an independent professional .
Some state laws or regulations may restrict a licensee’s scope of practice and may prohibit the SLP from providing such diagnoses. SLPs should check with their state licensure boards and/or state departments of education for specific requirements.
See the Assessment section of the Autism Spectrum Disorders Evidence Map for pertinent scientific evidence, expert opinion, and client/caregiver perspective.
Interdisciplinary collaboration and family involvement are essential in assessing and diagnosing ASD. The SLP is a key member of an interdisciplinary team that includes the child’s pediatrician, a pediatric neurologist, and a developmental pediatrician. There are a number of available algorithms and tools to help physicians develop a strategy for early identification of children with ASD .
Do You Capitalize Sports Team Names
SPORTS TEAMS: You dont have to capitalize the names of the sports. The Mens Basketball team has a tall Canadian on the roster is incorrect. It should be The mens basketball team has a tall Canadian on the roster. More capitalization rules: championship, regionals, etc. are not capitalized.
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History Of Delayed Language Onset In Asd
To our knowledge, this is the first MEG study to show increased right hemispheric response in a semantic task in individuals with ASD who had delayed language onset versus individuals with ASD without delayed language. It is possible that the increased right hemispheric lateralization seen in previous studies was also related to a history of language delay in individuals with ASD. It is unclear, however, whether the development of different semantic networks caused, or was caused by, a delay in language onset. Another possibility is that the development of aberrant semantic networks and a delay in language onset could both have been caused by a third factor, genetic predisposition. All studies show that there is considerable genetic heterogeneity in ASD , therefore it is very likely that multiple physiological processes are affected.
Restrictive / Repetitive Behaviors May Include:
- Repeating certain behaviors or having unusual behaviors. For example, repeating words or phrases, a behavior called echolalia
- Having a lasting intense interest in certain topics, such as numbers, details, or facts
- Having overly focused interests, such as with moving objects or parts of objects
- Getting upset by slight changes in a routine
- Being more or less sensitive than other people to sensory input, such as light, noise, clothing, or temperature
People with ASD may also experience sleep problems and irritability. Although people with ASD experience many challenges, they may also have many strengths, including:
- Being able to learn things in detail and remember information for long periods of time
- Being strong visual and auditory learners
- Excelling in math, science, music, or art
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Challenges Of Identifying High
High-functioning individuals with ASD pose particular challengesâboth for identification and for determining eligibility for services. These individuals often have either verbal or nonverbal intelligence within or above the average range and appear to succeed in some or most academic subjects, particularly in early school years. As a result, many are not diagnosed until later school age, adolescence, or even adulthood.
Long-term outcomes for these individuals show that challenges with social engagement and social communication can significantly affect their ability to adjust to social demands in later academic and community settings and in the workplace . These findings suggest the importance of providing intervention to address the gap between cognitive potential and social adaptive functioning.
Determining eligibility for educational services requires using a variety of strategies for gathering information, including
- standardized measures of social adaptive functioning,
- naturalistic observation across a range of settings, and
- caregiver/teacher interviews or questionnaires.
Regardless of the assessment measures or tools used, the clinician needs to be aware of any subtle signs and symptoms consistent with a diagnosis of ASD.
For a comprehensive discussion of individuals with ASD as they transition into and through adulthood, see IACC, 2017.
Consistent with the WHO framework, treatment is designed to
Semantic Processing In Autism Spectrum Disorders Is Associated With The Timing Of Language Acquisition: A Magnetoencephalographic Study
- 1Fetal-Neonatal Neuroimaging and Developmental Science Center, Department of Pediatrics, Division of Newborn Medicine, Boston Childrens Hospital and Harvard Medical School, Boston, MA, United States
- 2Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- 3Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Hemispheric Asymmetry In Asd
Previous research suggests a strong relationship between atypical laterality of language and language impairment in ASD . Atypical hemispheric asymmetry, increased right hemispheric activity and/or decreased left hemispheric activity, in ASD is seen across different aspects of language processing, including speech processing , sentence listening , passive listening to speech-like sounds , silent sentence reading , passive listening to speech sounds , lexico-semantic processing , understanding of irony , semantic category decision-making , processing of congruous and incongruous final words , word generation , and story listening during sleep . Such atypical hemispheric lateralization has been observed also in non-language tasks such as passive listening to simple tone stimuli . Abnormal rightward lateralization has been found both in very young children with autism , as well as in 37 year old children with autism , reflecting an early developmental pathology , although the relationship with language development was not reported.
Cultural And Linguistic Considerations
Awareness of individual and cultural differences is essential for accurate diagnosis. For example, direct eye contact with an authority figure may be considered disrespectful in some cultures, and silence may be valued as a sign of respect. In a U.S. school system, these behaviors could easily be misinterpreted as socially inappropriate.
The core characteristics of ASD may be viewed through a cultural lens leading to under-, over-, or misdiagnosis . Signs and symptoms that are clearly “red flags” in the U.S. health care or educational system may not be viewed in the same way by someone from a culture that does not formally define the disorder.
Cultural and linguistic variables may contribute to the disparity in the diagnosis of ASD among some racial/ethnic groups . For example, Begeer et al. found that Dutch pediatricians might be inclined to attribute social and communication problems of non-European minority groups to their ethnic origin, while attributing these same characteristics to autistic disorders in children from majority groups.
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Red Flags And Clinical Presentations Of Asd
Overt behavioural signs of ASD are not generally present in the first 6 months of life. Prospective studies of high-risk infants suggest an emerging ASD prodrome in the latter half of the first year of life, which may include delayed motor control , feeding and sleeping difficulties, and/or excessive reactivity or passivity .
Symptoms in the core domains of ASD usually emerge between 12 and 24 months. Initial presentations vary, and there is no one behavioural sign that rules an ASD diagnosis in or out. Parents initial concerns may include language delay, lack of response when the childs name is said, and limited eye contact.
Other early warning signs at different stages of development are summarized in Table 3. Children with ASD may appear relatively typical with respect to early social engagement and communication, then become withdrawn or lose communication or language skills by 18 months . For some children with more advanced language and cognitive skills, ASD signs are relatively subtle in the early years but become more apparent as they reach school age and begin to struggle with increasing social demands .
Signs And Symptoms Of Asd
People with ASD have difficulty with social communication and interaction, restricted interests, and repetitive behaviors. The list below gives some examples of the types of behaviors that are seen in people diagnosed with ASD. Not all people with ASD will show all behaviors, but most will show several.
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Current State Of Evidence For Asd Screening
There have been several comprehensive reviews evaluating measures used as ASD screens, specifically for accuracy in particular test populations and contexts, and the evidence for their impact on age of diagnosis, access to intervention services, and long-term outcomes . ASD screening evidence has also been reviewed within previous ASD assessment guidelines and by the US Preventative Services Task Force .
Several conclusions can be drawn. First, ASD screening tools have been evaluated in community contexts that accurately differentiated between toddlers with and without ASD . Second, compared with an open-ended question regarding parental concerns, some screening tools ) detected ASD earlier and more consistently . Third, there is little evidence from clinical trials regarding how ASD screening influences diagnostic timelines and long-term outcomes. One published randomized clinical trial demonstrated younger diagnostic age by implementing the Early Screen for Autism in Toddlers, although differences may have reflected collateral effects rather than the screen itself . The lack of clinical trial evidence was cited by the USPSTF when they found insufficient evidence to assess the balance of benefits and harms of screening for ASD in young children for whom no concerns of ASD have been raised by their parents or a clinician.
|Table 4. General developmental assessment tools
Deafness And Deaf Culture
The word deaf, when written in lowercase refers to the physical or neurological inability to hear. When Deaf is used as a proper noun it refers to the community of Deaf people in terms of Deaf culture, a socio-linguistic group identity. These are people whose native language is a sign language. Most Deaf people were either born deaf or lost their hearing in infancy, before the stage at which spoken language is typically developed. They form a linguistic and cultural minority within the general population. Someone who is hard of hearing has hearing loss but is not profoundly incapable of hearing. Hard of hearing people are accepted in the Deaf community and tend to self-identify as culturally Deaf. People who become deaf later in life usually retain speech that is indistinguishable from a hearing person’s, and do not generally become part of the Deaf community.
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