My child may have Autism, now what? Guidelines for assessment ...

My child may have Autism, now what? Guidelines for assessment ...

My Patient May Have Autism, Now What? Guidelines for Assessment, Intervention, and Next Steps. DoriAnn Adragna, Ph.D., Ed.S., Peak Pediatric Psychology Licensed Psychologist Licensed School Psychologist My background Bachelors of Arts in Psychology from Colorado Mesa University

Education Specialist Degree from the University of Denver Doctor of Philosophy from the University of Denver Completed a two year fellowship in pediatric traumatic brain injury Completed a one year psychology externship at JFK Partners and Childrens Hospital Colorado in Autism and other Neurodevelopmental Disorders Founding member of PEAK Pediatric Psychology Objectives At the end of this presentation participants will: Be able to identify some of the early warning signs for an

autism spectrum disorder Identify screening tools to determine when a more thorough assessment is warranted Learn how to help families navigate a new diagnosis What is Autism? Previous Terms Used: Aspergers Disorder Autistic Disorder Retts Disorder Pervasive Development Disorder Childhood Disintegrative Disorder

Current DSM-V Terms: Autism Spectrum Disorder Category which includes a range of related disorders that vary in severity Severity can be Mild (level 1), Moderate (Level 2), or Severe (level 3) Autism Spectrum Disorder The core of autism is a social communication disorder.

The term Autism comes from the Greek word Autos which means self. DSM V criteria that need to be met to have a diagnosis of ASD: A) Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text): Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.

Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers. DSM V-Major criteria that need to be met to have a diagnosis of ASD:

B) Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text): Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases). Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day). Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). Hyper- or hyporeactivity to sensory input or unusual interest in sensory

aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement). Early Warning Signs of ASD: Infant Does not orient to name Lack of eye contact Lack of social smile Early Warning Signs: Toddler/Preschool Speech development

Delays Echolalia Impairments in nonverbal communication Play skills Functional vs pretend play Joint attention Interactions with peers Does the child approach other children at a park? How does the child respond to approaches from other children? Restricted interests/ Repetitive Behaviors Interest common to age but with more intense focus Fascination with certain items (long objects,

water, toilet flushing, etc.) Complex hand mannerisms/Stereotypical movements Behavioral rituals/rigidity/difficulty with routines Be On The Lookout for Regression Loss of skills previously acquired (such as if the child suddenly stops speaking) Research suggests screening at these age intervals for regression and to follow up with more assessment if warranted 18 months 24 months

36 months ASD Screening Tools Ages and Stages Questionnaire (ASQ) Ages: 1 month to 5 years old M-CHAT Ages: Toddlers ages 16-20 months Social communication questionnaire (SCQ) Ages: 4 years old and older with mental age of 2 years old Formal

Assessment Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) Developmental Interview Cognitive abilities Wechsler Intelligence Scales for Children, Fifth Edition Leiter International Performance Scale (Nonverbal assessment) Developmental Assessment Mullen Scales of Early Learning Adaptive Behaviors Adaptive Behavior Assessment System, Third Edition (ABAS-3)

Vineland Adaptive Behavior Scales, Third Edition Therapies Speech and Language Therapy Communication skills Pragmatic skills Occupational therapy Sensory concerns Fine/Gross motor skills Psychosocial interventions ABA therapy CBT Early intensive (25-40 hours a week over at

least 2 years) therapy Floor Time (DIR) Model How to Help a Family Navigate a New Diagnosis Reassure them that their child is still the same child that they know and love Connect them to local resources Provide referrals to occupational therapy, speech therapy, and behavioral therapy Check in with the family to follow up on referrals, therapies, applications

Priority Recommendations 100 day tool kit from the Autism Speaks Website https://www.autismspeaks.org/family-servi ces/tool-kits/100-day-kit Social Stories/ Comic Strip Conversations Video Modeling The Autism Society of America, Colorado chapter can be contacted at 720-214- 0794 to gain information about local resources in Colorado. The Autism Speaks website also has a lot of helpful information for families of children with ASD. Please see www.autismspeaks.org The Arc of West Central Colorado provides

advocacy and support for people with intellectual and developmental disabilities. Please see www.arcwcco.org for more information Thank you! Questions? Lets keep in touch [email protected] Peak Pediatric Psychology

Recently Viewed Presentations

  • Šírenie živočíchov - UVLF

    Šírenie živočíchov - UVLF

    ČLÁNKONOŽCE ARTHROPODA Doc. MVDr. Juraj Toporčák, PhD ARTHROPODA fylogeneticky nadväzujú na mnohoštetinavce známych viac ako milión druhov prispôsobené - vo vode - na zemi - vo vzduchu obrovský rozvoj článkonožcov umožnili progresívne znaky v telesnej stavbe i v spôsobe života...
  • Lecture #5 - Anatomical Structure of Softwoods, part I

    Lecture #5 - Anatomical Structure of Softwoods, part I

    Lecture #5 - Anatomical Structure of Softwoods, part I ... Strand Tracheids (STs) Strand tracheids are short cells that are arranged in longitudinal strings or "strands" STs have one or two "square ends" They contain bordered pits. They are usually...
  • Document Docketing DOCKETING STATION Drop Folder Distribution Process

    Document Docketing DOCKETING STATION Drop Folder Distribution Process

    Auto Docketing(EPO Mailbox, USPTO Private Pair, BOPI) Depending on user rights they have access to different layouts for Docketing Station . DD - CONFIGURATION. Basic Configuration Values: BC 300 'Default Docketing Term' - optional.
  • Australian Commission on Safety and Quality in Health Care

    Australian Commission on Safety and Quality in Health Care

    Clinical Handover Process - Issues Day Procedure Centre example Patient handover situations may include: Handover between theatre staff with recovery staff Procedures for handover at discharge to the primary carer and the patient such as a discharge summary 2. ......
  • The Lure of the Dark and Mysterious: Observational

    The Lure of the Dark and Mysterious: Observational

    (provided by the CMB) The initial conditions are determined by the first 300,000 years of history. I will not discuss this. The Hubble Expansion Discovered in 1929. (Hubble, Slipher, Leavitt) Imagine a rubber sheet that is being uniformly stretched: r2...
  • Introduction to Java programming

    Introduction to Java programming

    ESSENTIAL KNOWLEDGE. Data types can be categorized as eitherprimitive or reference.. A class is the formal implementation, or blueprint,of the attributes and behaviors of an object. A class contains a constructor that is invokedto create objects.. Constructors are used to...
  • Themes and Symbols: Appearances vs. Reality Objective: To ...

    Themes and Symbols: Appearances vs. Reality Objective: To ...

    Tragic Character ArcsObjective: To evaluate the tragic journey of key characters and the causes of their regression.. Lesson 9 [Character Arc]The journey of a character and the dynamics of their character traits throughout the course of a narrative. [Tyranny] Cruel...
  • Interpreting Parables I. What is a parable? A.

    Interpreting Parables I. What is a parable? A.

    The Book of Proverbs is a collection of short, pithy statements that are intended to teach practical principles of living. d. Most of the other times that it is used it is speaking of an incident in someone's life becoming...