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					                                                             Autism Spectrum
                                                                    Disorders
                                                                                           A publication of NICHCY
                                                                                             Disability Fact Sheet #1
                                                                                                           June 2010
          Ryan’s Story
    Ryan is a healthy, active two-    After talking with their family        mental Disorders”—a category
year-old, but his parents are         doctor, Ryan’s parents call the        that’s often referred to as simply
concerned because he doesn’t          Early Intervention office in their     the “autism spectrum.”
seem to be doing the same             community and make an
things that his older sister did at   appointment to have Ryan                   As painful as this is for his
this age. He’s not really talking,    evaluated.                             parents to learn, the early
yet; although sometimes, he                                                  intervention staff encourage
repeats, over and over, words              When the time comes, Ryan         them to learn more about the
that he hears others say. He          is seen by several professionals       autism spectrum. By getting an
doesn’t use words to communi-         who play with him, watch him,          early diagnosis and beginning
cate, though. It seems he just        and ask his parents a lot of           treatment, Ryan has the best
enjoys the sounds of them.            questions. When they’re all            chance to grow and develop. Of
Ryan spends a lot of time             done, Ryan is diagnosed with           course, there’s a long road
playing by himself. He has a          autism, one of the five disorders      ahead, but his parents take
few favorite toys, mostly cars, or    listed under an umbrella cat-          comfort in knowing that they
anything with wheels on it! And       egory of “Pervasive Develop-           aren’t alone and they’re getting
sometimes, he spins himself                                                  Ryan the help he needs.
around as fast as he does the
wheels on his cars. Ryan’s                                                       What are the Characteristics
parents are really concerned, as                                                   of Autism Spectrum
he’s started throwing a tantrum
whenever his routine has the
                                                                                         Disorders?
smallest change. More and                                  is the
                                                                                  Each of the disorders on the
more, his parents feel stressed,       National Dissemination Center
                                                                             autism spectrum is a neurologi-
not knowing what might trigger         for Children with Disabilities.
                                                                             cal disorder that affects a child’s
Ryan’s next upset.                                                           ability to communicate, under-
                                                 NICHCY
                                                                             stand language, play, and relate
    Often, it seems Ryan doesn’t      1825 Connecticut Avenue N.W.,
                                                                             to others. They share some or
notice or care if his family or                  Suite 700
                                                                             all of the following characteris-
anyone else is around. His                Washington, DC 20009
                                                                             tics, which can vary from mild
parents just don’t know how to         1.800.695.0285 (Voice / TTY)
                                                                             to severe:
reach their little boy, who seems       202.884.8200 (Voice / TTY)
so rigid and far too set in his               nichcy@aed.org                 •     Communication problems
ways for his tender young age.                www.nichcy.org                       (for example, with the use


                                            Disability Fact Sheet #1 (FS1)
    or comprehension of                              Pervasive Developmental Disorders (PDD)
    language);

•   Difficulty relating to people,       Autistic         Asperger      Rett        Childhood
    things, and events;                                                            Disintegrative     PDDNOS
                                         Disorder        Syndrome    Syndrome
                                                                                     Disorder
•   Playing with toys and
    objects in unusual ways;                        Current Classification Scheme in the DSM-IV-TR
•   Difficulty adjusting to
    changes in routine or to
    familiar surroundings; and             What are the Specific                   The five conditions are
                                                                              defined in the Diagnostic and
                                            Disorders on the
•   Repetititive body move-                                                   Statistical Manual, Fourth Edition,
    ments or behaviors.1                    Autism Spectrum?                  Text Revision (DSM-IV-TR) of
                                                                              the American Psychiatric Society
    These characteristics are            There are five disorders             (2000). This is also the manual
typically evident before the age     classified under the umbrella            used to diagnose autism and its
of three.                            category officially known as             associated disorders, as well as a
                                     Pervasive Developmental                  wide variety of other disabili-
    Children with autism or one      Disorders, or PDD. As shown              ties.
of the other disorders on the        above, these are:
autism spectrum can differ                                                        At the moment, according
considerably with respect to         •    autism;                             to the 2000 edition of the DSM-
their abilities, intelligence, and                                            IV, a diagnosis of autistic disor-
                                     •    Asperger syndrome;
behavior. Some children don’t                                                 der (or “classic” autism) is
talk at all. Others use language     •    Rett syndrome;                      made when a child displays 6 or
where phrases or conversations                                                more of 12 symptoms across
are repeated. Children with the      •    childhood disintegrative            three major areas:
most advanced language skills             disorder; and
tend to talk about a limited                                                  •   social interaction (such as
range of topics and to have a        •    Pervasive Developmental                 the inability to establish or
hard time understanding                   Disorder Not Otherwise                  maintain relationships with
abstract concepts. Repetitive             Specified (often referred to            peers appropriate to the
play and limited social skills are        as PDDNOS).2                            level of the child’s develop-
also evident. Other common                                                        ment,
symptoms of a disorder on the            Although there are subtle
autism spectrum can include          differences and degrees of               •   communication (such as the
unusual and sometimes uncon-         severity between these five                  absence of language or
trolled reactions to sensory         conditions, the treatment and                delays in its development),
information—for instance, to         educational needs of a child                 and
loud noises, bright lights, and      with any of these disorders will
                                     be very similar. For that reason,        •   behavior (such as repetitive
certain textures of food or
                                     the term “autism spectrum                    preoccupation with one or
fabrics.
                                     disorders”—or ASDs, as they are              more areas of interest in a
                                     sometimes called— is used                    way that is abnormal in its
                                     quite often now and is actually              intensity or focus).
                                     expected to become the official
                                                                                  When children display
                                     term to be used in the future
                                                                              similar behaviors but do not
                                     (see the box on the next page).3
                                                                              meet the specific criteria for
                                                                              autistic disorder, they may be


NICHCY: 1.800.695.0285                               2                              Autism Spectrum Disorders (FS1)
diagnosed as having one of the      ances within the brain. These           determine if they do have a
other disorders on the spec-        disorders are not due, however,         disability and, because of the
trum—Aspergers, Rett’s, child-      to psychological factors or, as         disability, need special services
hood disintegrative disorder, or    has been widely reported in the         under IDEA. Those special
PDDNOS. PDDNOS (Pervasive           press, to childhood vaccines.6          services are:
Developmental Disorder Not
Otherwise Specified) is the least                There
                                              Is There                      •   Early intervention | A
specific diagnosis and typically                                                system of services to support
                                           Help Available?                      infants and toddlers with
means that a child has dis-
played the least specific of             Yes, there’s a lot of help             disabilities (before their 3rd
autistic-like symptoms or           available, beginning with the               birthday) and their families.
behaviors and has not met the       free evaluation of the
criteria for any of the other                                                        • Special education
                                    child. The nation’s special
disorders.                                                                           and related services |
                                    education law, the
                                                                                      Services available
                                    Individuals with Dis-
     Terminology used with                                                            through the public
                                    abilities Education Act
autism spectrum disorders can                                                          school system for
                                    (IDEA), requires that
be a bit confusing, especially                                                         school-aged
                                    all children suspected
the use of PDD and PDDNOS                                                               children, including
                                    of having a disability
to refer to two different things                                                        preschoolers (ages
                                    be evaluated without
that are similar and intertwined.                                                      3-21).
                                    cost to their parents to
Still, it’s important to remember
that, regardless of the specific
diagnosis, treatments will be
similar.

        How Common                                  A Look at ASD Diagnoses in the Future
         are ASDs?                    In early 2010, the American Psychiatric Association released draft
                                      revisions to its Diagnostic and Statistical Manual of Mental Disor-
    According to the National
                                      ders (DSM-5) and invited comments from both professionals
Institute of Mental Health
                                      and the general public. The final and official fifth revision of the
(NIMH) and the Centers for
                                      DSM is expected to be published in May 2013.7
Disease Control and Prevention
(CDC), some form of autism            When published, the DSM-5 is expected to affect how autism
affects 2 - 6 of every 1,000          and associated disorders are diagnosed. Among the proposed
children, with the most recent        revisions are:
statistic being 1 in 110.4 ASDs
are four times more common in         •   changing the name of the diagnostic category to Autism
boys than in girls, although Rett         Spectrum Disorders;
Syndrome has only been
diagnosed in girls.5                  •   including Asperger Syndrome, Childhood Disintegrative
                                          Disorder, and PDDNOS under the diagnosis of Autism
    What Causes an ASD?                   Spectrum Disorders, rather than defining them separately
                                          and a bit differently, as is now the case;
    The causes of autism and
the other disorders on the            •   removing Rett Syndrome from the DSM entirely (and, thus,
spectrum are not known.                   from the autism spectrum).8
Researchers are currently study-
ing such areas as neurological        All this is to say...stay tuned. The criteria for diagnoses of ASDs
damage and chemical imbal-            are in the process of changing.


NICHCY: 1.800.695.0285                          3                                 Autism Spectrum Disorders (FS1)
                                                                                In addition to academic
                                                                            instruction, special education
                    Definition of “Autism” under IDEA                       programs for students with
                                                                            ASDs focus on improving
   Under IDEA, autism is defined as:
                                                                            communication, social, aca-
       .....a developmental disability significantly affecting verbal       demic, behavioral, and daily
     and nonverbal communication and social interaction,                    living skills. Behavior and
     generally evident before age three, that adversely affects a           communication problems that
     child’s educational performance.                                       interfere with learning often
                                                                            require the assistance of a
       Other characteristics often associated with autism are               professional who is particularly
     engaging in repetitive activities and stereotyped movements,           knowledgeable in the autism
     resistance to environmental change or change in daily                  field to develop and help
     routines, and unusual responses to sensory experiences. The            implement a plan which can be
     term autism does not apply if the child’s educational                  carried out at home and school.
     performance is adversely affected primarily because the child
     has an emotional disturbance, as defined in IDEA.                        The classroom environment
                                                                            should be structured so that the
       A child who shows the characteristics of autism after age 3
                                                                            program is consistent and
     could be diagnosed as having autism if the criteria above are
                                                                            predictable. Students with an
     satisfied.   [34 CFR §300.8(c)(1)]
                                                                            ASD learn better and are less
                                                                            confused when information is
                                                                            presented visually as well as
    Under IDEA, children with           section, State Agencies. The        verbally. Interaction with
a disorder on the autism                agency listed there will be able    nondisabled peers is also
spectrum are usually found              to put you in contact with the      important, for these students
eligible for services under the         early intervention program in       provide models of appropriate
category of “autism.” In the fall       your community.                     language, social, and behavioral
of 2005, more than 160,000                                                  skills. Consistency and continu-
school-aged children (3-21)                 To have a school-aged child     ity are very important for
received special education and          evaluated for an ASD or to          children with an ASD, and
related services in the public          access special education services   parents should always be
schools under the “autism”              for a school-aged child, we         involved in the development of
category.9 IDEA specifically            recommend getting in touch          their child’s program, so that
defines “autism” as shown in            with your local public school       learning activities, experiences,
the box above.                          system. Calling the elementary      and approaches will be most
                                        school in your neighborhood is      effective and can be carried over
    To have a child evaluated to        an excellent place to start.        into the home and community.
see if he or she has a disability,
including one on the autism                   What about School?                With educational programs
spectrum, or to access early                                                designed to meet a student’s
intervention services for a child           Early diagnosis and             individual needs and special-
up to his or her 3rd birthday, we       intervention are very important     ized adult support services in
recommend consulting                    for children with an ASD. As        employment and living arrange-
NICHCY’s State Resource Sheet           we’ve mentioned, under IDEA         ments, many children and
for your state (available online        children with an ASD may be         adults with a disability on the
at: http://www.nichcy.org/              eligible for early intervention     autism spectrum grow to live,
Pages/StateSpecificInfo.aspx).          services (birth to 3) and an        work, and participate fully in
You’ll find a listing for early         educational program appropri-       their communities.
intervention under the first            ate to their individual needs.


NICHCY: 1.800.695.0285                            4                               Autism Spectrum Disorders (FS1)
                                                                                References
               Tips for Parents
                        Parents
                                                                1
                                                                 Autism Society of America. (2008). About
  • Learn about autism spectrum disor-                          autism. Available online at: www.autism-
    ders—especially the specific disorder                       society.org
    of your child. The more you know,
                                                                2
    the more you can help yourself and                           American Psychiatric Association.
    your child. Your state’s Parent                             (2000). Diagnostic and statistical manual of
    Training and Information Center                             mental disorders fourth edition, text revision
    (PTI) can be very helpful. You’ll find                      (DSM-IV-TR). Arlington, VA: Author.
    your PTI listed on NICHCY’s online                          3
                                                                 American Psychiatric Association. (2010).
    State-Specific Information (under                           DSM-5 proposed revisions include new
    “Organizations Especially for Parents”). We’ve also         category of autism spectrum disorders (press
    listed organizations on page 6 that can help you            release). Available online at:
    become knowledgeable about your child’s disorder.           www.dsm5.org/Newsroom/Documents/
                                                                Autism%20Release%20FINAL%202.05.pdf
  • Be mindful to interact with and teach your child in
                                                                4
    ways that are most likely to get a positive response.        Centers for Disease Control and
    Learn what is likely to trigger a melt-down for your        Prevention (CDC). (2009). Autism
    child, so you can try to minimize them. Remember, the       spectrum disorders: Data and statistics.
                                                                Available online at: www.cdc.gov/
    earliest years are the toughest, but it does get better!
                                                                ncbddd/autism/data.html
  • Learn from professionals and other parents how to           5
                                                                 Centers for Disease Control and
    meet your child’s special needs, but remember your son      Prevention (CDC). (2009). Autism
    or daughter is first and foremost a child; life does not    spectrum disorders: Research. Available
    need to become a neverending round of therapies.            online at: www.cdc.gov/ncbddd/autism/
                                                                research.html
  • If you weren’t born loving highly structured, consistent
                                                                6
    schedules and routines, ask for help from other parents       Centers for Disease Control and
    and professionals on how to make it second nature for       Prevention (CDC). (2009). Concerns about
    you. Behavior, communication, and social skills can all     autism: CDC statement on autism and
    be areas of concern for a child with autism and experi-     thimerosal. Available online at:
                                                                www.cdc.gov/vaccinesafety/Concerns/
    ence tells us that maintaining a solid, loving, and
                                                                Autism/Index.html
    structured approach in caring for your child, can help
    greatly.                                                    7
                                                                 American Psychiatric Association.
                                                                (2009). DSM-5 publication date moved to
  • Learn about assistive technology (AT) that can help         May 2013 (press release). Available at:
    your child. This may include a simple picture commu-        www.dsm5.org/Newsroom/Documents/
    nication board to help your child express needs and         09-65%20DSM%20Timeline.pdf
    desires, or may be as sophisticated as an augmentative
                                                                8
    communication device.                                        American Psychiatric Association. (2010).
                                                                Proposed revision: Autistic disorder. Available
  • Work with professionals in early intervention or in your    online at: www.dsm5.org/
    child’s school to develop an IFSP or an IEP that reflects   ProposedRevisions/Pages/
                                                                proposedrevision.aspx?rid=94#
    your child’s needs and abilities. Be sure to include
    related services, supplementary aids and services, AT,      9
                                                                 U.S. Department of Education. (2007).
    and a positive behavioral support plan, if needed.          27th annual report to Congress on the
                                                                implementation of the Individuals with
  • Be patient and stay optimistic. Your child, like every      Disabilities Education Act, 2005 (Vol. 2).
    child, has a whole lifetime to learn and grow.              Washington, DC: Author.




NICHCY: 1.800.695.0285                           5                            Autism Spectrum Disorders (FS1)
                                                                            Your
                                                             Organizations: Your Gateway to
            Tips for Teachers
                     Teachers                            Information, Connection, and Research

 • Learn more about the autism                           For incredible amounts of information on
   spectrum. Check out the research                      ASDs, visit the organizations listed below.
   on effective instructional interven-
   tions and behavior on NICHCY’s                        Autism Society of America
   website. The organizations listed in                  1.800.3AUTISM (1.800.328.8476)
   this publication can also help.                       http://www.autism-society.org/site/
                                                         PageServer?pagename=about_home
 • Make sure directions are given
   step-by- step, verbally, visually, and                Autism Speaks
   by providing physical supports or                     888-AUTISM2 (288-4762)
   prompts, as needed by the student. Students with      http://www.autismspeaks.org/
   autism spectrum disorders often have trouble
   interpreting facial expressions, body language,       OASIS @ MAPP
   and tone of voice. Be as concrete and explicit as     Online Asperger Syndrome Information
   possible in your instructions and feedback to the     and Support (OASIS) and MAAP Services
   student.                                              for Autism and Asperger Syndrome.
                                                         http://www.aspergersyndrome.org
 • Find out what the student’s strengths and inter-
   ests are and emphasize them. Tap into those           Exploring Autism
   avenues and create opportunities for success.         Information in English and Spanish.
   Give positive feedback and lots of opportunities      http://www.exploringautism.org/
   for practice.
                                                         Autism Collaboration
 • Build opportunities for the student to have social    http://www.autism.org/
   and collaborative interactions throughout the
   regular school day. Provide support, structure,       Autism Research Institute
   and lots of feedback.                                 1.866.366.3361
                                                         en español | 1.877.644.1184 (ext. 5)
 • If behavior is a significant issue for the student,   http://www.autism.com/
   seek help from expert professionals (including
   parents) to understand the meanings of the            Interactive Autism Network
   behaviors and to develop a unified, positive          http://www.ianproject.org/
   approach to resolving them.
                                                         National Autism Association
 • Have consistent routines and schedules. When          1.877.622.2884
   you know a change in routine will occur (e.g., a      http://www.nationalautismassociation.org/
   field trip or assembly) prepare the student by
   telling him or her what is going to be different      OAR | Organization for Autism Research
   and what to expect or do.                             http://www.researchautism.org/

 • Work together with the student’s parents and          CDC | Centers for Disease Control and
   other school personnel to create and implement        Prevention
   an educational plan tailored to meet the              Information in English and Spanish.
   student’s needs. Regularly share information          www.cdc.gov/ncbddd/autism/index.html
   about how the student is doing at school and at
   home.                                                 TACA | Talk About Curing Autism
                                                         Information in English and Spanish.
                                                         http://www.talkaboutcuringautism.org/
                                                         index.htm
NICHCY: 1.800.695.0285                           6                        Autism Spectrum Disorders (FS1)

				
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Description: Autism Spectrum Disorders