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Autism Trends _ Updates

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					Autism Update

   M. Ellen Gellerstedt, MD,
             FAAP
 Eastern Maine Medical Center
         May 12, 2009
            Autism
Complex neurobehavioral disorder
  characterized by:
• Impairment in social interaction
• Impairment in communication
• Restricted, perseverative behaviors,
  interests, and activities
       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 Diagnosis DSM-IV
   Qualitative Impairment in
    communication as manifested by
    at least one 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 Diagnosis DSM-IV
   Restricted repetitive and
    stereotyped patterns of behavior,
    interests, and activities, as
    manifested by at least one 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
      Pervasive Developmental
             Disorders
   Autistic Disorder (299.00)
   Asperger’s Disorder (299.80)
   Pervasive Developmental
    Disorder, NOS (299.80)
   Rett Syndrome (299.80)
   Childhood Disintegrative
    Disorder (299.10)
    Autism Spectrum Disorders –
       confusing terminology
 PDD vs. PDD, NOS
 Asperger vs High Functioning
  Autism
 Autism with or without
  mental retardation
 Autism Spectrum Disorder
    Explanatory Models
 Theory of Mind
 Mind Blindness

 Others
         Etiology of Autism
   Probably no single etiology
   Approximately 10% may be
    behavioral profile associated with
    specific condition – e.g.
    Tuberous Sclerosis, Fragile X
    syndrome, untreated
    phenylketonuria, others
   Probably more than one gene
    responsible for vulnerability
          Etiology of Autism
   Likely interplay of genetic
    predisposition and precipitating
    event(s)
      Environmental
      Infectious
      Immunologic
      Other
   Large multisite studies underway
    to further investigate causes
        What you are looking for
   Atypical use of
    non-verbal
    behaviors
    • Eye gaze
    • Gestures
    • Facial expression
       What you are looking for
   Impaired Spontaneous
    seeking to share
    enjoyment
       Joint Attention
       What you are looking for
   Restricted
    interests,
    stereotypies, and
    repetitive
    behaviors
       What you are looking for
   Atypical
    development of
    spoken language
      Language regression
      Echolalia
      Not turning to name
       What you are looking for
   Atypical social and
    emotional
    reciprocity
    • Responding to
      name
    • Orient toward
      people
              Specifically
   Does the child
    respond to
    parental attention
   Does the child
    watch the parent
    for social cues
   Does the child
    respond to his/her
    name
www.firstsigns.org
On the Spectrum
Thank You

				
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