Transcript Autism Spectrum Disorder 2015 slideshow

What is Autism?
Shirley Alleyne M.B.B.S
Paediatric & Adult Psychiatrist
What is Autism
Spectrum Disorder?
Autism Spectrum Disorder
(Objectives)

Define Autism Spectrum Disorder
(ASD)

Review Epidemiology & Aetiology

Discuss early signs and symptoms
Autism Spectrum Disorder
(Objectives)
Review:

The diagnostic process

Evidence based intervention in
2015
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Resources for the management of
ASD
Autism Spectrum Disorder
(Definition)
Abnormalities In:

Social Interaction

Communication

Restricted interest

Stereotyped behaviour
Autism Spectrum Disorder
(Demographics-International)

Medium prevalence of ASD 1.3/1000

M:F = 4:1

No socioeconomic bias

More common in children of older
PARENTS
Autism Spectrum Disorder
(Demographics- Caribbean)

Aruba prevalence 5.3/ 1000 children
(Balkom et al 2009)

Jamaica- mean age of parental concern
21+months/+/-10 months.

Jamaica-mean age of accessing intervention 44
months.

Jamaica-% of teachers and medical providers
who referred on first contact 5.6% & 4.6%
respectively.
(Samms-Vaughan et Franklin-Benton 2015)
Autism Spectrum Disorder
(Etiology)

Unknown

Genetics-5% common & rare variant

18.7% recurrence rates
Autism Spectrum Disorder
(Early Intervention-Screening)

Routine assessment of
communication and social
relatedness

Use of screeners- M-CHAT at 18 and
24 months
Autism Spectrum Disorder
(Diagnosis)

Based on knowledge of typical
development

Based on clinical history

Based on clinical observations

May include the use of diagnostic
tools (ADOS, ADI etc)

Genetic testing is recommended
Autism Spectrum Disorder
(Diagnotic Criteria)
PERSISTENT deficits in:
Social Communication
Poor
eye contact
One
sided conversations
Limited
facial expression & use of
gestures
Autism Spectrum Disorder
(Diagnotic Criteria)
PERSISTENT deficits in:
Social Interaction
 Unable to initiate or maintain social
interactions
 Poor interest in others
 Inability to read nonverbal cues
 Inability to adjust to changes in the
social environment
Autism Spectrum Disorder
(Diagnotic Criteria)
Restricted, Repetitive Behaviours,Interests
or Activities

Stereotyped motor movements, use of
objects or speech

Insistence on sameness

Highly restricted fixation interests

Hypo or hyperactivity to sensory inputs
Autism Spectrum Disorder
(Early Intervention & Outcomes)
Early Intervention
Capitalizes on increase brain
plasticity in early childhood
 Proven to improve long-term
prognosis
 Proven to improve communication
and social skills
 Proven to improve intelligence

Autism Spectrum Disorder
(Management)

Communication Intervention

Educational Intervention

Behavioural Interventions

Pharmacotherapy

Alternative/Complimentary
treatments

Supportive Psychotherapy-Family
Steve Wiltshire- renown Artist, person with ASD.
“Hope is being able to see that there is light despite
all of the darkness”- Desmond Tutu
Autism Spectrum Disorder
(Resources on Island)

The Albert C. Graham Development Centre

Sunshine Early Stimulation Centre

The John Payne School

Schoolhouse for Special Needs

The Learning Centre

The Derrick Smith Secondary School
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The Autism Association of Barbados

Spectrum Possibilities Charity
Autism Spectrum Disorder
(Resources)
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www.cdc.gov
www.babycenter.com
www.autismspeaks.org
www.autismsource.org
www.aacap.org
www.aap.org
www.healthychildren.org
www.autism.kennedykrieger.org
Autism Spectrum Disorder
(References)

Tchaconas, A., & Adesman, A. (2013). Autism spectrum
disorders: a pediatric overview and update. Current
opinion in pediatrics, 25(1), 130-143.

Volmar, Fred et Al.Practice Parameter for the Assessment
and Treatment of Children and Adolescents with Autism
Spectrum Disorder www.aacap.org (JAACAP Vol 53 2014)

van Balkom, I. D., Bresnahan, M., Vogtländer, M. F., van
Hoeken, D., Minderaa, R. B., Susser, E., & Hoek, H. W.
(2009). Prevalence of treated autism spectrum disorders in
Aruba. Journal of neurodevelopmental disorders, 1(3),
197-204.

Samms‐Vaughan, M., & Franklyn‐Banton, L. (2008). The role
of early childhood professionals in the early identification
of autistic disorder. International Journal of Early Years
Education, 16(1), 75-84.
Autism Spectrum Disorder
(References)

Dawson, G., Rogers, S., Munson, J., Smith, M., Winter,
J., Greenson, J., ... & Varley, J. (2010). Randomized,
controlled trial of an intervention for toddlers with
autism: the Early Start Denver Model. Pediatrics,
125(1), e17-e23.
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Wetherby, A. M., Guthrie, W., Woods, J.,
Schatschneider, C., Holland, R. D., Morgan, L., & Lord,
C. (2014). Parent-Implemented Social Intervention for
Toddlers With Autism: An RCT. Pediatrics, 134(6), 10841093.
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Kasari, C., Gulsrud, A., Paparella, T., Hellemann, G., &
Berry, K. (2015). Randomized Comparative Efficacy
Study of Parent-Mediated Interventions for Toddlers
With Autism.
Shirley Alleyne
[email protected]
www.cpapsclinic.com
THANK-YOU