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Autism

 

Autism

Autism Society of Greater Phoenix has Autism 101 classes offered every month rotating around the valley.  To learn more about our monthly support group meetings, Autism 101 classes and Mom’s Meet Up meetings click on the one that interests you.

What is Autism?
Autism is a complex developmental disability that is present from birth or very early in development. It affects essential human behaviors such as social interaction, the ability to communicate ideas and feelings, imagination, self-regulation, and the ability to establish relationships with others. Although precise neurobiological mechanisms have not yet been established, it is clear that this disability reflects the operation of factors in the developing brain. Autism is estimated to occur in as many as 1 in 110 individuals (CDC). Autism is four times more prevalent in boys than in girls and knows no racial, ethnic, or social boundaries. Family income, life-style, and educational levels do not affect the chance of a child having autism. Autism is currently thought of as a “spectrum disorder.” This means that the severity of symptoms differs in people with ASD.

Here is a short video on What is Autism?

http://practicaltrainingsolutions.net/2016/02/03/intro-to-autism-by-dr-james-adams/

How much does Autism cost?
Currently, the Autism Society estimates that the lifetime cost of caring for a child with autism ranges from $3.5 million to $5 million, and that the United States is facing almost $90 billion annually in costs for autism (this figure includes research, insurance costs and non-covered expenses, Medicaid waivers for autism, educational spending, housing, transportation, employment, in addition to related therapeutic services and caregiver costs).

What Causes Autism?
Although these is no single specific cause of autism, current research links autism to biological and neurological differences in the brain, and Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) scans show abnormalities in the structure and function of the brain and frontal lobe. In some families, there appears to be a pattern of autism or related disabilities which suggests there may be a genetic basis to this disorder.

Several older theories about the cause of autism have now been proven false. Autism is not a mental illness, and individuals with autism do not choose to behave differently. Autism is not caused by bad parenting. Furthermore, no known psychological factors in the development of the individual have been shown to cause autism.

How is Autism Diagnosed?
There are no medical tests for diagnosing autism. Many professionals utilize a medical diagnostic reference, the Diagnostic and Statistical Manual now in its fourth edition (DSMIV-TR) to diagnose the five Pervasive Developmental Disorders. Autism typically appears by age 3, though diagnosis and intervention can and should begin earlier. In order to be diagnosed accurately, an individual must be observed by professionals skilled in determining communication, behavioral, and developmental levels. Ideally, an individual should be evaluated by a multidisciplinary team which may include a neurologist, psychologist, developmental pediatrician, speech/language pathologist, occupational therapist, education consultant, or other professional knowledgeable about autism.

However, because many of the behaviors associated with autism are shared by other disorders, a doctor may complete various medical tests to rule out other possible causes. A brief observation in a single setting cannot present a true picture of an individual’s abilities and behavior patterns. At first glance, the person with autism may appear to have mental retardation, a learning disability, or problems with hearing. However, it is important to distinguish autism from other conditions, since an accurate diagnosis can provide the basis for building an appropriate and effective educational, vocational, and treatment program.

Is there a Cure for Autism?
The understanding of autism has grown immensely since it was first described in 1943 by Leo Kanner. There is currently no known cure for autism; however, we are continuously finding better ways to understand the disorder and help families and individuals affected by Autism cope with the various symptoms of the disability. Some of these symptoms may lessen as the individual ages; others may disappear altogether. With appropriate intervention, many of the behaviors commonly associated with autism can be positively changed, even to the point that the child or adult may appear to the untrained person to no longer have autism. The majority of children and adults will, however, continue to exhibit some of the symptoms of autism to some degree throughout their lives.

Types of Autism
Mental health professionals diagnose based on the Diagnostic and Statistical Manual of the American Psychiatric Association, fourth edition (DSM-IV). DSM-IV was published in 1994. It is the first edition of the DSM to include both autism and Asperger syndrome as diagnoses. The DSM does not use the term autism spectrum. Autism and Asperger syndrome are listed in the category Pervasive Developmental Disorders. There are three diagnoses in this category that are autism spectrum diagnoses, autism, Asperger syndrome, and Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS).
Autism is characterized in the DSM-IV by:

  1. Qualitative impairment in social interaction
  2. Qualitative impairment in communication
  3. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities

Asperger syndrome is characterized by:

  1. Qualitative impairment in social interaction
  2. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities
  3. No clinically significant delay in the acquisition of speech

Diagnosis of autism requires a total of six (or more) items from the three areas, with at least two in the area of social interaction and at least one in the other two areas. Diagnosis of Asperger syndrome requires at least three items with at least one in the area of social interaction. If a clinician feels that there are concerns in all three areas but there are not enough specific items to diagnose autism or Asperger syndrome he/she might diagnose PDD-NOS.

Since the publication of the DSM-IV our understanding of the autism spectrum has grown. Most clinicians recognize that difficulties with communication occur in all people on the spectrum. There continues to be much disagreement on what, if any differences there are between Asperger syndrome and autism. Each clinician may use a slightly different definition although typically those diagnosed with Asperger syndrome have fluent speech and at least average IQ scores.

Characteristics of autism change with age and learning. The qualitative differences look different in two-year-olds and twenty-year-olds so some clinicians may diagnose PDD-NOS when they are not sure whether a behavior meets criteria.

For a list of doctors that can diagnose in Arizona, please click here. (link to Doctors who diagnose list)

If you are a physician that is qualified to diagnose children with Autism, and are not shown on this list, please contact Katie at katie@phxautism.org to have your name listed.

Therapies for Autism
Educational/behavioral therapies are often effective in children with autism, with Applied Behavioral Analysis (ABA) usually being the most effective. These methods can and should be used together with biomedical interventions, as together they offer the best chance for improvement. Parents, siblings, and friends may play an important role in assisting the development of children with autism. Typical preschool children learn primarily by play, and the importance of play in teaching language and social skills cannot be overemphasized. Ideally, many of the techniques used in ABA, sensory integration, and other therapies can be extended throughout the day by family and friends.

Applied Behavior Analysis
Many different behavioral interventions have been developed for children with autism, and they mostly fall under the category of Applied Behavioral Analysis (ABA). This approach generally involves therapists who work intensely, one-on-one with a child for 20 to 40 hours/week. Children are taught skills in a simple step-by-step manner, such as teaching colors one at a time. The sessions usually begin with formal, structured drills, such as learning to point to a color when its name is given; and then, after some time, there is a shift towards generalizing skills to other situations and environments. A study published by Dr. Ivar Lovaas at UCLA in 1987 involved two years of intensive, 40-hour/week behavioral intervention by trained graduate students working with 19 young autistic children ranging from 35 to 41 months of age. Almost half of the children improved so much that they were indistinguishable from typical children, and these children went on to lead fairly normal lives. Of the other half, most had significant improvements, but a few did not improve much. ABA programs are most effective when started early, (before age 5 years), but they can also be helpful to older children. They are especially effective in teaching non-verbal children how to talk. Parents are encouraged to obtain training in ABA, so that they provide it themselves and possibly hire other people to assist. Qualified behavior consultants are often available, and there are often workshops on how to provide ABA therapy.

Speech Therapy: This may be beneficial to many autistic children, but often only 1-2 hours/week is available, so it probably has only modest benefit unless integrated with other home and school programs. Sign language and PECS may also be very helpful in developing speech.

Occupational Therapy: This can be beneficial for the sensory needs of these children, who often have hypo and/or hyper sensitivities to sound, sight, smell, touch, and taste. Many autistic individuals have sensory problems, which can range from mild to severe. These problems involve either hypersensitivity or hyposensitivity to stimulation. Sensory integration focuses primarily on three senses — vestibular (i.e., motion, balance), tactile (i.e., touch), and proprioception (e.g., joints, ligaments). Many techniques are used to stimulate these senses in order to normalize them.

Physical Therapy: Often children with autism have limited gross and fine motor skills, so physical therapy can be helpful.

Auditory Interventions: There are several types of auditory interventions. The only one with significant scientific backing is Berard Auditory Integration Training (called Berard AIT or AIT) which involves listening to processed music for a total of 10 hours (two half-hour sessions per day, over a period of 10 to 12 days). There are many studies supporting its effectiveness. Research has shown that AIT improves auditory processing, decreases or eliminates sound sensitivity, and reduces behavioral problems in some autistic children. Other auditory interventions include the Tomatis approach, the Listening Program, and the SAMONAS method. There is limited amount of empirical evidence to support their efficacy. Information about these programs can be obtained from the Society for Auditory Intervention Techniques’ website www.sait.org.

Relationship Development Intervention (RDI): This is a new method for teaching children how to develop relationships, first with their parents and later with their peers. It directly addresses a core issue in autism, namely the development of social skills and friendships. Website: www.rdiconnect.com

These are just a few of the most commonly used treatments for children with Autism.  Please see our Resources section for more information on other helpful treatments.

Watch our Autism 101 Video