Welcome! Autism is. Autism Spectrum Disorders (ASD) What are ASD s? Autism: Associated Features may occur, not required for diagnosis

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1 Autism Spectrum Disorders (ASD) Welcome! You can download this handout from under Workshops Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 1 Behaviour difficulty with change intense interests repetitive and sticky Anxiety What are ASD s? Social Communication low social interest friendships for level not reciprocal weak sharing eye contact weak nonverbal no/delayed speech 2-way conversation not reciprocal weak nonverbal weak play Sensory Issues Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 2 Autism is a spectrum disorder from very delayed to above average abilities from mild to moderate to severe autistic behaviours developmental abilities & symptoms may improve with good programming Autism: Associated Features may occur, not required for diagnosis cognitive; deficits, strengths & weaknesses (50-70% intellectual impairment) unusual motor behaviours unusual sensory behaviours eating, sleeping, drinking attention; joint, shifting, focus mood; anxieties & fears medical conditions, seizures Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 3 Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 4 1

2 Early Signs of ASD Red Flags immediate evaluation if no babbling by 12 months no gesturing by 12 months no single words by 16 months no 2-word phrases by 24 months (not just echolalic) any loss of any language or social skills at any age (30%) Filipek et al, Amer. Acad. Neurology, Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 5 Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 6 First Signs of Autism: Behaviour At 12 months of age, may see unusual eye contact visual tracking disengagement of visual attention orienting to name imitation social smiling reactivity, social interest & affect sensory behaviors Zwaigenbaum, Bryson, Rogers, Rogerts, Brian & Szatmari, 2005 First Signs of Autism: Other Temperament: 6 months, marked passivity & low activity level 12 months, extreme distress, fixating on particular objects, & rarely in a positive mood Delayed expressive & receptive language Zwaigenbaum, Bryson, Rogers, Rogerts, Brian & Szatmari, 2005 Challenging behaviours may be the first sign of high functioning autism Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 7 Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 8 2

3 Why? Early Diagnosis of Autism early intervention better prognosis so parents know connect to autism community support for families Ontario Parents Experiences A. Spadafora, M.A., parents of 80 children with PDDs median birth year of 2000 ( ) average age of diagnosis ~ 51 months (early intervention best before 42 months) age at first concern ~ 19 months (1 48 mo.); approx. 34 months before diagnosis! Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 9 Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 10 Early Identification What we are doing already is NOT good enough for EARLY identification & intervention! Causes of Autism neurological disorder 4.6 boys to every girl genetic susceptibility environmental triggers? not related to parenting or learning not related to MMR vaccine or preservatives in vaccines Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 12 3

4 More Children with Autism? 67 per 10,000 children (CDC, 2007) 1 in every 150 children 1 in every 100 boys more children identified now??? better identification? - better public awareness - wider definition - misdiagnoses? increased prevalence, incidence? Families and their Children s ASD Diagnoses? denial? anger? bargaining? depression? acceptance? Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 14 Acceptance Spiral Families: Research Shows Social Support helps parents of children with autism helps siblings of children with autism AND It s a process - it takes time! Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 15 helps children with autism make more progress Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 16 4

5 Autism brings strong families closer Intervention can drive distant families apart Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 18 Basic Supports for All Children Supportive Environment basic needs: food, shelter, medical care, nurturance access to preferred toys, activities, interests & friends opportunities for success at the child s level Basic Supports for All Children Supportive Caregivers parents and teachers need to be supported too! staff & parent relationships professionals; attitude is more than half the battle. don t take things personally, avoid power struggles Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 20 5

6 Autism Spectrum Disorders (ASD) Children with ASD learn differently. They need different supports to help them learn & maintain behavioural control. General Helpful Supports for Children with Autism/PDD 1. Make things predictable 2. Reduce language 3. Use visual supports 4. Broaden preoccupations 5. Reduce anxiety Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Make Things Predictable develop routines so the child can predict what will happen next e.g. work, homework, bedtime and chores teach the child to use a schedule (picture, word, object), calendar prepare in advance for transitions & unexpected events, e.g. when playtime is over clear expectations 2. Reduce Language use clear simple language, even if the person talks a lot avoid slang, metaphorical language, sarcasm, rhetorical questions, etc develop cue phrases.; talk less when he is excited or upset Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 24 6

7 3. Use Visual Supports use pictures, videos, drawings, & manipulatives visually organize materials clearly, e.g. baskets, colour coding, tape on floor visual strategies e.g. Triangle of Choices written language is visual for people who can read 4. Broaden Preoccupations use intense narrow, interests to teach & motivate getting rid of preoccupations rarely works in the short term schedule specific times for his interests e.g. dinosaur time, Dracula time Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Reduce Anxiety use above strategies (make things predictable, reduce language, make things visual) allow the person time -- to process, to cope, to be alone try relaxation training, vigorous rhythmic exercise, medication Intervention Components earliest age (as soon as autism is suspected) active engagement in intensive, 5 fulldays, min. 25 hrs/wk, full-year, 1 on 1 teach social, communication, cognitive development, & play skills systematic, individualized generalization parent involvement National Research Council, Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 28 7

8 Community Resources for ASD Community Resources list 4 page list of Windsor resources for children with autism good resource to give to parents click on Local Autism Services Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 30 The Summit Centre for Preschool Children with Autism UNITY: 3 Month Intensive ABA Parent Training at The Summit Centre for Preschool Children with Autism affiliated with U of W! Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 32 8

9 Purpose to provide high-quality intensive Applied Behaviour Analysis (ABA) training to selected parents of children with autism to enable parents to provide ABA home programming for their children based on the model of the HOPE Center, Beaumont Hospital, Berkley, MI Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 33 All About Autism Introductory workshops for parents of children with a diagnosis or suspicion of autism 3 rd Wed. of month (except July & Aug) different speakers & topics Sponsored by: Dedicated Parents, Autism Society Ontario Windsor/Essex Chapter, Autism Services Inc., Children First, Children s Rehabilitation Centre, Ontario Early Years Centres, Talk to Me (Essex Preschool Speech & Language) The Summit Centre for Preschool Children with Autism, Thames Valley Children s Centre The Autism Program South West Region Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 34 Autism Resource Library Autism Services Incorporated books, videos, DVD s on autism will loan via school courier online catalog of what is available! Even the smallest footsteps can cross great distances. Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 36 9