Life Course Development of Adolescents and Adults with Autism Spectrum Disorders
|
|
- Dora Jones
- 6 years ago
- Views:
Transcription
1 Life Course Development of Adolescents and Adults with Autism Spectrum Disorders Marsha R. Mailick, PhD
2 Autism Spectrum Disorders Impairments in communication Impairments in reciprocal social interaction Restrictive repetitive behaviors and interests w a i s m a n c e n t e r, u n i v e r s i t y o f w i s c o n s i n m a d i s 2o n
3 Images of Autism in the Media Almost exclusively focused on early childhood Children portrayed alone, not with family
4
5 Diagnostic Boom 1990: beginning of the surge in diagnosis of autism Children diagnosed in 1990 are now young adults Gurney, Fritz, Ness, Sievers, Newschaffer, & Shapiro (2003). Archives of Pediatric and Adolescent Medicine.
6 NIH Inter-Agency Coordinating Council on Autism (1/19/10) Question 6: What does the future hold, particularly for adults? Need for studies of the scope and impact of the spectrum of autism in adults, including critical life transitions. Need for longitudinal studies that follow carefully characterized cohorts and their families into adulthood to understand the risk and protective factors that account for quality of life outcomes.
7 Past Research on Adult Outcomes
8 8 boys, 3 girls average age 8 in 1943 average age 78 in 2013
9 History of Blaming the Family (Kanner, 1943)
10 Adolescents and Adults with Autism Focus on the family context of autism. Prospective, longitudinal study spanning 14 years in the life of each family, funded by NIH and Autism Speaks ( ). Repeated measures of the mother, father, siblings, and adolescent/adult with ASD. Overall goal: to investigate the course of change in the characteristics of people with autism during adolescence and adulthood, and its impact on the family.
11 Our Research Approach Large sample (n=406) Recruited from the community (MA and WI) Wide age range to 52 years of age at Time 1 (1998) 62% adolescents age % adults age 22-52
12 Specific Aims Change in autism symptoms, behavior problems, health, activities of daily living during adolescence and adulthood. Change associated with life course turning points and adult outcomes. Bi-directional parent-child effects. Biomarkers of the impact of lifelong parenting.
13 Specific Aims Change in autism symptoms, behavior problems, health, activities of daily living during adolescence and adulthood. Change associated with life course turning points and adult outcomes. Bi-directional parent-child effects. Biomarkers of the impact of lifelong parenting.
14 Study Timeline 14 Years Time 6 Daily Diary/Cortisol Time 1 Time 2 Time 3 Time 4 Time 7 Time 8 Time 9 18 Months Time 5 Proband Interview Time 10 Quality of Life Proband Interview
15 Time 1 Sample Characteristics mean age: 22 years (individual with autism) 51 years (mother) 73% male 65% living with parents at Time 1 74% verbal (use of 3+ word phrases) 95% had Autistic Disorder mean household income: $52,600
16 Co-Occurring Conditions Intellectual Disability (ID, < 70 IQ) 70% Seizures 22% Any mental health dx 51% anxiety disorder 29% OCD 25% depression 18% ADHD 16% schizophrenia 1% bipolar disorder 6%
17 Start with Conclusions Adolescence is a time of improved functioning for those with ASD, on average. HS exit is a turning point, when improvement slows. Behavior problems remain highly prevalent in adulthood. ADL skills should be a target of intervention. Very limited independence in employment and residential arrangements.
18 Autism Across the Life Course Autism is a lifelong disorder whose features change with development (Piven et al., 1996). Teresa across the life course.
19 Teresa in Childhood At age 4 or 5: Constant flapping, spinning, constant motion, running out of the house, severe tantrums if anything was moved or touched. She threw things, smeared toothpaste on mirrors. Did not play with toys looked through them. She had some useless speech. Almost no social interaction. She did have some interaction with siblings but left the room when other people came to the house.
20 Teresa in Adulthood At age 46: She went from almost non-verbal to a complete, understandable appropriate range of communication. She most generally lives in the here and now, this world. Before she was rarely in this world. And she s aware of what goes on in the whole world because she reads so many things. She no longer pulls away from people and she doesn t leave the room. She makes you feel that she wants to be there and wants to be friendly. Now she s more at ease. Not like you or I, but she wants to be there.
21 Teresa in Adulthood Moved to an apartment at age 28, lives alone with staff support. Has two supported employment positions (each 10 hrs per week) doing clerical work. Has had one friend since preschool (who also has a DD diagnosis). At age 46, has significant health problems -- diabetes, high cholesterol, high blood pressure, sleep apnea, anxiety disorder, OCD.
22 Arnold Age 60 Mission
23 Arnold Lives with his elderly parents (~ age 80+). Less independent in ADLs now than when younger (needs help with toileting, bathing, dressing, etc). Has anxiety, GI problems, sleep problems, and takes Librium, Temazepam, and Buspirone for anxiety; Valium when he goes to the doctor or dentist; and Ranitidine for ulcers.
24 Arnold (continued) Focused interests (sequentially): playing a few keys on the piano repeatedly, record players, flushing toilet, canned jar lids on a string, doorstop springs, rubber bands (last 10 years). He did not attend school (day care programs sporadically). Has attended the same adult day program for 30 years, 25 hrs per week, transportation provided. Has one friend, at the day program.
25 Arnold (continued) Has become resistant to going to new places, prefers to be alone. When at home, watches Sesame Street and reruns of Lawrence Welk, while holding his rubber bands. Younger brother is expected to take over responsibility after parents are no longer able; on a waiting list for a group home.
26 Trajectories and Outcomes 1. Change over time in symptoms and behavior problems 2. Change after HS exit 3. Change over time in functional abilities 4. Change in health 5. Employment after HS and residential arrangements in adulthood
27 Change in Autism Symptoms 4.5 years Between T1 and T4 Autism symptom change was examined by comparing ADI-R scores at Time 1 with the data collected 4.5 years later (Time 4). ADI-R sub-scales: NVC = Non-verbal Communication VC = Verbal Communication SR = Social Reciprocity RB/SI = Repetitive Behaviors/Specialized Interests Shattuck et al., JADD, 2007
28 4.5 years between T1 and T4 14 Years Time 6 Daily Diary/Cortisol Time 1* 18 Months Time 2 Time 3 Time 4* Time 5 Proband Interview Time 7 Time 8 Time 9 Time 10 Quality of Life Proband Interview
29 Individual Level Change in Autism Symptoms from Time 1 to Time 4 (by +/- 1/2 SD) Improved No change Worsened 60% 50% 40% 30% 20% 10% 0% NVC SR VC RB/SI
30 Interpretation Reduction in autism symptoms does not necessarily imply development of skills. Example: Impairments in Verbal Communication Reduction of symptoms includes less echolalia, less use of inappropriate statements, fewer verbal rituals Does not imply the improvement of communication skills
31 Change in Behavior Problems Maladaptive Total Scale of the Scales of Independent Behavior Revised (SIB-R; Bruininks et al., 1996) Internalized behaviors (e.g., hurtful to self, unusual or repetitive habits, etc.) Externalized behaviors (e.g., hurtful to others, destructive, disruptive) Asocial behaviors (e.g., socially offensive behavior, uncooperative)
32 Individual Level Change in Behavior Problems from Time 1 - Time 4 (by +/- 1/2 SD) Improved No change Worsened 60% 50% 40% 30% 20% 10% 0% Internalized Externalized Asocial Maladaptive Total
33 Summary Stability or reduction in symptoms and behavior problems over a 4 ½ year period in most adolescents and adults with ASD. The trend continues when we extend out to Time 8 (more than 10 years). But this analysis masks stage-related or age-related trajectories.
34 Percent of Adults Repetitive B ehavior How Prevalent are Behavior Problems in Adulthood? (8 Day Diary Study) Withdrawn Uncooperative Socially Offensive Hurtful to Property Hurtful to Others Hurtful to Self Any Behavior Problem
35 Stage-Related Change: High School Exit Sub-sample who were in high school when the study began (n = 242) Timing of HS exit ranged from age 17 to 22 in our sample Compared change in autism symptoms and BPs from before to after HS exit Factors predicting change: intellectual disability (ID), family income, unmet needs Taylor & Seltzer, JADD, 2010
36 Autism Symptoms Autism symptoms improved while youth were in high school (symptoms became less severe) High School Exit Improvement continued but slower after HS exit
37 Behavior Problems Behavior problems improved while youth were in high school (behavior problems became less severe) High School Exit Pattern of change after HS exit varied by income group and ID status
38 Subjective Burden Relationship Closeness High School Exit High School Exit Taylor & Mailick Seltzer, JADD, 2011
39 Stage-Related Change Leaving HS is a significant turning point. Overall pattern of symptom reduction continues but improvement slows after HS exit. Low income adolescents who do not have ID are at greatest risk for worsening BPs. Higher income adolescents with ID continue to improve after HS exit link with services? Parental burden increases after HS exit and the parent-child relationship was affected in those who had high unmet service needs.
40 Age-Related Change in Daily Living Skills We measured by Activities of Daily Living (ADLs) Personal care (bathing, grooming, dressing) Mealtime (eating, preparing foods, setting and clearing the table, washing dishes) Housekeeping (laundry, household tasks) Running errands, money management Smith, Maenner, & Seltzer, JACAP, 2012
41 Waisman ADL Scale (W-ADL) 17 items, scored 0 = does not have the skill, 1 = performs with help, 2 = independent Maximum score = 34 Measured at Times 1, 4, 8 (~ a 10 year period between T1 - T8) ; r with Vineland =.82 Graphed to show age-related change in performance of ADL skills Compared to adults with Down syndrome Maenner et al., Disability and Health, 2012
42 10 years between T1 and T8 14 Years Time 6 Daily Diary/Cortisol Time 1* 18 Months Time 2 Time 3 Time 4* Time 5 Proband Interview Time 7 Time 8* Time 9 Time 10 Quality of Life Proband Interview
43 W ADL Scores for Autism Sample Figure 1. Change in W ADL score o ver time, individual and group trajectories. Quadratic (age^2) mixed model paramaterizations displayed W ADL 15 Intellectual Disability No ID Has ID Age in years
44 W ADL Scores for Down Syndrome Sample
45 W-ADL Scores for Autism Sample W-ADL Scores for Down Syndrome Sample
46 ADL Skills and Autism Need for caution in interpretation of trends in older age (fewer cases, possible cohort effects). The data suggest the need to focus on acquisition and maintenance of ADL skills for adults with ASD. Why do adults with DS continue to improve in ADL skills? Implications for services for adults with ASD?
47 Age-Related Change in Health Status (excellent, good, fair, poor) Health Rating Age
48 Change in Excellent Health
49 Changes in Psychotropic Medication T1-T7
50 Number of Prescription Medications number of medications Number of Meds Total Psych Non-Psych Age
51 Summary: Age-Related Health Trajectories Need for health surveillance Medication trends (we found that once a psychotropic medication is prescribed, it is 11 times more likely to continue to be prescribed than to be discontinued). Is age 45 a turning point, with increased risk or cohort effects?
52 Employment after HS and Residential Arrangements in Adulthood Post-secondary education and employment after HS exit Residential arrangements in adulthood
53 Vocational Index Taylor & Mailick Seltzer, JADD, 2012
54 Percent of Adults with ASD in Each Vocational Index Category Taylor & Mailick Seltzer, JADD, 2011
55 10-Year Change in Vocational Index Scores Focus on sub-sample who had already exited HS at Time 1 (n = 164) Plotted change in VI scores across 6 time points over 10 years Analyzed factors that predicted change Separate analysis for men and women
56 10 years between T1 and T8 14 Years Time 6 Daily Diary/Cortisol Time 1* 18 Months Time 2 Time 3 Time 4 Time 7 Time 8* Time 5 Proband Interview Time 9 Time 10 Quality of Life Proband Interview
57 Change in Vocational Index Scores Taylor & Mailick, under review
58 Change in Vocational Index Men, on average, are in sheltered work settings, either with some community supported employment or volunteering. Women start out in sheltered settings with community supported employment and decline over 10 years to sheltered work settings -- but less than 10 hrs/week. Loss of stimulating, structured, and social day activity; impact on the family.
59 Summary: Post-High School Day Activities ¼ of adults are in community employment or post-secondary education after leaving HS. ¼ have no work activities (either less than 10 hrs per week or no formal work activities). Women show a pattern of downward mobility; men show a pattern of stability.
60 Effect of Vocational Activities on Behavioral Development Does having stimulating vocational activities (or the lack thereof) lead to change in behavioral development for adults with ASD? Among typical adults, competency in work is one of the strongest predictors of psychological wellbeing (stronger than financial autonomy, romantic/peer relationships) and losing a job is one of the greatest risk factors for personal and familial dysfunction.
61 Effect of Vocational Activities on Behavioral Development Does the level of engagement and independence in vocational activities lead to change in behavior in adults with ASD? autism symptoms behavior problems activities of daily living
62 5.5 years between T4 and T8 14 Years Time 6 Daily Diary/Cortisol Time 1 18 Months Time 2 Time 3 Time 4* Time 5 Proband Interview Time 7 Time 8* Time 9 Time 10 Quality of Life Proband Interview
63 Effects of Vocational Activities Sub-sample who had exited HS before T4 (n=153) Average age = 30 at T4, 69% had ID, 75% were verbal, 46% lived with parents T4 Vocational Independence T8 Vocational Independence T4 Vocational Independence T8 Vocational Independence and T4 Behavior T8 Behavior T4 Behavior T8 Behavior
64 Vocational Independence Predicts Significant Behavioral Change over 5.5 Years T4 Vocational Independence T8 Vocational Independence T4 Vocational Independence T8 Vocational Independence -.12* -.14* T4 Autism Symptoms T8 Autism Symptoms T4 Behavior Problems T8 Behavior Problems T4 Vocational Independence T8 Vocational Independence.12** Taylor, Mailick, & Smith, in preparation T4 Daily Living Skills T8 Daily Living Skills
65 Behavioral Level Does Not Predict Change in Vocational Independence over 5.5 Years T4 Vocational Independence T8 Vocational Independence T4 Vocational Independence T8 Vocational Independence T4 Autism Symptoms ns T8 Autism Symptoms T4 Behavior Problems ns T8 Behavior Problems T4 Vocational Independence T8 Vocational Independence Taylor, Mailick, & Smith, in preparation T4 Daily Living Skills ns T8 Daily Living Skills
66 Effects of Work Environments Direction of effects: from Vocational Index to behavior. The reverse pattern was not significant. The higher the Vocational Index score at Time 4, the lower the level of autism symptoms and behavior problems, and the higher the level of independent daily living skills 5.5 years later. Being in a structured day program has significant benefit for symptoms, behavior, and self-sufficiency. Advocacy for the best possible vocational placement may result in better adult outcomes.
67 Living Arrangements at Time 8
68 Living Arrangements in Adulthood Half of the adults continue to live with family (parents). Few (5%) live completely independently. Reveals the full autism spectrum. Need for long-term support, either partial or full-time staff, or family support.
69 Overall Conclusions: Mixed Picture Stability or reduction in severity of autism symptoms and behavior problems in adulthood, on average. Leaving high school is a turning point, with an elevation of risk for those with average intelligence and from low income families. Adults with ASD may be at risk of declining ADL skills and health in midlife. Only ¼ are in post-secondary education or competitively employed after HS. Only 5% live independently.
70 Overall Conclusions (continued) The transition to adulthood is a time of risk for youth with ASD. More independent vocational activities lead to improved adult outcomes. Goal: obtain as high a level of vocational activity as possible immediately after HS exit.
71 Recommendations for Services Importance of post-secondary education for young adults with ASD (even if not in a degree-granting program). Advocacy for vocational opportunities. Need for autism-specific adult services. Importance of continuing psychological and psychiatric services to reduce behavior problems throughout the life course. Importance of family support.
72 Research Agenda Population-based longitudinal cohort study of early, midlife, and older adults with ASD. Development of protocols for diagnosing and tracking ASD in adulthood. Study of how having ASD takes a toll on health (stress, limited access to health care, long-term polypharmacy). Study of quality of life in midlife. Intervention research what services and supports improve adult outcomes?
73 Acknowledgements Lifespan Family Research Laboratory - Jan S. Greenberg, PhD, Co-PI Leann Smith, PhD Jinkuk Hong, PhD Matthew Meanner, PhD Renee Makuch, Project Manager Julie Lounds Taylor, PhD (now at Vanderbilt University) Anna Esbensen, PhD (now at Cincinnati Children s Hospital) Gael Orsmond, PhD (now at Boston University) Paul Shattuck, PhD (now at Washington University in St. Louis) Dan Bolt, PhD University of Wisconsin-Madison Catherine Lord, PhD Weill Cornell Medical College Funding: NIA (R01 AG08768), NICHD (P30 HD03352), Autism Speaks
The Transition to Adulthood for Individuals with Autism Spectrum Disorders and their Families
The Transition to Adulthood for Individuals with Autism Spectrum Disorders and their Families Julie Lounds Taylor Vanderbilt Kennedy Center, Department of Pediatrics, Vanderbilt University AUCD 2010 Conflict
More informationStudy on Family Adaptation to Fragile X Syndrome
Waisman Center University of Wisconsin Madison Dedicated to the advancement of knowledge about human development, developmental disabilities, and neurodegenerative disease. Study on Family Adaptation to
More informationChanges in the Autism Behavioral Phenotype During the Transition to Adulthood
J Autism Dev Disord (2010) 40:1431 1446 DOI 10.1007/s10803-010-1005-z ORIGINAL PAPER Changes in the Autism Behavioral Phenotype During the Transition to Adulthood Julie Lounds Taylor Marsha Mailick Seltzer
More informationAAA. Report #10 A Profile of Adolescent and Adult Siblings. - Principal Investigators Marsha Mailick Seltzer, Ph.D.
AAA Adolescents & Adults with Autism A Study of Family Caregiving Report #10 A Profile of Adolescent and Adult Siblings - Principal Investigators Marsha Mailick Seltzer, Ph.D. Jan S. Greenberg, Ph.D. Waisman
More informationStudy on Family Adaptation to Fragile X Syndrome
Waisman Center University of Wisconsin Madison Dedicated to the advancement of knowledge about human development, developmental disabilities, and neurodegenerative disease. Study on Family Adaptation to
More informationStudy on Family Adaptation to Fragile X Syndrome
Waisman Center University of Wisconsin Madison Dedicated to the advancement of knowledge about human development, developmental disabilities, and neurodegenerative disease. Study on Family Adaptation to
More informationStudy on Family Adaptation to Fragile X Syndrome
Waisman Center University of Wisconsin Madison Dedicated to the advancement of knowledge about human development, developmental disabilities, and neurodegenerative disease. Study on Family Adaptation to
More informationBackground on the issue Previous study with adolescents and adults: Current NIH R03 study examining ADI-R for Spanish speaking Latinos
Sandy Magaña Background on the issue Previous study with adolescents and adults: brief description of study examining comparison between whites and Latinos in on the ADI-R Current NIH R03 study examining
More informationAutism Grows Up: Transitions to Adulthood. Elizabeth Reeve MD, HealthPartners Medical Group
Autism Grows Up: Transitions to Adulthood Elizabeth Reeve MD, HealthPartners Medical Group Agenda Brief overview Transition issues Impact on person with autism Impact on the family Community resources
More informationPreparing for adult life. Turin, December 2016
Preparing for adult life Turin, December 2016 Why do we need to focus more on adult life? Huge challenges: Combined prevalence of autism in adults of all ages in England was 11/1000 (95% CI 3-19/1000)
More informationAAA. Report #14 Transitioning Together: Developing an Education and Support Program for Families. - Principal Investigators -
AAA Adolescents & Adults with Autism A Study of Family Caregiving Report #14 Transitioning Together: Developing an Education and Support Program for Families - Principal Investigators - Marsha Mailick
More information1/30/2018. Adaptive Behavior Profiles in Autism Spectrum Disorders. Disclosures. Learning Objectives
Adaptive Behavior Profiles in Autism Spectrum Disorders Celine A. Saulnier, PhD Associate Professor Emory University School of Medicine Vineland Adaptive Behavior Scales, Third Edition 1 Disclosures As
More informationNIH Public Access Author Manuscript J Autism Dev Disord. Author manuscript; available in PMC 2012 October 1.
NIH Public Access Author Manuscript Published in final edited form as: J Autism Dev Disord. 2011 October ; 41(10): 1397 1410. doi:10.1007/s10803-010-1166-9. Changes in the Mother Child Relationship During
More informationAdaptive Behavior Profiles in Autism Spectrum Disorders
Adaptive Behavior Profiles in Autism Spectrum Disorders Celine A. Saulnier, PhD Associate Professor Emory University School of Medicine Director of Research Operations Marcus Autism Center Vineland Adaptive
More informationSocial Support and Well-being at Mid-Life Among Mothers of Adolescents and Adults with Autism Spectrum Disorders
J Autism Dev Disord (2012) 42:1818 1826 DOI 10.1007/s10803-011-1420-9 ORIGINAL PAPER Social Support and Well-being at Mid-Life Among Mothers of Adolescents and Adults with Autism Spectrum Disorders Leann
More informationAUTISM SPECTRUM DISORDER: DSM-5 DIAGNOSTIC CRITERIA. Lisa Joseph, Ph.D.
AUTISM SPECTRUM DISORDER: DSM-5 DIAGNOSTIC CRITERIA Lisa Joseph, Ph.D. Autism Spectrum Disorder Neurodevelopmental disorder Reflects understanding of the etiology of disorder as related to alterations
More informationAUTISM SCREENING AND DIAGNOSIS PEARLS FOR PEDIATRICS. Catherine Riley, MD Developmental Behavioral Pediatrician
AUTISM SCREENING AND DIAGNOSIS PEARLS FOR PEDIATRICS Catherine Riley, MD Developmental Behavioral Pediatrician Disclosure I do not have any financial relationships to disclose I do not plan to discuss
More informationDr. Roizen has no conflicts of interest to report OBJECTIVES. Adults with Down Syndrome
Dr. Roizen has no conflicts of interest to report Adults with Down Syndrome Nancy J. Roizen, MD Professor of Pediatrics Rainbow Babies and Children s Hospital Division Developmental-Behavioral Pediatrics
More informationMatthew P. Janicki, Ph.D.
Matthew P. Janicki, Ph.D. State Policy Summit: Innovations in Adult Programming - Autism Services, Education, Resources, & Training Collaborative Philadelphia, PA March 22, 2016 CONTEXT Data from the
More informationMaternal Cortisol Levels and Behavior Problems in Adolescents and Adults with ASD
J Autism Dev Disord (2010) 40:457 469 DOI 10.1007/s10803-009-0887-0 ORIGINAL PAPER Maternal Cortisol Levels and Behavior Problems in Adolescents and Adults with ASD Marsha Mailick Seltzer Jan S. Greenberg
More informationAAA. Report #9 Study Update. - Principal Investigators Marsha Mailick Seltzer, Ph.D.
AAA Adolescents & Adults with Autism A Study of Family Caregiving Report #9 Study Update - Principal Investigators Marsha Mailick Seltzer, Ph.D. Jan S. Greenberg, Ph.D. Waisman Center University of Wisconsin
More informationAutism 101: An Introduction to Understanding Autism
Autism 101: An Introduction to Understanding Autism What is Autism? Autism is a disorder that affects the brain s normal development of social and communication skills. ~ Autism Society of Colorado The
More informationNeurodevelopmental Disorders
Neurodevelopmental Disorders Intellectual Disability Disorder Autism Spectrum Disorder (ASD) Attention-Deficit Hyperactivity Disorder (ADD/ADHD) Motor Disorders/Tourette s Disorder Intellectual Disability
More informationDiagnosing Autism, and What Comes After. Natalie Roth, Ph. D. Clinical Psychologist, Alternative Behavior Strategies
Diagnosing Autism, and What Comes After Natalie Roth, Ph. D. Clinical Psychologist, Alternative Behavior Strategies Cigna Autism Awareness Education Series, January 12, 2017 1 Autistic Spectrum Disorder
More informationINFORMATION PAPER: INTRODUCING THE NEW DSM-5 DIAGNOSTIC CRITERIA FOR AUTISM SPECTRUM DISORDER
INFORMATION PAPER: INTRODUCING THE NEW DSM-5 DIAGNOSTIC CRITERIA FOR AUTISM SPECTRUM DISORDER What is the DSM-5? The Diagnostic and Statistical Manual of Mental Disorders (the DSM) is developed by the
More informationIntroduction. Background
Autism Spectrum Disorders and The Family Impact Sheila Hamill 1 University of Wisconsin-Milwaukee In collaboration with the Waisman Center, University of Wisconsin-Madison and Leadership Education in Neurodevelopmental
More informationAutism/Autism Spectrum Disorders
Autism/Autism Spectrum Disorders Autism spectrum disorders (ASDs) are a group of developmental disabilities that can cause significant social, communication and behavioral challenges. People with ASDs
More informationAdult Core Competencies Curriculum: Teaching Skills to Adults with Autism and Severe Behavioral Challenges
Adult Core Competencies Curriculum: Teaching Skills to Adults with Autism and Severe Behavioral Challenges John M. Guercio, Ph.D., BCBA-D, CBIST, LBA Clinical Director-Beh Licensed Behavior Analyst Benchmark
More informationAutism Diagnosis and Management Update. Outline. History 11/1/2013. Autism Diagnosis. Management
Autism Diagnosis and Management Update Cathleen Small, PhD, BCBA-D Developmental Behavioral Pediatrics Maine Medical Partners Outline Autism Diagnosis Brief history New, DSM-5 diagnostic criteria Expressed
More informationNTG-EDSD v.1/ Instructions: For each question block, check the item that best applies to the individual or situation. Name of person: (3) First
NTG-EDSD v.1/2013.2 The NTG-Early Detection Screen for Dementia, adapted from the DSQIID*, can be used for the early detection screening of those adults with an intellectual disability who are suspected
More informationDevelopmental Psychology
Developmental Psychology Trajectories of Emotional Well-Being in Mothers of Adolescents and Adults With Autism Erin T. Barker, Sigan L. Hartley, Marsha Mailick Seltzer, Frank J. Floyd, Jan S. Greenberg,
More informationDevelopmental Disabilities: Diagnosis and Treatment. Sara Sanders, Psy.D. 03/05/15
Developmental Disabilities: Diagnosis and Treatment Sara Sanders, Psy.D. 03/05/15 1 Developmental Disability A severe and chronic disability that is attributable to a mental or physical impairment that
More informationBreaking the Mold. Objectives For Today. Autism statistics 10/24/2015. Justin Lundstedt, OTR/L. Currently 1/68 children are diagnosed with ASD
Breaking the Mold Creating a Blueprint for the Adult with ASD using an Occupational Therapy Approach Justin Lundstedt, OTR/L Objectives For Today Brief introduction / reintroduction to autism Understand
More informationInitial assessment scheduled and completed. Recommendations and Treatment Plan sent to insurance
We appreciate your interest in our Outpatient ABA Services. To begin the new client process, please submit the below listed documents: Insurance Verification form (Provided below) Client Intake form (Provided
More informationDaily Experiences Among Mothers of Adolescents and Adults with Autism Spectrum Disorder
DOI 10.1007/s10803-009-0844-y ORIGINAL PAPER Daily Experiences Among Mothers of Adolescents and Adults with Autism Spectrum Disorder Leann E. Smith Æ Jinkuk Hong Æ Marsha Mailick Seltzer Æ Jan S. Greenberg
More informationSimons VIP Phenotyping: What we ve learned so far. Ellen Hanson, Ph.D. and Raphael Bernier, Ph.D. Family Meeting Summer, 2015
Simons VIP Phenotyping: What we ve learned so far Ellen Hanson, Ph.D. and Raphael Bernier, Ph.D. Family Meeting Summer, 2015 Outline Brief review of data collection procedures Discussion of Neurodevelopmental
More informationRepetitive behavior in toddlers may signal autism
NEWS Repetitive behavior in toddlers may signal autism BY JESSA NETTING 20 MARCH 2014 1 / 5 Clear signs: Repetitive and unusual hand movements are easy enough to spot with just a simple parent survey,
More informationAutism Spectrum Disorder What is it?
Autism Spectrum Disorder What is it? Robin K. Blitz, MD Director, Developmental Pediatrics Resident Autism Diagnostic Clinic Lecture Series #1 Learning Objectives What can we talk about in 20 minutes?
More informationLeaving the Nest: Transition Challenges for Youth with ASD and Other DD s. Alice Kuo, MD, PhD Chief, Medicine-Pediatrics Section 11 March 2015
Leaving the Nest: Transition Challenges for Youth with ASD and Other DD s Alice Kuo, MD, PhD Chief, Medicine-Pediatrics Section 11 March 2015 Disclosures No conflicts of interest to disclose What is Transition
More informationSlide 1. Slide 2. Slide 3. Overview. Autism Spectrum Disorder (ASD) Washington Speech-Language Hearing Association. Annette Estes October 8-10, 2015
Slide 1 Early Identification and Intervention for Autism Spectrum Disorders Washington Speech-Language Hearing Association Annette Estes October 8-10, 2015 Slide 2 Overview What is an Autism Spectrum Disorder
More informationUnderstanding Autism Spectrum Disorder. By: Nicole Tyminski
Understanding Autism Spectrum Disorder By: Nicole Tyminski What is Autism? Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These
More informationAutism/Pervasive Developmental Disorders Update. Kimberly Macferran, MD Pediatric Subspecialty for the Primary Care Provider December 2, 2011
Autism/Pervasive Developmental Disorders Update Kimberly Macferran, MD Pediatric Subspecialty for the Primary Care Provider December 2, 2011 Overview Diagnostic criteria for autism spectrum disorders Screening/referral
More informationDEPRESSIVE SYMPTOMS IN ADOLESCENCE AS A PREDICTOR OF YOUNG ADULT EMPLOYMENT OUTCOMES
DEPRESSIVE SYMPTOMS IN ADOLESCENCE AS A PREDICTOR OF YOUNG ADULT EMPLOYMENT OUTCOMES Kathryn A. Sabella, MA Maryann Davis, PhD Transitions RTC, SPARC, Department of Psychiatry, University of Massachusetts
More informationQuality of life and autistics: the critical roles of social support and subjective well-being. Steven Kapp
Quality of life and autistics: the critical roles of social support and subjective well-being Steven Kapp 1 Introduction Autism mainly diagnosed by social communication Social interaction occurs between
More informationThe Nuts and Bolts of Diagnosing Autism Spectrum Disorders In Young Children. Overview
The Nuts and Bolts of Diagnosing Autism Spectrum Disorders In Young Children Jessica Greenson, Ph.D. Autism Center University of Washington Overview Diagnostic Criteria Current: Diagnostic & Statistical
More informationSymptoms in children with autism follow diverse paths
NEWS Symptoms in children with autism follow diverse paths BY JESSICA WRIGHT 9 FEBRUARY 2015 1 / 5 Growing pains: Researchers are following hundreds of children with autism into adulthood to better understand
More informationOverview. Clinical Features
Jessica Greenson, Ph.D. Autism Center University of Washington Clinical Features Overview Diagnostic & Statistical Manual IV (DSM IV) Prevalence Course of Onset Etiology Early Recognition Early Recognition
More informationAn Autism Primer for the PCP: What to Expect, When to Refer
An Autism Primer for the PCP: What to Expect, When to Refer Webinar November 9, 2016 John P. Pelegano MD Chief of Pediatrics Hospital for Special Care Disclosures None I will not be discussing any treatments,
More informationAutism Spectrum Disorder
Autism Spectrum Disorder Diagnosis Treatment Impact Jill A Dudik Bross, MD FAAP General Pediatrician and COE for HCA state of WA Parkview Medical Group Moses Lake, WA What is Autism: Autism is a pervasive
More informationParent initiated Why evaluate (3) Questions about program appropriateness School initiated Conflict resolution Component of a regular peer review proc
Evaluating Educational Services for Students with Autism Spectrum Disorders Erik Mayville, Ph.D., BCBA-D The Institute for Educational Planning, LLC Connecticut Center for Child Development, Inc. & mayville@iepinc.org
More informationA Family-Centered Transition Intervention for High School Students with Autism Spectrum Disorders
A Family-Centered Transition Intervention for High School Students with Autism Spectrum Disorders Kate Szidon, Waisman Center, UW-Madison Bonnie Kraemer, Brian Valentini & Sara McDaniel San Diego State
More informationSURVEY OF AUTISM SPECTRUM DISORDER CONCERNS
Survey of Autism Spectrum Disorder Concerns Presented by Curtis L. Timmons, Ph.D., LSSP GOALS OF THE WORKSHOP 1. Understand why there were changes between the DSM-IV and the DSM-5 2. Understand the current
More informationTeaching Students with Special Needs in Inclusive Settings: Exceptional Learners Chapter 9: Autism Spectrum Disorders
Teaching Students with Special Needs in Inclusive Settings: Exceptional Learners Chapter 9: Autism Spectrum Disorders Background Autistic is a broad term coined in the twentieth century by Bleuler that
More informationAutism Update: Classification & Treatment
Autism Update: Classification & Treatment Dana Battaglia, Ph.D., CCC-SLP NYSUT Professional Issues Forum on Healthcare April 26 th, 2013 10:30-12:30 1 Who is here today? Our Goals for This Morning Introduce
More informationFrom: What s the problem? Pathway to Empowerment. Objectives 12/8/2015
Overcoming Intellectual Disability and Autism to Achieve Vocational & Academic Success Pathway to Empowerment Objectives 1 2 4 Learn to distinguish between intellectual disability and autism spectrum disorders.
More informationAutism or Something Else? Knowing the Difference
Autism or Something Else? Knowing the Difference SUSAN BUTTROSS, M.D., FAAP PROFESSOR OF PEDIATRICS CENTER FOR THE ADVANCEMENT OF YOUTH UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MISSISSIPPI Disclosure
More informationAUTISM Definition. Symptoms
AUTISM Definition Autism spectrum disorder is a serious neurodevelopmental disorder that impairs a child's ability to communicate and interact with others. It also includes restricted repetitive behaviors,
More informationUnderstanding Autism. Julie Smith, MA, BCBA. November 12, 2015
Understanding Autism Julie Smith, MA, BCBA November 12, 2015 2 Overview What is Autism New DSM-5; changes to diagnosis Potential causes Communication strategies Managing difficult behaviors Effective programming
More informationPatricia Howlin Emeritus Professor of Clinical Child Psychology, King's College, London Professor of Developmental Disorders Sydney University
INSAR 2016 Summer Institute Session V: ASD in Adulthood Patricia Howlin Emeritus Professor of Clinical Child Psychology, King's College, London Professor of Developmental Disorders Sydney University July
More informationPresented by: Jan Miller- Vogel, M.S. Sarah Shick, B.S.
Presented by: Jan Miller- Vogel, M.S. Sarah Shick, B.S. TLC The Treatment and Learning Centers! The Treatment and Learning Centers is a private, non-profit organization founded in 1950 in Rockville, MD!
More informationPENNSYLVANIA AUTISM NEEDS ASSESSMENT Middle/High School Module
PENNSYLVANIA AUTISM NEEDS ASSESSMENT Middle/High School Module 1367 caregivers of children in middle school and high school diagnosed with autism spectrum disorders completed this needs assessment module.
More informationSection Objectives. Module 7 Health Care Advocacy 2/26/2018. Conditions of use. Participants will be able to:
3/15 Module 7 Health Care Advocacy 1 Conditions of use The Education and Training Curriculum on Dementia and Intellectual and Developmental Disabilities is copyrighted by the American Academy of Developmental
More information[INSERT TITLE] 2/24/19. Understanding Restricted and. Repetitive Behaviors in HFA. Kimberlee Flatt, PhD, LPC,BCBA/LBA DSM-5
Understanding Restricted and [INSERT TITLE] Repetitive Behaviors in HFA Kimberlee Flatt, PhD, LPC,BCBA/LBA DSM-5 B. Restricted, repetitive patterns of behavior, interests, or activities 1. Stereotyped
More informationOur plan for the next hour
Early Intensive Intervention Services Using Applied Behavior Analysis for Young Children with Autism Spectrum Disorders: Provider and Family Perspectives Nan Perrin Lisa Smith Shelly Gaudreau Louise Heinz
More informationAdults with Autism Spectrum Disorder. Elizabeth Schroeder. University of North Carolina at Chapel Hill
Running Head: PARENTAL EXPECTATIONS IN ASD 1 High Early Parental Expectations Predict Improved Independent Living and Quality of Life for Adults with Autism Spectrum Disorder Elizabeth Schroeder University
More informationPromoting Aging Well with Autism Nisonger Autism Institute
Promoting Aging Well with Autism Nisonger Autism Institute Tamar Heller June 25, 2013 Columbus, OH Rehabilitation Research and Training Center on Aging with Developmental Disabilities: Lifespan Health
More informationOutcome for adults with autism- how can the future be improved? Patricia Howlin
Outcome for adults with autism- how can the future be improved? Patricia Howlin Huge challenges Cost of supporting people with autism & their families in the U.S. alone greater than the entire GDP of 139
More informationPiecing the Puzzle Together: Pharmacologic Approaches to Behavioral Management in Autism Spectrum Disorder
Piecing the Puzzle Together: Pharmacologic Approaches to Behavioral Management in Autism Spectrum Disorder Hannah Sauer, PharmD PGY1 Pediatric Pharmacy Resident Mayo Clinic 2015 MFMER slide-1 Objectives
More informationAUTISM SPECTRUM DISORDER
AUTISM SPECTRUM DISORDER Targeting Autism National Forum March 4, 2015 Springfield, IL Russell J. Bonanno, M.Ed. 1 AGENDA What is ASD (definition, causes) Diagnostic Criteria (DSM-5) Getting a Diagnosis
More informationFor more than 100 years, extremely hyperactive
8 W H A T W E K N O W AD/HD Predominantly Inattentive Type For more than 100 years, extremely hyperactive children have been recognized as having behavioral problems. In the 1970s, doctors recognized that
More informationAutism 101 Glenwood, Inc. 2013
Autism 101 Glenwood, Inc. 2013 DSM-5 CURRENT DX CRITERIA Although ASD s are neurological, there are no current medical tests to use for a diagnosis. We currently use behavioral symptoms to make a diagnosis,
More informationDifferential Diagnosis. Not a Cookbook. Diagnostic Myths. Starting Points. Starting Points
Educational Identification of Individuals with Autism Spectrum Disorders Ohio Center for Autism and Low Incidence (OCALI) 5220 N. High Street Columbus, OH 43214 Main Line: 866-886-2254 Fax: 614-410-1090
More informationFrom Diagnostic and Statistical Manual of Mental Disorders: DSM IV
From Diagnostic and Statistical Manual of Mental Disorders: DSM IV (I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C) (A) qualitative impairment
More informationTHE RELATIONSHIP OF EMPLOYMENT AND SOCIAL DEFICITS IN ADULTS WITH AUTISM SPECTRUM DISORDER. Shaun P. Thomas
THE RELATIONSHIP OF EMPLOYMENT AND SOCIAL DEFICITS IN ADULTS WITH AUTISM SPECTRUM DISORDER Shaun P. Thomas A thesis submitted to the faculty at the University of North Carolina at Chapel Hill in partial
More informationAssessment and Care for Patients on the Autism Spectrum
Assessment and Care for Patients on the Autism Spectrum Autism Spectrum Disorder (ASD) refers to a group of complex neurodevelopment disorders characterized by repetitive and characteristic patterns of
More informationDaily living skills in individuals with autism spectrum disorder from 2 to 21 years of age
575840AUT0010.1177/1362361315575840AutismBal et al. research-article2015 Special Issue Article Daily living skills in individuals with autism spectrum disorder from 2 to 21 years of age Autism 2015, Vol.
More informationA Longitudinal Pilot Study of Behavioral Abnormalities in Children with Autism
Volume 1, Issue 4 Research Article A Longitudinal Pilot Study of Behavioral Abnormalities in Children with Autism Robin A. Libove 1, Thomas W. Frazier 2, Ruth O Hara 1, Jennifer M. Phillips 1, Booil Jo
More informationPeople with autism need specialist care and education. EMIS 2010, as distributed onhttp:// Autism.htm Used with permission.
Autism is a disorder that affects the way a person communicates with, and relates to, other people. Most (but not all) people with autism also have a learning disability. People with autism need specialist
More informationInclude Autism Presents: The Volunteer Handbook
Include Autism Presents: The Volunteer Handbook 1 The Volunteer Handbook: Working With People Who Have An Autism Spectrum Disorder Brought to you by: Include Autism 2 Include Autism, Inc. 2014 Table of
More informationWhat does NCI tell us about people with autism? An update
NCI Data Brief ISSUE 3 April 2011 What does NCI tell us about people with autism? An update The 2008-2009 National Core Indicators Consumer Survey Report (see www.nationalcoreindicators.org for the full
More informationAUTISM: THE MIND-BRAIN CONNECTION
AUTISM: THE MIND-BRAIN CONNECTION Ricki Robinson, MD, MPH Co-Director, Descanso Medical Center for Development and Learning - La Canada CA Clinical Professor of Pediatrics, Keck School of Medicine-USC
More informationAutism Spectrum Disorder What is it? Robin K. Blitz, MD Resident Autism Diagnostic Clinic Lecture Series #1
Autism Spectrum Disorder What is it? Robin K. Blitz, MD Resident Autism Diagnostic Clinic Lecture Series #1 Learning Objectives What can we talk about in 20 minutes? What is Autism? What are the Autism
More informationThis is autism. Autism in different diagnostic manuals 1(6)
1(6) This is autism Original title: Det här är autism Eric Zander Översättning: Semantix Autism is a functional impairment. People who have autism have difficulty interacting and communicating with others
More informationMemory & Aging Clinic Questionnaire
Memory & Aging Clinic Questionnaire The answers you give to the questions below will assist us with our evaluation. Each section is equally important so please be sure to complete the entire questionnaire.
More informationQ: What can you tell us about the work you do and your involvement with children with autism?
If you know one person with autism, you know one person with autism April is Autism Awareness & Acceptance month and in an attempt to further educate the public about autism, Catriona Monthy, a registered
More informationDown Syndrome and Autism
Down Syndrome and Autism Lina Patel, Psy.D. Sie Center for Down Syndrome Children s Hospital Colorado University of Colorado School of Medicine Lina.Patel@childrenscolorado.org Financial Disclosure Objectives
More informationAutism Spectrum Disorder
Autism Spectrum Disorder 1) Approximately 1 out of every children in the United States will have an ASD. a) 44 b) 88 c) 122 d) 244 2) Asperger s syndrome presents more frequently in boys than it does in
More informationAutism 101: An Introduction for Families
Autism 101: An Introduction for Families Lindsey Miller, ARNP Rachel Montague, Ph.D. June 5, 2012 Overview of Presentation What are Autism Spectrum Disorders? Prevalence & causes Characteristics & related
More informationAutism Spectrum Disorder What is it?
Autism Spectrum Disorder What is it? Robin K. Blitz, MD Resident Autism Diagnostic Clinic Lecture Series #1 Learning Objectives What can we talk about in 20 minutes? What is Autism? What are the Autism
More informationBeacon Assessment Center
Beacon Assessment Center Developmental Questionnaire Please complete prior to your first appointment Contact Information: Client Name: DOB: Dates of Evaluation: Age: Grade: Gender: Language(s) spoken in
More information2017 Gatlinburg Conference Symposium Submission SS-8
Symposium Title: Qualitative Approaches to Understanding Family Experiences Chair: Gael I. Orsmond 1 Discussant: Julie Lounds Taylor 2 Overview: Recent editorials have espoused enthusiasm for and discussed
More informationAutism beyond childhood. The Challenges
Autism beyond childhood The Challenges Why ASD and Why Now? Prevalence Historically emphasis has been on childhood Adults fall through cracks Poor services Government responses Pervasive Developmental
More informationtopic : Co-Morbid Conditions by Cindy Ring, MSW, LSW and Michele LaMarche, BCBA
ABA Literature Summary e-newsletter OCTOBER 2011 ISSUE 5 topic : Co-Morbid Conditions by Cindy Ring, MSW, LSW and Michele LaMarche, BCBA 1. Co-Morbidity Rates and Types in Individuals with Autism............
More informationPARENT/CAREGIVER MANAGEMENT TRAINING
PARENT/CAREGIVER MANAGEMENT TRAINING Dr Agboola Paul, Consultant Child Psychiatrist (M.B.Ch.B, FWACP, MPH) Child and Adolescent Mental Health Unit Neuropsychiatric Aro abeokuta BEFORE DIAGNOSIS Period
More informationau#sm Lori McIlwain, Execu#ve Director
au#sm Lori McIlwain, Execu#ve Director AUTISM SAFETY TRAINING 2014 au#sm UTISM IS A DEVELOPMENTAL DISABILITY THAT CAN CAUSE SIGNIFICANT SOCIAL, COMMUNICATION & BEHAVIORAL CHALLENGES. 1 IN 68 CHILDREN HAVE
More informationStarting Points. Starting Points. Autism Screening and Resources for the Practitioner. The Importance of Screening
Autism Screening and Resources for the Practitioner Ruth Aspy, Ph.D., and Barry G. Grossman, Ph.D. The Ziggurat Group, PA www.texasautism.com Keynote Presented for the Greater Texas Chapter National Association
More informationa spectrum disorder developmental Sensory Issues Anxiety 2/26/2009 Behaviour Social
Autism Spectrum Disorders (ASD) Welcome! You can download this handout from www.uwindsor.ca/autism under Workshops Email mgragg@uwindsor.ca www.summitcentre.org Marcia Gragg, PhD, CPsych, Feb. 8, 2008
More informationAutism Spectrum. Mental Health Issues. A guidebook for mental health professionals
Autism Spectrum & Disorder Mental Health Issues A guidebook for mental health professionals Introduction to Autism & Mental Health This guide has been developed to provide mental health professionals with
More informationAttention-Deficit/Hyperactivity Disorder Nathan J. Blum, M.D.
ADHD in Preschool Children Preschool ADHD: When Should We Diagnose it & How Should We Treat it? Professor of Pediatrics Diagnosis of ADHD in Preschool Children: Impact of DSM-IV Is Preschool ADHD Associated
More informationECI WEBINAR SERIES: PRACTICAL STRATEGIES FOR WORKING WITH CHILDREN WITH AUTISM. Kathleen McConnell Fad, Ph.D.
ECI WEBINAR SERIES: PRACTICAL STRATEGIES FOR WORKING WITH CHILDREN WITH AUTISM Kathleen McConnell Fad, Ph.D. PART 1: ESTABLISHING RELATIONSHIPS WITH FAMILIES AND BECOMING AN EFFECTIVE COACH Let s start
More information