Words are not enough: Social Communication & Early Signs of Autism Spectrum Disorders

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Words are not enough: Social Communication & Early Signs of Autism Spectrum Disorders Pamela Rollins, MS Ed.D. University of Texas at Dallas, School of Behavior and Brain Sciences, Callier Center for Communication Disorders, rollins@utdallas.edu

TODAY What is Autism Spectrum Disorder Early Identification Social development in infants Foundation for social communication Why words are not enough

Core Deficits Social Communication & Interactions Nonverbal & verbal communication for social interaction Lack of social reciprocity Restricted Repertoire of Interests & Activities

Current Prevalence Estimates 1 in 91 children American Academy of Pediatrics 1 in 100 children Center for Disease Control

Reasons for Increase in Prevalence Unidentified environmental, genetic &/or epigenetic factors Change in diagnostic criteria Diagnostic substitution Increased awareness

School-Age Years

Learn the signs Act Early!! Reliable diagnosis 18-24 months

What are the early signs?? Social Communication Impairment prominent Restricted Repertoire of Activities & Interests may not yet be evident

Early Social Development 2 mo 6-9 mo 12 mo Sharing Emotion Pursuing Goals Sharing Intention

Sharing Emotion Social smile Social responsiveness Face-to-face (dyadic) interaction

Proto-conversations Reciprocal exchanges of emotions Turn-taking sequences Rhythmic, balanced Mutual gazing Responds to vocalization & facial expressions

6-9 months: Interaction shifts dyadic to triadic

Sharing Perception & Pursuing Goals Goal directed Selective attention to goal Persist until goal is met Happy when goal is met Understand other s goals Follows adult s line of regard Predict what comes next

Sharing Attention & Intention Mutual knowledge that they are doing something together Coordinate their plans & help each other

9-12 mos: Infant begins to communicate Social Routines Wave bye bye, peek-a-boo Share Attention Show Direct Attention Point Behavior Regulation Request, protest

COMMUNICATION PURSUING GOALS SHARED INTENTION Request & Protest Share & Direct Attention

COMMUNICATION PURSUING GOALS SHARED INTENTION Isolated words True rule governed language

Early indicators of ASD No warm, joyful engagement by 5 months No two-way, back-&-forth gesturing, smiles or social-emotional reciprocity by 9 months By 12 months Limited use of communicative gestures (words) Showing Waving Pointing Sharing Attention Limited use of back and forth interactions (peek-a-boo) Does not follow adults gaze or point Does not respond to name ANY loss of ANY language or babbling or social skills

Resources if you are concerned Talk to your doctor or nurse and ask for a referral to a developmental pediatrician or other specialist Contact your local early intervention agency (for children under 3) http://www.dars.state.tx.us/ecis/publications/referral.pdf Contact your local public school (if 3 and older) Check out The ACT Early website http://www.cdc.gov/ncbddd/actearly/index.html

Contact The Center for Children and Family s Infant Development Program http://infantdp.utdallas.edu/ Offers developmental screenings for infants and toddlers Make sure you mention that you are concerned about ASD. Contact Emily Touchstone at 972-883-4827 etouchstone@utdallas.edu The Chrystal Charity Ball Autism Project s Coordinated Referral Services A centralized phone number for direct access coordinated autism related services, provides educational information, referral information, and access to on-line and community resources for families and children with ASD. Call 214-456-7700 The Callier Center for Communicative Disorders http://www.utdallas.edu/calliercenter/clinic/autism/ Provides individual, group and classroom-based social communication therapy and parent training by certified speech/language pathologists Call the Dallas location at 214-905-3000 Call the Richardson location at 972-883-3630