AutismDevelopmental Awareness

and Screenings

Becky LaMont MSN, APN-CNP

Links

• CDC video• CDC website• signs 1• video

ASD Facts

• Present at birth, with onset of symptoms before 36 months

• Accurate diagnosis possible at 18-24 months

• Parents first voice concerns around 18 months, but diagnosis is typically not until 3 years or older

ASD Facts: Epidemiology

• Conservative prevalence: 1 in 150• ASD more prevalent in pediatric

population than:– Cancer, Diabetes and Downs Syndrome

• Male to female ratio: 4 to 1• Diagnostic rate increase 1:20 then 1:4

CDC, AAP, Autism Speaks

2007

Strike that-

• Since I have been giving this lecture the prevalence of autism spectrum disorders has changed 3 times.

• 1 in 300 to 1 in 150 • To current CDC stats of 1 in 68• To current Easter Seals stats of 1 in 88

What is Autism?

• Neurodevelopmental disorder with a spectrum of clinical conditions

• 3 areas of dysfunction:– Social interaction/social relatedness

difficulty– Communication impairment– Restrictive/repetitive behaviors and

interests

Pervasive Developmental Disorder

AutismAsperger’s Syndrome

PDD – NOS(not otherwise

Specified)

Rett’sSyndrome

ChildhoodDisintegrative

Disorder

Typical DevelopmentJoint Attention

• 2 mo. Shared smiles• 9 mo. Follows a point• 12 mo. Point to request

Language soon follows joint attention,No joint attention, no need to share

language.

Typical DevelopmentSocial Interaction

• 4 mo. Interest in faces, smiles shared• 9 mo. Orients to name• 12 mo. Uses gesture to get needs met• 15 mo. Check expressions, check this!• 18 mo. Pretend play, attracts attention• 24 mo. Enjoys playing by others, gives

toys

Typical DevelopmentPlay Behavior

• 4-12 mo Sensor motor • 12+ Functional Play• 16mo Symbolic Play• 30+ Imaginative Play

Language Delay:Absolute indications for immediate

evaluation

9 months: No babbling12 months: No pointing or other gestures16 months: No single words24 months: No functional 2-word phrases

(not echolalic) Any loss of language or social skills

ASD Basics Summary

• Autism is a neurodevelopmental disorder with a broad spectrum of behavioral manifestations.

• Early awareness and intervention are key.

• It’s OK to discuss concerns.

Challenging Behaviors

• Stimming: Repetitive, Stereotyped, and Sometimes Self-Injurious Behaviors

• Restricted Interests: Obsessions, "Special Topics", and Attention Deficits

• Insistence on Sameness • Sensory Issues: Seeking and Avoiding • Mood Instability and Meltdowns • Activities of Daily Living

Myths-

• Refrigerator mothers• Others?

Stir the pot

• Conflict of interest?

Final thoughts

• Autism speaks resource—assisting with speech