Lecture 4 - ASD, Aspergers and Related Disorders (1)-unlocked 2.pdf

9/17/24 Learning Objectives...

9/17/24 Learning Objectives Discuss ASD, Asperger’s and other related disorders that have a direct Autism, Asperger’s, and impact on a person’s speech, language and swallowing skills Relate their communication and swallowing concerns in the context of Related Disorders assessment, diagnostic process and planning for intervention Identify the persons/professionals involved in management of conditions associated with communication and swallowing difficulties Carmela Marie A. Carandang, RSLP, MRS-SP in this population Niña Luisa O. Salido, RSLP CASLD 1 A cademics T. E ouches A heart. Mducates mind. rticulates vision. 1 odels excellenc e. 2 Outline Autism Spectrum Disorder Definition, etiology, epidemiology Developmental disorder that affects communication and behavior Characteristics and features Onset before the age of 3 Prognosis No cure but early intervention Treatment/Intervention 4x more likely in boys than in girls Role of SLPs Etiology unknown but risk factors include Team Members Having children with ASD Older parents at time of conception Certain genetic conditions Very low birth weight 3 4 AUTISM SPECTRUM DISORDER Milestones DSM V CRITERIA A. Persistent deficit in social communication and social interaction. Deficits in: 1. Social-emotional reciprocity 2. Nonverbal communicative behaviors 3. Developing, maintaining and understanding relationships 5 6 1  9/17/24 AUTISM SPECTRUM DISORDER AUTISM SPECTRUM DISORDER DSM V CRITERIA DSM V CRITERIA B. Restricted, repetitive patterns of behavior, interests, or activities C. Present in early developmental period 1. Stereotyped or repetitive motor movement D. Clinically significant impairment 2. Insistence of sameness E. Not better explained by intellectual disability or global developmental 3. Restricted, fixated interests delay 4. Hyper- or hypoactive mcwahabmd 7 8 AUTISM SPECTRUM DISORDER Video: What is Autism? Autism https://www.youtube.com/watch?v=MTW7H5UQ8Ts Asperger’s Disorder Childhood disintegrative disorder Pervasive Developmental Disorder – Not otherwise specified (PDD-NOS) mcwahabmd 9 10 Video: Subtle signs of autism ASPERGER’S DISORDER https://www.youtube.com/watch?v=FGTcXAgzxWw AKA high-functioning autism May have high IQ with adequate adaptive skill Focused on topics that the child is interested in and can discuss it non- stop Difficulty with social interaction mcwahabmd 11 12 2  9/17/24 Video: Kid with Asperger’s CHILDHOOD DISINTEGRATIVE DISORDER https://www.youtube.com/watch?v=IJFnkGEiz0U Rarest Children developing normally then quickly lose many social, language and mental skills usually between the ages of 2 and 4 Most will develop seizure disorder 13 14 Pervasive Developmental Disorder – Not otherwise specified (PDD-NOS) New Classification of Autism (3 Levels) ASD Level 1: Requiring ASD Level 2: Requiring ASD Level 3: Requiring Very Include children whose symptoms are more than Asperger’s but not as Support Substantial Support Substantial Support severe as Autism Mildest Social communication Severe challenges in Highest functioning and repetitive behaviors social communication Asperger’s Syndrome Challenges in Nonverbal or use only a Difficulty verbal/nonverbal comm few words understanding social Reduced responses to Marked inflexibility of cues social cues behavior Difficulty maintaining Inflexibility Restrictive repetitive personal relationships behaviors interfere function 15 16 Autism in the Philippines AUTISM SPECTRUM DISORDER Approximately 1 out of 100 to 500 Filipinos have autism Formal assessment through psychometric evaluation needed 140,000 of the 70 million population (CDC) Needs a multidisciplinary approach in treatment Factors affecting prognosis Cognitive ability Treatment age Quality of treatment Treatment intensity Consistency 17 18 3  9/17/24 AUTISM SPECTRUM DISORDER Pharmacological therapy Second Generation Antipsychotics Risperidone, aripiprazole ATTENTION DEFICIT Selective Serotonin Reuptake Inhibitors Fluoxetine HYPERACTIVITY DISORDER ASD have characteristics similar with OCD 19 20 ATTENTION DEFICIT HYPERACTIVITY DISORDER ATTENTION DEFICIT HYPERACTIVITY DISORDER ADHD has 5% prevalence in children and 2.5% prevalence in adults Three types of presentation More likely in Males Predominantly inattentiveness RISK FACTORS Predominantly hyperactivity-impulsivity Very low birth weight Combined presentation Maternal history of smoking during pregnancy Genetic Maternal history of alcohol abuse 21 22 ATTENTION DEFICIT HYPERACTIVITY DISORDER ATTENTION DEFICIT HYPERACTIVITY DISORDER DSM V CRITERIA DSM V CRITERIA – INATTENTIVENESS A. Inattention Often fails in the following tasks: B. Hyperactivity Giving close attention to details Sustaining attention Present for at least 6 months and inappropriate for developmental Listening when spoken to directly level Following through on instructions 6 or more symptoms for children up to 16 years old or 5 or more for Organizing tasks and activities 17 years above Loses things Easily distracted Forgetful in daily activities 23 24 4  9/17/24 ATTENTION DEFICIT HYPERACTIVITY DISORDER ATTENTION DEFICIT HYPERACTIVITY DISORDER DSM V CRITERIA – HYPERACTIVITY DSM V CRITERIA Presenting characteristics: Symptoms present before the age of 12 Fidgets with or taps hands and feet, squirms Symptoms present in two or more settings Leaves seat in situations remaining seated is expected Clear evidence that there is interference with, reduce the quality of Runs and climbs in situations social, school or work functioning Unable to play/engage in activities quietly Symptoms are not explained by another condition Often on the go Talks excessively Blurts out answers Difficulty waiting for their turn Interrupts others 25 26 ATTENTION DEFICIT HYPERACTIVITY DISORDER Video: What is ADHD? Formal testing to identify type and needs https://www.youtube.com/watch?v=5l2RIOhDXvU Treatment: psychological, behavioral and educational Pharmacologic management for hyperactivity Methylphenidate American Academy of Pediatrics Recommendation Behavioral therapy under age of 6 Pharmacologic therapy with behavioral therapy from 6-11 y/o 27 28 Role of SLPs Role of SLPs Provide information on the diagnosis for individuals or groups at risk Counselling Educating other professionals on roles in diagnosing and managing Consulting and collaborating with other professionals, family members, Screening language and communication difficulties caregivers Conducting culturally and linguistically relevant comprehensive assessment Partnering with families in assessment and intervention Assessing the need and requirements for AAC Providing parent education Assessing and treating feeding issues Remaining informed of research Referring to other professionals Advocating for individuals Develop speech and language goals Serving as a member of an interdisciplinary team Providing treatment, documentation, and determining dismissal Providing quality control and risk management 29 30 5  9/17/24 Team Members Summary Autism Spectrum Disorder Attention Deficit and Hyperactivity Disorder Role of SLPs Team members 31 32 6