Please enable JavaScript.
Coggle requires JavaScript to display documents.
Autism Spectrum Disorder ( under pervasive developmental disorders in ICD…
Autism Spectrum Disorder ( under pervasive developmental disorders in ICD-10)
assessment
challenges
it is important to know that the problems cannot be explained by other issues, f.ex. problems in hearing
what to assess
IQ
degree of mental impairment
language skills
social interactions
degree of autism specific symptoms
problem behaviour
anxiety
very common in people with ASD: 40-84% of any anxiety siroder
contributes to impairment in adaptive functioning
can be difficult to distinguish between ASD core symptoms and f.ex. OCD and social anxiety
use of structured interviews has begun to be shown to be effective in distinguishing between this
children's self-reports of anxiety have shown small effect sizes and are not useful for detecting change through treatment
parent ratings + clinicians assessment of anxiety was sensitive ot detecting treatment change
cognitive and processing abilities
verbal reasoning skills
reading comprehension
visual - motor integration skills
assessment of competencies and need of help when transitioning from youth to adulthood
assessment tools
cognitive tests
developmental tests
parent interview
observational assessment
a context where social-communicative behaviour and play can be observed
childhood autism/infantil autisme (ICD-10)
defined by
presence of abnormal or impaired devlopment that is manifest before the age of three years
abnormal functioning in
reciprocal social interaction
communication
restricted, stereotyped, repetitive behaviour (also interests)
other normal aspects
phobias
eating and sleeping disturbances
temper tantrums
(self-directed) aggression
Asperger syndrome
defined by (ICD-10)
problems in interaction with others
restricted, stereotyped, repetitive repertoire of interests and activities
no general retardation in development of language or cognitive development (differs this way from autism)
psychotic episodes can occur in early adult life
loosing touch with reality (hallucinations, delusions)
marked clumsiness
strong tendency for abnormalities to persist into adolescence and adult life
treatment
help should be started as early as possible
dansk indsats (programmes?)
fokus på
(pædagogisk/psykologisk) behandling
udvikling af sociale kompetencer
selvfortåelse
hjælp til almindelig daglig funktioner
forsøgelsesgrundlag
bolig, arbejde, uddannelse
rettet mod forældre med børnmed autisme
De Utrolige År - evidence based, but originally for handling problem behaviour (good with ADHD), --> doenplay the parts where the child needs to be taken away form a social situation, and fokus on visual communication
tidlig indsats for helt små børn med autisme
Early Start Denver Model
9-18 month age important time for developing autism
develoment kan be lowered with early help
best documented programme to have effect on the core symptoms of autism
younger siblings of children with autism are risk group for developing autism
targeted for 12-48 month children
behavioural program
fokuses on motivation, samspil, joint attention, communication, speech development, reinforcement of goaloriented social behaviour
indsatser rettet mod børn og unge med autisme
biggest evidence for approaches that are based on behaviour analysis, behavioural psychology, positive behaviour support (validating)
45-83% recieve pharmacotherapy, but no good medicine has been found to be great for anxiety treatment amongst ASD
CBT
reduce anxiety
has shown significant effects in treating anxiety in children with ASD (relative to waitlist and TAU control conditions)
CBT for ASD
TEACCH (Treatment and Education of Autistic and related Communication-handicapped CHildren)
other things to note
autism comes in different forms and levels of severity
influences
interests
personality development
lifesituation
social contexts
they have a hard time imagining/ understanding what others think and feel
theory of mind
sally anne test
hard to navigate social situations
misunderstandings
problems with senses
difficulty with certain smells + sounds
sense of feel
difficulty with having clothes on, take a bath, wash hair etc.
can be overstimulated by sensory information ?
Relative strength in and preference for processing visual information (compared to difficulties with auditory processing, particularly of language
3-25% of those diagnosed with autism as children have normal cog. functioning and have independent lives as adults. They may still have difficulties in social interaction and communcation
severity of autism, symptoms and development in early childhood are important for prognosis
one is not born with autism, but with a predisposition for it
epidemology
1% of danish children and youth
more boys than girls
can be because girls are better at mastering strategies to hide/compensate their difficulties. BUT they don't have the underlying understanding for social contexts --> anxiety, exhaustion
parents of children with autism are at a grearter risk for stress, depression, sadness, lowered quality of life etc.
has also a negative economical effect on the family
hereditery
many families have more than one child with autism
amount of people diagnosed with autism has risen
comorbidity
anxiety
people with autisme that are normal (normaltbegavede) often have anxiety
depression
self-harm
ADHD
developmental retardation/problems (udviklingshæmning)
forekomst af autisme stiger med graden af udviklingshæmning
epilepsi
eating-disorders
udadreagerende adfærd
evidence based practice
Indsatser: more research with children with autism (with RCT) than with youth and adults (and these have small samples, no control group , no description of sample selection, no proper description of the indsats)
has been difficult for work around autism
The importance of research is indisputable, but we concur with the broader APA (2006) definition of evidence-based practice in psychology that also incorporates the elements of clinical expertise and flexibility based on cultural variables and clients’ unique circumstances
comprehensive behavioral programs
early intensive behavioural intervention can a very effective treatment for children with autism
common to use
research basis varies from program to program
comprehensive developmental and eclectic programs
based on developmental theory
research basis for programs highly variable
the Denver model
reserarch of the effectiveness has just been made
focus on
core difficulties in the areas of social interaction
imitation
perception of affect
in a developmental framework
developmental, individual-difference, relationship model (DIR)
considerable interest but needs more empirical support
focuses on
building relationships
improve overall social engagement
reciprocal interaction
self-regulation
attention
The social communication , emotional regulation, transactional support approach (SCERTS)
considerable interest but need more empirical support
focus on
fostering social-communication skills
addressing behvaiours that may interfere with learning and social interaction
TEACCH (Treatment and Education of Autistic and related Communication-handicapped CHildren) (ecletic program)
needs empirical support
emphasis on
supporting learning, fostering communication, increasing independence
has centers, provides consultation and has special classrooms within public schools (USA, north carolina)
most of the treatment programs are targeted towards children. There is a lack of evidence-based treatment programs for adolescents and adults with ASD
SOCIAL-COMMUNICATIOSN INTERVENTIONS
largest body of work from study of peer mediated interaction
train typically developed children to support social interaction in children with autism (roleplay, play scripts, peert tutoring, teaching peers a pivotal response approach
groups are common format of teaching, weak designs have been used, lack necessary research
popular interventions, but effects tend to be modest and research shortcomings
communication interventions
behavioural interventions have yielded positive results in preverbal children with autism
some positive results but needs more research as research has been limites in some areas
focal behavioural treatment is well researched
PSYCHOPHARMACOLOGY
SSRI studies have not supported the use of these for treatment of repetitive behaviour in children with pervasive developmental diorders
atypical antipsychotic - risperidone: more positive results - decreases in a range of maladptive behaviours
problem a gap with what is knowning research studies and what is done in real-life settings