Autism in Early Childhood:Identification and Supports Tammi Poppe B.S. ECE Autism Specialist C.H.A.S.A.E.R. LLC Oct. 10, 2007
Life on the Spectrum • Autism is one of five major disorders that fall on the Pervasive Developmental Disorder (PDD) spectrum.
Pervasive Developmental Disorders • Autism • Asperger’s Syndrome • Childhood Disintegrative Disorder • Rhett’s • Pervasive Developmental Disorder Not Otherwise Specified (PDD/NOS)
Autistic Disorders • “Autism is a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction, and communicative skills.” • Autism Society of America
Autism • Leo Kanner – 1943 • No language • “autism” formerly used by Blueler in 1912 to mean “escape from reality”, which he ascribed to schizophrenia. • Previously diagnosed as emotionally disturbed and/or mentally retarded.
Asperger’s • Hans Asperger- Austria 1944 • Higher functioning population • Language developed • Believed in biological rather than psychological cause. • WW2
Childhood Disintegrative Disorder • Heller 1908 • Onset between ages 2-4 in children who previously exhibit normal development. • More boys than girls diagnosed • 10 x less common than Kanner’s Infantile Autism
Rhett’s Syndrome • Andreas Rhett – Austria, 1966 • Almost exclusively affects girls • Brief period of normal development followed by multiple areas of deterioration • Characteristics include mental retardation, small brain and head size, seizures and hand wringing. • 4-Stage deterioration, early death
Pervasive Developmental DisorderNot Otherwise Specified “Subthreshold” diagnosis used when a person has many traits of another PDD, but not enough to meet DSM criteria for a diagnosis of another PDD.
What causes autism? • Genetics • Autism Genome Project • Neurexin 1 located on chromosome2 • Glutomate functioning • Sequence swath on chromosome 11
What causes autism? • Environment • Mercury toxicity • Immunizations • fish • Pollutants • Hydrogen sulfide • Water
What are the odds? • 1 in 150 • This number DOES NOT include Asperger’s, PDD/NOS or other spectrum disorders!!! • Every 20 minutes a child is diagnosed with autism! • When we add other spectrum disorders the numbers are more like1 in 98!!!
What are the cost? • Currently more than $90 billion annually to the U.S. and expected to more than double in the next decade. • Wisconsin • 1 Intensive waiver child = $44,000/yr NOT including medical and educational expenses! • 1 Post-Intensive child = apx $11,000/yr NOT including medical and educational cost!
What does autism look like? • While there is a set of basic diagnostic criteria; no two children present the same. • This creates a challenge in diagnosing, treating and educating the ASD (autism spectrum disorder) population.
Infants Colicky Thrush Sleep Issues Social Delays Eye contact Smile Response to play
Toddlers Language delay 50-200 words by age 2 Apraxia Echolalia Rituals Food Play
Toddlers Continued Social deficits Parallel play Modeling Joint attention Physically Frequent ear infections Yeast issues Toe walking Skin issues
Pre-School Continued echolalia Disney/Pixar Repetitive viewing Obsession w/movie/TV characters Social deficits
Preschool Continued May have lost earlier language acquisitions Aggression Self abuse Shows little to no interest in peers, or peers on his/her terms Aversion to change Poor/no play skills Physical Bowel/toilet Skin sensitivity Stomach issues
Kindergarten Receptive/expressive language issues PEC Singing V.O.D. ( voice output device) Sensory Issues Auditory Tactile Visual Oral Olfactory Increased behaviors Over stimulating environment Change in routine Processing issues
Kindergarten Continued Medication What will it control Danger to self and others Social Inappropriate response to stimuli Rule bound Right vs. Wrong or Fair vs. equal Team sport/multi player games Personal cares
Children’s Long Term Support • Funding Source • Diagnosis • Referral to County • CLTFS • Waiver Application • MA • Wait List • 250 slots per year on 3 year cycle
Autism Waiver • Intensive • 20-35 hours per week of intensive in home therapeutic services. • $44,000/yr Post Intensive Services Family Direct $11,000/yr
RESOURCES • Reproduction of graphs with the permission of the Kennedy Krieger Institute, Baltimore, MD. • Wisconsin Department of Public Instruction • www.dpi.state.wi.us/sped/autdata.html • Autism Genome Project