Autistic Spectrum Disorders

Prepared by Dr Shewikar El Bakry

Ass Prof of Neuropsychiatry

Banha University

AgendaIntroduction to Autism

Clinical Picture

Red Flags

Etiology

Diagnosis

Identifying Tools

Management

History of Autism

1048700 Autism was first described in literature by LeoKanner in 1943

1048700 He called the syndrome ldquoearly infantileautismrdquo

1048700 Autism was also often misdiagnosed aschildhood schizophrenia

1048700 Early psychologists hypothesized that childrenbecame autistic due to ldquocold and unnurturingrdquo

mothers This theory was proven false in1979

Facts on Autism ndash What WeKnow So Far

Autism1048700 occurs in approximately 1 out of 250 birthsand has a 10-17 annual growth rate

1048700 typically manifests around the ages of 18months to 3 years

1048700 is found throughout the world in families of all racial ethnic and social backgrounds

occurs mostly in males The ratio is about41

Why study autism

The rate ofAUTISM

was One in 10000

BirthsJust 10 years ago

NOW AUTISM

occurs in 1 of every 150

births

AUTISM AWARENESS RIBBON

Palestine statistics

bull The Prevalencebull Ghaza strip 2649

from a population of 1324991

bull West bank 4622 from 2311204

bull The Incidencebull Ghaza strip 14 from

a population of 1324991

bull West bank 25 from 2311204

What is Autism

bull Autism is a complex neurobiological disorder

bull Inhibits a persons ability to ndash Communicate ndash Develop social relationshipsndash Often accompanied by behavioral challenges

Facts about Autism

bull One of the most severe mental disabilities that has impact on the individuals behavior

bull Putting out flames without finding the cause

Affects bullLearning capability

bullSocial up bringingbullOccupation

bullRehabilitation bullAbility for work

proficiency

By the end of 7 monthsbull Smile back at another personbull Respond to sound with soundsbull Enjoy social play

Red FlagsbullNo big smiles or other warm joyful

expressions by six months or thereafter

bullNo back-and-forth sharing of sounds smiles or other facial expressions by nine months or thereafter

By the end of 12 monthsbull Use simple gestures bull Imitate actions in their play bull Respond when told ldquonordquo

Red FlagsbullNo back-and-forth gestures such as

pointing showing reaching or waving bye

bullNot answering to onersquos name when called

bullNo babbling ndash mama dada baba

By the end of 18 months

bull Do simple pretend play bull Point to interesting objectsbull Use several single words unprompted

Red FlagsbullNo single words by 18 months

bullNo simple pretend play

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

AgendaIntroduction to Autism

Clinical Picture

Red Flags

Etiology

Diagnosis

Identifying Tools

Management

History of Autism

1048700 Autism was first described in literature by LeoKanner in 1943

1048700 He called the syndrome ldquoearly infantileautismrdquo

1048700 Autism was also often misdiagnosed aschildhood schizophrenia

1048700 Early psychologists hypothesized that childrenbecame autistic due to ldquocold and unnurturingrdquo

mothers This theory was proven false in1979

Facts on Autism ndash What WeKnow So Far

Autism1048700 occurs in approximately 1 out of 250 birthsand has a 10-17 annual growth rate

1048700 typically manifests around the ages of 18months to 3 years

1048700 is found throughout the world in families of all racial ethnic and social backgrounds

occurs mostly in males The ratio is about41

Why study autism

The rate ofAUTISM

was One in 10000

BirthsJust 10 years ago

NOW AUTISM

occurs in 1 of every 150

births

AUTISM AWARENESS RIBBON

Palestine statistics

bull The Prevalencebull Ghaza strip 2649

from a population of 1324991

bull West bank 4622 from 2311204

bull The Incidencebull Ghaza strip 14 from

a population of 1324991

bull West bank 25 from 2311204

What is Autism

bull Autism is a complex neurobiological disorder

bull Inhibits a persons ability to ndash Communicate ndash Develop social relationshipsndash Often accompanied by behavioral challenges

Facts about Autism

bull One of the most severe mental disabilities that has impact on the individuals behavior

bull Putting out flames without finding the cause

Affects bullLearning capability

bullSocial up bringingbullOccupation

bullRehabilitation bullAbility for work

proficiency

By the end of 7 monthsbull Smile back at another personbull Respond to sound with soundsbull Enjoy social play

Red FlagsbullNo big smiles or other warm joyful

expressions by six months or thereafter

bullNo back-and-forth sharing of sounds smiles or other facial expressions by nine months or thereafter

By the end of 12 monthsbull Use simple gestures bull Imitate actions in their play bull Respond when told ldquonordquo

Red FlagsbullNo back-and-forth gestures such as

pointing showing reaching or waving bye

bullNot answering to onersquos name when called

bullNo babbling ndash mama dada baba

By the end of 18 months

bull Do simple pretend play bull Point to interesting objectsbull Use several single words unprompted

Red FlagsbullNo single words by 18 months

bullNo simple pretend play

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

History of Autism

1048700 Autism was first described in literature by LeoKanner in 1943

1048700 He called the syndrome ldquoearly infantileautismrdquo

1048700 Autism was also often misdiagnosed aschildhood schizophrenia

1048700 Early psychologists hypothesized that childrenbecame autistic due to ldquocold and unnurturingrdquo

mothers This theory was proven false in1979

Facts on Autism ndash What WeKnow So Far

Autism1048700 occurs in approximately 1 out of 250 birthsand has a 10-17 annual growth rate

1048700 typically manifests around the ages of 18months to 3 years

1048700 is found throughout the world in families of all racial ethnic and social backgrounds

occurs mostly in males The ratio is about41

Why study autism

The rate ofAUTISM

was One in 10000

BirthsJust 10 years ago

NOW AUTISM

occurs in 1 of every 150

births

AUTISM AWARENESS RIBBON

Palestine statistics

bull The Prevalencebull Ghaza strip 2649

from a population of 1324991

bull West bank 4622 from 2311204

bull The Incidencebull Ghaza strip 14 from

a population of 1324991

bull West bank 25 from 2311204

What is Autism

bull Autism is a complex neurobiological disorder

bull Inhibits a persons ability to ndash Communicate ndash Develop social relationshipsndash Often accompanied by behavioral challenges

Facts about Autism

bull One of the most severe mental disabilities that has impact on the individuals behavior

bull Putting out flames without finding the cause

Affects bullLearning capability

bullSocial up bringingbullOccupation

bullRehabilitation bullAbility for work

proficiency

By the end of 7 monthsbull Smile back at another personbull Respond to sound with soundsbull Enjoy social play

Red FlagsbullNo big smiles or other warm joyful

expressions by six months or thereafter

bullNo back-and-forth sharing of sounds smiles or other facial expressions by nine months or thereafter

By the end of 12 monthsbull Use simple gestures bull Imitate actions in their play bull Respond when told ldquonordquo

Red FlagsbullNo back-and-forth gestures such as

pointing showing reaching or waving bye

bullNot answering to onersquos name when called

bullNo babbling ndash mama dada baba

By the end of 18 months

bull Do simple pretend play bull Point to interesting objectsbull Use several single words unprompted

Red FlagsbullNo single words by 18 months

bullNo simple pretend play

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Facts on Autism ndash What WeKnow So Far

Autism1048700 occurs in approximately 1 out of 250 birthsand has a 10-17 annual growth rate

1048700 typically manifests around the ages of 18months to 3 years

1048700 is found throughout the world in families of all racial ethnic and social backgrounds

occurs mostly in males The ratio is about41

Why study autism

The rate ofAUTISM

was One in 10000

BirthsJust 10 years ago

NOW AUTISM

occurs in 1 of every 150

births

AUTISM AWARENESS RIBBON

Palestine statistics

bull The Prevalencebull Ghaza strip 2649

from a population of 1324991

bull West bank 4622 from 2311204

bull The Incidencebull Ghaza strip 14 from

a population of 1324991

bull West bank 25 from 2311204

What is Autism

bull Autism is a complex neurobiological disorder

bull Inhibits a persons ability to ndash Communicate ndash Develop social relationshipsndash Often accompanied by behavioral challenges

Facts about Autism

bull One of the most severe mental disabilities that has impact on the individuals behavior

bull Putting out flames without finding the cause

Affects bullLearning capability

bullSocial up bringingbullOccupation

bullRehabilitation bullAbility for work

proficiency

By the end of 7 monthsbull Smile back at another personbull Respond to sound with soundsbull Enjoy social play

Red FlagsbullNo big smiles or other warm joyful

expressions by six months or thereafter

bullNo back-and-forth sharing of sounds smiles or other facial expressions by nine months or thereafter

By the end of 12 monthsbull Use simple gestures bull Imitate actions in their play bull Respond when told ldquonordquo

Red FlagsbullNo back-and-forth gestures such as

pointing showing reaching or waving bye

bullNot answering to onersquos name when called

bullNo babbling ndash mama dada baba

By the end of 18 months

bull Do simple pretend play bull Point to interesting objectsbull Use several single words unprompted

Red FlagsbullNo single words by 18 months

bullNo simple pretend play

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Why study autism

The rate ofAUTISM

was One in 10000

BirthsJust 10 years ago

NOW AUTISM

occurs in 1 of every 150

births

AUTISM AWARENESS RIBBON

Palestine statistics

bull The Prevalencebull Ghaza strip 2649

from a population of 1324991

bull West bank 4622 from 2311204

bull The Incidencebull Ghaza strip 14 from

a population of 1324991

bull West bank 25 from 2311204

What is Autism

bull Autism is a complex neurobiological disorder

bull Inhibits a persons ability to ndash Communicate ndash Develop social relationshipsndash Often accompanied by behavioral challenges

Facts about Autism

bull One of the most severe mental disabilities that has impact on the individuals behavior

bull Putting out flames without finding the cause

Affects bullLearning capability

bullSocial up bringingbullOccupation

bullRehabilitation bullAbility for work

proficiency

By the end of 7 monthsbull Smile back at another personbull Respond to sound with soundsbull Enjoy social play

Red FlagsbullNo big smiles or other warm joyful

expressions by six months or thereafter

bullNo back-and-forth sharing of sounds smiles or other facial expressions by nine months or thereafter

By the end of 12 monthsbull Use simple gestures bull Imitate actions in their play bull Respond when told ldquonordquo

Red FlagsbullNo back-and-forth gestures such as

pointing showing reaching or waving bye

bullNot answering to onersquos name when called

bullNo babbling ndash mama dada baba

By the end of 18 months

bull Do simple pretend play bull Point to interesting objectsbull Use several single words unprompted

Red FlagsbullNo single words by 18 months

bullNo simple pretend play

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Palestine statistics

bull The Prevalencebull Ghaza strip 2649

from a population of 1324991

bull West bank 4622 from 2311204

bull The Incidencebull Ghaza strip 14 from

a population of 1324991

bull West bank 25 from 2311204

What is Autism

bull Autism is a complex neurobiological disorder

bull Inhibits a persons ability to ndash Communicate ndash Develop social relationshipsndash Often accompanied by behavioral challenges

Facts about Autism

bull One of the most severe mental disabilities that has impact on the individuals behavior

bull Putting out flames without finding the cause

Affects bullLearning capability

bullSocial up bringingbullOccupation

bullRehabilitation bullAbility for work

proficiency

By the end of 7 monthsbull Smile back at another personbull Respond to sound with soundsbull Enjoy social play

Red FlagsbullNo big smiles or other warm joyful

expressions by six months or thereafter

bullNo back-and-forth sharing of sounds smiles or other facial expressions by nine months or thereafter

By the end of 12 monthsbull Use simple gestures bull Imitate actions in their play bull Respond when told ldquonordquo

Red FlagsbullNo back-and-forth gestures such as

pointing showing reaching or waving bye

bullNot answering to onersquos name when called

bullNo babbling ndash mama dada baba

By the end of 18 months

bull Do simple pretend play bull Point to interesting objectsbull Use several single words unprompted

Red FlagsbullNo single words by 18 months

bullNo simple pretend play

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

What is Autism

bull Autism is a complex neurobiological disorder

bull Inhibits a persons ability to ndash Communicate ndash Develop social relationshipsndash Often accompanied by behavioral challenges

Facts about Autism

bull One of the most severe mental disabilities that has impact on the individuals behavior

bull Putting out flames without finding the cause

Affects bullLearning capability

bullSocial up bringingbullOccupation

bullRehabilitation bullAbility for work

proficiency

By the end of 7 monthsbull Smile back at another personbull Respond to sound with soundsbull Enjoy social play

Red FlagsbullNo big smiles or other warm joyful

expressions by six months or thereafter

bullNo back-and-forth sharing of sounds smiles or other facial expressions by nine months or thereafter

By the end of 12 monthsbull Use simple gestures bull Imitate actions in their play bull Respond when told ldquonordquo

Red FlagsbullNo back-and-forth gestures such as

pointing showing reaching or waving bye

bullNot answering to onersquos name when called

bullNo babbling ndash mama dada baba

By the end of 18 months

bull Do simple pretend play bull Point to interesting objectsbull Use several single words unprompted

Red FlagsbullNo single words by 18 months

bullNo simple pretend play

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Facts about Autism

bull One of the most severe mental disabilities that has impact on the individuals behavior

bull Putting out flames without finding the cause

Affects bullLearning capability

bullSocial up bringingbullOccupation

bullRehabilitation bullAbility for work

proficiency

By the end of 7 monthsbull Smile back at another personbull Respond to sound with soundsbull Enjoy social play

Red FlagsbullNo big smiles or other warm joyful

expressions by six months or thereafter

bullNo back-and-forth sharing of sounds smiles or other facial expressions by nine months or thereafter

By the end of 12 monthsbull Use simple gestures bull Imitate actions in their play bull Respond when told ldquonordquo

Red FlagsbullNo back-and-forth gestures such as

pointing showing reaching or waving bye

bullNot answering to onersquos name when called

bullNo babbling ndash mama dada baba

By the end of 18 months

bull Do simple pretend play bull Point to interesting objectsbull Use several single words unprompted

Red FlagsbullNo single words by 18 months

bullNo simple pretend play

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

By the end of 7 monthsbull Smile back at another personbull Respond to sound with soundsbull Enjoy social play

Red FlagsbullNo big smiles or other warm joyful

expressions by six months or thereafter

bullNo back-and-forth sharing of sounds smiles or other facial expressions by nine months or thereafter

By the end of 12 monthsbull Use simple gestures bull Imitate actions in their play bull Respond when told ldquonordquo

Red FlagsbullNo back-and-forth gestures such as

pointing showing reaching or waving bye

bullNot answering to onersquos name when called

bullNo babbling ndash mama dada baba

By the end of 18 months

bull Do simple pretend play bull Point to interesting objectsbull Use several single words unprompted

Red FlagsbullNo single words by 18 months

bullNo simple pretend play

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

By the end of 12 monthsbull Use simple gestures bull Imitate actions in their play bull Respond when told ldquonordquo

Red FlagsbullNo back-and-forth gestures such as

pointing showing reaching or waving bye

bullNot answering to onersquos name when called

bullNo babbling ndash mama dada baba

By the end of 18 months

bull Do simple pretend play bull Point to interesting objectsbull Use several single words unprompted

Red FlagsbullNo single words by 18 months

bullNo simple pretend play

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

By the end of 18 months

bull Do simple pretend play bull Point to interesting objectsbull Use several single words unprompted

Red FlagsbullNo single words by 18 months

bullNo simple pretend play

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

By the end of 2 years (24 months)

bull Use 2- to 4-word phrasesbull Follow simple instructionsbull Become more interested in other childrenbull Point to object or picture when named

Red FlagsbullNo two-word meaningful phrases

(without imitating or repeating)bullLack of interest in other children

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Red Flag Any loss of speech or babbling or social skills

Regression at any age is cause for immediate referral

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Watch Video How to Recognize the Early Signs of Autism YouTube at blinkxwmv

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picture

No real fear of dangers

Inappropriate laughingor giggling

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

17

Apparent insensitivityto pain

May not want cuddling

Clinical Picture

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

18

Sustained unusual orrepetitive play

Uneven physical or verbal skills

May avoid eye contact

Clinical Picture

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

19

May preferto be alone Difficulty in expressing

needs May use gestures

Clinical Picture

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

20

Inappropriate attachments to objects

Insistence on

sameness

Clinical Picture

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

21

Echoes words or phrases

Inappropriate response or no response to sound

Clinical Picture

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

22

Spins objects or self

Difficulty in interactingwith others

Clinical Picture

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picture

Does not seek opportunities to interact withothers

Unwillingness andor inability to engage incooperative play

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picture

Fails to produce appropriate facialexpressions to specific occasions

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picture

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picture

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picture (Social Skills) bull bull Lack of awareness of the existence or

feelings of othersbull 1048700 Severe impairment in the ability to relate

to othersbull 1048700 Aloof and distant from othersbull 1048700 Appears not to listen when spoken to

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picture (Social Skills)

Fails to produce appropriate facial

expressions to specific occasions

1048700 Avoids eye contact

1048700 Difficulty with changes in environment and

routine

1048700 Does not seek opportunities to interact with others

1048700 Unwillingness andor inability to engage in

cooperative play

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picture (Communication Skills)

bull Deficits or differences in communication skills

are common with individuals with autism

bull 1048700 Difficulties in using and understanding both

verbal and non-verbal languagebull 1048700 Failure to initiate or sustain conversational

interchangebull 1048700 Abnormalities in the pitch stress rate

rhythm and intonation of speech

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picture (Communication Skills)

bull Poor receptive and expressive skillsbull 1048700 May echo words (echolalic speech)bull 1048700 May use screaming crying tantrumsbull aggression or self-abuse as ways tobull communicatebull 1048700 Repeating words or phrases in place of

normal responsive languagebull Does not refer to self correctly

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picturebull Unusual and repetitive movements of the body that

interfere with the ability to attend to tasks or activities such as hand flapping finger flicking rocking hand clapping grimacing or eye gazing

bull Marked distress over changes in seemingly trivial aspects of the environment

bull 1048700 Laughing crying or showing distress for reasons not apparent to others

bull 1048700 Unreasonable insistence on following routines in precise detail

Behavior Skills

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picturebull Unresponsive to normal teaching methodsbull 1048700 Acts as deafbull 1048700 Apparent over- or under-sensitivity to painbull 1048700 No fear of real dangerbull 1048700 Uneven gross and fine motor skillsbull 1048700 May not want to cuddle or be cuddledbull 1048700 Inappropriate attachment to objectsbull 1048700 Noticeable physical over-activity or extreme

under-activity

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Clinical Picturebull May use an adultrsquos hand like a tool for

accomplishing tasksbull 1048700 Does not spontaneously imitate the play of other

childrenbull 1048700 Tendency to spend inordinate amounts of time

doing nothing or pursuing ritualistic behaviors

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Etiology

bull Psychoanalyticalbull Geneticbull anatomical brain areas annomelies bull Infectionbull Vaccinationbull Prenatal and perinatal factorsbull Environmentalbull Toxins

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

bull Common physical findings in ASDbull (all consistent with expected and reported findings of severe mercury toxicity)bull ndash Blocked ldquomirror-neuronsrdquo in frontal cortex (inability to respond tobull momrsquos feelings love gaze smile)bull ndash Inflammatory Bowel Diseasebull ndash Increased size of frontal lobe and white matterbull ndash Cerebellar atrophy (reduced number of Purkinje cells)bull ndash Increased ldquoneuronal packingrdquo in cortexbull ndash Cytoarchitectural changes in subcortical structuresbull ndash Micro-and astroglia activation with leaky blood brain barrierbull ndash Altered glutamate receptorsbull ndash Hippocampal damagebull ndash Elevation of inflammatory cytokines in brain and CSF MCP-1bull IFNgammabull ndash IgA deficiency and increased IgEbull ndash Lymphopeniabull ndash T-cell abnormalitiesbull ndash Abnormal NK cell function

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

F84 Pervasive developmental disorder F840 Childhood autismF841 Atypical autismF842 Retts syndromeF843 Other childhood disintegrative disorderF844 Overactive disorder associated with mental

retardation and stereotyped movementsF845 Aspergers syndromeF848 Other pervasive developmental disordersF849 Pervasive developmental disorder unspecified

International Classification of Diseases 10

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Changes in 2013hellip Diagnostic and Statistical Manual of Mental Disorders 5th

Edition (DSM-5) revisionsminus Autism spectrum disorders

bull Includes autism Asperger syndrome PDD-NOS and child disintegrative disorder (CDD)

minus Concentrates on required featuresbull Socialcommunication deficitsbull Restricted repetitive patterns of behavior interests activities

o Addition of sensory criteriaminus Increases specificity while maintaining sensitivity

bull Important to distinguish spectrum from non-spectrum developmental disabilities

bull Improves stability of diagnosis

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Assessment

The Autism Diagnostic Observation Schedule-Generic (ADOS-G)

Autistic Diagnosis Interview (ADI-R)

Vineland Adaptive Behavior Scales

Mullenrsquos communication Scales

M-CHAT CHAT Pervasive Developmental Disorder

Screening Test CSBS Caregiver Questionnaire

Screening Tool for Autism in Two-Year-Olds (STAT)

Childhood Autism Rating Scale Autism Behavior Checklist (ABC)

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

SECTION A- لألهل توجه أسئلة

يهتز و األهل ركبة على الجلوس أو بالمراجيح طفلك يستمتع هلآخرين أطفال صحبة في طفلك يستمتع هل

السلم على الصعود أو األشياء تسلق طفلك يحب هل( ( البخ أو األستغماية يلعب أن طفلك يحب هل

شاي طقم باستخدام يشربه و شاي كوب يحضر مثال بأنه طفلك يتظاهر األوقات بعض في هل( أخرى ( بأشياء يتظاهر أن ممكن لعبة

( يطلبها ( التي األشياء على المشاورة في السبابة طفلك يستخدم هل ( عليه ( المشار الشيء بهذا استمتاعه ليبين السبابة طفلك يستخدم هل

( أو ( يسقطهم أن بدون والعربيات كالمكعبات صغيرة بأشياء اللعب أن طفلك يستطيع هلفمه في يضعهم

( لك ( ليريها األب أو األم أخرى أشياء أو لعبه طفلك يحضر هل

للمرض المبكر اإلكتشاف

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

SECTION B-

الحكيمة أو العام الممارس خالل من بالمالحظة تتم

في أ- الطفل نظر هل الزيارة أثناء فيعينيك

وقل ب- مسليا يكون أن ممكن شئ على أشر ثم منتبها الطفل أجعل ( وجه ( على وانظر مثال دميه هذه أنظر أن ( له التأكد يجب تشير كنت ماذا إلى ليرى الطفل نظر هل الطفل

ولم إليه تشير كنت ما إلى فعال نظر ) الطفل يديك إلى فقط ينظر

ج- الشاي من كوب لك يجهز أن منه واطلب شاي وبراد األكواب من لعبه طقم أعطيه ثم منتبها الطفل اجعلالتظاهر ( ممكن ويشربه البراد من الشاي يصب بأنه الطفل يتظاهر هل( مختلفة بلعب

د- أشياء مع هذا كرر اللمبة إلى بالسبابة الطفل يشاور هل النور مثال إلى يشير أو يريك أن الطفل اسأل

هذا ( على لإلجابة يشير وهو وجهك إلى ينظر أن أيضا يجب نور كلمة معنى يفهم الطفل يكن لم إذا أخرى

بنعم)فوق ( ه- مكعب كم المكعبات من برج يبنى أن الطفل يستطيع هل

بعضه)

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Training of Early Head Start Staff

Early Screening and Diagnosis of ASDsndash What are the early signs of ASDndash Why is early diagnosis importantndash How to screen for autism at an early age appropriate

screeners (MCHAT)ndash Effective ways to collaborate and share information

with families about the screening possible need for referral and benefits of beginning intervention early

ndash How to make an appropriate referral for a child who fails a screening

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Data Collection for Analysis and Program Changes

bull Design student progress measurement systemsbull Conduct assessment and evaluationbull Use data-based decision-making

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

The emergence of anew autism model

bull Older modelbull bull Genetically determinedbull bull Brain basedbull bull Treatable but not

curable

Is autism a BRAINbull DISORDER

bull Newer modelbull bull Environmentally triggeredbull bull Genetically influencedbull bull Both brain and bodybull bull Metabolic abnormalities play big

rolebull bull Treatable and recovery possible

bull OR is itbull A DISORDER THATbull AFFECTS THE BRAIN

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Management Plan

Should address

bull Establishing goals for languagecommunication interventions

bull Establishing goals for educational interventionbull Prioritizing target symptomscomorbid conditionsbull Monitoring multiple domains of functioningbull Behavioral adjustmentbull Adaptive skillsbull Academic skillsbull Socialcommunication skillsbull Social intervention with family members and peersbull Monitoring medications

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Treatmentbull Goals

ndash Minimize core features and associated deficits ndash Maximize functional independence and QOLndash Alleviate family stress

bull Educational interventionbull Developmental Therapies

ndash Communicationndash Sensory fine motor gross motor

bull Behaviorally Based treatmentsndash Core and associated symptomsndash Social skills

bull Medical or biologic treatmentsbull Support family in home and community

Treatments and EducationalStrategies

bull Autism is not a disease There is not a single treatment such as a drug or therapy program that will work for all individuals with autism

bull 1048700 Treatment often comes in the form ofbull individualized plans designed to meet all areas of needbull 1048700 Meeting the challenges of autism is better described as

educational rather than treatmentbull 1048700 No single program or service will fill the needs of

everyone with autism Strategies to help a person with autism should be part of a comprehensive plan

Early intervention programs

ldquopsychosocial interventions can change the disorders courserdquo

bull Such programs involve highly focused and individualized teaching activities targeting all areas of development

bull Several different programs egTEACCH (Treatment and Education of Autism and related communications handicapped children)

bull LOOVAS methodbull The Denver modelbull LEAP (learning experiences and alternative program for

preschoolers and parents)

Psychopharmacology

Adjunct to educational developmental amp behavioral treatments

So far no evidence of impact on core symptoms

Evidence supporting is variable

Toolkit ndash handouts for MD amp families

bull Treat target symptomsndash Stereotypiesndash Withdrawalndash Obsessionsndash Irritabilityndash Hyperactivityndash attention spanndash self-injurious behavior ndash Aggressionndash sleep

Treatment

Atypical antipsychotic Abilify (Aripiprazole) oral formulation was approved November 24 2009 by the FDA for the treatment of irritability associated with ASD in children aged 6-17 years

Data based on two 8 week randomized placebo-controlled multicenter studies evaluating its efficacy for improving mean scores on the Caregiver-rated Irritability subscale of the Aberrant Behavior Checklist (ABC-I)

Biologically Based

SupplementsB6Magnesium B12DMG TMG Vitamin A Vitamin CFolateOmega 3 Fatty Acids

Elimination DietsCasein gluten free

Off-label medications

Secretin

bull Immunendash Antifungal therapyndash Immunotherapy steroidsndash AntibioticsAntiviralsndash Stem cell transplantation

bull Immunization-relatedndash With-hold immunizationndash Chelation

bull Hyperbaric oxygen therapy (HBOT)

Always others coming alonghellip

52

GUT Issues must be dealt with before dealing with the heavy metal issue

There are 3 main issues common to all autistic Children

1 Yeast Overgrowth

2 Leaky gut

3 Heavy Metal Accumulation

53

Another approach to therapy

Dealing with the yeast overgrowthDealing with the leaky gutHeavy metals and their effectsChelationMethylcobalamin

SpeechLanguage Therapy

bull Behaviorally based intensive structured teaching ndash Eg Verbal Behavior

bull Augmentative strategiesndash Sign languagendash PECSndash Aided augmentative alternative system(s)

bull Decrease non-communicative languagebull Developmental-pragmatic approaches

ndash appropriate use of language in social situationsndash eg SCERTSndash Social skills training

Content Areasbull Communication

ndash Teaching the child to use nonverbal communicative gestures

ndash Teaching motor imitationndash Teaching the meaning and important of

communicationndash Teaching symbolic representation

Environmental and Classroom Arrangement

bull Employ visual strategiesbull Use techniques of structured teachingbull Use consistency in designing the learning

environmentbull Monitor and modify environmental stimuli

Behavioral Intervention

ABA (Applied Behavioral Analysis)General behavioral teaching approach involves reinforcement and consequences to shape behavior

All of our parents used it

Involves the A B CrsquosNot airway breathing circulation

Antecedent Behavior Consequence

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Early intervention programs

ldquopsychosocial interventions can change the disorders courserdquo

bull Such programs involve highly focused and individualized teaching activities targeting all areas of development

bull Several different programs egTEACCH (Treatment and Education of Autism and related communications handicapped children)

bull LOOVAS methodbull The Denver modelbull LEAP (learning experiences and alternative program for

preschoolers and parents)

Psychopharmacology

Adjunct to educational developmental amp behavioral treatments

So far no evidence of impact on core symptoms

Evidence supporting is variable

Toolkit ndash handouts for MD amp families

bull Treat target symptomsndash Stereotypiesndash Withdrawalndash Obsessionsndash Irritabilityndash Hyperactivityndash attention spanndash self-injurious behavior ndash Aggressionndash sleep

Treatment

Atypical antipsychotic Abilify (Aripiprazole) oral formulation was approved November 24 2009 by the FDA for the treatment of irritability associated with ASD in children aged 6-17 years

Data based on two 8 week randomized placebo-controlled multicenter studies evaluating its efficacy for improving mean scores on the Caregiver-rated Irritability subscale of the Aberrant Behavior Checklist (ABC-I)

Biologically Based

SupplementsB6Magnesium B12DMG TMG Vitamin A Vitamin CFolateOmega 3 Fatty Acids

Elimination DietsCasein gluten free

Off-label medications

Secretin

bull Immunendash Antifungal therapyndash Immunotherapy steroidsndash AntibioticsAntiviralsndash Stem cell transplantation

bull Immunization-relatedndash With-hold immunizationndash Chelation

bull Hyperbaric oxygen therapy (HBOT)

Always others coming alonghellip

52

GUT Issues must be dealt with before dealing with the heavy metal issue

There are 3 main issues common to all autistic Children

1 Yeast Overgrowth

2 Leaky gut

3 Heavy Metal Accumulation

53

Another approach to therapy

Dealing with the yeast overgrowthDealing with the leaky gutHeavy metals and their effectsChelationMethylcobalamin

SpeechLanguage Therapy

bull Behaviorally based intensive structured teaching ndash Eg Verbal Behavior

bull Augmentative strategiesndash Sign languagendash PECSndash Aided augmentative alternative system(s)

bull Decrease non-communicative languagebull Developmental-pragmatic approaches

ndash appropriate use of language in social situationsndash eg SCERTSndash Social skills training

Content Areasbull Communication

ndash Teaching the child to use nonverbal communicative gestures

ndash Teaching motor imitationndash Teaching the meaning and important of

communicationndash Teaching symbolic representation

Environmental and Classroom Arrangement

bull Employ visual strategiesbull Use techniques of structured teachingbull Use consistency in designing the learning

environmentbull Monitor and modify environmental stimuli

Behavioral Intervention

ABA (Applied Behavioral Analysis)General behavioral teaching approach involves reinforcement and consequences to shape behavior

All of our parents used it

Involves the A B CrsquosNot airway breathing circulation

Antecedent Behavior Consequence

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Psychopharmacology

Adjunct to educational developmental amp behavioral treatments

So far no evidence of impact on core symptoms

Evidence supporting is variable

Toolkit ndash handouts for MD amp families

bull Treat target symptomsndash Stereotypiesndash Withdrawalndash Obsessionsndash Irritabilityndash Hyperactivityndash attention spanndash self-injurious behavior ndash Aggressionndash sleep

Treatment

Atypical antipsychotic Abilify (Aripiprazole) oral formulation was approved November 24 2009 by the FDA for the treatment of irritability associated with ASD in children aged 6-17 years

Data based on two 8 week randomized placebo-controlled multicenter studies evaluating its efficacy for improving mean scores on the Caregiver-rated Irritability subscale of the Aberrant Behavior Checklist (ABC-I)

Biologically Based

SupplementsB6Magnesium B12DMG TMG Vitamin A Vitamin CFolateOmega 3 Fatty Acids

Elimination DietsCasein gluten free

Off-label medications

Secretin

bull Immunendash Antifungal therapyndash Immunotherapy steroidsndash AntibioticsAntiviralsndash Stem cell transplantation

bull Immunization-relatedndash With-hold immunizationndash Chelation

bull Hyperbaric oxygen therapy (HBOT)

Always others coming alonghellip

52

GUT Issues must be dealt with before dealing with the heavy metal issue

There are 3 main issues common to all autistic Children

1 Yeast Overgrowth

2 Leaky gut

3 Heavy Metal Accumulation

53

Another approach to therapy

Dealing with the yeast overgrowthDealing with the leaky gutHeavy metals and their effectsChelationMethylcobalamin

SpeechLanguage Therapy

bull Behaviorally based intensive structured teaching ndash Eg Verbal Behavior

bull Augmentative strategiesndash Sign languagendash PECSndash Aided augmentative alternative system(s)

bull Decrease non-communicative languagebull Developmental-pragmatic approaches

ndash appropriate use of language in social situationsndash eg SCERTSndash Social skills training

Content Areasbull Communication

ndash Teaching the child to use nonverbal communicative gestures

ndash Teaching motor imitationndash Teaching the meaning and important of

communicationndash Teaching symbolic representation

Environmental and Classroom Arrangement

bull Employ visual strategiesbull Use techniques of structured teachingbull Use consistency in designing the learning

environmentbull Monitor and modify environmental stimuli

Behavioral Intervention

ABA (Applied Behavioral Analysis)General behavioral teaching approach involves reinforcement and consequences to shape behavior

All of our parents used it

Involves the A B CrsquosNot airway breathing circulation

Antecedent Behavior Consequence

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Treatment

Atypical antipsychotic Abilify (Aripiprazole) oral formulation was approved November 24 2009 by the FDA for the treatment of irritability associated with ASD in children aged 6-17 years

Data based on two 8 week randomized placebo-controlled multicenter studies evaluating its efficacy for improving mean scores on the Caregiver-rated Irritability subscale of the Aberrant Behavior Checklist (ABC-I)

Biologically Based

SupplementsB6Magnesium B12DMG TMG Vitamin A Vitamin CFolateOmega 3 Fatty Acids

Elimination DietsCasein gluten free

Off-label medications

Secretin

bull Immunendash Antifungal therapyndash Immunotherapy steroidsndash AntibioticsAntiviralsndash Stem cell transplantation

bull Immunization-relatedndash With-hold immunizationndash Chelation

bull Hyperbaric oxygen therapy (HBOT)

Always others coming alonghellip

52

GUT Issues must be dealt with before dealing with the heavy metal issue

There are 3 main issues common to all autistic Children

1 Yeast Overgrowth

2 Leaky gut

3 Heavy Metal Accumulation

53

Another approach to therapy

Dealing with the yeast overgrowthDealing with the leaky gutHeavy metals and their effectsChelationMethylcobalamin

SpeechLanguage Therapy

bull Behaviorally based intensive structured teaching ndash Eg Verbal Behavior

bull Augmentative strategiesndash Sign languagendash PECSndash Aided augmentative alternative system(s)

bull Decrease non-communicative languagebull Developmental-pragmatic approaches

ndash appropriate use of language in social situationsndash eg SCERTSndash Social skills training

Content Areasbull Communication

ndash Teaching the child to use nonverbal communicative gestures

ndash Teaching motor imitationndash Teaching the meaning and important of

communicationndash Teaching symbolic representation

Environmental and Classroom Arrangement

bull Employ visual strategiesbull Use techniques of structured teachingbull Use consistency in designing the learning

environmentbull Monitor and modify environmental stimuli

Behavioral Intervention

ABA (Applied Behavioral Analysis)General behavioral teaching approach involves reinforcement and consequences to shape behavior

All of our parents used it

Involves the A B CrsquosNot airway breathing circulation

Antecedent Behavior Consequence

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Biologically Based

SupplementsB6Magnesium B12DMG TMG Vitamin A Vitamin CFolateOmega 3 Fatty Acids

Elimination DietsCasein gluten free

Off-label medications

Secretin

bull Immunendash Antifungal therapyndash Immunotherapy steroidsndash AntibioticsAntiviralsndash Stem cell transplantation

bull Immunization-relatedndash With-hold immunizationndash Chelation

bull Hyperbaric oxygen therapy (HBOT)

Always others coming alonghellip

52

GUT Issues must be dealt with before dealing with the heavy metal issue

There are 3 main issues common to all autistic Children

1 Yeast Overgrowth

2 Leaky gut

3 Heavy Metal Accumulation

53

Another approach to therapy

Dealing with the yeast overgrowthDealing with the leaky gutHeavy metals and their effectsChelationMethylcobalamin

SpeechLanguage Therapy

bull Behaviorally based intensive structured teaching ndash Eg Verbal Behavior

bull Augmentative strategiesndash Sign languagendash PECSndash Aided augmentative alternative system(s)

bull Decrease non-communicative languagebull Developmental-pragmatic approaches

ndash appropriate use of language in social situationsndash eg SCERTSndash Social skills training

Content Areasbull Communication

ndash Teaching the child to use nonverbal communicative gestures

ndash Teaching motor imitationndash Teaching the meaning and important of

communicationndash Teaching symbolic representation

Environmental and Classroom Arrangement

bull Employ visual strategiesbull Use techniques of structured teachingbull Use consistency in designing the learning

environmentbull Monitor and modify environmental stimuli

Behavioral Intervention

ABA (Applied Behavioral Analysis)General behavioral teaching approach involves reinforcement and consequences to shape behavior

All of our parents used it

Involves the A B CrsquosNot airway breathing circulation

Antecedent Behavior Consequence

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

52

GUT Issues must be dealt with before dealing with the heavy metal issue

There are 3 main issues common to all autistic Children

1 Yeast Overgrowth

2 Leaky gut

3 Heavy Metal Accumulation

53

Another approach to therapy

Dealing with the yeast overgrowthDealing with the leaky gutHeavy metals and their effectsChelationMethylcobalamin

SpeechLanguage Therapy

bull Behaviorally based intensive structured teaching ndash Eg Verbal Behavior

bull Augmentative strategiesndash Sign languagendash PECSndash Aided augmentative alternative system(s)

bull Decrease non-communicative languagebull Developmental-pragmatic approaches

ndash appropriate use of language in social situationsndash eg SCERTSndash Social skills training

Content Areasbull Communication

ndash Teaching the child to use nonverbal communicative gestures

ndash Teaching motor imitationndash Teaching the meaning and important of

communicationndash Teaching symbolic representation

Environmental and Classroom Arrangement

bull Employ visual strategiesbull Use techniques of structured teachingbull Use consistency in designing the learning

environmentbull Monitor and modify environmental stimuli

Behavioral Intervention

ABA (Applied Behavioral Analysis)General behavioral teaching approach involves reinforcement and consequences to shape behavior

All of our parents used it

Involves the A B CrsquosNot airway breathing circulation

Antecedent Behavior Consequence

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

53

Another approach to therapy

Dealing with the yeast overgrowthDealing with the leaky gutHeavy metals and their effectsChelationMethylcobalamin

SpeechLanguage Therapy

bull Behaviorally based intensive structured teaching ndash Eg Verbal Behavior

bull Augmentative strategiesndash Sign languagendash PECSndash Aided augmentative alternative system(s)

bull Decrease non-communicative languagebull Developmental-pragmatic approaches

ndash appropriate use of language in social situationsndash eg SCERTSndash Social skills training

Content Areasbull Communication

ndash Teaching the child to use nonverbal communicative gestures

ndash Teaching motor imitationndash Teaching the meaning and important of

communicationndash Teaching symbolic representation

Environmental and Classroom Arrangement

bull Employ visual strategiesbull Use techniques of structured teachingbull Use consistency in designing the learning

environmentbull Monitor and modify environmental stimuli

Behavioral Intervention

ABA (Applied Behavioral Analysis)General behavioral teaching approach involves reinforcement and consequences to shape behavior

All of our parents used it

Involves the A B CrsquosNot airway breathing circulation

Antecedent Behavior Consequence

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

SpeechLanguage Therapy

bull Behaviorally based intensive structured teaching ndash Eg Verbal Behavior

bull Augmentative strategiesndash Sign languagendash PECSndash Aided augmentative alternative system(s)

bull Decrease non-communicative languagebull Developmental-pragmatic approaches

ndash appropriate use of language in social situationsndash eg SCERTSndash Social skills training

Content Areasbull Communication

ndash Teaching the child to use nonverbal communicative gestures

ndash Teaching motor imitationndash Teaching the meaning and important of

communicationndash Teaching symbolic representation

Environmental and Classroom Arrangement

bull Employ visual strategiesbull Use techniques of structured teachingbull Use consistency in designing the learning

environmentbull Monitor and modify environmental stimuli

Behavioral Intervention

ABA (Applied Behavioral Analysis)General behavioral teaching approach involves reinforcement and consequences to shape behavior

All of our parents used it

Involves the A B CrsquosNot airway breathing circulation

Antecedent Behavior Consequence

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Content Areasbull Communication

ndash Teaching the child to use nonverbal communicative gestures

ndash Teaching motor imitationndash Teaching the meaning and important of

communicationndash Teaching symbolic representation

Environmental and Classroom Arrangement

bull Employ visual strategiesbull Use techniques of structured teachingbull Use consistency in designing the learning

environmentbull Monitor and modify environmental stimuli

Behavioral Intervention

ABA (Applied Behavioral Analysis)General behavioral teaching approach involves reinforcement and consequences to shape behavior

All of our parents used it

Involves the A B CrsquosNot airway breathing circulation

Antecedent Behavior Consequence

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Environmental and Classroom Arrangement

bull Employ visual strategiesbull Use techniques of structured teachingbull Use consistency in designing the learning

environmentbull Monitor and modify environmental stimuli

Behavioral Intervention

ABA (Applied Behavioral Analysis)General behavioral teaching approach involves reinforcement and consequences to shape behavior

All of our parents used it

Involves the A B CrsquosNot airway breathing circulation

Antecedent Behavior Consequence

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Behavioral Intervention

ABA (Applied Behavioral Analysis)General behavioral teaching approach involves reinforcement and consequences to shape behavior

All of our parents used it

Involves the A B CrsquosNot airway breathing circulation

Antecedent Behavior Consequence

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Motor and Sensory

Occupational therapy is the assessment and treatment of physical and psychiatric conditions using specific purposeful activity to prevent disability and promote independent function in all aspects of daily life

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Motor and Sensorybull Sensory Integrative Therapy and Autism

is based on the idea that some people struggle to receive process and make sense of information provided by the senses For example some people with autism are hyper-sensitive (over-sensitive) to some things such as loud noises but hypo-sensitive (under-sensitive) to other things such as pain

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Sensory Integration Strategies

Some examples of treatment approaches

bull Oral sensory motor development can be aided by whistles blowers and bubble blowing kits

bull Fine motor A number of toys like cone and ball catch puppets etc

bull For kids with fidgety fingers many blocks fixes etc that help them focus

bull Gross motor Bean bags Therabands

bull Vestibular and Proprioception Swings trampoline

bull Tactile Fabrics brushes

bull High arousal anxiety weighted jackets ldquosquishesrdquo

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Motor and Sensorybull Hippo Therapy

Dance Movement Therapy

Chiropractic Therapy

Coloured FiltersWeighted

Items

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Other

bull Animal Therapybull Dolphin Therapybull Assistance Dog

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Psychotherapy

bull Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

bull Play ndash social physical constructive symbolic

and independentndash Age-appropriate play skills ndash Individual teaching and directly guided in

inclusive preschool experiences

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Psychotherapy

bull Holding Therapybull CBTbull Music Therapybull Art Therapy

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Behavioural and Developmental

bull Relationship Development Intervention focuses on a childrsquos difficulties with flexibility of thought emotional regulation and perspective-taking

bull RDI is based on the idea that children with autism have missed key developmental milestones ndash such as social referencing joint attention ndash that enable them to think flexibly regulate their emotions and understand social situations

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Behavioural and Developmentalbull Social Storiestrade and Autism

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Typical Daily Schedules of Intervention

730-830amHome dressing and mealtime programs

900-1200Inclusive preschool intervention

1200-130Mealtime programs hygiene programs

130-430 11 structured teaching programs

430-530 Play indoors and outdoors530-700 Chores mealtime program

communication programs

800-Bedtime Book routines

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

bull Role of families ndash Families are at the helm of their childrsquos

treatmentndash Parents are the primary teachersndash Home visits are scheduled as needed

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions

Questions

• Autistic Spectrum Disorders
• Agenda
• History of Autism
• Slide 4
• Facts on Autism ndash What We Know So Far
• Why study autism
• Palestine statistics
• What is Autism
• Facts about Autism
• By the end of 7 months
• By the end of 12 months
• By the end of 18 months
• By the end of 2 years (2
• Slide 14
• Slide 15
• Clinical Picture
• Slide 17
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Clinical Picture (2)
• Clinical Picture (3)
• Clinical Picture (4)
• Clinical Picture (5)
• Clinical Picture (6)
• Slide 27
• Clinical Picture (Social Skills)
• Clinical Picture (Social Skills)
• Clinical Picture (Communication Skills)
• Clinical Picture (Communication Skills) (2)
• Clinical Picture (7)
• Clinical Picture (8)
• Clinical Picture (9)
• Etiology
• Slide 36
• International Classification of Diseases 10
• Changes in 2013hellip
• Assessment
• الإكتشاف المبكر للمرض
• Slide 41
• Training of Early Head Start Staff
• Data Collection for Analysis and Program Changes
• The emergence of a new autism model
• Management Plan
• Treatment
• Treatments and Educational Strategies
• Early intervention programs
• Psychopharmacology
• Treatment (2)
• Biologically Based
• GUT Issues must be dealt with before dealing with the heavy met
• Another approach to therapy
• SpeechLanguage Therapy
• Content Areas
• Environmental and Classroom Arrangement
• Slide 57
• Behavioral Intervention
• Motor and Sensory
• Slide 60
• Motor and Sensory (2)
• Sensory Integration Strategies
• Motor and Sensory (3)
• Other
• Slide 65
• Psychotherapy
• Slide 67
• Psychotherapy (2)
• Behavioural and Developmental
• Behavioural and Developmental (2)
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Questions