Download - AutiSM A GROWING CONCERN
AUTISM A GROWING CONCERN
Robyn SmithDepartment of Physiotherapy
UFS2012
Learning outcomesAfter this module the learner is to be able to:
Be able to define and understand what autism is Be able to identify the key areas of development that are
affected by autism Be able to identify autistic spectrum characteristics in a
child Be able to identify the possible causes of autism Be able to provide a brief overview of treatment options
available and used in the child with autism Understand the role of the physiotherapist, and therapy
approach to be used the child with autism
How common is Autism? Autism is on the increase Incidence 1/110 children Statistics are of
concern Boys: 1/70
Autism is not going away and is going to have a huge impact on society in future years
Autism Awareness Little known about autism World Autism day 2 April to raise awareness Lack of treatment facilities Lack of trained persons to help autistic
children, burden often falls solely on parents
What is autism?
Grouped as part of the Autistic Spectrum Disorders (ASD)
Also including Asperger’s Syndromes A complex neurodevelopmental disorder, that is present
from early on in life Involving the impairment of social interaction as well as
deficits in language and communication Also often accompanied by rigid and repetitive
behaviours Development of the child with autism is frequently uneven
with areas of strength alongside areas of difficulty.
What is autism? Other conditions may be present in addition to the
‘core features’ of autism. These are numerous and commonly include sensory processing problems, seizures, physical disorders, sleep problems, depression and high levels of anxiety, which may give rise to behavioural or other problems.
May have difficulties in forming and maintaining friendships and in realising their academic and employment potential.
The child and their families are also at high risk of social exclusion.
Causes of Autism Caused by abnormalities in brain structure or
function. Brain scans show differences in the shape and structure of the brain in autistic versus non-autistic children
The exact cause of autism has not been established to date.
Causes of autism Epigenetic – disorder has a strong genetic link.
Abnormalities of chromosome 5 have now been linked to an increased risk for autism
strong familial genetic disposition with one autistic child has a 1/20 chance of having another, one twin is autistic 90% chance other is
Has been linked to the Measles-Mumps & rubella vaccination may be contributing factor
???? Environmental factors
CHARACTERISTIC BEHAVIOUR
SocialisationImpaired social interaction is the hallmark of autism
Do not make eye contact Fail to respond to their names Appear not to hear you at times Resist cuddling or holding Unaware of other peoples feelings Prefer to play alone and retreat into their “own
world”
Communication Start talking later than others, some children are
non-verbal Often loose previously acquired sentences and
words Never make eye contact when asking for something Abnormal articulation and voice often singsong or
robotic like Cannot initiate or continue a conversation Repeat words or sentences verbatim without
understanding how to use them
Behaviour Repetitive movements e.g. rocking, spinning
and hand flopping Develops routines and rituals Become upset at the slightest change in
routine or ritual Constantly moving Fascinated by parts of objects e.g. spinning of
wheels of a toy car Overly sensitive to light, touch and sound –
have lot of sensory integration problems
Treatment of AutismThere is no cure for autism
Therapies and behavioural intervention are aimed at addressing specific symptoms with the hope of brining about an improvement
Treatment options
More than 700 treatment options
Good to use various treatment options but most importantly do not forget about reaching the child
Ring of professionals
surrounding the child
Educational and behavioural therapies
Children often need a very structured learning environment and often cannot be mainstreamed.
How one teaches is more important than what one teaches Need to teach them to interact socially, emotional regulation and
different ways of finding a route through activities Various educational programmes used with success e.g. SNAP
programme, TEACCH, PECS, SCERTS model Appropriate school placements Appropriate vocational placements If acting out in a group revert to activities in isolation Make use of reward system Can make use of their obsessions during therapy
Need to find a route through
activities for the child
Educational aspects to focus on
Try and teach child to concentrate -go back to basics . Break tasks down into its simplest components to limit anxiety and stress
Tell them when an activity is over Social stories Visual timetable –breakdown of activities and must run in
order Objects of reference First and then boards Zoning of areas Communication books, boards and devices
Speech and language therapy
To address language and communication skills
Occupational therapy Address sensory integration problems Cognitive stimulation very important Perceptual activities
SENSORY ISSUES !!!!
Deep pressure and brushing with a soft brush often work well to calm children down
“Bear Hug” Unrolling ear Blowing things e.g. Whistle, bubbles etc
Physiotherapy Not always referred to physiotherapy
Due to the core nature of their problems the physical aspects may be overlooked
Many of these children also have: Developmental delays Low muscle tone Co-ordination and balance problems
Medication Various medications can be used in the treatment
of Autism
Mood stabilising medications e.g. Tegretol, Lithium Antipsychotic medications e.g. Risperdal Antidepressant and Antianxiety Medications e.g.
Prozac Stimulant medications for ADHD e.g. Ritalin Non Stimulant medications for ADHD e.g.
Strattera
Alternative therapies Stem Cell therapy
Controversial therapy. Value of stem cell therapy in autism still under investigation. Stem cell therapy illegal in most countries.
HBOTRemains controversial, efficacy has not been proven in the case of autism
References Smith, R. 2010. Paediatric dictate, UFS (unpublished). Griesel, D. 2010. PANDA autism seminar (unpublished) List of Autism medications for children . Available online
at http://www.child-autism-parent-cafe.com/autism-medication.htmlRetrieved on 18/03/10
Research autism available online at http://www.researchautism.net/pages/autism/indexRetrieved on the 18/03/10
Autism fact sheet. 2010. available online at http://www.ninds.nih.gov/disorders/autism/detail_autism.htm