treating autism part 1 with equine assisted counseling
DESCRIPTION
Treating Autism Spectrum with Equine Assisted Counseling (EAC) by Dr. Kay Trotter PhDTRANSCRIPT
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EPIC TRAINING
Treating The Autism Spectrum with Equine Assisted Counseling
PART 1: The Autism Spectrum
Kay Sudekum Trotter PhDLicensed Professional Counselor and Supervisor, National Certified Counselor, Registered Play Therapist and Supervisor, Certified Equine Assisted Counselor, and EPIC Creator (Equine Partners In Counseling)
www.KayTrotter.com
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Prevalence of Autism
• From 1994 to 2005, the number of children ages 6-21 years receiving services for autism increased from 22,664 to 193,637. 1
– A 754% increase
• Currently 1 in every 150 children is being diagnosed with Autism. 2
– Estimates range as high as 1/4% to 1/2% of the population
• These estimates include those with Autism, Asperger's Syndrome, and PDD.
• Autism is three times more likely to affect males than females. 1,2 – 75% of children with Autism meet criteria
for mental retardation (MR) • But affected females are more likely to
suffer from severe MR
The Autism Clock calculates the current estimated U.S. incidence of Autism for children ages 3-22.
It was developed to allow real-time access to the current Autism incidence.
The U.S. Economic Cost is calculated using an estimate of $30,000 USD annually for each child.
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What is Autism?Autism is a form of Pervasive Developmental Disorder (PDD) – a group of neurobiological disorders. There are five types or subgroups of PDDs
1. Childhood Autism
2. Asperger’s Syndrome3. Pervasive Developmental Disorder NOS 4. Childhood Disintegrative Disorder5. Rhett's Disease
ASD is a behavioral disorder of speech, communication, social interaction, and repetitive type compulsive behavior. The most commonly encountered are PDD NOS, childhood autism, and Asperger's Syndrome.
All these "different" conditions have common diagnostic and physiologic features but differ slightly by the specific diagnostic criteria.
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Current Knowledge of Disorder• Autism Spectrum Disorders (ASDs) are lifelong
developmental disabilities. People with ASDs have impairments in social interaction skills, or verbal and nonverbal communication, or by the presence of stereotyped (purposeless and repetitive) behaviors, interests, or activities.3
• They often have repetitive behaviors or unusual interests. Each of the behaviors associated with ASD may range from mild to severe.
• Some individuals may have relatively good verbal skills and only a minimal language delay but have significantly impaired social skills. Others may be nonverbal or have very little ability or interest in communicating or interacting with others.
• People with ASD often do not take part in pretend play, have a hard time initiating social interactions, and engage in self-stimulatory behaviors (e.g., flapping hands, making unusual noises, rocking from side to side, or toe-walking).
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Current Knowledge continued• There is no medical test for ASD. Typically, a
diagnosis is made after a thorough evaluation. Such an evaluation might include clinical observations, parent interviews, developmental histories, psychological testing, speech and language assessments, and possibly the use of one or more Autism diagnostic tests.
• No adjective can describe every type of Autism. – Some individuals are anti-social, some are
asocial, and others are social. – Some are aggressive toward themselves and/or
aggressive toward others. • Approximately half have little or no language. • Some repeat (or echo) words and/or phrases, and
others may have normal language skills.
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Co-Morbid Influences
• Children with an ASD may have other developmental disabilities, such as – mental retardation, seizure disorder, fragile X
syndrome, or tuberous sclerosis
• Most ASD children may have mental health problems such as – depression or anxiety
• Some children with ASDs may also have – attention deficits, sleeping disorders, sensory
issues, sleep problems, and gastrointestinal
disorders
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Major Characteristics - Infants
•Different from birth• Two common characteristics exhibited include
– arching their back away from their caregiver to avoid physical contact – failing to anticipate being picked up (i.e., becoming limp)
• As infants, they are often described as either passive or overly agitated babies.
• During infancy, many begin to rock and/or bang their head against the crib; but this is not always the case.
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Major Characteristics - Toddlers• Approximately one-half of Autistic
children develop normally until somewhere between 1 1/2 to 3 years of age; then Autistic symptoms begin to emerge.
• Some people in the field believe that Candida albicans, vaccinations, exposure to a virus, or the onset of seizures may be responsible for this regression.
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Major Characteristics - Children• Tend to fall behind their same-aged peers in the areas
of communication, social skills, and cognition.
• Dysfunctional behaviors may start to appear, such as self-stimulatory behaviors (i.e., repetitive, non-goal directed behavior, such as rocking, hand-flapping), self-injury (e.g., hand-biting, head banging), sleeping and eating problems, poor eye contact, and insensitivity to pain, hyper-hypo-activity, and attention deficits.
• Insistence on ‘sameness’ or ‘preservative’ behavior.
• Overly insistent on routines; if one is changed, even slightly, the child may become upset and tantrum. Some common examples are: drinking and/or eating the same food items at every meal, wearing certain clothing or insisting that others wear the same clothes, and going to school using the same route.
• One possible reason for ‘insistence on sameness’ may be the person's inability to understand and cope with novel situations.
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Major Characteristics - Adolescents
• Difficulty with the transition to puberty• Approximately 25% have seizures for
the first time during puberty, which may be due to hormonal changes
• Behavior problems can become more frequent and more severe
• Others experience puberty with relative ease
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Childhood Autism
• Autism has its origins in the first weeks or months of life, and is always presents before 36 months of age. These children may have some speech developmental and social interactive regression, usually around 18 months of age. • Autism is associated with various kinds of neurobiological symptoms, ranging from3
– persistence of usual reflexes– high rates of seizure disorder (25%)
• Characterized by marked problems in – social interaction – delayed and deviant communication (speech is absent in about 50% of cases)– insistence on sameness motor behaviors (hand flapping, body rocking)– insistence on sameness and resistance to change
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Childhood Autism continued
• Childhood Autism must meet the specific DSM IV criteria and will therefore present with:
• poor eye contact, pervasive ignoring, language delay, and other features
• These children will have a severe impairment in– speech, communication, or social interaction
• Many of them will be completely non-verbal and "in their own world"
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Asperger’s Syndrome
• A form of Autism that is characterized by concrete and literal thinking, obsession with certain topics, excellent memories, and being ‘eccentric.’
• Affects language less, yet there are difficulties with appropriate speech and communicative development. These children have social interaction difficulties and impairments related to a restricted, repetitive, stereotype behavior.
• These kids may have very high IQs, may do very well academically, have a superior memory for "unimportant" details, such as the birth dates of all baseball players, some historical or geographical trivia.
– These individuals are considered high-functioning and are capable of holding a job and of living independently
• These individuals may talk repetitively about a certain topic without understanding that it may be boring to others.
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Asperger’s Syndrome continued• The "amount" of memory of these individuals is
incredible and one may expect different degrees of impairments with Asperger's Syndrome. This may involve more or less memory and more or less social communicative impairment with regards to being able to live independently.
• Many people with this condition remain undiagnosed because of their ability to compensate with their memory or excellent academic abilities, yet they are considered by others to be “socially inept,” “weird,” “nerds,” “bizarre,” “eccentric,” etc.
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A typical example of a child with Asperger's Syndrome• They think we know what they know and think. They can’t
imagine that we don’t know what they are thinking or what they know.
• A typical example of a child with Asperger’s Syndrome would be that of a child who has some odd behaviors, poor eye contact, “sluggish” social interaction abilities, and an extreme interest in a central topic such as a washing machine.
• The child likes to sit and watch the washing machine rotate, knows everything about it including its operative and professional manual.
• Such a child, when he has a play date, may try to involve his friend in his most exciting interest (the washing machine) without realizing how boring it is to others and that will be the end of the play dates forever.
• This pattern may present itself in different degrees and circumstances, but the principal is the same:
– the lack of the ability to understand how other people perceive what you do, say, or express with body language and facial expressions.
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Pervasive Developmental Disorder NOS• Present similarly to the kids who have Autism
but will have a lesser degree of a severe impairment.
• These kids are more likely to be verbal and have some degree of verbal or non-verbal effective communication, yet they must have the Autistic features and a severe impairment in– social interaction, communication, or repetitive
stereotype behavior
• This term is reserved for children with a severe impairment who do not fully qualify for any other Autistic diagnosis, due to age of onset or combination of Autistic features.
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Childhood Disintegrative Disorder• Form of Mental Retardation in which the long
arm on the X chromosome is constricted.
• Approximately 15% of people with Fragile X Syndrome exhibit Autistic behaviors.
• Behaviors include: delay in speech/language, hyperactivity, poor eye contact, and hand-flapping.
– The majority of these individuals function at a mild to moderate level.
• As they grow older, their unique physical facial features may become more prominent (e.g., elongated face and ears), and they may develop heart problems.
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Rett Syndrome
Affects mostly females and usually develops between 1/2 to 1 1/2 years of age.
• These are girls who develop normally until 6 months of age and regress
• Their regression is associated with microcephaly (small head). The head size seems to stop growing from 6 months and on, from the time of the observed regression.
• Behaviors include: loss of speech, repetitive hand-wringing, body rocking, and social withdrawal.– Those individuals suffering from this disorder may
be severely to profoundly mentally retarded.
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Williams Syndrome
• Autistic behaviors including:– developmental and language
delays, sound sensitivity, attention deficits, and social problems.
• In contrast to many Autistic individuals, those with Williams Syndrome are quite sociable and have heart problems.
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ASD Sensory Processing Considerations in Treatment• Hearing auditory detail is impaired
– Tone is the language not the words– Parrot TV commercials because they always
sound the same– Stretch out and enunciate consonants– Hearing can be like a bad cell phone
connection
• Visual Processing– Signs of Visual Processing Difficulties
• Finger flicking near eyes• Tilts head• Hates escalators• Difficulty catching a ball• Eye exams may be normal
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ASD Sensory Processing Issues• Children with sensory-motor differences
have trouble perceiving and moving effectively and comfortably in the world.
• This means they are at risk for missing the beat in the “dance of relationships.”– Example: A playmate may call a child’s name
to join in a game. If there is a delay before that child is able to process and respond to that invitation, the playmate may feel ignored and move off in search of other friends. A parent may tap the child on the shoulder to get his or her attention, but that light touch may be perceived as so threatening that the child instinctively lashes out - and another chance for purposeful interaction is lost.
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ASD Sensory Processing Issues• Immature lower brain areas• Abnormal brain circuits between
brain regions• Sensory problems are variable• Word-based tasks may be
processed in visual areas of the brain
• Less frontal cortex utilization
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References
1 Center of Disease and Control and Prevention, Autism Community Report, Retrieved from: www.cdc.gov/NCBDDD/autism/documents/AutismCommunityReport.pdf
2 Stephen M. Edelson, Ph.D. - Center for the Study of Autism Retrieved from: http://www.featnt.org/readarticle.php?article_id=52
3 American Psychiatric Association, 2000. Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision) (DSM-IV-TR). Washington, DC: American Psychiatric Association.
4 Yale School of Medicine, Yale Child Study Center Autism, Retrieved from: http://www.med.yale.edu/chldstdy/autism/autism.html
5 FightingAutisum.org
6 Stanley Greenspan, “Reconsidering the Diagnosis and Treatment of Very Young Children with Autistic Spectrum or Pervasive Developmental Disorder” Zero to Three (Vol. 13, No. 2, 1992)
7 Anne Donnellan and Martha Leary, Movement Difference and Diversity in Autism/Mental Retardation (DRI Press, 1995)