How To Know If You Are Autistic Or Not

Transcription

1 Autism Spectrum Disorder in the DSM 5 What s in a Name? T A McDonald Parent LEND Trainee

2 August 1997 Speech & Language Assessment No social exchange with parents Play with toys in unmeaningful manner Throwing toys after inspection No response to request No eye contact or looking to object Did not look at picture cards (handled them and dropped to floor) Jargoned at mirror Receptive-Expressive Emergent Language Scale-2 Diagnosis: severe language delay (receptive & expressive)

3 September 1997 Cobb County Early Intervention Evaluation Findings Concern in the areas of Fine motor skills Gross motor skills Self help skills Coping skills Relationship to inanimate objects Relationship to persons Emotions and feeling states (Infant-Toddler Assessment and Peabody Developmental Motor Scales)

4 February 1998 Physical Therapy Evaluation 10 month delay in gross motor skills Gross motor portion of Peabody gross motor scales Constantly seeking vestibular and movement activities Rocking, swinging, jumping, Constantly chews on pacifier Refusal of wearing shoes (preferring barefoot)

5 February 1998 Developmental Assessment (WPS) Battelle Personal Social Overall 2 standard deviations below the mean Adaptive Behavior Domain Overall 2.33 standard deviations below the mean Locomotion Domain 2 standard deviations below the mean Communication 2.33 standard deviations below the mean Vineland Adaptive Behavior Scales All results similar to Battelle Adult Interaction 1 st %ile Feelings/Affect 1 st %ile Self concept 8 th %ile Peer Interaction 18 th %ile Coping Skills 2 nd %ile Social Role 1 st %ile Attention 1 st %ile Eating 1 st %ile Dressing 13 th %ile Personal Responsibility 6 th %ile Toileting 1 st %ile Expressive language 1 st %ile Reasoning & academic 1 st %ile Diagnosis: Developmental Delay

6 April 1998 Developmental Pediatrician Revised Gesell Developmental Schedules Test Was TOLD he fell within the range for mental retardation Childhood Autism Rating Scale Moderately autistic range Fleeting eye contact Inconsistent response to name or requests Jargoning, babbling, vocalizing No recognizable words Did not tolerate sitting (struggled & cried) Climbed tall chairs (no fear) Pushed blinds back and forth Diagnosis: Autistic Disorder

7 June 1998 Neurology Clinic Normal fragile X screen MRI Metabolic studies Electroencephalogram Excessive self-stimulatory behaviors Excessive hand flapping Toe walking Hitting head Flipping light switches Excessive vocalizations Rubbing face with keychain (with attached toys) Impressions: Pervasive Developmental Delay

8 July 1998 Little Walden Program Emory University ADI-Revised ADOS-G CARS Moderate Autism Severe delays (ADOS-G) Pointing Use of gestures Unusual eye contact Showing behaviors Joint attention Quality of social overtures Also Observed Communication of squeaks and squeals Hand-flapping Sideways glancing, Spinning (self and objects) Parts of toys Diagnosis: Autism (is appropriate)

9 October 1998 Follow up with Developmental Pediatrician CARS 28 (30 or higher for Autism) impressive improvement dramatic improvement Diagnosis: Pervasive Developmental Disorder Not otherwise specified

10 July 1999 Follow-up with Developmental Pediatrician Continued Diagnosis of PDD-NOS

11 Kindergarten September 2000 Developing Skills Checklist Math Language Memory Auditory Print Concepts 10 th %ile 5 th %ile 36 th %ile 1 st %ile 8 th %ile

12 Special Education Category: Autism Georgia Headstart Kindergarten - ½ year Full inclusion (special education support) California Kindergarten 2 nd Grade Autism Special Day Class 3 rd Grade Special Day Class with some mainstreaming 4 th Grade Special Day Class with some G & T education 5 th Grade G & T education 6 th Grade Full time aide, general education classrooms Wisconsin 7 th Graduation Full inclusion (special education support)

13 What s the Diagnosis? 9 th Grade Nice, Personable, Outgoing Strong academic, language & intellectual skills Impressive sense of humor Participation not on topic Struggles with Social participation/skills/cues Eye contact Conversation skills Sensory Issues Preoccupations/interests Organization Completing & turning in work 12 th Grade Bright, kind student Extremely talented, exceptional programmer Meticulous, perfectionist Not motivated by grades Grades don t reflect ability Turns ins sub-par work Participation off topic Struggles with Organization Completing & turning in work

14 Jasmine Lee O Neill (1999) An individual who is autistic may also have two or more of these combined. For an example, I am a classical Kanner autistic also with Asperger Syndrome traits.

15 Michael John Carley (2008) Executive director, GRASP The Global & Regional Asperger Syndrome Partnership Where an individual falls on the spectrum is, oddly enough, not important. What s important is concentrating on what that individual s needs are

16 What about individuals with ASDs? What do these terms mean for adolescents & adults who already have a diagnosis? How are the DSM IV labels perceived and communicated in society?

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19 ASD s and Identity Autism Much Awareness More Stigma More Services More of a barrier to access Few role models Asperger s Syndrome Much Awareness Less Stigma Less Services Less of a barrier to access More role models And theorized role models taken from historic accounts Pervasive Developmental Disorder My experience: folks have no idea what this is Some immediately associate it with Intellectual Disabilities

20 Michael John Carley (2008) Executive director, GRASP The Global & Regional Asperger Syndrome partnership The autism spectrum is complicated, and intimidating, and frustrating. It is so diverse, in fact, that pretty much everyone involved in the autism world seems to want to chop it up so as to better compartmentalize and address the differing needs of people on opposite ends of this vast gradient. Unfortunately, we can t. We can t dumb it down so as to make it easier to describe, or swallow. Autism is that complicated; and we who work in the field have to better own up to that fact if we are to become successful advocates and not confuse the world with contradictory messages, such as this side of the spectrum needs services versus this side of the spectrum needs to get rid of them.

21 What s in a Name? Spread the word to change the word: Stigma attached to the term mental retardation This term is often used by bullies to kids with both autism & Asperger s For those with a diagnosis of Asperger s: Their diagnosis may serve as irrefutable proof against these messages What impact will the removal of this term have on individuals who already have a diagnosis of Asperger s How can we support their needs Not just services- but Identity, Reputation, Public Perception On a personal level- parents, teachers, clinicians, etc Institutionally- organizations, advocacy, awareness campaigns, research, etc

22 What makes sense? Autism Awareness was promoted through deliberate and successful message campaigns New Autism Awareness will need this too! These messages must assist the needs of parents AND the needs of individuals on the spectrum Previous messages did great work on de-stigmatizing parents Keep up the great work!! New messages need to assist with de-stigmatizing individuals on the spectrum An example of a New Message could include: Individuals and children with autism are ever-changing and growing Who you see today may not be who you see tomorrow Works for both seeking services and de-stigmatization