Autism Spectrum Disorder – Intervention & Support

 

There are a number of different intervention options to treat individual with an autism spectrum disorder. They are tailored according to the specific needs of the patient and often combinations are used to improve patient and carer quality of life.

 

Behavioural interventions: 

 

This type of intervention is built on the basis that human behaviour is learnt through the interaction between an individual and their environment. Implemented strategies aim to teach and increase positive behaviours while reducing non-adaptive behaviours. Such interventions include Applied Behaviour Analysis (ABA) which aims to increase, maintain and reduce target behaviours. These behaviours include learning skills, social skills, communication and basic adaptive living skills such as gross and fine motor skills, toileting, dressing, orientation and work skills.

 

Therapy based interventions:

 

Therapy based interventions focuses on developing communications and social skills as well as sensory motor development. Interventions include Speech pathology/ Speech therapy and occupational therapy.

 

As patients with an ASD often experiences challenges in different areas of communication, for some verbal communication is realistic, for others other forms of communication such as gestures or symbols. The sole aim of speech pathology/ speech therapy is to improve useful communication by establishing goals and evaluating to determine the best approach for the individual patient.

 

Occupational therapy aims to introduce new skills while maintaining and improving current skills to allow an individual to independently participate in meaningful life activities. Target areas including coping skills, fine motor skills, play skills, self-help skills, and socialisation skills.

 

Development interventions:

 

Intervention includes relationship development interventions (RDI) which comprises of six objectives:

It employs a systematic approach to build motivation and teaching skills based on the patient’s current developmental level of functioning. As the patient develops and progresses through the intervention it adds to the patient’s ability to form and maintain relationships.

 

Support:

Parents and carer’s reaction to a positive diagnosis most definitely involves the feeling of grief.  It often ranges from shock and outrage to relief that they have found an answer. Thus, it is important that parents, carer’s and the people around them seek support to aid them on the path of intervention and to improve quality of life for both patient and their carer’s.There are many support groups and services available which are willing to ease you into living with ASD. These include:

• http://www.carersnsw.org.au/ 
• http://www.autismawareness.com.au/index.php 
• http://www.autismspectrum.org.au/ 
• http://www.autismsupport.org.au/ 
• http://www.aass.org.au/ 

 

 

 

Autism Spectrum disorder – Explained

Autism spectrum disorder (ASD)characterises itself with difficulties in the domains of social interactions, communications and behaviour. It is referred to as a spectrum disorder due to the wide variety in the difficulties and challenges experienced by patients with ASD.

Prevalence

Currently 1 in 100 people in Australia have been diagnosed with autism spectrum disorder and it appears to be more in males relative to females, with males being four times more likely to be diagnosed with autism spectrum disorder.

Characteristics

The video provided is from the National centre for disabilities and explains the characteristic features of patients with ASD:

Social interactions	Communications	Behaviour
limited use and understanding of non-verbal communication such as eye gaze, facial expression and gesture difficulties forming and sustaining friendships lack of seeking to share enjoyment, interests and activities with other people difficulties with social and emotional responsiveness	delayed language development difficulties initiating and sustaining conversations stereotyped and repetitive use of language such as repeating phrases from television	unusually intense or focused interests stereotyped and repetitive body movements such as hand flapping and spinning repetitive use of objects such as repeatedly switching lights on and off or lining up toys insistence on sticking to routines such  travelling the same route home each day and doing things in exactly the same order every time unusual sensory interests such as sniffing objects or staring intently at moving objects sensory sensitivities including avoidance of everyday sounds and textures such as hair dryers, vacuum cleaners and sand intellectual impairment or learning difficulty

 

Autism involves challenges in social interactions, communication and behavioural domains. It is not considered a learning disability in itself but a separate disorder which comprises of learning disabilities.

Diagnosis:

If autism spectrum disorder is suspected it is very important that you seek a diagnosis as it often brings relief to those who have struggled with the social challenges they are facing without knowing the cause of their difficulties. A diagnosis can also open access to therapies, assistive schemes and support group that aid in improving patient function in areas of difficulty and overall quality of life.

Currently there is no single medical test that can diagnose ASD. A diagnosis is conducted by trained medical professionals who assess the social and communication skills, and their patterns of behaviour. This process often requires a multidisciplinary team of health care professionals which may include a paediatrician, psychologist, speech and language pathologist and occupational therapist.  All the diagnostic methods aim to determine if the individual meets the diagnostic criteria set out in the Diagnostic and Statistical Manual fourth edition (DSMIV) for ASD.

 

 

 

Dysgraphia – Strategies

Writing is a core skill in learning and can be debilitating to patients as it may disadvantage them from “success”. However, there are many strategies that can be employed to improve the symptoms of dysgraphia and in the individuals learning process. The most important strategy is for the patient to continual to practice hand writing and participating in writing activities at school, home or even out in the community. Strategies generally aim to aid writing practice:

1. Use paper with raised lines for a sensory guide to staying within the lines.

1. Patients with dysgraphia may have difficulty in gipping writing utensils so experiment with different pens and pencils to find one that’s most comfortable and encourage proper grip, posture and paper positioning for writing. Reinforcing aims to reduce bad writing habits.

1. Large motor movements such as practicing writing letters and numbers in the air with big arm movements to improve motor memory of these important shapes. Also practice letters and numbers with smaller hand or finger motions. This generally aims to help patients remember how to form letters.

1. Use multi-sensory techniques for learning letters, shapes and numbers. For example, speaking through motor sequences, such as “b” is “big stick down, circle away from my body.” This can also help with spelling by establishing visual, auditory and motor memory.

1. Introduce a word processor on a computer early; however do not eliminate handwriting for the child. While typing can make it easier to write by alleviating the frustration of forming letters, handwriting is a vital part of a person’s ability to function in the world.

1. To help patients organise their thoughts and ideas use the steps of the writing process “POWER”

• Plan your ideas
• Organise with idea maps and outlines
• Write your thoughts down
• Edit your own writing and then let someone else edit
• Revise your work

 

Dysgraphia – Explained

What is dysgraphia?

The act of writing requires complex set of motor and informational processing skills, dysgraphia refers to learning disabilities in writing. It can involve an individual’s ability to physically write or the person ability to transfer information and thought processes on paper. Individuals with dysgraphia may have these symptoms:

* Poor handwriting

* Trouble writing in between lines

* Trouble spelling words consistently

* Difficulty in copying information

* Difficulty in organising thoughts and expressing them on paper coherently

 

Down Syndrome – Features

Common Physical Features:

* Decreased or poor muscle tone

* Short neck, with excess skin at the back of the neck

* Flattened facial profile and nose

* Small head, ears, and mouth

* Upward slanting eyes, often with a skin fold that comes out from the upper eyelid and covers the inner corner of the eye

* White spots on the colored part of the eye

* Wide, short hands with short fingers

* A single, deep, crease across the palm of the hand

* A deep groove between the first and second toes

 

Cognitive impairment, intellectual disability and problems with learning and thinking commonly affect people with Down syndrome to varying degrees. While severe cognitive impairment is rarely seen it commonly ranges from mild to moderate.

Common cognitive and behavioral problems include: 

* Short attention span

* Poor judgment

* Impulsive behavior

* Slow learning

* Delayed language and speech development

Down Syndrome – Explained (Science)

In each cell in our body there are typically 46 chromosomes, with the DNA in our chromosomes determining how we develop. Down syndrome is a genetic condition caused when there is an extra chromosome, meaning people with Down syndrome have 47 chromosomes in each cell instead of 46. It is the most common chromosome disorder occurring at contraception, affecting over 270 babies born in Australia per year since 2007 to parents of all ethnic, social and age groups. The population of people with Down syndrome in Australia is now over 13,000.

Down syndrome is caused by a random error in cell division, leading to an extra chromosome copy of chromosome 21. When a cell divides into two, usually one pair of chromosomes goes into one cell and the other pair goes into the other cell. in Down syndrome, nondisjunction error occurs where both pairs of chromosomes go into one cell and no chromosomes go into the other cell. The error commonly and randomly occurs during the formation of an egg or sperm with no known cause, leading to all the person’s cells having three copies of chromosome 21 instead of two.  This is known as complete trisomy 21 and is the cause of 95% of Down syndrome cases. At this stage in time, no environmental or behavioural factors of parents is known to cause Down Syndrome however in more than 90% of cases the extra chromosome copy of chromosome 21 comes from the mother.  However, advancing maternal age increases risk of giving birth to a child with Down syndrome as older eggs have a greater risk of error in chromosome division.

Down syndrome is commonly recognised at birth and diagnosis is confirmed through a blood test but tests can be carried before the baby is born. After birth, Down syndrome is often suspected based on the baby’s appearance and a blood test called a chromosomal karyotype will be conducted. This test will analyse the child’s chromosomes and if an extra 21 chromosome is present in some or all cells then a diagnosis of Down syndrome is confirmed.

 

Screening tests for Down syndrome is also offered to all pregnant women in Australia and while it is not a definite diagnosis it can tell you how likely the baby has Down syndrome. In the first trimester, screening involves a blood test and an ultrasound scan and is offered while the woman is between weeks 9-13 weeks 6 days of pregnancy. The blood test measures hormone levels in the blood which change during pregnancy free B-hcG and PAPP-A, with a presence of abnormal hormone levels indicating there may be a genetic condition. During the

ultrasound, the thickness of the nuchal translucency, a pocket of fluid at the back of the baby’s neck is measured with the nuchal translucency being larger in babies with Down Syndrome. Using the blood test and ultrasound, the chance of the baby having Down syndrome is worked out.

 

References:

Morris, JK; Mutton, DE; Alberman, E (2002). “Revised estimates of the maternal age specific live birth prevalence of Down’s syndrome.”. Journal of medical screening 9 (1): 2–6. PMID 11943789

American College of Obstetricians and Gynecologists (ACOG). Screening for Fetal Chromosomal Abnormalities. ACOG Practice Bulletin, number 77, January 2007. 1. NDSS. (n.d.). Elementary & secondary education. Retrieved June 11, 2012, from http://www.ndss.org/en/Education-Development–Community-Life/Elementary–Secondary-Education [top]

Winders, P. C. (n.d.). Gross motor development and Down syndrome. Retrieved June 11, 2012, from the NDSS website: http://www.ndss.org/en/Education-Development–Community-Life/Therapies–Development/Physical–Occupational-Therapy/#gross [top]

Kumin, L. (n.d.). Speech & language skills in infants, toddlers & young children with Down syndrome. Retrieved June 11, 2012, from the NDSS website: http://www.ndss.org/en/Education-Development–Community-Life/Therapies–Development/Speech–Language-Therapy/#infants

 

 

Dyspraxia – Treatment?

There is no cure for dyspraxia but over time and with proper management options. There are therapies that help with improving motor skills that are specifically needed for everyday activities. For some children, occupational therapists assist with sensory perception skills to help with fine tuning difficult activities like walking or running in a straight line. Aids such as weighted balls or spring loaded scissors are often used to help. It is encouraged that children are consciously engaging in active play to develop control of motor skills.

A speech pathologist may assign specific exercises that involve producing different consonants, vowels, words and sentences of various lengths and complexities.

Support groups:

Australian Dyspraxia Support Group and Resource Centre

The Communication Disorders Treatment and Research Clinic

Myths about ADHD

1. Children with ADHD are hyperactive

FACT: Some children with ADHD are hyperactive but many others with attention problems are not. Children who are inattentive with ADHD may appear spacey and unmotivated.

 

2. Children with ADHD never pays attention

FACT: Children with ADHD are able to concentrate on enjoyable activities, however they have trouble maintaining focus on boring and repetitive tasks.

3. Children with ADHD could behave better if they wanted to

FACT: Children with ADHD will try to do their best to be good, but still they are unable to sit still and pay attention, however it does not mean they are being disobedient on purpose.

4. Children will eventually grow out of ADHD

FACT: Symptoms of ADHD will continue until adulthood. Treatment aims at helping child to cope and manage symptoms.

5. Medication is the best treatment for ADHD

FACT: Medication is not the first line of treatment for ADHD as it is not the best option. Effective treatment should look at your child’s behaviour and formulating techniques on how to make a child with ADHD stable.

6. Certain foods can make ADHD worse

FACT: There is little evidence that ADHD is caused or made worse by certain foods (such as food additives). Some studies had suggests that a small number of children with ADHD may benefit slightly from dietary changes, but this is not always the case.

 

 

TEDx – Overcoming Dyslexia

TEDx is a program of local, self-organized events that bring people together to share a TED-like experience. At a TEDx event, TEDTalks video and live speakers combine to spark deep discussion and connection in a small group. This was a video from TEDx Youth given by Piper Otterbein who gives a brilliant insight into the life of a young child with dyslexia!

 

Dyselxia – Explained

Dyslexia is the most common and well recognised among the ranges of specific learning disabilities.

The definition of dyslexia:

Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede the growth of vocabulary and background knowledge.

As indicated by Fletcher and colleagues (2007),

Reference: Fletcher, J. M., Lyon, G. R., Fuchs, L. S., & Barnes, M. A. (2007). Learning disabilities: From identification to intervention. New York: Guilford.)

Basically for people with dyslexia reading, spelling and pronouncing words are a challenge as they cannot decode the phonological components of words.

The first step in helping someone with dyslexia is to IDENTIFY THEM:

To help identify a person with dyslexia here are some questions that can be asked:

Does the child…

• …have difficulty learning the relationship between sounds and letters?
• …appear to forget instructions easily?
• …frequently misread/misspell commonly occurring words?
• …have difficulty reading words quickly and accurately?
• …read a word accurately on one line and then fail to recognise it further down the page?
• …have difficulty remembering how to spell words over time?
• …have difficulty applying spelling rules?
• …experience literacy difficulties that are unexpected when compared to their strengths in other academic, artistic or sporting areas?
• …often substitute words that look similar when reading?
• …have difficulty comprehending what they read because of difficulties with word recognition?
• …tire easily and become distracted especially when expected to complete literacy tasks?
• …have a family member (or family members) with reading and writing difficulties?
• …read slowly and dysfluently?
• …experience difficulty in playing with the sounds in words when rhyming, counting syllables and removing individual sounds?
• …often leave literacy tasks unfinished?
• …struggle with reading and spelling particularly in comparison with their peers?
• …put in a great deal of effort but have little to show for it?
• …not progress at the expected rate despite extra assistance?
• …struggle for no apparent reason?

If someone says Yes to many of these statements, there is a potential chance they have dyslexia and need a more thorough diagnosis.