Tag Archives: Emotional Reciprocity

Question?: What Is Autism Spectrum Disorder

Betty asks…

How will Asperger syndrome and PDD be Diagnosed in the future once the definition is Changed?

I heard that instead of 3 being diagnosed with High Functioning Autism (aspergers syndrome), PDD-NOS and Autistic disorder there will only be one type
but, what if the child have mild symptoms of Autism just like Aspergers, how will they be diagnosed? How will Aspergers syndrome and PDD-NOS be diagnosed differently under the dsm-5 if they have symptoms of an autism Spectrum disorder?

admin answers:

Actually there are currently 5 subtypes…also childhood disintegrative disorder and retts

instead of labeling by subtype–they will just use one label for all groups

Autism Spectrum Disorder

Must meet criteria A, B, C, and D:

A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:

1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction,

2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.

3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of interest in people

B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:

1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).

2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).

3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).

4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

D. Symptoms together limit and impair everyday functioning.

Aspergers and PDDNOS CAN fit into this definition….instead of listing different types—there will just be one type…they won’t be diagnosed differently.

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Question?: Pdd-nos Checklist

Linda asks…

What are signs that a child has Autism?

admin answers:

I tend to worry about checklists, because they’re often taken out of context…ie “My child flaps his hands when he’s really excited, could it be autism?” Lots of kids, and adults flap when excited. Ever watch Wheel of Fortune?

A really good website if you’re concerned is First Signs http://www.firstsigns.org/index.html

EDITED TO ADD: Another good website, with examples of what the diagnostic criteria means.. This website is great for those that don’t know much about autism. Http://www.bbbautism.com/diagnostics_psychobabble.htm

To be diagnosed with autism, a child should have a total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):

(1) qualitative impairment in social interaction, as manifested by at least two of the following:
(a) marked impairment in the use of multiple nonverbal behaviors, such as eye-to- eye gaze, facial expression, body postures, and gestures to regulate social interaction
(b) failure to develop peer relationships appropriate to developmental level
(c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
(d) lack of social or emotional reciprocity

(2) qualitative impairments in communication, as manifested by at least one of the following:
(a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
(c) stereotyped and repetitive use of language or idiosyncratic language
(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

(3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities as manifested by at least one of the following:
(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(b) apparently inflexible adherence to specific, nonfunctional routines or rituals
(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting or complex whole-body movements)
(d) persistent precoccupation with parts of objects

AND:
B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.

In a child age 16-30 months, the MCHAT is an excellent screening tool to see if you should evaluate for autism. Http://messageboards.ivillage.com/n/mb/message.asp?webtag=iv-ppautism&msg=20700.1&ctx=0

Edited to add: I have an issue with autism being diagnosed where the criteria is being disregarded. Are you using autism and pdd-nos interchangeably? If so, then I can see how it could happen. Beetlemilk, because your son’s don’t meet the criteria for autism, they’ve been diagnosed with pdd-nos. PDD-NOS is a diagnosis by exclusion. If a child presents with some symptoms from (1), (2), and/or (3), and their pattern of symptoms is not better described by one of the other PDD diagnoses (i.e., Autistic Disorder, Asperger’s Disorder, Rett’s Disorder, or Childhood Disintegrative disorder) then a professional might decide that a diagnoses of PDD-NOS is warranted.

When comparing PDD-NOS to Autism, PDD-NOS is used when a child has symptoms of autism, but not in the configuration needed for an autism diagnosis. Social component is where the most impairment is seen. Children who fail to meet criteria for autism and don’t have adequate social impairment typically have a developmental disability, and their symptoms can by accounted for by that.

Regarding the childbrain quiz, my daughter now scores around 118, and that was using the grading guide before answering each question. Without using that guide, I did score it closer to 132. Still in the moderate range, and it’s an accurate reflection. When she was younger, she did score higher. I’ve seen that to be a very good screening tool as well. One caution though, children with speech delays could fall under “mild pdd” when it’s not present. That’s why it’s important to follow up with a reputable diagnostician.

Within the autism diagnostic criteria, My daughter has the following profile From section 1 A is fairly mild, B severe, C is fairly resolved, D is mild
From section 2 A mild since language is comming in, B Severe, C moderate, D moderate
From section 3 A & B moderate…working very hard to resolve these, but her obsessive tendancies are pretty tough to crack. C & D are not issues at all, nor have they ever been issues.

Within the criteria for an autism diagnosis, her spectrum is mild to severe, depending on symptom. She’s also very high functioning (which relates more to self help skills, and IQ) I would say honestly she’s mild/moderate autistic

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Autism. Did you know?

Autism

Many of us have heard of people who appear to live in their own world, with unusual sensory interests such as sniffing objects or staring intently at moving things. We may be familiar with stories of individuals who are very good at mathematics, such as Einstein, or have other specific heightened abilities. The same people can be extremely sensitive to sensory input, causing them to avoid everyday sounds from hair dryers or other motorized machines, and certain sensations like the texture of sand. They even have intellectual impairments or learning difficulties. The term “autism” is commonly used to describe these people. In fact, Autism Spectrum Disorder includes classic autism, Asperger Syndrome and Pervasive Developmental Disorders. Each person with one of these disorders is unique and needs specific treatment. The common element among these disorders is developmental disabilities that may make these individuals have a strongly reduced capacity for social interaction, emotional reciprocity or communication and display stereotypical behaviour. The effects of an Autism Spectrum Disorder can often be minimised by early diagnosis, and with the right interventions, many children and adults with an ASD show marked improvements. Many children with autism go to school and continue on to university, work and raising a family.

Symptoms ASD

Even though people with ASD differ, they generally share three main difficulties:

1. Severe delay in social interaction, including some of the bellow –

Limited use of non-verbal communication such as eye contact, facial expressions gestures and postures.Difficulties forming and sustaining relationships due to a lack of empathy (understanding and being aware of the feelings of others).Lack of spontaneity and difficulties sharing enjoyment, interest and activities with other people.Difficulties with social and emotional responsiveness; dislike of cuddling or being touched.

2. Severe slowdown in language development and communication that occurs with:

Delayed language developmentDifficulties initiating and sustaining conversationStereotyped and repetitive use of language, i.e., repeating phrases, echolaliaLimited imagination or spontaneity characterized by a lack of make-believe play or role-play

3. Restricted, repetitive and stereotyped interests and activities, such as:

Unusually intense or focused interestsStereotyped and repetitive body movements like hand flapping and spinning obsessionsRepetitive use of objects like flicking a doll’s eyes or lining up toysAdherence to non-functional routines such as insisting on travelling the same route home each day

Diagnosis of Autistic Spectrum Disorders

To diagnose ASDs professionals administer standardised tests or questionnaires and family interviews, normally in early childhood. Families usually visit paediatric physicians when their children are infants for routine examinations. Certain behaviour may prompt doctors to perform examinations for ASDs. The important thing is that professionals work with parents in order to make a correct and timely diagnosis. Professionals should support parents so they do not feel guilty or hopeless. They must also care for the children by providing appropriate treatment to help them improve. People with ASD can have different symptoms and display very different characteristics. Early diagnosis is made by paediatricians who screen children (usually 18 months to 3 years of age), checking their developmental abilities for their age, like eye contact, language skills, gesturing, posturing, and for the presence of ritualistic behaviour/stereotypy, etc.

Autism can exist on its own or in combination with other developmental disorders like mental retardation, learning disabilities, epilepsy, deafness, blindness, etc. Cases range in a continuous spectrum from mild to more severe.

What causes ASD?

Currently, there is no single known cause for ASD, however recent research has identified strong genetic links. Other studies suggest a neurological problem that affects those parts of the brain that process language and sensory information. There may be a specific chemical imbalance of certain substances in the brain. Some genes are suspected to have links to ASD. Autism may in fact result from a combination of various causes.

Did you know…?

Autism is one of the major developmental disorders, occurring 1-2 times in every thousand children born.Autism occurs worldwide in all races, nationalities and social classes. Four out of five people with autism are male.A person with autism feels love, happiness, sadness and pain just like everyone else, but some may not express their feelings in typical ways.With early diagnosis and treatment there are always improvements that can assist individuals with autism in having jobs and families.They may have “special abilities” in music, maths, etc.

Is there any cure?

Early diagnosis that leads to early intervention can help. Every individual with ASD will make progress, although each individual’s progress will be different depending on a number of factors like developmental factors, the child’s present level of functioning and capabilities, and the type of intervention. The aim of treatment is to achieve a good quality of life and to help families identify and participate in treatment programs based on an individual child’s needs. ABA (applied behaviour analysis) and experimental behaviour analysis focus on individualized education programs including teaching social and motor skills, speech, personal care and job skills. Some common characteristics of these interventions are a 1:1 therapist-child ratio, parent counselling and education with home intervention programs, supervised school integration and social inclusion, which are useful in reducing or eliminating maladaptive behaviours. Medication is also helpful in treating some symptoms of autism or other coexistent disorders in some children.

References

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (Revised 4th ed.). Washington, DC: Author.

Cohen, D., Donnellan, A., Rhea, P. (1987). In (eds): Handbook of Autism and Pervasive Developmental Disorders. New York, Wiley.

Kaplan, H.I., & Sadock, B.J., Grebb, J.A (1994). In (eds): Kaplan & Sadock’s Synopsis of Psychiatry. 7th ed. Baltimore, MD: Williams & Wilkins, pp 1016-1154.

Rutter, M. Taylor, E., Hersov, L. (1994). Child and Adolescent Psychiatry, Blackwell, Scientific Publications (3d ed). Oxford: England.

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Criteria for Asperger Syndrome

Asperger syndrome is a neurobiological illness that is part of a set of conditions called autism spectrum disorders. The name “autism spectrum” refers to progressive disabilities that comprise autism as well as other illnesses with comparable characteristics.

What it is to know with Asperger Syndrome?

Asperger Syndrome can be known and detected in many ways. One major criterion is the patient’s qualitative impairment in social interaction. This is revealed by the use of multiple nonverbal behaviors such as eye-to-eye contact, facial expressions, body postures, and gestures to control social interaction. Other patients suffering in this disorder also fail to cultivate peer relationships fitting to their developmental levels. They also have lack of natural seeking to share enjoyment, interests, or achievements with other people and they also have the lack of social or emotional reciprocity.


How to identify if a person has Asperger Syndrome?

* Another major criterion to identify Asperger syndrome is the patient’s limited repetitive and stereotyped patterns of behavior, likes, and activities.

* Patients have encompassing obsession with stereotyped and restricted patterns of interests that is abnormal in intensity and/ or in focus.

* They also have stereotyped and repetitive motor mannerisms like hand or finger twisting and flapping and whole body complex movements.

* They also have persistent obsession with parts of objects and are apparently adherent to specific, non-functional routines.

* The Disorder also causes clinically major impairment in the community, in work and in other important areas of functioning. However, there is no delay in language of children with asperger syndrome. In example, two year olds use single words to communicate while 3 year-old use communicative phrases.

* There is also no setback in the progress of self-help abilities, adaptive behavior, and curiosity about the surroundings in childhood.

These criteria sounds like there’s a significant difference in diagnosis between Asperger syndrome and High-functioning Autism, but the truth is, in the words of Asperger syndrome expert Dr. Tony Attwood, “the difference between them is mostly in the spelling.”

This is mainly the situation as children grow up and differentiations in language ability at the age of three become extraneous. When children with Asperger Syndrome or high-functioning autism become teenagers, those distinctions have basically disappeared, making it very hard to differentiate amid the two diagnoses.

Help your Asperger child by giving them the support and love that they need!

Dr. John E. Neyman, Jr.Christian CounselorDr. John has reared 3 children, Philip, Laura, and Matthew. Dr. John has been teaching families for the last 30 years. He is a family coach that specializes in parenting. Dr. John’s motto is “Empowering parents to transform their homes.” Dr. John was a pastor for 25 years.Dr. John has been serving as a Counselor/therapist for 30 years. He is currently a Behavior Specialist Consultant and Mobile Therapist in Western PA. Dr. John also is the director /Owner of the Renewed Life Counseling Center. Dr. John is a bestselling author entitled Wake up Live the Life You love: Success and Wake up Live the Life You Love: Freedom.Dr. John has developed a strategy that parents are able to use immediately, and effectively. It is entitled Power moments with Your Children. It takes less than 1 minute to put a strategy into place. Dr. John holds degrees from Liberty University and Rochville University.Dr. John has a passion to teach principles that transforms lives. He has spoken to audiences from 4 to 4 thousand. Dr. John’s teachings are practical, pointed, and powerful.
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