Early Indicators of Autism in Young Children Early
- Slides: 18
Early Indicators of Autism in Young Children Early Childhood Educators of BC Provincial Conference, May 13, 2004 Pat Mirenda, Ph. D. University of British Columbia
Why Early? • Research evidence is clear – Early identification of children who are “at risk” for autism spectrum disorder (ASD) facilitates early intervention – Early intervention is essential for better outcomes
Early Identification • Firm diagnosis possible by 36 months, with indicators for concern appearing earlier • Numerous studies have examined early indicators of ASD from 1 st birthday party videotapes, parent surveys, formal test measures – Osterling & Dawson (1994) reviewed videotapes of the 1 st birthday parties of 11 children later diagnosed with ASD and 11 typically developing children • At one year of age, children with autism did less pointing, showing objects to others (joint attention), looking at others, and orienting in response to name
First Signs • A U. S. project directed toward educating pediatricians to recognize early indicators of ASD • Produced a videotape and support package for distribution to physicians • Equally relevant for early childhood educators • Videotape: “First Signs” – http: //www. firstsigns. org/index. html
Red Flags! • Relating with warmth and pleasure – Looking at faces and smiling back at others by 4 mo – No big smiles and joyful expressions by 6 mo • Back and forth vocalizations and gestures – No sharing of sounds, smiles, facial expressions by 9 mo – No responding to name when called by 12 mo – No babbling by 12 mo – No reciprocal gestures (pointing, showing, reaching, waving) by 12 mo
Red Flags! (Con’t) • Problem solving – No attempts to recreate or continue interesting displays or events, either motorically or communicatively (e. g. , asking for “more” or “help”) • Two way communication with words – No words by 16 mo – No two-word meaningful phrases (without imitating or repeating) by 24 mo – ANY loss of speech or babbling at ANY age
ASD vs. Developmental Delay • Question: is it possible to distinguish between young children at risk for ASD and those at risk for other types of developmental delays? • Answer: YES!
Wetherby, Prizant, & Hutchinson (1998) • Compared 22 children with autism (CA 17 -60 mo, mean 36 mo) and 22 children with language delays – Used the Communication and Symbolic Behavior Scales (CSBS) • Similar use of vocal/verbal communication • BUT children with autism had substantially lower scores in – Number of communicative functions – Use of communicative gestures, reciprocity (i. e. , turn taking) – Social/affective signaling, and – Symbolic behavior
Osterling, Dawson, & Munson (2002) • Examined first birthday party videotapes of 20 infants later diagnosed with ASD, 14 later diagnosed with mental retardation (MR), and 20 typically developing infants • Infants with both ASD and MR – Used gestures less often – Looked at objects held by others less often and – Engaged in repetitive motor behaviors more often than those who were typical • Infants with ASD – Looked at others less often and – Oriented to their name less often than those with MR or those who were typical
“Baby Sibling” Project • A team of Canadian researchers are following >100 infant siblings of children with ASD to look for early indicators of risk – http: //www. geocities. com/autismandpdd/Our. Studie s. him#Infant%20 Sibling%20 Study • Results to date indicate that approximately 25% of the “baby sibs” show some indication of difficulty in early development • Those with 7 or more markers are most likely be later diagnosed with ASD (not other disabilities)
“Baby Siblings” (Con’t) • The major markers are: – Failure to look at other people (i. e. , decreased eye contact) – Failure to orient to name – Reduced reciprocal social smiling – Atypical sensory behavior – Difficulty initiating visual tracking and disengaging visual attention – Difficulty with imitation and – A general lack of social interest • Screening tool in development
Screening Tools • CHAT: Checklist for Autism in Toddlers – Screening instrument for 18 -month olds, developed in the UK; 16, 235 children screened (M=18. 7 mo) – Baird, Charman, Baron-Cohen, Cox, Swettenham, Wheelwright, & Drew (2000): 6 -year follow-up to the original CHAT study: • Good specificity (proportion of children without ASD identified as normal): 97. 7% • Low sensitivity (proportion of children with ASD identified by the CHAT): 35. 1% • Low positive predictive value (proportion of children with a positive screen who had a disorder): 8. 1% for ASD; 16. 7% for all developmental disorders
Screening Tools • Also M-CHAT (Modified-CHAT): American version of the CHAT, also translated into Spanish – Good specificity (95%) – Good sensitivity (97%) – Moderate positive predictive value (36%)
Screening Tools • Communication and Symbolic Behavior Scales Infant-Toddler Checklist (Wetherby & Prizant, 2002) – http: //firstwords. fsu. edu/ – http: //www. brookespublishing. com/store/books/wet herby-csbsdp/checklist. him • Advisable to use all of these as first stage screening tools: “Is there any type of developmental delay, not necessarily autism? ”
What if Screening is Positive? • Refer family to their pediatrician • Pediatrician should refer the child for a multidisciplinary assessment • BC Autism Assessment Network (BCAAN): http: //www. phsa. ca/Patients/autism. him – – Fraser Health Authority AAN (Surrey) Interior Health AAN (Kelowna) Northern Health Authority AAN (Prince George) Vancouver Island Autism Assessment Services (Victoria) – Vancouver Coastal Health Authority AAN (Vancouver)
Standards and Guidelines • Standards and Guidelines for Assessment and Diagnosis of Young Children with Autism Spectrum Disorder in British Columbia – http: //www. healthservices. gov. bc. ca/cpa/pu blications/asd_standards_0318. pdf
The Punchline • ASD looks different in young children than in older children – More subtle – Fewer “behavior problems” and self-stimulatory behavior – More than 1 -2 signs, typically – Social relatedness and social interaction skills are the most affected • Early childhood educators have an important role to play!!!
References Baird, G. , Charman, T. , Baron-Cohen, S. , Cox, A. , Swettenham, J. , Wheelwright, S. , & Drew, A. (2000). A screening instrument for autism at 18 months of age: a 6 -year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 694 -702. Osterling, J. , & Dawson, G. (1994). Early recognition of children with autism: A study of first birthday home videotapes. Journal of Autism and Developmental Disorders, 247 -257. Robins, D. L. , Fein, D. , Barton, M. L. , & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31, 131 -144. Wetherby, A. , Prizant, B. , & Hutchinson, T. (1998). Communicative, social/affective, and symbolic profiles of toying children with autism and pervasive developmental disorders. American Journal of Speech-Language Pathology, 7, 79 -91.
- Self as context
- Working with young children chapter 1
- Unit 10 caring for children and young people
- Tscyc screening form
- Alcohol consumption causes blood vessels to contract.
- Phonemic awareness in young children
- Hampshire early years advisory team
- Early cpr and early defibrillation can: *
- What is aspergers vs autism
- The autism iceberg
- Texas autism supplement example
- Autism hos vuxna
- Autism
- Autism in america
- Fallbeskrivning autism
- Autism
- Infantile autism
- Autism lifespan
- Nourishing hope for autism