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Copy of Piece of the Puzzle - Free Prezi Template

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samantha evlogimenos

on 24 September 2015

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Transcript of Copy of Piece of the Puzzle - Free Prezi Template

Autism Spectrum Disorder and
Attention- Deficit/Hyperactivity Disorder (ADHD)
How does the world feel for someone who is diagnosed with Autism?

Download this Free Prezi Template from:
Usually 1st Diagnosed in
Infancy, Childhood, or Adolescence
By: Samantha Evlogimenos, Kenneth Carrasquilo, Landon J. Woolston, Andrea Bingham, and Cinthya Cabrera

What is Autism Spectrum Disorder?
ASD-is a developmental disability that can cause significant social, communication and behavioral challenges
Autism is not a single disorder, but a spectrum of closely related disorders with a shared core of symptoms.
Associated Features Supporting ASD Diagnosis
• Intellectual Impairment and/or language impairment
• Motor deficits
o Self-injuries
o Clumsiness
o Catatonic-like motor skills
• Adolescents and Adults with ASD are prone to anxiety and depression

Associated Features Supporting ADHD Diagnoses

• Mild delays in language, motor, or social development
• Low frustration tolerance, irritability, or mood lability
• Impairment in academic and work performance
• Inattentive behaviors

What is Attention Deficit Hyperactivity Disorder (ADHD)?
Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood brain disorders and can continue through adolescence and adulthood
Culture-Related Diagnostic Issues (ASD)
Despite differing cultural norms around social interaction, individuals with autism are:
Significantly impaired against the social norms in their given cultural context.
For example, if eye contact with elders is the norm in their culture, they won’t make eye contact with elders. If eye contact is NOT the norm, they would make eye contact
Socioeconomic and/or cultural factors may prevent early recognition/diagnosis (IE late or underdiagnosis among African American children in the US)

Gender- Related Diagnostic Issues in ASD
Diagnostic Markers (ASD)
No known diagnostic (biological) markers for autism exist at this time
Although 15% of cases appear to be associated with a known genetic mutation, this is more of a risk factor than a diagnostic marker, since this single mutation may not always result in autism
Suicide Risk- ASP & ADHD
Differential Diagnosis- ASD
Rett syndrome
Selective Mutism
Language Disorders and Social (pragmatic) Communication Disorder
Intellectual Disability
Stereotypic Movement Disorder
Attention- Deficit/Hyperactivity Disorder
ASD Comorbidity
70% of individuals may have one comorbid mental disorder
40% of individuals may have two or more comorbid mental disorders
Usually associated with structural language disorder and intellectual impairment:
Developmental coordination disorder and specific learning difficulties(literacy and numeracy) are common
Medical conditions commonly associated with autism spectrum disorder:
Sleep problems
Should be noted under the “associated with a known medical or genetic condition or environmental factor” specifiers

ASD Comorbidity (cont.)
Things to look for in a nonverbal individuals with Autism Spectrum Disorder
Changes in sleeping or eating
Increases in challenging behavior

Common features
Avoident/restrictive food intake disorder and extreme and narrow food preferences are also features of autism spectrum disorder

ASD Treatment

There is no cure for autism
Treatment for Autism includes:
Treating ASD early
School based programs

ASD Treatments (cont.)
Early Intervention Programs:
According to the American Academy of Pediatrics, effective early intervention programs feature the following:
Focused and challenging learning activities adequate to developmental level for at least 25 hours per week
Small classes for individual attention and small group activities
Special trainings for parents and family members
Constant assessment of the child’s progress and adjustments of treatment plan as needed
High degree of structure, routine and visual cues
Guidance on how to maintain and how to apply skills learned to new situations

ASD Treatment (cont.)
Early Intervention Programs (cont.):
ABA – Applied Behavior Analysis
TEACCH - Treatment and Education of Autistic and related Communication handicapped Children
Interpersonal synchrony
Social skills training program

ASD Treatment (cont.)
School-Based Programs
Begin with reaching out to a representative at the child's school for an evaluation
Once evaluated, if eligible for special classes under the Disabilities Education Act (IDEA), the child must get an individualized education plan within 30 days. If not eligible, the child can still be provided free public education suited to their needs, regardless of the type of severity of disability

ASD Treatment (cont.)
At this time, the only medications the FDA has approved for treating aspects of ASD are the antipsychotics risperidone (Risperdal) and aripripazole(Abilify)
Used for their ability to treat irritability (e.g. aggression, self-harming acts, temper tantrums, etc.) in children ages 5-16 with ASD
Doctors might also prescribe “off-label” medication for children
Antipsychotic medications
Antidepressant medications
Stimulant medications

ADHD Comorbid disorders
Oppositional defiant disorder
Conduct disorder
Disruptive mood dysregulation disorder
Specific learning disorder
Anxiety disorders
Major depressive disorder
Intermittent explosive disorder
Substance use disorder
Antisocial and other personality disorders
Obsessive-compulsive disorder
Tic disorders
Autism spectrum disorder

ADHD Treatments
Education and training
Combination of treatments

ADHD Treatments (cont.)
Stimulants (methylphenidate[Ritalin] and amphetamines[Adderall]) are the most common type of medication used to treat ADHD.
Non-stimulants (atomoxetine [Strattera], guanfacine[Tenex], and clonidine[Kapvay])
-The medications come in different forms (pill, capsule, liquid, or skin patch) and come in short-acting, long-acting, or extended release varieties
-These medications activate brain circuits that support attention and focused behavior which consequently reduces hyperactivity. They could also improve physical coordination
-Concerns of using medication:
Side effects (e.g. decreased appetite, sleep problems, personality changes (“flat” or without emotion affect), or less common side effects such as repetitive movements and sounds called “tics”)

ADHD Treatments (cont.)
Behavior therapy
Social skill training
ADHD Treatments (cont.)
Education & Training:

Educating parents about ADHD
Parenting skills
Family therapy
Support groups

The End!!!

Functional Consequence ASD
In children:
hamper learning
make routine care difficult
difficulties in planning
coping with change

In adulthood:
difficulties establishing independence

In old age:
likely to impact health
ASD Prevalence
In recent years, reported frequencies for autism spectrum disorder across U.S. and non-U.S. countries have approached 1% of the population, with similar estimates in child and adult samples
Affects every 1 out of every 110 children in the United States
Ratio of males to females unchanged (4:1)
Recent studies show 1% of all 8 year olds with an ASD
Devlopment & Course (ASD)
Typically recognized during the second year of life
Some experience developmental plateaus or regression
Not a degenerate disorder, continues throughout life
Risk & Prognostics for ASD
Risk Factors:
advanced parental age,
low birth weight,
or fetal exposure to valproate
-Genetic and Physiological:
37%-90% are heritable
Prognostic Factors:
Associated intellectual disability and language impairment:
ADHD Prevalence
Occurs in about 5% of the population in most culture and about 2.5% in adults
More prevalent in males than females
Male:female ratio is 3:1 in epidemiological samples
Ranges from 3:1 - 9:1 in clinical samples
50% of children referred to mental health clinics are referred for ADHD-related problems
Annual societal cost of illness for ADHD estimated to be between $36 - 52 billion $12,005 -- $17,458 annually per individual

ADHD Development & Course
Elementary School:
Fidgetiness or an inner feeling of jitteriness, restlessness, or impatience
Risk & Prognostic Factors of ADHD
Functional Consequences of ADHD

In children:
reduce school performance and academic attainment
social rejection
higher probability of developing conduct disorder

In Adults:
poor occupational performance attainment
higher probability of unemployment
elevated interpersonal conflict
high probability of developing antisocial personality disorder and substance use disorders
traffic accidents and traffic violations

Culture-Related Diagnostic Issues in ADHD
Differences in the prevalence seen across regions is likely due to different diagnostic criteria
Cultural variations/attitudes toward children’s behaviors may also impact reporting, symptom ratings, and ultimately diagnosis
Diagnoses more frequently among Caucasians in the US than in Latino or African American populations

Gender-Related Diagnostic Issues in ADHD
ADHD diagnosed 2x more often in males than females
Females more likely to present with just inattentive features (without the hyperactivity component)

Functional Consequences of ADHD
In children:
reduce school performance and academic attainment
social rejection
higher probability of developing conduct disorder

In Adults:
poor occupational performance attainment
higher probability of unemployment
elevated interpersonal conflict
high probability of developing antisocial personality disorder and substance use
traffic accidents and traffic violations

Differential Diagnosis -ADHD
Oppositional Defiant Disorder
Intermittent Explosive Disorder
Specific Learning Disorder
Autism Spectrum Disorder
Anxiety Disorders
Depressive Disorders
Bipolar Disorder
Personality Disorder

ASD Diagnostic Criteria DSM- 5
A. Persistent deficits in Social communication and social interaction across multiple contexts:

1. Deficits in social-emotional reciprocity
2. Deficits in nonverbal communicative behaviors used for social interactions
3. Deficits in developing, maintaining, and understanding relationships
Specify current severity:
Severity is based on social communication impairments & restricted, repetitive patterns of behaviors

ASD Diagnostic Criteria (cont.)
B. Restrictive, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive motor movements, use of objects, or speech
2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior
3. Highly restricted, fixated interests that are abnormal in intensity of focus
4. Hyper-or- hyporeactivity to sensory input or unusual interest to sensory aspects of the environment.
Specify current severity:
Severity is based on social communication impairments
& restricted, repetitive behavior
ASD Diagnostic Criteria (cont.)

C. Symptoms must be present in the early developmental period

D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning

E. These disturbances are not better explained by intellectual disability or global development delay

Specify if:
With or without accompanying intellectual impairments
With or without accompanying language impairments
Associated with a known medical or genetic condition or environmental factor
Associated with another neurodevelopmental, mental, or behavioral disorder
or with catatonia

ADHD Diagnostic Criteria- DSM-5
A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interfere with functioning or development, as characteristics by (1) and/or (2):
Six (or more) of the following symptoms have persisted for at least 6 months:
a. Often fails to give close attention to details or makes careless mistakes
b. Often has difficulty sustaining attention in tasks or play
c. Often does not seem to listen when spoken to directly
d. Often does not follow through on instructions & fails to finish school work, chores, or duties in the workplace
e. Often has difficulty organizing tasks & activities
f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
g. Often loses things necessary for tasks or activities
h. Is often easily distracted by extraneous stimuli
i. Is often forgetful in daily activities
ADHD Diagnostic Criteria (cont.)
2. Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
a. Often fidgets with or taps hands or feet, or squirms in seat.
b. Often leaves seat in situations when remaining seated is expected.
c. Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
d. Often unable to play or take part in leisure activities quietly.
e. Is often "on the go" acting as if "driven by a motor".
f. Often talks excessively.
g. Often blurts out an answer before a question has been completed.
h. Often has trouble waiting his/her turn.
i. Often interrupts or intrudes on others (e.g., butts into conversations or games)
In addition, the following conditions must be met:

B. Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
C. Several inattentives or hyperactive- impulsive are present in two or more setting, (e.g., at home, school or work; with friends or relatives; in other activities).
D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
E. The symptoms do not happen only during the course of schizophrenia or another psychotic disorder. The symptoms are not better explained by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

Based on the types of symptoms, three kinds (presentations) of ADHD can occur:

Combined Presentation:
if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present for the past 6 months

Predominantly Inattentive Presentation:
if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months

edominantly Hyperactive-Impulsive Presentation:
if enough symptoms of hyperactivity-impulsivity but not inattention were present for the past six months.

Because symptoms can change over time, the presentation may change over time as well.

Specifiers for severity :
Few, if any, symptoms in excess of those required to mke the diagnosis are present, and sypmtoms result in minor impairments in social or occupational functioning.
Symptoms or functional impairment between "mild" & "severe"
symptoms are present in excess and/or particularly severe degree
Temperamental Factors:
Behaviors associated with ADHD:
reduced behavioral inhibition
effortful control, or constraint;
negative emotionality;
and/or elevated novelty seeking.

These traits may affect some children with ADHD but are not specific to the disorder

Diagnosed 4x more often in males than females
Females often show an accompanying intellectual disability or language delays
Females manifest social/communication difficulties more subtly
Without an accompanying intellectual disability, females may not always get diagnosed

Diagnostic Markers- ADHD

No known diagnostic (biological) markers for ADHD exist at this time
Some genetic risk factors do exist, but none are conclusive or specifically causal
Full transcript