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PNB 4A03 > ASD > Flashcards

ASD Flashcards

1
Q

Autism Spectrum Disorder (ASD)

A

A developmental disability caused by differences in the brain

● Individuals with ASD may interact, behave, communicate and learn in ways that are different from others

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2
Q

ASD May experience impairments in

A

Social interactions

○ Restricted or repetitive behaviours or interests

○ Communication

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3
Q

Multi-agency service model:

A

Includes screening, assessment, resource support, and community
training

● Examples:
* Speech and language pathologist
* Occupational therapist
* Behavioural therapist
* Psychologist
* Special education training
* Early childhood educators

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4
Q

Physical exams before assessing ASD

A

EEG
* Visual
* Hearing
* Neurologic
* Genetic
* Developmental

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5
Q

How to test vision

A

Snellen letters

or

allen pictures

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6
Q

hearing testing

A

Verbal children: regular
hearing test using tones
of various frequencies

Non-verbal children:
Auditory Brainstem
Response (ABR)

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7
Q

Assesement of ASD includes

A

●Interviews with parents / other important adults

● Standardized tests

● Behavioural observations

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8
Q

diagnosis of ASD is based on

A

behavioural information

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9
Q

Challenges with testing ASD

A

Children with ASD are very hard to test

Basic deficits and dysfunctions interfere with test
performance and administration
* Social cues
* Organizing behaviour
* Language delays

Must determine very quick – the point at which the child is unable to succeed

● If the child flounders too long or is confused, it becomes impossible to reorient the child back to the test materials

● Most difficult tasks involve language and conceptual thought
○ Stressful for the child
○ Should be interspersed with other non-verbal items

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10
Q

Impediment to testing for ASD:

A

Clinicians over expectation of the child’s skills

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11
Q

How to accurately estimate starting point

Best practices

A
  • Try to start the test with a task that the child is likely to perform and have success
  • Across the session, alternate between easier and difficult tests
  • Leave some pleasurable activities on hold for use in the later part of the session – when a child gets tired or distractible
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12
Q

Language delays ?

Delays in social aspects of language

A

Prosody - rhythm and sound

○ Initiating and sustaining conversations

○ Understanding the nuances of social communication

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13
Q

Mitigating challenges - 4 options

A

Rapport

Task Presentation

Rewards and Routine

Standardization

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14
Q

mitigating challenges - establishing rapport

A

Establishing a rapport is difficult due to deficits in language

Strategies that can be used:
○ Avoid language that is too complex

○ Use short telegraphic sentences / single words
○ Prompts / exaggerated actions

○ May need to rely on child’s ability to draw from structure of the test materials

○ Ideas of Greenspan & Floortime: engage at child’s level – take direction from child and be unintrusive when forming an initial rapport

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15
Q

mitigating challenges task presentation

A

Task presentation
● How materials are organized and presented becomes important

● Any material important to the CURRENT task are on the table

● Preparation: materials introduced in a way that facilitates quick presentation

● For the hard to test: the materials can help hold interest
○ e.g. imitate the examiner placing blocks in a cup because of
interest in the activity or the effects of the activity (i.e. the sound
produced as the blocks fall into the cup)

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16
Q

mitigating challenges
rewards and routines

A

Rewards and Routine
● Prepared in advance
○ Preferred foods
○ Time with favourite toy
○ Physical stimulation (e.g. swinging)
○ Social praise
○ Tokens / exchanged for primary reward

● Thin out rate of reinforcement as session proceeds

● Reward serves as a concrete signal – where language is limited

● Establish consistent routines and visual cues identifying ”what comes next”

17
Q

mitigating challenges

standardization

A

Flexible test administration
○ Many tests designed to study preschool children have greater
flexibility

● If modifications involve adapting the test situation or the instructions of the task, it becomes reasonable to pass child on correct items

● NOTE: Any special efforts in behaviour management and
communication should be described in the evaluation report

18
Q

assessing ASD
major focus

A

– the presence or absence of expressive
language

19
Q

If expressive language is absent:
○ Examine:
how does assessment focus change

A

Level of language comprehension

■ Is there communicative intent?

■ Nonverbal communication behaviours (e.g. eye contact,
gesture, shifting of gaze, and symbolic play)

○ Assessment focus → social interactions and play behaviours

20
Q

If expressive language is present:

A

Receptive / expressive vocabulary

■ Articulation

■ Spontaneous language use

■ Prosody and pragmatic skills

21
Q

Receptive vocabulary –
Peabody Picture Vocabulary Test (PPVT)

A

Can score relatively high on receptive
language vocabulary but do more poorly on
tasks involving speech production and
sentences
word - which picture is it

22
Q

Assessing ASD play impairments

A

Shows difficulties with simple interactive play such as patty-cake or
peak-a-boo

● Reflect deficiencies in social interest and motor imitation

● Difficulties observed in imaginative or symbolic play skills

23
Q

Assessing ASD

Repetitive Restricted and Stereotyped Behaviours and Interests

A

Takes many forms including:
● Body rocking
● Flapping
● Adherence to elaborate and nonfunctional rituals, insistence on sameness
● Overly repetitive play
● Activities highly focused and idiosyncratic circumscribed interests

24
Q

assessing ASD
adaptive behavior

A

Adaptive skills
○ Functioning in social contexts
○ Toileting
○ Dressing oneself
○ Social praise
○ Ability to relate to peers, family, and others

● Information from parents & other adults
● Instruments most common – the Vineland Adaptive Behaviour Scales

25
Q

assessing ASD
academic achievement

A

Part of a comprehensive battery

● May demonstrate highly specific academic skills in the absence of related skills
○ E.g. may develop very strong decoding skills in reading but still have very limited comprehension
OR
○ Counting skills may be learned in rote fashion without
understanding of number concepts

● Do not use brief assessment – need more thorough analysis

26
Q

behavioural assessements - what is it and two purposes

what elements are we looking for

A

Systematic observation of child’s behaviour
● Two primary purposes:
1. Establish the baseline rates
2. Gather info regarding the causes

● Essential elements that we are looking out for:
○ Frequency or duration of behaviour
○ The context in which the behaviour occurs
○ Stimuli that appear to be present at onset
○ Consequences that follow the behaviour

27
Q

assessing ASD - observation schedules

A

s (e.g. a chart posted near child)
● Chart

  • Specific behaviour
  • Time of occurrence
  • Context
  • Stimuli
  • Consequences
  • Teacher’s comments concerning the circumstances of
    the behaviour

● More complex behaviour observation and coding systems require trained observers

● E.g. Lovas – method for recording behaviours of ASD children – forms basis of
Intensive Behavioural Intervention (IBI)

28
Q

autism is diagnosed BLANK

A

behaviourally

29
Q

Age most generally receive diagnosis

A

2 or 3 yrs

30
Q

Possible to identify early behavioural signs such as

A

Less looking at others

  • Responding less to name being called
  • Less reciprocal exchanges
31
Q

CARS – Childhood Autism Rating Scale

A

15 will item scale used to document social communication and
behavioural symptoms that indicate autism

● Used by clinician as part of formal assessment

examines

Relating to people
⦁ Imitation
⦁ Emotional resposnes
⦁ Body use
⦁ Object use
⦁ Adaptation to change
⦁ Visual response
⦁ Listening response
⦁ Taste, smell, and touch
response and use
⦁ Fear or nervousness
⦁ Verbal communication
⦁ Nonverbal
communication
⦁ Activity level
⦁ Level and consistency
of intellectual response
⦁ General impressions

CARS rating is based on information from a parent interview regarding
developmental history, results from other autism diagnostic
instruments, and clinical observation (3 hours)

● Evaluation ratings are only as good as the behaviour sample upon
which they are based

● Good for licensed professional with extensive experience with ASD

● BUT cannot assume that the CARS will operate in the same way
unless it is used by raters with a comparable level of training

32
Q

Autism Spectrum Rating Scales

A

Completed by parent or teacher
* 71 item questionnaire about ASD
* 2 versions (age 2-5 years & age 6-18 years)
* ASR scales
* Social communication
* Unusual behaviour
* Self regulation

  • DSM-IV Scales
  • Peer socialization
  • Adult socialization
  • Social reciprocity
  • Atypical language
  • Stereotypy
  • Behavioural rigidity
  • Sensory sensitivity
  • Attention / self-regulation

PNB 4A03 (17 decks)

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