AUTISM SPECTRUM DISORDER IN INFANTS AND TODDLERS

1. In cooperation with the Missouri Department of Health and Senior Services and your local public health agency Child Care Health Consultation Program AUTISM SPECTRUM DISORDERIN INFANTS AND TODDLERS

2. INTRODUCTION AUTISM SPECTRUM DISORDER

3. DEFINITION • Autism Spectrum Disorder (ASD): “a group of developmental disabilities that can cause significant social, communication and behavioral challenges”

4. ASD Facts • ASD is a developmental disability • People with ASD do not look any different than people who don’t have ASD • People with ASD may communicate, interact, behave, and learn in ways that are different from most other people

5. ASD Facts • Learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged • Some people with ASD need a lot of help in their daily lives; others need less • Many people with ASD also have different ways of learning, paying attention, or reacting to things

6. ASD facts • ASD is now diagnosis for several conditions that formerly were diagnosed separately: • Autistic disorder • Pervasive developmental disorder not otherwise specified (PDD-NOS) • Asperger syndrome These conditions are now ALL called Autism Spectrum Disorder

7. SIGNS AND SYMPTOMS Autism Spectrum Disorder

8. Signs and Symptoms of ASD • Signs may begin in early childhood • May repeat certain behaviors • May not want daily routine changed • May not point at objects of interest • May not look at objects when another person points at them • May have trouble relating to others or not have interest in other people at all

9. Signs and Symptoms of ASD • May avoid contact and want to be alone • May have trouble understanding other people’s feelings or talking about their own feelings • May prefer not to be held or cuddled, of only if they want to • May appear to be unaware of people talking to them, but respond to other sounds

10. Symptoms of ASD • May be very interested in other people, but not know how to talk, play or relate with them • May repeat of echo words or phrases said to them or repeat words or phrases in place of normal language • May have trouble expressing their needs using typical words or motions

11. Symptoms of ASD • May not play ‘pretend’ games (feeding dolls) • May repeat actions over and over again • May have trouble adapting when a routine changes • May have unusual reactions to their other senses (how things smell, taste, look, feel, sound) • May lose skills they once had (stop using words they’d been using)

12. DIAGNOSIS Autism spectrum disorder

13. How ASD is Diagnosed • There are no medical tests (bloodwork,) for diagnosing ASD • Doctors must observe a child’s behavior and development to diagnose ASD • Sometimes can be detected in children 18months and younger • Diagnosis is usually very reliable by age 2 years

14. How ASD is Diagnosed • Many children are not diagnosed until much older • This can cause a delay in getting them the help they need—the earlier the intervention, the better improvement seen in the child’s development

15. TREATMENT Autism spectrum disorder

16. How ASD is Treated • Currently there is no cure for ASD • Early intervention services help children from birth to age 3 years (36 months) • Early intervention helps these children learn important skills, such as walking, talking, and interacting with others • This is why early diagnosis is so important!

17. How ASD is Treated • Even short of a formal diagnosis for ASD, children under age 3 may be eligible for services under the Individuals with Disabilities Education Act if they are at risk for developmental delays • Treatment for particular symptoms (such as speech therapy) often does not need to wait for a formal ASD diagnosis

18. CAUSES AND RISK FACTORS Autism spectrum disorder

19. Causes and Risk Factors for ASD • All causes for ASD are not known • Factors that may make a child more likely to have an ASD include: environmental, biologic, and genetic factors • Science indicates that genetics can make some people more likely to develop ASD

20. Causes and Risk Factors for ASD • Children who have a sibling with ASD are at higher risk of also having ASD • ASD occurs more often in people with chromosomal conditions such as fragile X syndrome or tuberous sclerosis • Taking prescription drugs valproic acid and thalidomide while pregnant increases the risk of ASD

21. Causes and Risk Factors for ASD • Children born to older parents are at greater risk • Some evidence suggests that development of ASD happens during the critical period before, during and immediately after birth

22. WHO IS AFFECTED Autism spectrum disorder

23. Who is affected by ASD • ASD occurs in ALL racial, ethnic, and socioeconomic groups • ASD is four times more likely to affect boys than girls • About 1 in 59children is identified with ASD • The increase in numbers diagnosed with ASD may be due to broader definitions and better diagnosis, but a true increase in cases can’t be ruled out

24. WHAT TO DO IF YOU SUSPECT Autism spectrum disorder

25. What to Do • If there is a suspected problem with the way a child plays, learns, speaks, or acts, the parents should contact their physician

26. What to Do • The physician can refer the family to a specialist if needed. Specialists who do more in depth evaluation include: Developmental Pediatricians Child Neurologists Child Psychologists

27. What to Do • Learn how you can help identify children who could need help in their development • Watch Me! Celebrating Milestones and Sharing Concerns was developed by the Centers for Disease Control and Prevention’s “Learn the Signs. Act Early.” Program Can take four short online modules for 1 clock hour! • http://www.cdc.gov/ncbddd/watchmetraining/index.html

28. What to Do • In these modules you can learn: • How to monitor children’s development • Your role in developmental monitoring • Monitoring children as they reach certain milestones • How to talk to parents about their child’s development

29. Developmental Checklists Free developmental checklists are available at: https://www.cdc.gov/ncbddd/actearly/freematerials.html

30. RESOURCES Autism spectrum disorder

31. Resources • Some states have early childhood intervention systems which can assist families with getting evaluated. More information is available at the Early Childhood Technical Assistance Center: http://ectacenter.org/contact/619coord.asp

32. ECTA Contact for Missouri: • Ginger Henry, Part B 619 Coordinator • Department of Elementary and Secondary Education • Effective Practices Section/Office of Special Education • PO Box 480 • Jefferson City, MO 65102-0480 • Phone: (573) 751-0625 • Email: ginger.henry@dese.mo.gov • Website: http://dese.mo.gov/special-education/early-childhood-special-education

33. MDHSS—Children & Youth with Special Health Care Needs Program • The CYSHCN Program provides assistance statewide for children and youth with special health care needs from birth to age 21. The program focuses on early identification and service coordination for children and youth who meet medical eligibility guidelines. As payer of last resort, the program provides limited funding formedically necessary diagnostic and treatment services for children whose families also meet financial eligibility guidelines. Children with special health care needs are those who have, or are at increased risk for a disease, defect or medical condition that may hinder their normal physical growth and development. These children require health and related services that go beyond those required by children in general.

34. MDHSS (State Health Dept) • Special Health Care NeedsMissouri Department of Health and Senior Services PO Box 570Jefferson City, MO 65102-0570 Telephone: 573-751-6246 or(toll-free) 800-451-0669

35. Local Resources