Autism

done by:
G. Vikraman
BOT 2nd yr
211701060
Definition:
Autism spectrum disorder, previously
known as the the pervasive developmental
disorder is a phenotypically heterogeneous
group of neurodevelopmental syndromes, with
polygenic heritability, characterized by a wide
range of impairmens in social communication
and restricted and repetitive behaviours.
— Kaplan and sadocks.
Causes:
Genetic factors:The higher concordance in
monozygotic than dizygotic twins ( 36 %
versus 0 %)
Medical causes: postnatal neurological
infections ( meningitis, encephalitis )
congenital rubella and cytomegalovirus,
phenylketonuria and rarely perinatal
asphyxia.
Psychodynamic and parental
Influence:
The parents of autistic
children intellectual,obsessive socially
reserved, cold and emotionally detached
(so called refrigerator parents)
Biomechanical factors:
1/3 of clients with autistic
disorder have elevated plasma
serotonin level, the significance of
which is unclear.
Perinatal factors:
Maternal bleeding after 1st
trimester & maconium in amniotic fluid.
Clinical features:
Behavioral:
Inappropriate social interaction poor
eye contact compulsive behaviour impulsivity
repetitive movements, self harm or persistent
repetition of words or actions
Developmental:
Learning disability or speech delay in
a child
Cognitive:
Intense interest in a limited number
things or problem paying attention.
Psychological:
Unaware of the other's emotions
or expression
Also common:
Anxiety, change in voice
sensitivity to sound.
Assessment areas:
✓ Daily living skills and
performance.
✓ play skills
✓ preacademic or readiness
skills
✓ Regulatory and sensory
processing skills.
Assessment Tools:
1. Modified Checklist for Autism in
Toodlers (MCHAT)
2. Childhood Autism Rating Scale
(CARS)
3. The First Year Inventory (FYI)
4. Gillim Autism Rating Scale (GARS)
5. Indian Scale for Assessment of
Autism (ISAA)
Goals:
The goal of therapy is to encourage
adaptive responses such as postural
reactions purposeful activities, self-
directed imitations and social interaction
neurodevelopmental therapy appears to
work best for individuals with postural
tonal and movement deficits such as
unusual weight-bearing patterns low tone
adequate postural control, reduced
movement and clumsiness.
Short term goals: Long term goals:

I. Improving eye I. Improve ADL

contact. skills.
II. Sensory issues II. Improve social

improvement. communication.
III. Improving III. Improving

attention and academic skills.

concentration.
Treatment:
Treatment is based on the
models of sensory, occupation role and
functioning, neuro developmental
therapy, sensory diet approach, social
communications approach, behaviour
modification, auditory integrative
tarining and play therapy.
Self care :
Increase independence in
performance of activities of daily living.
In adolescence increase
independence in daily living skills to
permit living in a group home.
Productivity:
In adolescence promote
vocational readiness skills.
Increase the level of play skills
from sollitary to parallel and cooperative
play computer game may be useful.
Increase home management skills
including meal preparation, shopping,
budgeting and housecleaning.
 Increase play skills by
beginning play within a familiar
environment such as the person's home
with active play partener. Few cognitive
and communication demands and
involvement of parents. Use modeling
and reinforcement techniques.
Leisure:
Explore interests that could be
development to leisure activities.
Sensorimotor:
Improve gross motor skills
through directed practice in a variety of
play activities
Improve muscle tone by
facilitating coactivation during activities
that provide vestibular input while
stopping and holding.
 Increase motor planning skills
using mazes or obstacle courses.
Improve balance reactions by
challenging the equilibrium reactions
during function activities that provide
vestibular input in which is altered by
showing down, stopping and holding.
 For hyperesponsiveness and
hyperactivity reduce environmental visual
and auditory stimuli while providing
vestibular, proprioceptive and tactile input.
Increase skills in spatial relations
and ability to negotiate space by creating
mazes for the scooter board or a navigation
pathway around the room.
 Provide vestibular
stimulation ( swinging, riding, rocking)
Increase body awareness
( proprioceptive & kinesthetic )
Decrease tactile
defensiveness ( rolling in a blanket,
swaddling)
Cognitive:
Provide directive command and repeat
them frequently to assist the person in focusing
attention on the activity or listening to
directions.
EXAMPLE: “Look at me”or “look at the picture"
Increase attending behavior and
attention span by decreasing extraneous visual
and auditory stimuli.
Psychosocial:
Increase comfort level on in
maintenance of proximity to others
Increase adaptive and copying
skills
Decrease dependence on
routines repetitive behaviors by
encouraging the person to engage in
novel behavior
 Teach relaxation techniques
and other stress reduction behaviors.
Encourage development of
social skills through games and sports.
Increase ability to take
initiative in social interaction.
Frame of reference:
 Sensoryintegration
 Behavioural therapy
 Cognitive behaviour therapy