AUTISM SPECTRUM DISORDER:

First, there is no “one treatment” that fits all, just as there is no "cure all treatment" for Autism Spectrum Disorder.   However, the good news is that there are treatments, interventions and educational approaches that may reduce some of the challenges that come with this disorder.  Treatments vary with all children according to the individuals strengths and needs and according to the Spectrum.   No one treatment helps all children; a vast amount of interventions are needed for ASD individuals.

Autism is a life long developmental disorder that typically appears in the first 3 years of life.  It is a result of a neurological disorder that affects the brain.  

It is 4 times more prevalent in boys than in girls and knows no racial, ethnic or social boundaries.   

According to the American Psychiatric Association, Autism is classified as a Pervasive Developmental Disorder.  Autism affects 1:  Language Development-They do not understand or say many words, repeat things (“echoes”) or uses third person.  2:  Social Skills- They are not interested in peers, no imitative play, poor eye contact, does not respond when spoken to, does not show/point to things.  3:  Behavior Issues- Repetitively plays with objects in a specific way, wants things be done the same way or engages in self stimulatory actions—hand flapping, staring at hands, fingers or objects or smelling things, and self injurious behaviors.   

Autistic children are quite different from each other, some are affectionate, some do have pretend play, some speak fairly well, and some do very little self-stimulating, some do have good eye contact.  This is why Autism is a Spectrum Disorder and is so unique.  I was once told autistic children are like snowflakes, because each autistic child is different in their own way, unique and special because of their differences on the spectrum.   Autism is the third most common developmental disability, more common than Down syndrome. 

Update:February 8, 2007 

See CDC Links 

"The number of children who have an autism disorder — as many as 1 in every 150 — is significantly higher than previously thought, according to a new federal report being billed as the most complete assessment to date. 

CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network released data February 8, 2007 that found about 1 in 150 8-year-old children in multiple areas of the United States had an ASD.

Down syndrome, the most commonly identified cause of mental retardation, occurs in about 1 in 800 births.  Juvenile diabetes, a common childhood disorder, occurs in about 1 in 400 to 500 children and adolescents, which is similar to the lower range of the ASD rates of 1 in 500. However, ASDs are more common than childhood cancer, which has a prevalence rate of 1.5 per 10,000 children, according to the National Cancer Institute.

Results from CDC’s ADDM Network showed the average ASD prevalence among states participating in the project was 6.7 per 1,000 children in 2000 (6 sites) and 6.6 per 1,000 in 2002 (14 sites), or approximately 1 in 150 children. Most sites identified between 5.2—7.6 per 1,000 8-year-old children with ASD in 2000 and 2002.

Using the prevalence data stated above, we can estimate that if 4 million children are born in the United States every year and assuming the prevalence rate has been constant over the past two decades, we can estimate that up to 560,000 individuals between the ages of 0 to 21 have an ASD.

In 2005, 193,637 children ages 6–21 and 30,305 children ages 3–5 were served under the “autism” classification for special education services. 

Accurate reporting of ASD prevalence can help people plan for the resources needed such as therapies, trained teachers, diagnosticians, health care providers, and related service professionals.

A recent study (Ganz 2006) indicated that the economic costs associated with autism are approximately $35 billion dollars per year; not to mention the untold challenges that families face in understanding their family member with ASD.  Precise reporting of ASDs can also lead to greater awareness, encourage commitment by service providers and researchers, and help lead the way to more effective intervention and prevention".

No specific cause is know for autism, autism is not a mental illness, children with autism do not choose to behave in this manner and it is not caused by poor parenting.   

In a “medical sense”, there is no cure, however coping mechanisms and strategies may lessen and may even remove some of the effects.  With appropriate interventions, many of the associated behaviors can be changed, to the point that the child may appear to no longer have autism, to the untrained persons eye.  As a plain old mom, who has lived it, learned it, and loved it, there is HELP. 

There is HOPE!!

APPLIED BEHAVIORAL ANALYSIS

Remember I am just a mom; in “mom terms”, ABA is Learning to Learn Again, Basic Baby Steps.  ABA is an intensive in-home mental health service/treatment (this is why insurances and state Medicaid should pay the Consultants fees to train the parents and team members).  

ABA involves breaking down all skills/tasks into discrete trials or small baby steps.  Each skill/task is taught in a highly sequenced, structured manner and environment.  A reward or reinforcer is given for appropriate and correct behaviors and responses.  Prompts, cues and modeling are some of the techniques used to teach each skill/task.  

Each ABA program is intensively individualized to each child and each child’s strengths and weaknesses.  It is recommended for an ABA program to be effective; that a child needs to receive between 20 and 35 hours a week of service, again this is according the child and the child’s strengths and weaknesses. 

Families hire between 3-5 team members to complete these hours and the parents provide services also.   Team members are trained with entire consistency of the entire group; this is why it is so intensive.  No differences, all must be the same.  Ex: Some people say Kleenex, some people, say tissue.  Some people say, please at the beginning of their statements, some say the statement first and end with, please.   It has to be that consistent and precise, to work. 

Skills/tasks are taught in a certain manner, an autistic child needs to master the skill/task 8/10 trials/times to prove he/she had retained the skill/task.  The child also has to be able to do the same skill/task in different contexts, environments and with different people or caregivers.  Ex: just because a child can say his/her ABC’s in the home does not mean a child can say them at school, or in the park.  A child might know the color red in the shape of a red circle, but can the child identify red, as in a red apple, a red car, red paint, or a red square. 

After the child can perform all of the different skills/tasks in a different manner with consistency the skill/task is considered retained only after 6 months and then the child still after six months needs to be able to perform that skill/task on comand again for the next 6 months on a weekly basis, with 8/10 trials/times. 

Documentation is extremely important to track the retention of the skill/task.   

(((Some helpful books are Behavioral Intervention For Young Children by Catherine Maurice and Let Me Hear You Voice, also by Maurice; A Work In Progress by Ron Leaf and John Mc Eachin; BIFYC by Maurice is what some ABA Consultants refer to as the “ABA Bible”, many will ask if you have it and require you to purchase it, be aware it about $50.00))) (I hope this all makes some sense, remember I am only a mom)

Dr. O. Ivar Lovaas from UCLA has reported (1987) that approximately 50% of intensively treated young autistic children have been able to reach (normal) (no-handi-capped) levels of functioning with ABA when training is applied early and intensively.  It is known now that if ABA is started at an early age and continued, through ages 2-5 years a child can have all prompts and NO special Para’s at school by age 7. 

WOW!  That is my goal for Kane!!!!!We need ABA Preschools for age’s 2 through school age children, to give these children a chance, which they deserve.  The need is there or there would not be excessive waiting lists.  Staff ratio needs to be acceptable, training and education is necessary.  We need to have qualified, sequenced, structured, visual and tactile preschools, with adequate staff ratio per child and their needs. 

Autistic children are very intelligent and have unbelievable abilities, if are given the chance. They need to be taught in a different manner than “typical” children. In our small little town, we do not have that… we do have an appropriate ABA structured “special needs” Preschool, 11 miles away from us, in a different school district.  We found out, there is a “regulation” that prohibits families from opting in to a different school district other than the district the family resides in.  (because of the long, long waiting lists)  THIS ONLY APPLIES TO “SPEICAL NEEDS” PRESCHOOLS.

When the child reaches kindergarten age, the family then can opt into any district they do not reside in.  Right now, is of importance, preschool age is the time when these children need to Learn to Learn, the Basic Baby Steps, not in kindergarten, these skills need to prepare them for kindergarten and follow them years down the road.  Waiting until kindergarten can affect the social, emotional and educational issues that are a struggle for these children already, not having the opportunity to get to know their peers before kindergarten.  The best outcome is at the earliest age possible, to start teaching and peer interactions.   

Many children not only autistic children would and can benefit from an ABA approach in a preschool.  Children that are “special” and that are speech, motor, physical, behavioral and socially impaired can also benefit from this approach.  Many Preschools and Schools do not understand this concept, are not trained appropriately, and cannot afford this intervention.  Preschools and schools need to work closely with parents and ABA team consultants and team members to HELP these bright children.  Preschools and schools need to use and be trained with this technique if they are going to work effectively with autistic children. 

Some of the simplest things for you and me to accomplish are so difficult for autistic children.  In my opinion as a mother, of an autistic preschooler, preschools need to have 1:  Communication, Choice and Needs Skills:  Calmly rejecting, saying “NO”, asking for help, “YES response to simple instructions, imitating sounds, words and songs.  2:  Social Interaction Skills:  Imitating adults and peers, responding to greetings, maintaining social approaches with adults and peers, initiating social interactions with adults and peers.  3:  Alternatives to Inappropriate Behavior Skills:  Wait, help, no, stop, learning to play, controlling self-stimulations.  4:  Domestic Skills:  Eating with a group appropriately, cleaning ones self and the environment, and play routines.  5:  School Based Skills:  Staying with a group, staying seated by self, peers and adults, following directions, transitioning between activities and locations, group and individual play routines, academic activities.  6:  Community Skills:  Eating appropriately in public, walking, shopping for daily essentials, appropriate dress for seasonal and public appearance, appropriate behaviors in public settings.