Wednesday, May 27, 2009

NSSLHA Meeting Minutes April 13th, 2009

NSSLHA Meeting 4/13/2009
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Topic: AUTISM Speaker: Gwendolyn Meier
- Autism is a spectrum disorder (classic autism -→ high functioning autism -→ Asperger Syndrome)
- A behaviorally defined condition
- Neurological disorder
- Severe impairments in: socialization, communication, behavior and interests
- Need 6 symptoms from 3 categories in the Diagnostic Criteria (DSM-IV): Social interaction (2 symptoms), Communication (1), Restricted, Repetitive, & Stereotyped Behavior & Interests (1)
- Diagnosis usually happens at Regional Centers
- Kids with autism don’t play with toys in the way typical children do: they focus on a specific part of a toy, employ self-stimulatory behaviors
- Idiosyncratic use of language
- Need very structured, concrete activities
- If something unexpected happens in their schedule, they may have a tantrum
- Many will self-stimulate: touch, visual
- Core deficits in Autism: what areas you think are core deficits will determine what you treat in therapy
1.) Joint Attention – poor response to name, lack of showing and sharing; if child doesn’t follow where his/her parent is pointing to, child won’t learn what the referent is.
2.) Symbolic Skills- coming up with the concept for the language referent; symbolic skills are apparent in language and play
- Estimates of incidence of Autism has changed a lot in recent years → could be due to population growth, data collection, investigators, change of diagnostic criteria, migration to CA, change in categorization
- Estimates of incidence of Autism are: 1 in 150 (Autism Speaks, 2009)
4-5/10,000 (prior to 1985)
- Etiology and Suspect Factors: genetic link, comorbid medical issues (GI concerns, sleep problems, allergies/infections), NOT caused by parenting, multifactorial cause
- Possible Triggers: Exposure (in utero, after birth, toxins), immunologic, metabolic, MMR vaccine debate (jury is still out)
- Evolution of Treatment: 40’s and 50’s: removal from home, 60’s and 70’s: behavioral teaching/operant conditioning, controlled settings (food deprivation, aversives, poor generalization), 80’s 90’s and 00’s: “naturalistic” behavioral approaches, natural reinforcers, daily settings, motivation, self-initiation, connection between communication and problem behavior, amount and type of stimulation (debate)
- No definitive evidence for any one treatment approach over another
- SLP Assessment: standardized measures look at language FORM and elicited responses, primary deficits lie in pragmatic USE of language/FUNCTIONS, initiation, and rate of communication, few resources aid us in evaluating pre-intentional, pre-verbal, and nonverbal communication
- Visual schedules: organizes the child’s day, establish routines, predictability, expectations
- Aided language stimulation/visually cued instruction: make language input visual and intransient, provides language model
- PECS: provides means to make requests
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