Friday, February 19, 2016

Children with Autism More Likely to Wander



A study by researchers at Cohen Children's Medical Center of New York (CCMC) suggests that more than one-quarter million school-age children with autism spectrum disorder (ASD) or other developmental disorders wander away from adult supervision each year.
More than 26% of children with special needs in the study had wandered away from a safe environment within the past 12 months, say the researchers, with public places being the most common location for it to occur. Children between the ages of 6 to 11 were more likely to wander than those ages 12 to 17.
Appearing in the online scientific journal PLOS ONE, it is the first published study to report the prevalence of elopement, or wandering, using a nationwide sample of school-age children with developmental disabilities, such as ASD, intellectual disability (ID), or developmental delay (DD).
Using data from a 2011 Centers for Disease Control and Prevention survey of parents and guardians of more than 4,000 children ages 6 to 17 with special health care needs, researchers divided the children into three groups: those with ASD only; ASD with ID and/or DD; and just ID and/or DD.
Researchers found that children with ASD (with or without associated cognitive delays) were more likely to wander off than children with cognitive impairment but no ASD. Across all groups, wanderers were more likely to not realize when they are in danger, to have difficulty distinguishing between strangers and familiar people, to show sudden mood changes, to over-react to situations and people, to get angry quickly, and to panic in new situations or if change occurs.
"The kids who are most likely to wander are the kids who are least likely to respond appropriately to police or rescue personnel – potentially further jeopardizing their safety;" added Dr. Adesman. "First responders need to recognize that children or young adults with an autism spectrum disorder may over-react to some well-intentioned interventions and may be unresponsive to simple commands or questions"
"As the prevalence of autism spectrum disorders in the United States continues to rise, there is a need to better understand the behaviors that may compromise the safety and well-being of these children," said Bridget Kiely a research assistant in the division of developmental and behavioral pediatrics at CCMC and principal investigator in the study.
In terms of prevention strategies, the researchers also found that caregivers of children with ASD and ID/DD were more likely than those in the other two groups to use fences, locks, alarms, electronic tracking devices or other measures to prevent wandering.
Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. He provides consultation services and best practice guidance to school systems, agencies, advocacy groups, and professionals on a wide variety of topics related to children and youth with autism spectrum disorders. Dr. Wilkinson is author of the award-winning books,  A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBTHe is also editor of a best-selling text in the APA School Psychology Book Series,  Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).


Thursday, February 4, 2016

Early Indicators of Autism Spectrum Disorder (ASD)

Early Indicators of Autism

It is well established that early identification and intervention are critical determinants in the course and outcome of autism spectrum disorder (ASD).  Although there are no “absolute” clinical indicators of autism, some of the early “red flags” include: • Does not smile by the age of six months • Does not respond to his or her name • Does not cry • Does not babble or use gestures by 12 months and • Does not point to objects by 12 months. Children with autism typically experience delays in speech and communication skills. Not only will they often develop spoken language later, but they are less likely to develop non-verbal communication skills such as “joint attention,” pointing, or gesturing. 
Young children with autism spectrum disorder (ASD) typically exhibit core deficits in social communication skills, particularly in the areas of joint attention, shared affect, eye-contact, conventional and symbolic gestures, and related skills in functional and symbolic play. Children seek to share attention with others spontaneously during the first year of life. “Joint attention” is an early-developing social-communicative skill in which two people (usually a young child and an adult) use gestures and gaze to share attention with respect to interesting objects or events. Before infants have developed social cognition and language, they communicate and learn new information by following the gaze of others and by using their own eye contact and gestures to show or direct the attention of the people around them. These developments in the first two years of life are potentially important early indicators of ASD which can facilitate earlier diagnosis. Researchers have identified five core deficits (‘red flags’) evident in the early years, namely gaze shifting, gaze point following, rate of communicating, joint attention and gestures; these were the strongest predictors of symptoms of autism at three years of age.
Research

Researchers in Melbourne Australia, working on a long-term study of children from eight months to seven years of age found that those with autism used fewer gestures to communicate than other kids. Parents of 1,911 children participating in the ‘Early Language in Victoria Study’ in Melbourne, Australia, completed questionnaires about their child’s development from infancy through to school age. At four years of age, a group of children identified with an autism spectrum disorder (ASD) were compared to other children from within the study; those with a developmental delay, language impairment, or typical development. Comparisons were made between the children’s early social communication skills (including eye-gaze, non-verbal communication, gesture, and speech skills) at 8 months, 1 year, and 2 years of age. By one year of age children with ASD used fewer early social communication skills than children with typical development. The only social communication skill that was found to be significantly different between children with ASD and all other children, however, was the use of gesture. Children with ASD used fewer gestures for communication than all other children at both 1 and 2 years of age.
Speech pathologist Carly Veness, who led the research, said there was a pattern of low gesture use among autistic children between the ages of eight months and two years. "We found that there was a decreased use of gestures like pointing, showing and giving,” she commented. The researchers noted that gestural deficits almost doubled the risk for ASD, pointing to the importance of targeting gesture deficits in infant early intervention approaches. They conclude that their results “… highlight the possibility of detecting risk signs for ASD as young as 12 months of age in a community sample, thus allowing for earlier recognition of the disorder.”
Veness, C., Prior, M., Bavin, E., Eadie, P., Cini, E., & Reilly, S. (2012). Early indicators of autism spectrum disorders at 12 and 24 months of age: A prospective, longitudinal comparative study. Autism, 16, 163-177.
Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. He provides consultation services and best practice guidance to school systems, agencies, advocacy groups, and professionals on a wide variety of topics related to children and youth with autism spectrum disorders. Dr. Wilkinson is author of the award-winning books,  A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBTHe is also editor of a best-selling text in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).


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