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SCREENING

The American Academy of Neurology and Child Neurology Society have also produced
red flags for ASD.If any of these are present, they recommend further evaluation:
No babbling or pointing or other gesture by 12 months
No single words by 16 months
No 2-word spontaneous (not echolalic) phrases by 24 months
Loss of language or social skills at any age.
Malaysia- Modified Checklist for Autism in Toddlers (M-CHAT)

DIAGNOSIS
Diagnosis of autism spectrum disorder should be made clinically based on comprehensive
history and observation. Diagnostic tools may be used to assist in the clinical diagnosis such
as:

Autism Diagnostic Interview-Revised (ADI-R)


Autism Diagnostic Observation Schedule (ADOS)
Diagnostic Interview for Social and Communication Disorders (DISCO)
Childhood Autism Rating Scale (CARS)

PHARMACOLOGICAL INTERVENTION
Potential therapies for symptoms of inattention and hyperactivity in children with ASD
include stimulant medications (eg,methylphenidate, dextroamphetamine)
alpha-2 adrenergic agonists (eg, guanfacine), atomoxetine,
atypical antipsychotics (eg, risperidone)
anticonvulsant mood stabilizers (eg, valproic acid)
Selective serotonin reuptake inhibitor (SSRI) may be helpful if anxiety is contributing to
symptoms. SSRI also may be used for repetitive behaviors, and depression.
BEHAVIORAL AND EDUCATIONAL INTERVENTIONS

target the core symptoms ASD with an objective of improving overall function
primary component of treatment programs for ASD
The interventions typically are carried out by special education personnel or trained
therapists.

Although treatment programs for children with ASD vary, they generally focus on
similar objectives. The overarching goals of treatment are to:
Maximize functioning
Move the child toward independence
Improve the quality of life for the child and family

Specific goals are to


Improve social functioning and play skills
Improve communication skills (both functional and spontaneous)
Improve adaptive skills
Decrease nonfunctional or negative behaviors
Promote academic functioning and cognition

INTERVENTIONAL MODELS

Children with ASD generally require a combination of therapies and interventions to


address their individual constellation of symptoms.

Approaches can be broadly categorized according to conceptual models as behavioral


(eg, Applied Behavior Analysis [ABA]), Structured Teaching (eg, the Treatment and
Education of Autistic and related Communication-handicapped CHildren [TEACCH]), or
developmental/relationship-based (eg, Floortime).

However, the types of interventions provided within these programs often overlap.

Integrative programs use a combination of strategies within the treatment program


(eg, Social Communication, Emotional Regulation, Transactional Support [SCERTS]).

Parental involvement is an important aspect of the treatment program. Some


therapies may be provided in the home, and parent training may be part of the
intervention.

OTHER INTERVENTIONS

Communication interventions

Communication, speech, and language-based interventions seek to improve core


deficits in social and functional communication skills.

Social skills instruction


o

Deficits in social function are one of the core deficits of ASD, and social skills
instruction is an important component of management.

The 2009 National Autism Center's National Standards Report identified four
therapies that directly target social skills for which there is evidence of benefit
from several well-controlled studies. These include:

Joint attention interventions (eg, pointing to objects, showing, etc)

Modeling (both real-life and video-based modeling)

Peer training package (including, but not limited to peer networks, peer
initiation training, and peer-mediated social interventions)

Story-based intervention package (including the Socials Stories approach)

Occupational therapy
o

Traditional OT

Children with ASD commonly present with deficits in adaptive functioning


and fine motor skills that affect academic and everyday functioning.
Occupational therapy is often used to address these deficits.

In young children with ASD, occupational therapy usually focuses on


enhancing sensory processing, sensorimotor and social-behavioral
performance, self-care (eg, dressing, hygiene), and participation in play.

In older children the focus of occupational therapy may include social and
behavioral performance and transition to work and independence in the
community.

Sensory integration therapy

The theory of sensory integration disorder or dysfunction is based


upon the hypothesis that various sensory experiences (eg,
vestibular, proprioceptive, gravitational, tactile, visual, and auditory)
help to guide development.

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