Overview
Autism spectrum disorder (ASD) is a range of complex neurodevelopment disorders, characterized by difficulties in social interaction and communication and by restricted or repetitive patterns of thought and behavior.
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Diagnosis is often a multi-stage process & includes
- Clinical evaluation by a pediatric neurologist or developmental pediatrician.
- Psycho educational logical evaluation
- Hearing screening & blood workup
- Developmental checklist, Occupational & speech evaluation for therapy planning.
- Genetic, metabolic tests and MRI in selected cases.
- Social Communication Disorders
Social Communication Disorders
A communication disorder is a persistent difficulty in the ability to receive, send, process, and comprehend concepts or verbal, nonverbal and graphic symbol systems. Processes of hearing, language, and/or speech may be involved. Often confused with autism it can be differentiated by the absence of repetitive and restrictive behavior. It is diagnosed and managed by speech and language therapists.
Treatment programs for ASD
I CONNECT (Autism Intervention Therapy)-
An Individual Therapy program which includes a combination of Speech therapy, Occupational Therapy and Developmental Education, offered for 11/2 hour a day for 3, 6 or 12 months targeting speech & language and PLS (Prerequisite Learning Skills), sensorimotor issues, ADL and communication.
This is a tailor-made therapy based on the child’s needs. This therapy focuses on the wholistic development of the child and aims at making the child ready for schooling. This therapy focuses on the child’s pre-requisite skills like eye gaze, eye contact, sustained attention, joint attention, sitting tolerance & compliance. It also focuses on concept building, cognitive skills and social skill training.
COM DEALL:
A year long program which involves intensive individualized therapy in a Group Setting, 3 hours a day, 5 days a week, for 1 full year, by a team of speech therapist, occupational therapist and developmental/special educator for a maximum of 12 children in a group.
Occupational Therapy:
This therapy focuses posture correction, sensory integration, making him independent in daily activities, fine motor, gross motor, attention, body awareness.
Speech Therapy:
This therapy focuses on the development of communication in the child. Once the child can communicate verbally, they focus on the pragmatic and articulation issues that the child might have.
How to test a child with suspected ASD/SCD?
Psychological Tests-
M- CHAT
It is a screening test used for children below 3 years of age. It was published in 2009 by Diana Robins, Deborah Fein and Marianne Barton It is used for children between 16 and 36 months of age to assess risk for autism spectrum disorder (ASD). It has 2 forms: Revised and Follow-up
CARS (Childhood Autism Rating Scale
It is testing done to diagnose autism from age 3 years of age. Parents are asked questions and at the same time the child is observed.
A 15-items behavior rating scale used to diagnose Autism. It is a diagnostic assessment method that rates children on a scale of one to four for various criteria, ranging from normal to severe, and yields a composite score ranging from non-autistic to mildly autistic, moderately autistic, or severely autistic.
Areas Assessed:
- Relating to People
- Imitation
- Emotional Response
- Body Use
- Object use
- Adaptation to Change
- Visual Response
- Activity Level
- Listening Response
- Taste, Smell, and Touch Response and Use
- Fear or Nervousness
- Verbal Communication
- Non-verbal Communication
- Level and Consistency of Intellectual Response
- General Impressions
ISAA- (Indian Scale for Assessment of Autism)
It is a test developed in India for Indian population. It assesses 6 domains and is a valid measure with distinct features. Indian standardized tool made for certificate issuance of disability. It based more on observation than parent rating. Age range is 3-11 years.
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Domains assessed:
- Social Relationships and Reciprocity
- Emotional Responsiveness
- Language & Communication
- Behavior Pattern
- Sensory Aspects
- Cognitive Abilities
Com Deall Developmental checklist
Communication Dialectic and Eclectic Approach to Language Learning (Com DEALL) is a Bengaluru based trust, working on providing therapy for the wholistic development of children with ASD or other communication disorders. This assessment is done by a Psychologist, Occupational Therapist and/or Speech Therapist. The following are some of the assessment carried out her:
i. Pre-Requisite learning Skill Assessment (PLS):
To assess where the child has age appropriate eye-contact, eye-gaze, joint attention, sustained attention, sitting tolerance and compliance; which are the essentials for learning new things.
ii. Com DEALL Developmental Checklist:
It assesses the wholistic development of the child and has eight domains namely; Gross Motor, Fine Motor, Activities of Daily Living, Receptive Language, Expressive Language, Cognition, Social and Emotions.
iii. Oro-Motor Assessment:
Assesses whether a child has problems with jaw movement, tongue movement, lip movement and speech.
iv. Pragmatic Assessment:
Assesses the social usage of language and communication of a child.