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April 19, 2014 / 19 Nisan, 5774
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Posts Tagged ‘Executive Administration’

The New DSM-5 Definition Of Autism And Its Impact On Services

Friday, September 14th, 2012

The newest addition of the DSM-5 manual is scheduled for publication in May 2013. The DSM is used by clinicians to determine whether a client or patient meets or does not meet the criteria for a particular diagnosis.

With a new edition comes a potential new definition of autism that can be critical for many people, especially regarding funding. Psychiatrists and parents have voiced concerns that the new definition of autism in the DSM-5 will exclude many people from both a diagnosis and state services.

As with many of the disorders in the DSM-5, new diagnostic criteria and classifications are being proposed and reviewed. A new requirement for Autism Spectrum Disorder(ASD) diagnosis is that a child must exhibit symptoms from every area of the DSM diagnostic criteria.

One of the most discussed changes in the DSM-5‘s definition of ASD is the removal of Asperger’s syndrome and PDD-NOS as individual diagnoses. Under the new diagnostic criteria, Asperger’s and PDD-NOS will come under the umbrella of ASD. A child whose diagnosis is currently Asperger’s syndrome would receive a new diagnosis of Autism Spectrum Disorder, with specifiers, such as “autism spectrum disorder with fluent speech” or “autism spectrum disorder with intellectual disability.”

Who will this affect?

Tens of thousands of people receive state-backed services to help offset the disorders’ disabling effects, which include severe learning and social problems.

Parents are justifiably concerned that any tightening of the Autistic Spectrum diagnosis will threaten their children’s eligibility for vital services. The Global and Regional Asperger Syndrome Partnership has launched a campaign to lobby the DSM-5 task force to keep a broad-spectrum concept of autism. The campaign urges those affected to contact the DSM-5 Committee to protest the newest changes.

Potential consequences

The overriding concern is what these changes mean for students receiving autism services through their Individualized Education Program. For students who currently have an IEP due to a diagnosis of Asperger’s syndrome, it seems that a change in services would be unlikely, except for the possibility of services for previously unmet needs being added.

The proposed changes are significant, and will affect not only those to whom the diagnostic labels are applied, but also the funding allocation systems and service delivery systems. In the middle of all this change are the parents who are trying to determine what this means for their children.

Backlash

Debate has also been rife among medical professionals. Many divisions of the American Psychological Association have banded together to issue an open letter and petition to the DSM-5 task force and American Psychiatric Association, urging that both associations should work together on any revisions of the DSM. They also publicly oppose various aspects of the proposed changes. Their letter states, “Psychologists are not only consumers and users of the manual, but we are also producers of seminal research on DSM-defined disorder categories and their empirical correlates.”

Both the medical profession and general public have generated a frenzy of petitions and campaigns against the proposed changes to the DSM autism criteria.

The APA, meanwhile, has reassured those affected that no previously covered group will be left out in the cold. The changes would involve merging several diagnoses currently listed separately in the DSM-5 into a single umbrella category of “Autism Spectrum Disorder.”

“The proposed criteria will lead to more accurate diagnosis and will help physicians and therapists design better treatment interventions for children who suffer from ASD,” said James Scully, MD, medical director of the APA, in a release.

Neurodevelopmental Work Group member Bryan H. King, MD, believes that with the changes “we are going to be able to better characterize individuals with autism, in part because of clearer criteria that have been written to better account for people across the age span. And one could argue that this will actually make it easier for adolescents and adults, and even young children potentially, to meet criteria for diagnosis than was previously the case.”

What can I do?

Parents, caregivers and special education advocates must become knowledgeable about the proposed diagnostic revisions for Autism Spectrum Disorder and the possible effects on students receiving autism-related services. It is imperative that attention be given to the APA’s development of ASD secondary feature definitions, and the specific qualifiers that will be attached to an autism diagnosis. Becoming educated about these changes and additions is necessary so that you can be your student’s best, most effective educational and medical advocate.

Autism and the Effectiveness of Augmentative and Alternative Communication

Sunday, March 18th, 2012

Our understanding of Autism Spectrum Disorders has advanced rapidly in recent years. Autism spectrum disorders (ASDs) are a family of neurodevelopmental conditions characterized by unusual patterns in social interaction, communication, and range of interests and activities. While this profile is generally applicable for the entire ASD population, much variation actually exists. No two individuals exhibit the exact same symptoms and as such, ASD is a heterogeneous disorder.

Autism spectrum disorders can often be reliably detected by the age of 3 years, and in some cases as early as 18 months. Studies suggest that many children eventually may be accurately identified by the age of 1 year or even younger. The appearance of any of the warning signs of ASD is reason to have a child evaluated by a professional specializing in these disorders.

By age 3, most children have passed predictable milestones on the path to learning language; one of the earliest is babbling. By the first birthday, a typical toddler says words, turns when he hears his name, points when he wants a toy, and when offered something distasteful, makes it clear that the answer is “no.”

Some children diagnosed with ASD remain non-verbal throughout their lives. Some infants who later show signs of ASD coo and babble during the first few months of life, but they soon stop. Others may be delayed, developing language as late as age 5 to 9. Some children may learn to use communication systems such as pictures or sign language.

Children who do speak often use language in unusual ways. They seem unable to combine words into meaningful sentences. Some speak only single words, while others repeat the same phrase over and over. Some ASD children mimic what they hear, a condition called echolalia. Even though there are children with no ASD who go through a stage where they repeat what they hear, it usually is gone by the time they are 3.

Some mildly affected children may have minor delays in language. Some seem to be very verbal with unusually large vocabularies, but have great difficulty in sustaining a conversation. The usual “give and take” of conversation is difficult for them. They often carry on a monologue on a favorite subject, giving no one else an opportunity to comment. They have other difficulties including the inability to understand body language, tone of voice, or “phrases of speech.” Sarcastic expression might often be misinterpreted. For example, if someone tells them, “Oh, that’s just great,” they would take the words literally, believing the speaker meant to tell them that it really IS great.

The body language of ASD children is also difficult to understand. Facial expressions, movements, and gestures rarely match what they are saying. Also, their tone of voice fails to reflect their feelings. A high-pitched, sing-song, or flat, robot-like voice is common. Some children with relatively good language skills speak like little adults, and do not pick up on the “kid-talk” approach so common with their peers.

People with ASD are at a loss to let others know what they need because they cannot make understandable gestures or lack the language to ask for things. Because of this, some may simply yell or just take what they want without asking. ASD children have great difficulty learning how to get through to others and express their needs. As ASD children grow up, they become more cognizant of their difficulties in understanding others and in making themselves understood, which can result in more anxiety, depression or maladaptive behaviors.

Studies show that augmentative devices are a great help in fostering language in children with autism and other disabilities, and have achieved remarkable results.

Augmentative communication is all of the ways we communicate other than speech. It includes:  Gestures  Sign Language  Vocalizations  Facial Expression  Communication Displays (boards)  Communication Devices A group of aids, starting from simple, notebook-size plastic boxes to more high-tech devices that resemble an IPod or BlackBerry, has been developed to help those with autism to express their needs. These devices range in price from about $100 to several thousand dollars. Most are portable and the simpler ones are also very durable and well-constructed, a real advantage for children with autism.

Augmentative and alternative communication (AAC) devices are tools to allow people with severe or significant speech impairments to express themselves. These devices are used as a method to allow children to exactly say what they want and as fast as they can. It’s a valuable communicator that allows them to express their feelings, thoughts, ideas and get their needs met. These devices can range from low tech picture cards to high end speech generating devices.

However, regardless of low or high tech, the most important questions about the suitability of an AAC Device is: • can the person say precisely what they want • can they say it quickly

Printed from: http://www.jewishpress.com/sections/health/autism-and-the-effectiveness-of-augmentative-and-alternative-communication/2012/03/18/

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