Checklist for Autism in Toddlers

Autism Info

• a developmental disorder - a condition in which there is a disturbance of some stage in a child’s typical physical and/or psychological development
• shows up in the first few years of a child’s life
• can affect childs ability to communicate, use his or her imagination, and connect with other people including parents and siblings. 
• ASD includes the following 5 diagnoses: Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder (CDD), Rett’s Disorder, and PDD-NOS (pervasive developmental disorder- not otherwise specified)
• ranges from mild to severe 
• severe or low-functioning may be unable to speak and also have mental retardation
• mild end or high-functioning may be able to function in a regular classroom and even reach the point where he or she no longer meets the criteria for autism.
• Typical children perceive a face as a whole. Our brains are not wired to register features discretely_ eyes, nose, mouth, chin, and forehead- then piece them together as if they were objects. When tested, typical children perceive faces more quickly than objects, whereas children with ASDs see faces feature by feature without compiling them into a whole. 
• eye contact is difficult for children with ASD because faces are rarely static- looking at a face maybe overwhelming. 

DSM-IV-TR Criteria for Autistic Disorder

1. A total of six or more items, with at least two from category 1.

1. Qualitative impairment in social interaction, as manifested by at least two of the following:
1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction 
2. Failure to develop peer relationships appropriate to developmental level
3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
4. Lack of social or emotional reciprocity
2. Qualitative impairments in communication as manifested by at least one of the following
1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gestures or mime)
2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others 
3. Stereotyped and repetitive use of language or idiosyncratic language
4. Lack of varied spontaneous make-believe play or social imitative play appropriate to developmental level 
3. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
3. Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole body movements)
4. Persistent preoccupation with parts of objects

1. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3: (1) social interaction, (2) language as used in social communication or (3) symbolic or imaginative play

Possible early indicators of ASD

According to the National Institute of Mental Health (NIMH), some possible early indicators of ASD include the following:

• does not babble, point, or make meaningful gestures by one year of age
• does not speak one word by 16 months
• does not combine two words by two years of age
• does not respond to his or her name
• loses language or social skills
• avoids eye contact
• doesn’t seem to know how to play with toys
• excessively lines up toys or other objects
• is attached to one particular toy or object 
• doesn’t smile
• at time seems to be hearing impaired

3 most common early symptoms of Autistic Disorder are a lack of eye contact, a lack of pointing, and a lack of responding

Standard Treatments and Interventions for ASDs

• Applied Behavior Analysis (ABA)
• pioneered by Dr. Ivar Lovaas
• based on theories of operant conditioning by B.F. Skinner
• uses different procedures to teach new skills to children
• best known one is called Discrete Trial Training- breaks down tasks into small teachable steps that children can learn more easily
• uses a reward system to motivate and reinfore children while they are learning new skills and behaviors
• no punishment is used-reward is simple with held 
• Floortime
• Also known as DIR (Developmental, Individual-Difference, Relationship Based)
• intensive one-on-one intervention that focuses on children’s individual strengths and their relationship to others. 
• individuals learn best when they are emotionally engaged
• learn building blocks of relating, communicating, and thinking
• Treatment and education of autistic and related communication handicapped children (TEACCH)
• developed 30 years ago at the University of North Carolina at Chapel Hill for the treatment of children at all points along the autistic continuum.
• core element is called Structured Teaching.
• In recognition of the significant deficits that children in the autistic spectrum demonstrate, the TEACCH program highly structures the child’s environment in order to build on strengths and minimize deficits.
• Medications
• Occupational therapy
• Pivotal response training 
• physical therapy
• sensory integration therapy
• Social Skills Training
• Speech and Language therapy
• Dietary Intervention  

Art Therapy

Art therapy is a mental health profession that uses the creative process of art making to improve and enhance the physical, mental and emotional wellbeing of individuals of all ages. It is based on the belief that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, develop interpersonal skills, manage behavior, reduce stress, increase self-esteem and self-awareness, and achieve insight. 

Art therapy is the therapeutic use of art making, within a professional relationship, by people who experience illness, trauma or challenges in living, and by people who seek personal development. Through art and reflecting on the art products and processes, people can increase awareness of self and others cope with symptoms, stress and traumatic experiences; enhance cognitive abilities; and enjoy the life-affirming pleasures of making art.  

American Art Therapy Association