Index of m PDFs tài liệu, giáo án, bài giảng , luận văn, luận án, đồ án, bài tập lớn về tất cả các lĩnh vực kinh tế, kin...
Trang 1Autism Spectrum Disorder (ASD) - Practice Guidelines
Kaiser Permanente NorthWest
Developmental Assessment Clinic
Mary-Lynn O’Brien, M.D and Betty Reiss, M.D
Statement of problem: Although autism had been considered a rare, untreatable psychiatric condition, recent dramatic increase in incidence and research findings compel us to become better educated on this complex disorder There is good evidence that early diagnosis and intervention will improve the outcome for affected children and their families AAP (American Academy of Pediatrics) and AAN (American Academy of Neurology) both recommend early screening for ASD, and failure-to-diagnose or delay-in-diagnosis may delay potentially helpful interventions
Recommendations: At every 18-month well-child visit, a screening tool should be utilized to assess any
early signs of autism CHAT (Checklist for Autism in Toddlers - click here to print) is the simplest to use, although others (M-CHAT and PDDST-II – available at:
http://www.firstsigns.org/pages/parent_resources/documents.html) are also effective For those who are not familiar with the management of ASD, any suspicious case should be referred to the Kaiser
Developmental Assessment Clinic
For those interested in managing the ASD, below is a brief outline of current issues:
1 Early Intervention:
Public educational services are provided by the county in which the patient resides (see numbers below), and should be contacted by the family once the suspicion of Autism has been established Intensive early educational, language and behavioral intervention during preschool years has resulted in improved outcomes for most young children with autism Early educational services should emphasize the development of social and pragmatic language skills, increase social interaction and decrease maladaptive behaviors The use of visual cues and predictable routines should be emphasized Behavioral training using behavioral management techniques should be initiated early at school and at home as well
Early Intervention Programs in Oregon:
Benton County ………… 541-967-8822 Clackamas County …… 503-675-4097 Columbia County ……… 503-397-0028 Linn County ……… 541-967-8822 Marion County ………… 800-995-6373, 503-588-5550 Multnomah County …… 503-916-5348
Polk County ……… 503-606-9901 Washington County …… 503-614-1272 Yamhill County ……… 503-472-8049
2 Laboratory and other recommendations:
serum lead
chromosomes
molecular Fragile X
hearing test
Trang 2EEG recommended with clinical seizures
Metabolic studies only if associated clinical or physical findings such as: Lethargy, hypotonia, cyclic vomiting, seizures, coarse facial features, significant loss of developmental landmarks
No clinical evidence to support the role of routine Neuro-imaging in Autism
3 Speech Therapy
Speech therapy, emphasizing the functional use of language, should be provided as a component
of EI service, and /or through Kaiser speech services
4 Medications
There is no medication for Autism Spectrum Disorder per se The purpose of medications is to help alleviate co-morbid symptoms such as sleep disorder, attention problems, and severe
aggression, which interfere with the child's development
5 Family dynamics
Divorce rate in families with autistic children is estimated at 85-90% range due to the severely strained resources and emotional trauma Siblings of autistic children often are deprived of attention Local resources for support should be sought The following are some of the
organizations and associations that have support groups for families with children with ASD See this link for list of resources
6 Complementary and Alternative Medicine
Although solid studies are lacking at this time, there is accumulating evidence that some of these may be effective The following resources are available but remember to make only one treatment change at a time, including educational and therapeutic, evaluate by selecting responses that can
be measured, and be knowledgeable about side effects
Defeat Autism Now (DAN!) Guidelines available from Autism Research Institute Cure Autism Now Foundation: www.canfoundation.org
Autism Network for Dietary Intervention: www.AutismNDI.com
Dietary: Harvard/MGH have recently started a large study to assess the possible link between the
Gastro-intestinal tract and Autism
Gluten free/casein free (GF/CF) diet has been shown to be effective in a controlled study in Europe Further research is being planned at OHSU, as well as other sites, on this For more information on dietary intervention, see www.autismNDI.com
Vitamins, Enzymes, Hormones - See www.autism.com/ari/