Autism Spectrum Disorders in Early
Childhood:Assessment and Intervention
Dr. Gina Cosgrove-Campbell House
Brief Overview of the Current DSM-V Criteria
Important Developmental Markers and Symptoms
Assessment and Intervention Considerations
Overview of the DSM-V Criteria
Patterns of pervasive impairment across developmental
domains.
Viewed as a spectrum with varying levels of impairment
across the areas of communication, cognition,
socialization, motor and adaptive functioning. Diagnosis
based on behavioral presentation. Autism Spectrum
Disorders (ASD)
Even within the same diagnosis, profiles are
heterogeneous.
DSM-V Overview
• Social-Communication Impairments
• Patterns of Restricted and Repetitive
Behaviors/Sensory Needs
• Level of Impairment is now identified (Level 1,
Level 2, Level 3). Basically a severity scale.
• Previous categories have been taken out:
Asperger’s Syndrome, PDD-NOS. Lacked
specificity.
Etiology/Prevalence
More prevalent among males (4:1)
Organically-based disorder (disruption in the early pruning
process - “over-connected”).
Genetic Risk
Etiology Unknown, though theories are proposed including
impact of toxins in the environment, vaccines, diet, metal
exposure, fertility treatments - none have been supported by
the research.
What are the early signs?
No babbling by 12 months.
No back and forth gesturing such as pointing, showing, reaching
or waving by 12 months.
Decreased responsiveness to name.
No words by 16 months.
No two-word meaningful phrases by 24 months.
Lack of eye contact.
Failure to imitate verbal/non-verbal behaviors.
Any loss of speech, babbling or social skills.
Current Research on Eye Gaze in Infants and Toddlers (Building
Issues in Early
Identification
Child doesn’t have enough behaviors to see
abnormalities
Parents are not yet aware of how social babies are
Adults automatically “fill in” for younger children
Factors that make assessment difficult (tired,
hungry)
Don’t judge to0 quickly - but don’t miss
opportunities
Communication Patterns of Children
with ASD
Decreased initiation of meaningful language.
Conversational Difficulties - lack of reciprocity.
Repetitive/idiosyncratic language.
Odd prosody, limited integration of gestures and
eye contact.
Deficits in understanding non-verbal
communication (theory of mind).
Social Interaction Deficits
Lack of social referencing/ imitation.
Decreased joint attention/shared enjoyment.
Decreased range of affect.
Difficulties with taking the perspective of others - egocentric.
Difficulties with forming and maintaining friendships (may
prefer adults to the exclusion of his/her peers).
Appear immature, naïve, lacking social insight (“pathetically
childish”).
Yale Child Study Center - MRI imaging: Faces as Objects
Restricted Interests/ Repetitive
Behaviors
Restricted play interests, over-reliance on sensory
play.
Insistence on sameness.
Over-reliance on non-functional routines.
Obsessive areas of interest
Perseverative questioning/ restricted topics.
Inflexibility within daily situations - transitional
challenges.
Stereotyped body movements
Related Challenges
Sensory Sensitivities (tactile, auditory, visual)
Self-regulatory challenges (emotional dysregulation,
attentional needs, mood fluctuations, sleep
disturbances, selective eating patterns).
Anxiety and compulsive patterns. Generalized
Anxiety.
Hyperactivity, Inattentiveness, Impulsivity (ADHD)
Disorganization/ Motor planning weakness
Medication can be helpful in treating some of these
symptoms.
Evidence-Based Practices
Recognition that intensity and the systematic nature of the
intervention are the critical components to successful outcomes.
Importance of interpreting research (be a good consumer!)
Applied Behavioral Analysis and Discrete Trial Teaching (errorless
learning).
Augmentative Communication Supports (PECS, Devices, IPads)
TEACCH Methodology - Examples of Visual Support Systems
Relationship-Based Approaches (RDI, FloorTime)
Communicative Intent of Behavioral
Patterns-Teach Replacement
Behaviors
It’s too loud in here
I need help
Let’s Play
I need a break
This is too hard
I don’t understand