Autism is the most severe disability within the spectrum of the Pervasive Developmental Disorders (disorders that can affect all areas of a person's development).
The range in this spectrum includes PDD NOS(Pervasive Developmental Disorder - Not Otherwise Specified),
Autism, Asperger's Syndrome, Rett's Disorder, and Childhood Disintegrative Disorder. There are 16 possible diagnostic characteristics, grouped into three categories: Social Interaction, Communication, Activities & Interest. If 8 of the 16 are present, the diagnosis is Autistic Disorder, if there are less than 8, the diagnosis would be PDD-NOS. ** Individuals with Aspergers tend to demonstrate better language and cognitive skills.
It is important to note that autism can co-exist with other disorders or may share common features with other conditions.
All children in this spectrum may experience some sensory integration issues, anxiety and challenging behaviors. It is also important to again note that this condition is a serious lifelong developmental disability.
A diagnosis of autism requires impairments in all of the following areas of development: ***
Communication: The impairment includes both spoken language and non-verbal skills (gestures, facial expressions and imaginative play). People with autism may have little to no verbal speech (50 %) or may have difficulty with speech production and/conversational skills.
Social Interaction: People with autism often do not relate well with other people, have difficulty learning to play with others, may not imitate well, and have difficulty learning how to respond to social games (e.g. peek-a-boo, hide and seek, etc).
Restricted Repertoire of Activities and Interests: This includes some of the unusual behaviors that are often associated with autism. Stereotyped body movements (hand flapping, toe walking), distress about changes in routines, preoccupation with parts of objects (wheels, handles etc.) and a restricted range of interests are all possible symptoms in this category.
Associated Features: Other features are associated with the disorder, and may or may not be present. These may include difficulties with eating, sleeping, toilet training, unusual fears, learning problems, repetitive behaviors, self-injury and peculiar responses to sensory input. People with autism may have any number of these associated features, and in various combinations.
Diagnosis and initial assessments are conducted in Saskatoon through the Kinsmen Children's Center by the Alvin Buckwold Child Development Program (ABCDP). This is the only referral center for Central and Northern Saskatchewan and with current resources, the team can generally assess 4 children per month. Only new referrals and crisis situations are accepted.
Typically autism is diagnosed by a team of practitioners, which can include: a family physician, developmental pediatrician, psychiatrist,
clinical psychologist, pediatric neurologist, speech and language pathologist, occupational therapist, teacher, and other related health professionals.
Additional assessments conducted either before or after diagnosis may be performed in order to develop appropriate programming.
** The Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, 1987
*** Reference: DSM III-R (1987)
Until recently, the accepted rate for autism was considered to be 10-12 in every 10,000 people (1:1000). Incidences in recent years are considered by many researchers to have doubled or quadrupled. It is generally estimated the numbers reflect up to 1 in every 500 children may be born with autism, when the complete spectrum of autism/PDD is considered, to as high as 1 in 250 (Szatmari, 1999). While this may be due in part to better diagnosis, there is general consensus that a significant increase is occurring. Although autism studies reflect an increase in the prevalence, indicators are that the ratio of males to females (3-4:1) has remained fairly constant (Bryson, 1996)
Within Saskatoon, the Alvin Buckwold Child Development Program has experienced greater than a 300% increase in the number of referrals for children with autism in the last five years. In 1996-1997, there were a total of 37 referrals. From April 1999 to March 2000, there were 120 referrals. Current statistics further reflect there are in excess of 200 children with autism between the ages of 3 and 18 years, who currently live within the Saskatoon Health District region. With approximately 10,000 births per year in Saskatchewan and an estimated incidence rate of 1:250 , it can be projected that at least 40 children born in Saskatchewan each year will be diagnosed with autism.
For most individuals with autism, there appears to be a genetic factor, as well as environmental triggers. It has been shown that people with autism have differences in brain structure and chemistry. The reasons for these differences are currently being investigated. Often, autism is accompanied by other physical symptoms, the causes of which are not yet fully understood.
While research indicates a genetic link, no gene has yet conclusively been isolated, nor any other contributing factors established with certainty. Autism may be the result of several different causes.
Myths about poor parenting that were popular in the 50' and 60's, have been disproven.
Early Intensive Intervention with a multidisciplinary approach beginning in the preschool years is considered to be the best possible treatment. The brain's neural plasticity is at it's greatest during these early years of a child's development.
Successful treatment frequently employs the professional skills of such specialists as Speech & Language Pathologists, Occupational Therapists and Behavioral Education Specialists. From the point of initial diagnosis to the implementation of child specific programs, the team may include a physician, psychiatrist, clinical psychologist, neurologist, speech/language, pathologist/therapist, developmental pediatrician, occupational therapist, teacher, teacher assistant, social worker and program facilitators trained in the field of Autism/PDD. Parents also play a great role in the success of these programs and should also be involved as much as possible.
This team approach should continue throughout the child's school years with supports phased out only as the child develops independent coping skills.
Children with autism and their families in Saskatoon (and throughout Saskatchewan) are in urgent need of improvements to their treatment and education in both their preschool and school years.
Following diagnosis, parents are frequently faced with limited, fragmented, and inconsistent treatment service with no ongoing assessments.
Limited services and programming are currently available through such agencies as: Alvin Buckwold Early Childhood Development Program, Kinsmen Children Center (KCC) Saskatoon; Autism Treatment Services of Saskatchewan (ATSS) Saskatoon; Autism Resource Centre (ARC) Regina; Community Living Division (CLD), Department of Social Services; Early Childhood Intervention Program (ECIP); Saskatchewan Association for Community Living (SACL); Saskatchewan Family Network and the respective school systems throughout the province.
While research suggests children with autism optimally require 15 to 40 hours of early intensive programming during their preschool years, children in Saskatchewan are sub-optimally treated. Many of these children have not received any service prior to entering school.
The Saskatoon and area school systems typically offer preschool with a teacher assistant at the age of three. While there are exceptional teachers and schools in the city, families continue to be confronted by a lack of staff training with respect to the affliction of autism. Children with autism benefit significantly from having a teacher assistant throughout their school years. However, there remain circumstances where parents are not aware of this opportunity. Throughout Saskatchewan, the climate for acceptance and innovative teaching of the student with autism is seen to continue to vary enormously.
Speech & Language Therapists within the Saskatoon school divisions commonly have as many as 400 children per case load. As a result, SLP services are extremely limited for children with autism who often face severe communication challenges. It is preferable these children be assessed weekly and provided with ongoing and progressive communication strategies i.e. visual strategies and social stories. With a ratio of 400:1, a student with autism may be seen approximately once every 6 weeks.
Parents who can afford private therapy are being forced to hire local professionals or are supporting the trend of accessing out-of-province experts to assess and create private programming for their children on a continuous basis. It goes without saying, that this costs a great deal and is not an option for most families in Saskatchewan.
Some families have opted to leave the province and according to a survey previously conducted by the Saskatoon Society for Autism, many more would have relocated if it were possible.
Some parents have been moved to explore and lobby for unorthodox treatments, while others are experimenting with various Pharmaceuticals, yeast free diets etc.
Although children with autism endure severe disabilities in communication and socialization and can experience overwhelming sensory and behavioral issues, they also possess encouraging and exciting potential. Most children with autism learn to display charm, love, sensitivity and humor. Many demonstrate giftedness and are keen learners when teaching and programming techniques have proven to be appropriate.
One of the primary objectives of Autism Treatment Services of Saskatchewan Inc. is to improve services to this vulnerable population. ATSS objectives include: enhanced fundraising initiatives, greater awareness & education activities, new programming initiatives and lobbying strategies involving families and related agencies.
From a recent ATSS survey, it was identified an immediate need to provide the following services:
Speech and Language Therapy
Sensory Integration-Occupational Therapy
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