Objectives: (Based on article in Journal of Autism and Developmental

Disorders Vol. 29, No. 6, 1999, pp. 439-484)

  1. Present new status of diagnosis of Autism to elementary teachers.

2. Show how The Moore Formula may work with the new diagnosis.

 I. Characteristics of Autistic Children--Three domains effected (Table #1a)

  A. Deficits in reciprocal social interactions.

B. Deficits in verbal and nonverbal communication.

C. Restrictive and repetitive behaviors or interests.

 II. Diagnosis and Differential Diagnoses (Table # 1b)

A. Level One: Routine Developmental Surveillance by Infant and Child Contact

 1. Indications for screening examinations.

 a. No babbling by 12 months of age.

b. No pointing or other gesturing by 12 months of age.

c. No single words by 16 months of age.

d. No two-word spontaneous phrases by 24 months of age.

e. Any loss of language or social skills at any age.

 2. Screening instruments for Autism

 a. Laboratory Investigation-Pediatric Audiometric Assessment

 b. Specific screening tests--PEDS, CHAT, PDDST-Stage I, Asperger's Screen

 B. Level II: Infant or child determined positive for Autism by the screening

tests listed above are referred for definitive diagnosis to Early

Intervention if under 36 months of age or to the local school district

if older (Public Laws 99-457 and 105-17: Individuals with

Disabilities Education Act-IDEA (1997)

 1. Formal Diagnostic Procedures to be done only by those who have had

professional training in evaluating Autism.

 a. Interview instruments

 b. Observation instruments

 c. Clinical Diagnosis based on the results of testing in item b above and the

diagnostic criteria for Autistic Disorder in Diagnostic and Statistical

Manual of Mental Disorders (4th Ed., pp 70-71), Wash. DC:

American Psychiatric Association, 1994. (Handout #1a)

 2. Determine Developmental Profile (Table #2a)

a. Speech-Language-Communication Evaluation--Table V

b. Cognitive & Adaptive Behavior Evaluation--Table VI, The Vineland

Adaptive Behavior Scales, The Scales of Independent Behavior-Revised

c. Sensorimotor Assessments by Occupational and Physical therapists.

d. Assessment of Family Resources

e. Neuropsychological, Behavioral & Academic Assessments

 3. Metabolic & Genetic Testing is still in research phase. Metabolic testing is

done with histories of lethargy, cyclic vomiting, mental retardation and

births outside the US. Genetic testing is done if there is a history of genetic

disease such as Fragile X or undiagnosed mental retardation. Genetic

counseling is recommended for those with one autistic child--there is a 50

fold risk for a second autistic child.

C. Differential Diagnosis or Comorbid disorders

III. Prevalence: Depends on diagnostic criteria used.

A. Prevalence of Autism (Table #2b)

B. Diagnosis of 'Autism' vs 'PDD' (Table # 2b)

C. Host Characteristics

1. Males:Female Ratio= 4:1

2. Includes many past medically and educationally diagnosed individuals as

ADD, ADHD, CDD, Learning Disabled, etc.

3. More common in siblings of diagnosed cases.

 IV. Etiology--Unknown, but thought to be combination of sub-disorders each

having its own cause or causes effecting the nervous system.

 V. Treatment

 A. No medications except Risperal or other tranquilizers for aggression.

B. Educational and Behavioral best--age appropriate intensive instruction in

speech, language and communication. Behavioral modification for social

and motor movement skills.

 VI. Discussion

A. Relationship of methods of diagnosis to results. (Table #3)

B. Best method of education for Autistic children--two schools of thought--

Whole Language approach ( consistent with the Moore Formula) vs. isolated

skills taught out of context with the environment.

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