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This book surveys autism care, covering long-term outcomes, home and class strategies, parent resilience training, pharmacological management, treatment assessment, best practices and more. Profiles such programs as Early Start, TEACCH, PROGress and others.

Background: Autism spectrum disorder is a complex heterogeneous condition that is characterized by impairments in social interaction, communication, and behavior which mostly co-exists with several comorbidities. The current prevalence of autism spectrum disorder in the general population is estimated to be 1 in 68 children. Despite significant advances in research and multiple treatment options, the management of the disease remains poor. Although there are governmental services and few non-governmental organizations working for individuals with autism, there is no official data available regarding the incidence and prevalence of autism in Malta. ; Methods: This study focuses on the need of increasing awareness for autism spectrum disorder in Malta among the general public and health care professionals which would benefit a better understanding of the disorder for early diagnosis and more effective treatments. This was best provided through questionnaires. ; Results: Our survey revealed that only a limited percentage of the Maltese population had some knowledge about the symptoms, age of onset, potential causes of the disease and treatment options for autism. ; Conclusion: There is an immense need for improvement regarding the awareness of autism in Malta to estimate the exact burden of the disorder and make the latest diagnostic and treatment options available to the people living with this disease on the island. ; peer-reviewed

PharmD ; Risperidone and aripiprazole (RiAr) are the only approved drugs by the FDA for the treatment of irritability associated with Autism Spectrum Disorder (ASD) in children and adolescents. The regulatory bodies in Europe (European Medicines Agency) and India (The Central Drugs Standard Control Organization) have not approved the drugs for the indication of ASD. Cultural, economic and regulatory variations may impact the approach towards the treatment of ASD in India and Malta. The objectives of the research are to 1) develop and administer a questionnaire to psychiatrists in India and Malta 2) evaluate and compare the accessibility and affordability of RiAr and 3) detect adverse drug reactions (ADRs) not listed in the approved Summary of Product Characteristics (SmPC) in children and adolescents treated with RiAr for ASD through Eudravigilance. The methodology included 1) a questionnaire, entitled ASD-Q (IND-MT) which was developed, validated (by 10 experts) and disseminated to psychiatrists (N=47) in India (n=31) and Malta (n=16). ASD-Q(IND-MT) consisted of 6 sections and 28 close ended Likert scale questions ranging from 1 (strongly disagree) to 5 (strongly agree) and gathered opinions on the perception of ASD, influence of culturally developed screening tools, Childhood Autism Rating Scale (CARS) in Malta and the Indian Scale of Assessment (ISAA) in India, prescribing behaviour of RiAr and role of pharmacists in managing ASD, 2) a comparison of the price of RiAr against the Monthly Per Capita Expenditure (MPCE) in India and Malta to obtain an indication of the affordability of the treatment, 3) Eudravigilance signal detection and French causality assessment was carried out and ADRs received duringNovember 2001 to September 2017 were extracted in the age group 6-17 years (risperidone) and 5-16 years (aripiprazole). Statistical analysis of the ASD-Q (IND-MT) indicated a significant difference (p<0.05) between the prescribing behaviour of RiAr. A significant difference (p=0.040) was noted between the psychiatrists when asked about the interpretation of the screening tools (ISAA/CARS) score. Thirteen Indian psychiatrists out of 31 and 2 Maltese psychiatrists out of 16 agreed that they prescribe RiAr to patients with mild to moderate autism. Eighteen Indian psychiatrists out of 31 and 14 Maltese psychiatrists out of 16 agreed that they would prescribe antipsychotics to patients who have severe autism. A statistically significant difference (p<0.001) is noted between psychiatrists when asked about the influence of screening tools (ISAA/CARS) on the prescribing behaviour of antipsychotics. The Likert mean score was 4.45±0.506 by Indian psychiatrists and 2.56±1.153 by Maltese psychiatrists indicating higher agreement by the Indian psychiatrists. The Cost analysis of RiAr revealed that RiAr would cost €3.5 and €3.9 in India and €26.7 and €28.8 in Malta monthly. The percentage of MPCE required for one month of treatment with RiAr is 11.30% and 12.60% in India and 3.30% and 3.56% in Malta respectively. Five ADR signals were assessed for risperidone and three signals for aripiprazole. The French causality assessment concluded "uncertain" or "unlikely" relation between the ADR signals and the drugs. Culturally developed screening tools have a different influence on the prescribing behaviour of drugs in India and Malta. The cost of medicines is low in India compared to Malta but the treatment is more affordable in Malta. The SmPC of RiAr includes all the ADRs indicated through the EudraVigilance signal detection in this study. ; N/A

This manual is a user-friendly, comprehensive description of the Center for Autism and Related Disorders (CARD) model of autism treatment-the latest scientific information on what truly works in treating autism in an integrated, organized, consumable format. The book details effective early behavioral intervention, covering topics such as challenging behavior, visual modification, parental involvement, improving language, cognition, and social skills, and ends with a section that explains how all of the treatments can be put together in real-life service provision organizations. The CARD mode

Intro -- AUTISM SPECTRUM DISORDERS: GUIDANCE, RESEARCHAND FEDERAL ACTIVITY -- CONTENTS -- PREFACE -- Chapter 1 A PARENT'S GUIDE TO AUTISM SPECTRUM DISORDER -- WHAT IS AUTISM SPECTRUM DISORDER (ASD)? -- WHAT ARE THE SYMPTOMS OF ASD? -- Social Impairment -- Communication Issues -- Repetitive and Stereotyped Behaviors -- Related Disorders -- HOW IS ASD DIAGNOSED? -- Screening -- Comprehensive Diagnostic Evaluation -- WHAT ARE SOME OTHER CONDITIONS THAT CHILDREN WITHASD MAY HAVE? -- Sensory Problems -- Sleep Problems -- Intellectual Disability -- Seizures -- Fragile X Syndrome -- Tuberous Sclerosis -- Gastrointestinal Problems -- Co-occurring Mental Disorders -- HOW IS ASD TREATED? -- Early Intervention -- AUTISM SPECTRUM DISORDERS: GUIDANCE, RESEARCH AND FEDERAL ACTIVITY -- Working with Your Child's School -- Medications -- HOW COMMON IS ASD? -- WHAT CAUSES ASD? -- Genetic Factors -- Environmental Factors -- ASD and Vaccines -- WHAT EFFORTS ARE UNDER WAY TO IMPROVE THE DETECTION AND TREATMENT OF ASD? -- HOW CAN I HELP A CHILD WHO HAS ASD? -- Understanding Teens with ASD -- Preparing for Your Child's Transition to Adulthood -- Living Arrangements for Adults with ASD -- CITATIONS -- Chapter 2 AUTISM PREVALENCE: MORE AFFECTED OR MORE DETECTED? -- REFERENCES -- Chapter 3 PREVALENCE OF AUTISM SPECTRUM DISORDERS: AUTISM AND DEVELOPMENTAL DISABILITIES MONITORING NETWORK, 14 SITES, UNITED STATES, 2008 -- ABSTRACT -- INTRODUCTION -- METHODS -- Study Sites -- Case Ascertainment -- Descriptive Characteristics -- Quality Assurance -- Analytic Methods -- Evaluation Methods -- RESULTS -- Overall ASD Prevalence Estimates -- Prevalence by Sex and Race/Ethnicity -- Previously Documented ASD Classification -- Special Education Eligibility -- Intellectual Ability -- Evaluation of Missing Records and Expanded ICD-9 Codes

Front Cover -- BIOMETALS IN AUTISM SPECTRUM DISORDERS -- BIOMETALS IN AUTISM SPECTRUM DISORDERS -- Copyright -- Contents -- Preface -- References -- Acknowledgments -- 1 - Introduction to metallomics: the science of biometals -- Introduction to metallomics -- The metal composition of our body -- Metals in the central nervous system -- References -- 2 - Measuring biometals -- Measuring metals -- Measuring metals in biomedical research and the clinics -- Detecting metal deficiencies -- Measuring zinc -- References -- 3 - The history of metals in autism spectrum disorders -- The history of autism spectrum disorders -- The history of metal abnormalities in autism spectrum disorders-heavy metal pollution -- Lead -- Mercury -- Mercury and vaccination -- Cadmium -- The history of metal abnormalities in autism spectrum disorders-dyshomeostasis of essential metals -- Iron -- Zinc -- Copper -- Other essential metals -- References -- 4 - Essential trace metals and their function in brain development -- Trace metals in brain development and function -- The role of iron in brain development and function -- The role of zinc in brain development and function -- The role of copper in brain development and function -- The role of manganese, cobalt, and molybdenum in brain development and function -- Conclusions -- References -- 5 - Nonessential metals and their brain pathology -- Pathology of toxic metals -- Neurotoxicity of lead -- Neurotoxicity of mercury -- Neurotoxicity of cadmium -- Pathomechanisms of toxic metals in autism spectrum disorder -- Competition with essential metals -- Oxidative stress and lipid peroxidation -- Mitochondrial dysfunction -- Neuroinflammation and gliosis -- Axonal demyelination -- Conclusions -- References -- 6 - Biometals and nutrition in autism spectrum disorders -- Absorption and transport of metals -- Iron -- Zinc -- Copper.

"Danksagung" -- "Inhalt" -- "Abbildungsverzeichnis" -- "Vorwort der Herausgeberinnen und Herausgeber der Schriftenreihe" -- "Vorwort von Klaus Grunwald" -- "1 Ausgangslage und einleitende Worte" -- "2 Menschen mit Autismus und deren Besonderheiten als Rezipient_innen der Umwelt" -- "2.1 Darstellung der Autismus-Spektrum-Störungen" -- "2.1.1 Historie des Störungsbildes Autismus" -- "2.1.2 Diagnostik von Autismus-Spektrum-Störungen" -- "2.1.3 Spezifische psychiatrisch-neurologische Erklärungsansätze" -- "2.1.3.1 Spiegelneuronen" -- "2.1.3.2 Theory of Mind" -- "2.1.3.3 Exekutive Dysfunktion" -- "2.1.3.4 Schwache zentrale Kohärenz" -- "2.1.3.5 Komorbiditäten" -- "2.2 Therapeutische und methodische Interventionen der Sozialen Arbeit" -- "2.2.1 Applied Behavior Analysis" -- "2.2.2 TEACCH" -- "2.2.3 Soziales-Kompetenz-Training" -- "2.2.4 Weitere Methoden und Techniken" -- "2.3 Autismus als Wahrnehmungs- und Informationsverarbeitungsstörung" -- "2.3.1 Wahrnehmung und Wahrnehmungsverarbeitung" -- "2.3.2 Folgen für das Erleben von Menschen mit Autismus" -- "3 Lebensweltorientierte Soziale Arbeit" -- "3.1 Philosophische und soziologische Wurzeln der Lebensweltorientierten Sozialen Arbeit" -- "3.1.1 Philosophische Wurzeln" -- "3.1.1.1 Phänomenologie" -- "3.1.1.2 Hermeneutik" -- "3.1.1.3 Kritische Theorie/Dialektik" -- "3.1.2 Soziologische Wurzeln" -- "3.1.2.1 Symbolischer Interaktionismus" -- "3.1.2.2 Intersubjektivität und Alltagswissen" -- "3.1.2.3 Soziale Interaktion als Theater/Totale Institutionen" -- "3.1.2.4 Ökonomisches, kulturelles, symbolisches und soziales Kapital/Habitus/Feld/Sozialer Raum" -- "3.2 Darstellung der Hauptbegriffe der Lebensweltorientierten Sozialen Arbeit in deren philosophisch-soziologischen Traditionen" -- "3.2.1 Alltag und Lebenswelt" -- "3.2.1.1 Lebenswelt" -- "3.2.1.2 Alltag" -- "3.2.2 Anerkennung

Purpose
– Studies have found innate vulnerabilities which potentially may increase the risk of an individual with autism spectrum disorders (ASD) finding themselves involved with the criminal justice system as a result of being charged with a sexual offence. The purpose of this paper is to evaluate the literature which has explored sexual offending in individuals with ASD.


Design/methodology/approach
– A systematic PRISMA review (PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted using internet-based bibliographic databases (PsycINFO, MEDLINE, Psychology and Behavioural Sciences Collection and PsycARTICLES) in order to access studies which investigated to any degree the association between ASD and sexual offending.


Findings
– Only a small number of case reports (n=7) on sexual offending in individuals with ASD and a small number of prevalence studies (n=7) were identified.


Research limitations/implications
– Research is urgently required to identify the specific requirements and needs of sexual offenders with ASD in order to inform an appropriate treatment strategy for successful outcomes.


Originality/value
– Relatively few studies and reviews have investigated the area of ASD and sexual offending specifically.

It is estimated 15% of adults worldwide have a disability (Hughes et al, 2012), with Autism Spectrum Disorders (ASD), affecting an estimated 1.1% of the adult population in England (Brugha et al, 2012). This article offers a perspective from the United Kingdom (UK), where there is significant legislation in place relating to ASD and other disabilities that are aimed age equality, inclusion and protection of rights as citizens. This article is to be published in Advances in Autism http://www.emeraldinsight.com/loi/aia

In Brazil, in spite of over half a million students with special needs in primary education, little research has been conducted about ASD diagnostic practices. This involves learning about the training that professionals are receiving, what diagnostic practices are being implemented on the field, and whether those are being contextualized according to the Brazilian culture. Students with special needs are directly affected by the results of diagnostic practices, since identifying the individuals is one of the first steps. Lack of understanding about that stage may lead to the problematic realities of underidentification or overidentification, exclusion of children who should receive that special intervention and inclusion of some who do not need them. Precision in diagnosis, that considers cultural factors, is a highly desired and continuous goal for special educators. Therefore, students with ASD are directly affected by the results of this research. The purpose of this study is 1) to determine the knowledge and training of professionals that diagnose Autism Spectrum Disorder in Brazil (Audiologists, Neurologists, Pediatricians, Psychologists, Psychiatrists, and others), 2) to determine if those professionals are using diagnostic practices similar to the US, 3) to investigate which procedures and instruments are used in the diagnosis of a child suspected of having an Autism Spectrum Disorder in Brazil; and 4) to determine what happens after diagnosis. This research can be placed within the context of studies focused on three complementary areas: conceptual, historical, and cross-cultural. The first area is related to the overall conceptual understanding of cultural factors in the diagnosis of ASD. The second one considers the historical influences in the diagnostic practices of children with ASD in Brazil, including government policies. The last one adopts a cross-cultural approach to the study of autism with emphasis on comparative studies. The survey instrument specifically designed for this study is The Autism Spectrum Disorders Assessment Survey comprised of thirteen questions (single and multiple choice items, and Likert-type items) designed to collect information in regards to demographic characteristics of the participant, description of the diagnostic team, procedures, instruments used for diagnosis, and knowledge about characteristics necessary to identify a child as having an ASD. The survey received 236 responses from professionals that diagnose Autism Spectrum Disorders from every state and the Federal District in Brazil. The results of this research suggest the need to invest in the training of professionals. Another related suggestion is to develop specific criteria and common diagnostic protocol for professionals in Brazil. Finally, providing access to inclusive education to people with autism would also provide them a more adequate opportunity for development.

In Brazil, in spite of over half a million students with special needs in primary education, little research has been conducted about ASD diagnostic practices. This involves learning about the training that professionals are receiving, what diagnostic practices are being implemented on the field, and whether those are being contextualized according to the Brazilian culture. Students with special needs are directly affected by the results of diagnostic practices, since identifying the individuals is one of the first steps. Lack of understanding about that stage may lead to the problematic realities of underidentification or overidentification, exclusion of children who should receive that special intervention and inclusion of some who do not need them. Precision in diagnosis, that considers cultural factors, is a highly desired and continuous goal for special educators. Therefore, students with ASD are directly affected by the results of this research. The purpose of this study is 1) to determine the knowledge and training of professionals that diagnose Autism Spectrum Disorder in Brazil (Audiologists, Neurologists, Pediatricians, Psychologists, Psychiatrists, and others), 2) to determine if those professionals are using diagnostic practices similar to the US, 3) to investigate which procedures and instruments are used in the diagnosis of a child suspected of having an Autism Spectrum Disorder in Brazil; and 4) to determine what happens after diagnosis. This research can be placed within the context of studies focused on three complementary areas: conceptual, historical, and cross-cultural. The first area is related to the overall conceptual understanding of cultural factors in the diagnosis of ASD. The second one considers the historical influences in the diagnostic practices of children with ASD in Brazil, including government policies. The last one adopts a cross-cultural approach to the study of autism with emphasis on comparative studies. The survey instrument specifically designed for this study is The Autism Spectrum Disorders Assessment Survey comprised of thirteen questions (single and multiple choice items, and Likert-type items) designed to collect information in regards to demographic characteristics of the participant, description of the diagnostic team, procedures, instruments used for diagnosis, and knowledge about characteristics necessary to identify a child as having an ASD. The survey received 236 responses from professionals that diagnose Autism Spectrum Disorders from every state and the Federal District in Brazil. The results of this research suggest the need to invest in the training of professionals. Another related suggestion is to develop specific criteria and common diagnostic protocol for professionals in Brazil. Finally, providing access to inclusive education to people with autism would also provide them a more adequate opportunity for development.

Objective: A diagnosis of an autism spectrum disorders is usually associated with substantial lifetime costs to an individual, their family and the community. However, there remains an elusive factor in any cost-benefit analysis of ASD diagnosis, namely the cost of not obtaining a diagnosis. Given the infeasibility of estimating the costs of a population that, by its nature, is inaccessible, the current study compares expenses between families whose children received a formal ASD diagnosis immediately upon suspecting developmental atypicality and seeking advice, with families that experienced a delay between first suspicion and formal diagnosis. Design: A register based questionnaire study covering all families with a child with ASD in Western Australia. Participants: Families with one or more children diagnosed with an ASD, totalling 521 children diagnosed with an ASD; 317 records were able to be included in the final analysis. Results: The median family cost of ASD was estimated to be AUD $ 34,900 per annum with almost 90% of the sum ($ 29,200) due to loss of income from employment. For each additional symptom reported, approximately $ 1,400 cost for the family per annum was added. While there was little direct influence on costs associated with a delay in the diagnosis, the delay was associated with a modest increase in the number of ASD symptoms, indirectly impacting the cost of ASD. Conclusions: A delay in diagnosis was associated with an indirect increased financial burden to families. Early and appropriate access to early intervention is known to improve a childs long-term outcomes and reduce lifetime costs to the individual, family and society. Consequently, a per symptom dollar value may assist in allocation of individualised funding amounts for interventions rather than a nominal amount allocated to all children below a certain age, regardless of symptom presentation, as is the case in Western Australia. ; Funding Agencies|Department of Social Services (DSS); Australian Governments Cooperative Research Centres Program; DSS [RES-HEA-CRD-TB-50940]

Autism spectrum disorders (ASD) are a common neurodevelopmental disorder of unknown etiology. Studies suggest a link between autism and neonatal jaundice. A 1:3 matched case–control study was conducted with children enrolled in the Military Health System born between October 2002 and September 2009. Diagnostic and procedure codes were used for identifying ASD and hyperbilirubinemia. Two definitions for hyperbilirubinemia were evaluated: an inpatient admission with a diagnosis of jaundice and treatment with phototherapy. A total of 2917 children with ASD and 8751 matched controls were included in the study. After adjustment, there remained an association between ASD in children and an admission with a diagnosis of jaundice (odds ratio = 1.18; 95% confidence interval = 1.06-1.31; P = .001) and phototherapy treatment (odds ratio = 1.33; 95% confidence interval = 1.04-1.69; P = .008). Children who develop ASD are more likely to have an admission with a diagnosis of jaundice in the neonatal period and more likely to require treatment for this jaundice.