COOCCURRING MEDICAL PROBLEMS Merlin L Taylor PhD CCCSLP BCBAD SpeechLanguage Pathologist Behavior Analyst Aspie CoOccurring Medical Problem Comorbid Condition existing simultaneously with and usually independently of another medical condition ID: 187081
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Slide1
IN THE CROSSFIRE
CO-OCCURRING MEDICAL PROBLEMS
Merlin L. Taylor, Ph.D., CCC-SLP, BCBA-D
Speech-Language Pathologist
Behavior Analyst
AspieSlide2
Co-Occurring Medical Problem =
Comorbid Condition
“existing simultaneously with and usually independently of another medical condition”
http://www.merriam-webster.com/dictionary/comorbidSlide3
Some Conditions That Can Be Comorbid With Autism Spectrum Disorder (ASD)
Diabetes
Epilepsy
Irritable Bowel Syndrome (IBS)
Iatrogenesis
Post-Traumatic Stress Disorder (PTSD
)Slide4
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide5
Problems of ComorbiditySlide6
Avoidance
Behavior
Actively evading circumstances or activities wherein symptoms might be elicited
.Slide7
Denial
Refusal
to acknowledge a disorder by way of
verbalization
, altered behavior, or any other
means.
(May even take the form of feigning symptoms of
another disorder.)Slide8
Misdiagnosis
Misdirected TreatmentSlide9
Symptom
Synergy
Combined effects of autism and co-occurring conditions.Slide10
Three Dimensions of DisorderSlide11
Deteriorating
Course
of
Illness
Progressive worsening of symptomsSlide12
Neurobiological/NeuropsychologicalSlide13
PsychoemotionalSlide14
PsychosocialSlide15
Three Dimensions of DisorderSlide16
DiabetesSlide17
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide18
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide19
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide20
Diabetes: Correlation with ASDSlide21
Complications of Comorbidity—Diabetes
Avoidance behaviors
Denial
Misdiagnosis
Misdirected treatment
Symptom synergy
Deteriorating course of illnessSlide22
EpilepsySlide23
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide24
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide25
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide26
Complications of Comorbidity—Epilepsy
Avoidance behaviors
Denial
Misdiagnosis
Misdirected treatment
Symptom synergy
Deteriorating course of illnessSlide27
IBSSlide28
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide29
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide30
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide31
Complications of Comorbidity—IBS
Avoidance behaviors
Denial
Misdiagnosis
Misdirected treatment
Symptom synergy
Deteriorating course of illnessSlide32
IatrogenesisSlide33
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide34
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide35
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide36
Complications of Comorbidity—
Iatrogenesis
Avoidance behaviors
Denial
Misdiagnosis
Misdirected treatment
Symptom synergy
Deteriorating course of illnessSlide37
PTSDSlide38
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide39
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide40
Signs
aggression
agitation
clinging
cramping
crying
flatulence
disorientation
hyperventilation
laughing
screaming
sluggishness
spasms
sweating
tremorSlide41
Complications of Comorbidity—PTSD
Avoidance behaviors
Denial
Misdiagnosis
Misdirected treatment
Symptom synergy
Deteriorating course of illnessSlide42
MOST COMMON SYNERGISTIC SYMPTOMSlide43
ANXIETYSlide44
The Problem of PTSD
In anxiety-prone individuals on the autism spectrum, whose sensory processing difficulties can render mundane sensory experiences terrifying, PTSD may occur on more than one occasionSlide45
The Problem of PTSD
Because of deficits in self-insight and/or verbal ability, this
individual incidence
of PTSD will largely remain unknownSlide46
The Problem of PTSD
PTSD can, in turn, lead to a number of highly maladaptive behaviors, including (but not limited to)
Aggression
Self-injury
Addictions (especially in higher-functioning individuals) Slide47
The Problem of PTSD
Very ironically, PTSD may be misdiagnosed as physiological due to its outward signs, while frankly physiological conditions may be misattributed to anxietySlide48
The Paradox of Anxiety
While a common factor exacerbating physiological symptoms anxiety is
rarely
a cause or a solitary symptom in cases of autism with comorbidity.Slide49
The Problem of PTSD
Misdiagnosis—and consequently misdirected treatment—can become
occasion for both
iatrogenesis
and psychological trauma
.Slide50
In Summary: Don’t
a
ssume that any physician can make a psychiatric diagnosis
s
ummon the dead to defend a poor diagnostic decision
e
xpect the health problems of individuals with autism to readily make sense
e
xpect
omnisicience
of any human being (yourself included)Slide51
In Summary: Do
L
isten, observe and reflect
Keep asking questions—if only in your mind
Look out for “zebras”
Perform thorough diagnostics as a clinician—insist upon these as a consumer
Keep trying. Keep trying. KEEP TRYING.Slide52
Thank you!Slide53
aspiehd@gmail.com
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