10/18 Autism - Novotny

Question 1

three core components of ASD

Answer 1

1. social deficits
   * deficits in reading cues
2. communication impairment
   * verbal and nonverbal
3. impulsivity (repetitive behavior, restricted interest, rigidity)

Question 2

narrow/classical vs broad autism

Answer 2

narrow/classical: low fx ASD

• relatively rare
• increased cog impairment

broad ASD

• more common
• more likely to have average/superior intelligence
• includes higher functioning subtypes

Question 3

ASD social deficits

Answer 3

• cue reading
• theory of mind
• socially/emotinally immature

NOT due to overinterpretation, antisocial behavior, missing cues due to poor attn!

Question 4

ASD communication deficits

Answer 4

delays in language acquisition

repetitive vocalization

poor use of lang to communicate

problems with higher level lang use (high functioning ASD)

Asperger’s subtype: no delay or major impairment in lang, but may have some difficulty with conversational skills

• today, coded as “with/without language/intellectual impairment”

Question 5

repetitive/restrictive behavior

Answer 5

lower functioning/younger children

• stereotypies
• self-stimulation
• preoccupations with parts

higher functioning

• rigidity
• intense, unusual interests

Question 6

associated features of ASK

emotion

sensory integration

cognition

neuro/physical difficulty

Answer 6

difficulty regulating emotion

• intense rxns to even mild situations
• incl anxiety, frustration, anger

sensory integration difficulty

• over/underreaction to environmental stimuli

cognitive disability

• may have significant mismatch between strengths and weaknesses
• can have any IQ (low-high)

neuro/physical difficulty

• may have difficulty with gross or fine motor abilities (varies with child/dx)
• seizure disorders
  
  • up to 50% abnormal EEG, up to 25% seizures
  • bimodal peak of seizure onset: before age 3, at puberty

Question 7

neurobiology of autism

anatomy

functional anatomy

Answer 7

large head size in toddlerhood

poor pruning, increased gray:white matter

abnormalities in cerebellum

micro-abnormalities

functional anatomy

• abnormal circuitry
• abnormal resting state
• poor global connectivity
• better local connectivity

Question 8

autism etiology

Answer 8

genetic

• 90% monozygotic twins condordant for traits
• 60% monozygotic condordant for autism
• 3-7% siblings concordant for traits

multigenetic

• at least 10-20 genes implicated → might only need 5 for syndrome!

Question 9

epigenetic hypotheses

Answer 9

environmental factors inveracting with genes

• toxins (methylmercury, insecticide_flea baths)
• parental age at birth (older → more likely to have a child with ASD)

Question 10

behavioral treatment for ASD

Answer 10

early intervention is key

• earlier = better

Applied Behavioral Analysis

• more intensive = better

floortime

Question 11

read slides for education, other tx for autism

Question 12

medication for ASD

Answer 12

symptom-driven

• atypical antipsychotics
• stimulants
• SSRIs
• anticonvulsants