2. History of ASD

Question 1

What did Leo Kanner term autism and what did he perceive the cause was?

Answer 1

‘Early Infantile Autism’ to distinguish from childhood schizophrenia.
Very narrow definition - “elaborate repetitive routines”’ “muteness or abnormal speech” “lack of emotional contact”
Cause: inability to relate to themselves, refrigerator parenting

Question 2

Describe the refrigerator mother theory. What was the treatment approach?

Answer 2

Some doctors tried to say autism was caused by the lack of warmth from mothers of autistic children. parenting pathology caused autism directly. Psychoanalytic approach.

Question 3

What did Bernard Rimland propose as a cause for autism?

Answer 3

Biological disorder with biological causes. BUT he proposed that vaccinations could be a cause for autism.

Question 4

What evidence did Sir Michael Rutter found to suggest the highly heritable nature of autism?

Answer 4

conducted the first autism twin studies

Question 5

After finding out that autism is highly heritable, what kinds of treatments were proposed by Sir Michael Rutter?

Answer 5

structured behavioral interventions; operant based techniques

Question 6

What did Sir Michael Rutter suggest was the key feature of autism?

Answer 6

emphasized the central role of social and communication deficits in autism.

Question 7

What did Lorna Wing contribute to the study of autism? (2)

Answer 7

1) Among the first to consider dimensional conceptualization of ASD (spectrum concept)
2) Introduced Triad of Impairments
- impaired social interaction
- impaired communication
- impaired imagination – narrow, repetitive pattern of activities

Question 8

What did Ivar Lovaas contribute to the autism community in terms of treatment?

Answer 8

Founder of ABA (Applied Behavioral Analysis)

Question 9

How do we typically organize our understanding of “atypical”/”condition”?

Answer 9

• specific sets of symptoms/presentations clustering together
• distress/impairment

Question 10

What are some advantages of classifying presentations/conditions/disorders? (6)

Answer 10

1) organizes knowledge
2) practical necessity
3) shared language/framework
4) communication
5) research
6) obtaining services

Question 11

What are some challenges of classifying presentations/conditions/disorders? (7)

Answer 11

1) labeling/stigma
2) medicalizing of human suffering
3) cultural/social differences
4) using N symptoms –> arbitrary; not reliable
5) too many categories/disorders!
6) comorbidity
7) not unique to individual

Question 12

How did DSM I classify autism?

Answer 12

Autism listed with schizophrenia (perceived similarity in behavior). Believed that these behaviors were psychotic.

Question 13

How did DSM II classify autism?

Answer 13

Schizophrenia, Childhood type. Occur before puberty. May result in mental retardation (ID).

Question 14

How did DSM III classify autism?

Answer 14

Infantile autism

• social impairment
• communication impairment
• behavioral impairment
• speech delay necessary for diagnosis. gross deficits in language development.
• explicit differentiation from schizophrenia

Question 15

Describe the shift from DSM II to DSM III. (5)

Answer 15

1) shift from psychodynamic to behavioral approaches
2) shift from case studies to more empirical research
3) increased awareness
4) perceived to be a lifelong condition. onset under 30 months.
5) social communication deficit found to play a central role

Question 16

Describe the DSM III-R.

Answer 16

Autistic disorder - 3 domains
A. Qualitative impairment in reciprocal social interaction
B. Qualitative impairment in verbal and nonverbal communication and in imaginative activity
C. Markedly restricted repertoire of activities
PDD-NOS = subthreshold
“not otherwise specified”

Question 17

Describe the changes between DSM-III and DSM-III-R. (2)

Answer 17

• more details and specific examples of symptoms

- addition of non-verbal communication, imaginative play

Question 18

Describe the changes between DSM-III-R and DSMIV. (3)

Answer 18

• added aspergers disorder
• removed criteria for speech delay
• introduced concept of a spectrum. basically all the disorders (asperger’s, childhood disintegrative, autistic, rett’s, PDD-NOS etc.) all fall under the same category as Pervasive Developmental Disorders

Question 19

Why did we have the new umbrella term ‘Autism Spectrum Disorder’ in the DSM-5?

Answer 19

• developmental outcomes of subgroups (aspergers, PDD NOS, autism) were not much different
• lack predictive valdiity to have so many terms
• kids get different labels in different clinics – not reliable, little consistency

Question 20

What are the key changes between DSM-IV and DSM-5? (3)

Answer 20

1) PDD-NOS was overused to get services and got abused. so removed asperger’s and PDD-NOS and replace it all under autism spectrum.
2) combined criterias for social and communication (3 core areas –> 2 core areas) combine because communication is largely social. we can’t really separate communication from social aspects.
3) introduced 4 specifiers