8- Autism Flashcards
History of autism- who was Leo Kanner (1943)
Observed a focus on objects/desire for sameness
History of autism- who was Hans Asperger (1944)
Observed fleeting eye contact
Individuals described by Asperger did not have intellectual disabilities/lang delay
What is DSM-IV (1994)?
It is the Autism “triad”
1. Social Interaction
2. “Communication” (verbal + non-verbal)
3. Restricted Interests/ behavioural repertoires
What are examples of autistic interests?
Forms of transport, animals, cosplay, manefactured artefacts e.g. hoovers
What is an example of a behavioural repertoire?
STIMMING- a repetitive action to help self-regulate/ calm down
E.G. rocking, touching fingertips, flapping hands
Sensory issues in Autism: HyPERsensitivity vs HyPOsensitivity
HYPER SENSITIVITY- avoidance of certain sounds, textures, light patterns etc
HYPO SENSITIVITY- Sensation seeking behaviours e.g. stimming, vestibular sensation seeking, pica = tasting of non-food items
DSM-IV CLASSIFICATION OF AUTISM. Think of a flowchart. Pervasive Developmental disorder splits off into ASD (autism) and Childhood Disintegrative Disorder+Rett’s syndrome.. What is the difference between these?
Unlike Autism, for the other disorders the child is typical up to a certain point then gradually cognitively and physically begin to decline. Autism- symptoms evident from early age.
In DSM IV,… ASD split into 3 subdomains. What are these?
Pervasive Developmental disorder not otherwise specified. (2 of the corners of the triad below threshold)
Asperger’s Syndrome- no lang delay, normal range IQ, mild repetitive traits
Autism- above threshold on all three corners of triad.
What updates did DSM-V (2013) bring?
○ Collapsed “social interaction” and “communication” into one domain.
○ Maintains early onset criterion to rule out Retts/ childhood disintegrative disorder.
○ Emphasized key role of sensory abnormalities.
○ Language delay removed as one of the possible descriptors.
Removed PDD-NOS and Asperger’s as a diagnosis.
Related characteristics of autism that are not in diagnostic schemas
Learning disability in some individuals (around a third)
Savant skills, i.e. exceptional skills that greatly exceed those allistic peers (10%)
Recent research indicates that, in general, autistic individuals are more rational thinkers, e.g. less prone to “sunk cost fallacy”
What are some language characteristics of autistic individuals?
- Echolalia
verbatim repetition of a whole phrase- can be immediate, or delayed
- examples of delayed echolalia: “don’t do that Paul”, “You’re a clever boy Gregory”, maybe TV commercials or fragments of songs (Prizant & Duchan, 1981)
- Pronoun reversals- may sometimes confuse 1st and 2nd person
Why is there rising incidence of autism?
Increased awareness, better diagnostic tools, expanded adult services by 2009 Autism Act
Especially increasing awareness of autistic females
What are the current diagnostic tools for autism
ADOS- Autism Diagnostic Observation Schedule (structured activities to observe behaviours)
ADI- Autism Diagnosis Inventory (structured interview with parent covering the 3 corners of the triad)
ADI and ADOS regarded as the gold standard
Short questionnaires like SCQ (4+ years) and M-CHAT (16-30 months)
ASQ (autism spectrum quotient)= approximate indicator of where you lie on the spectrum
CATI (Comprehensive Autistic Trait Inventory)
What are the cognitive theories of autism?
TWEM
- Theory of Mind
- Weak Central Coherence
- Executive Function Deficits
- Monotropism
Explain the theory of mind cognitive theory of autism
Difficulty understanding other’s mental states (beliefs, intentions, desires) and that others can have beliefs/knowledge that differ from own perspective
Could account for difficulty in behaviours such as joint attention, pretend play.
This may effect ability to read facial expressions because facial expressions reflect mental state.
What tasks are used to assess theory of mind?
Sally-Anne Task
Smarties Task
Criticism of ToM theory
ToM does not explain all traits of autism.
ToM performance may depend on verbal ability and age, leading to mixed results.
Explain Weak Central Coherence
A reduced tendency to integrate information into a cohesive ‘whole’. Focus on details rather than wholes.
Autistic individuals have a weak drive for central coherence.
What is the supporting evidence for Weak Central Coherence theory?
Supported by: strong performance in tasks requiring attention to detail
Difficulty using context to resolve ambiguity (e.g., homographs like “bow” in “take a bow” vs. “tie a bow”).
Embedded Figures Test. Autistic individuals excel at finding hidden figures within complex designs. Weak central coherence= find this task easy.
Block Design Task. Faster and more accurate in constructing patterns using individual blocks (Shah & Frith, 1993). ASD able to focus on the parts whilst ignoring the whole. E.g. neurotypical see as black diamond, ASD can see it as the 4 triangles of which it must be composed.
Reduced susceptibility to visual illusions.
Weak Central Coherence and Language in autism
Struggle to use preceding sentence context to determine the correct pronunciation of HOMOGRAPHS. Implies a lack of integration of sentence context, as if they were reading a list of unconnected words.
(from reading) Interesting to note this disappeared when instructed to read for meaning suggesting that weak CC characterises automatic processing preference, it is a cognitive ‘style’
Do not recall sentences better than word strings (unlike controls).
This suggests they do not use semantic relations (same category vs assorted words) or grammatical relations (sentences vs word lists) to aid memory.
Poor at making bridging inferences
Criticism of Weak Central Coherence
Does not fully explain social and communication difficulties.
Replicability of some findings (e.g., language studies) is inconsistent.
What is Executive Function Deficit Theory for Autism?
Autistic individuals have difficulties with the high-level cognitive processes involved with planning and execution of complex behaviour, flexibility, and inhibiting inappropriate responses.
In Autism, what are the core components of EF deficit?
Please
Shoot
Rude
Wild
Geese
Planning: Difficulty organizing steps to achieve goals.
Set-Shifting: Challenges transitioning between tasks or rules (e.g., perseverating on old patterns).
Response Inhibition: Struggles to suppress impulsive or automatic responses.
Working Memory: Difficulty holding and manipulating information.
Generativity e.g. tell me things which you’d find in the kitchen.
What are the tasks used to assess EF?
To assess Set-shifting:
Wisconsin Card-Sorting Test used : Cards are sorted based on changing rules (e.g., by color, shape, or number). Autistic individuals often perseverate, continuing with the old rule despite feedback.
To assess Response Inhibition:
Stroop Task. word (e.g., the word “blue” written in red ink).Autistic individuals perform well, showing intact response inhibition here.
Opposite Words. Say “1” when seeing “2” and vice versa, requiring inhibition of the natural response. Autistic individuals show poor response inhibition.
Walk don’t walk. Same as above, poor response
To assess working mem:
Tower of Hanoi. Measures planning ability by requiring a sequence of moves to achieve a goal. Autistic individuals often use more moves than necessary.
Criticism of EF Theory
○ EF deficits are not unique to autism (also observed in ADHD and other conditions).
Does not account for specific social and communication challenges
Explain Monotropism theory of Autism
A tendency to focus intensely on a small number of ‘preferred’/’absorbing’ interests or activities.
Contrasts with polytropism, where attention is distributed across many interests.
○ Immersion in absorbing interests, leading to “autistic joy.”
○ Hyper-focus creates difficulty shifting attention or engaging with less preferred activities.
Limited awareness outside the “attention tunnel.”
Explains why breaking routines or interrupting activities can lead to distress.
Accounts for difficulty noticing social cues unless they align with an absorbing interest.
Criticism of monotropism theory
Lacks a well-validated assessment method.
Descriptive rather than explanatory, as the cognitive mechanisms behind monotropism are not fully explored.
What is the overlap between autism and DLD?
Shared traits= difficulties with language, pragmatics, and social communication.
“Pragmatic language Impairment” = a disorder intermediate between autism and DLD
Evidence of genetic links between autism and DLD.
What is Happé’s criticism of Theory of Mind accounts?
Deficit accounts, including ToM and executive dysfunction, fail to explain the presence of superior skills in individuals with autism. ie. savant skills
What does Happé mean by the “extended phenotype”?
Autistic characteristics like weak central coherence might also characterise the relatives of people with autism.
Found to be especially true for fathers.
Baron-Cohen Extreme Maleness
According to Baron-Cohen, autism was associated with “extreme maleness” and characteristics include
Good performance on embedded figures task
Delayed language development
Poor social abilities
Poor mind-reading
Left-handedness (more likely in males)
Size of corpus callosum (smaller in males)
