ASD: Asperger’s, Diagnostic Precision, and Intervention Flashcards
What is the prevalence of ASD?
2.5-2.8%, with prevalence increasing
Who is Donald Triplett?
First case of ASD
What is the history of the shift in diagnoses of ASD?
Kanner study had 11 participants, all having difficulties with social interactions and strong preference for ritual. DSM3 autism reflected the symptoms of the 11 children but researchers realized there were many people who resembled these children but did not meet the diagnoses, termed “near misses”. Aspergers entered DSM in DSM4, with no clear differences between aspergers and autistic disorder. DSM5 makes it a single diagnosis as ASD.
Why is there a single diagnosis?
Better inter-rater reliability and can determine better services in some states. It was not uncommon for people with diagnoses from DSM4 to change overtime and it was not uncommon for practitioners to diagnose same person with different disorders.
What are the concerns with the new taxonomy?
“Worse” to have autism than aspergers. Fostered mistrust in mental health system. Aspergers formed a community.
How did the shift play out?
Narrow to wide description of symptoms. Rare to common, yet researchers still think it is under-diagnosed. From childhood to lifespan. From discrete to dimensional. From one to many ways ASD presents itself, and not just a single cause.
What is the etiology of ASD?
Unknown, complex. DNA mutations, Copy Number Variations (CNVs)
What are CNVs and how are they related to ASD?
CNVs are documented in about 30% ASD cases. Many CNVs are associated in regions of chromosomes that facilitate communication across different parts of the brain. More CNVs in these regions of chromosomes are associated with more severe symptoms of ASD.
Are CNVs related to parental age?
Can be. Higher prevalence of ASD has been documented in children born to older parents, with higher paternal age associated with greater likelihood of CNVs.
How is ASD treated?
Idiographic approach, case by case.
What is Applied Behavior Analysis?
ABA therapy. Based on principles of operant conditioning of shaping, rewards, punishments. Careful observation of child’s environment and triggers, and what are effective reinforcers. Removal of triggers and implementation of rewards.
What is Discrete Trial Learning in ABA?
Breaks down large tasks into lots of small, manageable ones. Each completed request is positively rewarded. If request is not completed, child is prompted and sometimes guided.
What is Incidental Learning?
Naturalistic, real world. Can occur in breaks, when child is not paying attention, outside of therapy session.
What is Pivotal Response Training (PRT)?
Recent update to ABA. While therapist guides ABA, child guides PRT. Kids pick activities, topics, and toys for session. Rather than only rewarding correct responses, rewards attempts to complete tasks.
What are the 4 pivotal areas?
1) Motivation: Increasing a child’s desire to learn and engage
2) Managing emotions: Developing skills to regulate emotions and behaviors
3) Initiation of speech and activity: Encouraging children to independently start interactions and activities
4) Multiple cues: Ability to absorb and respond to many different sources of information
What are the components of effective ABA treatment?
Early
Intensive
High structure
Family inclusion
Ongoing assessment
Does intervention work for people with mild autism?
Yes, draws on basic principles of behavior helpful for many different types of disorder.
Targets of intervention vary with severity (ex. volume thermometer).
Can ABA therapy change overtime?
Yes! Adolescents often help determine their own ABA goals, as social world becomes increasingly salient during adolescence and transitions to autonomy and adulthood can be tricky.
Why do people criticize ABA?
ABA works to make people with ASD “indistinguishable from peers”. Rather the social environment should be more respectful of differences across people.
