Autism!!!!!!!!!!!!!!!!!!!!!!!!! Flashcards
Autism is
A neurodevelopmental disorder
Deficits in social communication
Restricted/repetitive behaviors and/or interests
Neurologically based
A genetic predisposition
What are the two core domains of symptoms of autism
Deficits in social communication
Restricted/repetitive patterns of behavior and/or interest
How does general social communication deficits manifest in Autism?
Nonverbal communication impairments
Disruption in social-emotional reciprocity
Social relationship challenges
Examples of nonverbal communication impairments
Eye contact
Facial expressions
Gestures
Vocal intonation and prosody
Examples of disruption in social-emotional reciprocity
Reduced joint attention
Problems with reciprocal conversation
Deficits in theory of mind
Examples of social relationship challenges
Deficits in play skills, particularly imaginative play
Difficulty initiating and maintaining friendships
Level 1 Autism
“Requiring Support”
Social deficits cause noticeable impairments, Difficulty intitiating social interactions, atypical responses to social overtures of others, Appear to have decreased social interest
Inflexibilty of behavior causing significant intereference in one or more contexts, Difficulty switching between activites, Problems of organization and planning
What years does first concerns typically appear in autism
1 and 2 – always there from birth
Children with these stronger skills their concerns usually do not appear until when
Language and core cognitive skills, when social demands outpace their abilities
What is the social model of disability
Disability is rooted predominantly in inaccessible social and political infrastructure
Early diagnosis and treatment of autism has been shown to what
Improve many areas of functioning and decrease need for later services
What does comprehensive treatment for autism often includes?
Intensive behavioral intervention, building social and communication skills
What are the two most common comorbid ASD conditions
ID and ADHD
(T/F) A minority of children with ASD have comorbid neurodevelopmental or psychiatric conditions
False
What is the history of autism diagnosis
Leo Kanner in 1943, Hans Asperger in 1944, DSM-III in 1980, DSM-IV-TR (2000), DSM-V (2013)
Leo Kanner
1943
Notied social and behavioral impairments
No credit taken by Wolff in 2004
Hans Asperger
1944
Atypical talent in academic and creative domains
DSM-III
1980
Autism first recognized as a disorder as Infantile Autism
Pervasive Developmental Disorders
DSM-IV-TR
2000
5 pervasive developmental disorders
DSM-V
2013
Autism Spectrum Disorder
What has the rise in autism rates been
2000: 1 in 150
2004: 1 in 125
2008: 1 in 88
Are the rise in autism rates a concern
Maybe, better getting better at diagnosis, higher awareness, diagnostic substitution, and making it less socially stigmatized
Prevalence of Autism
1 in 36
Percentage of ASD people with co-occurring IDs
31%
What is the gender ratio in autism and sociodemographic factors of autism
Range of 2:1 to 6:1 boy to girl ratio – greater gender ratio (more boys to girls) for those with higher IQs
Women, Ethic minorities, and low income children are more likely to be misdiagnosed or diagnosed late
Prominent symptoms and challenges of autism from birth to 12 months
Reduced eye contact and gaze to faces
Lack of social smile
Reduced babbling and vocalizations
Unusual sensory responses
Impaired motor coordination
Prominent symptoms and challenges of autism from 2 - 5 years
Reduced peer interactions
Unusual or stereotyped language
Deficits in pretend play
Unusual and restricted interests
Insistence on sameness
Prominent symptoms and challenges of autism in middle childhood
Deficits in reciprocal conversation
Poor friendship quality
Problems with attention and learning
Prominent symptoms and challenges of autism in adolescense
Problems with execute funcitoning
Poor understanding of social cues
Poor hygiene and self care
Social isolation and bullying
Prominent Symptoms and Challenges of Autism in Adulthood
Under-employment
Housing challenges
Difficulties with activities of daily living
Few and poor quality relationships
What Lanaguage and Communcation Impairments do we see in Autism
Delayed or no spoken language
If speech: impairment in initiation and sustaining conversations
Sterotyped and reptitive use of langauge
Lack of varied and spontaneous make believe play or social imitative play appropriate
What are the early developmental signs of autism
Focus on inanimate objects
Less interest in parents faces
Failure of joint attention
Mind Blindness
The single most idangoistic sign in retrospective studies of autism (in 1st birthday party videos)
Lack of looking at faces
What is joint attention and why is it important
Situation where two people both focus on an object of interest
Important for social cognitive development such as theory of mind
What is mind blindness
The same thing as theory of mind
Deficits in ability to think of others in their shoes
In TD child when does focus on eye region start
2 months
In TD child when does discriminating direction of gaze start
4 - 5 months and competent by 18 months
In TD child when does joint attention begin
1 year
In TD child when does theory of mind begin
3 years
Describe TD newborns behavior with face like patterns when they are born
Like to look longer and track more consistently to face like patterns
Associated neurodevelopmental conditions
ID (31%), ADHD (16 - 50%), Tic disorders (22%)
Associated psychiatric conditions and how to treat them
Anxiety is most common
Also OCD, depression, etc
Best to treat with psychotherapy via CBT
Epilepsy and autism
8 - 30%
More common in females with co-occurring IDs
What percent of those with autism have a genetic condition
10%
Associated general psychopathological impairments
Sleep, Feeding, Toileting, Gastrointestinal symptoms
Percent of autism people that are nonverbal
25%
Specific social practices of autism
Echolalia, Pronoun reversal, monotonic voice, pragmatic deficits
What age does ability in communication predict outcomes
Age 5
(T/F) Deficits are not due to associated IDs in autism
True
What percent of autisms acquire language to be used for communication (5 years old level communication)
70%
What percent of diagnosed don’t meet criteria by school age
10%
The general catagories of etiology of autism
genetics, environmental factors, neural circuitry, brain development
What in genetics of ASD could be etiological?
Runs in families, association with known genetic disorders (FXS, PWS)
What in environmental factors of ASD could be etiological?
Pregnancy Complications, Neurodevelopmental insults, prenatal infections
What environmental factors has there been shown to be no etiological association with autism?
toxic environmental exposures, vaccines
What brain and development and neural circuitry areas are of focus in autism etiology?
Early overgrowth theory, Certain key brain areas, Differences in brain connectivity and funcitoning
Early overgrowth theory
The brain develops rapidly at the start and has to slow down
What are the key brain areas in the etiology of autism
Fronto-temporal and frontal parietal regions, Limbic brain regions, Fronto-stratal circuitry, Cerebellum
When are early children screened for autism
standard screening at 18 and 24 months and well child visits
What evaluation is used for asd?
developmental history and interview with caregivers, observation of child’s behavior, multidisciplinary assessment, questionnaires, interviews, physical examination, genetic testing
