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Neurobiology of Adult Brain Disorders > Autism > Flashcards

Autism Flashcards

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1
Q

The CDC estimates that 1 in __ persons have an ASD

A

59

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2
Q

Autism is 4-5 x more likely to be diagnosed in __ than in __

A

males; females

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3
Q

T/F: ASD is more prevalent than childhood cancer, HIV, and diabetes combined

A

true

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4
Q

What is the hallmark of autism?

A

a severe impairment in social interaction

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5
Q

Describe the requirement for an ASD diagnosis

A

onset prior to three years of age
6 or more of 12 features involving: social interactions, communication, and repetitive & stereotypical behavior

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6
Q

T/F: behavior changes overtime

A

true

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7
Q

Autism represents differences in __, __, and __

A

socialization, behavior, and communication

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8
Q

T/F: rates of autism are decreasing

A

false; increasing but reasons are unknown

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9
Q

List three proposed etiologies of genetic origin of ASD

A

disease susceptible alleles
micro-deletion or micro-duplication syndromes
gene promoter mutations affecting gene expression

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10
Q

List two of the proposed immunologic etiologies of ASD

A

maternal or childhood autoimmunity

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11
Q

List three proposed environmental etiologies of ASD

A

prenatal exposures - mercury, lead, Phthalates
neonatal or infant exposures
oxidative stress

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12
Q

Etiology of autism involves __ __ between __ and __ factors

A

complex interplay
genetics, environmental

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13
Q

Describe some of the signs and symptoms of people with ASD

A

often have problems with social, emotional, and communication skills
might repeat certain behaviors and might not want to change their daily activities
many people have different ways of learning, paying attention, or reacting to things

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14
Q

T/F: signs of ASD begin during early childhood and typically last throughout a person’s life

A

true

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15
Q

List three things some children or adults with ASD might:

A

not point at objects to show interest (for example, not point at an airplane flying over)
* not look at objects when another person points at them
* have trouble relating to others or not have an interest in other people at all
* avoid eye contact and want to be alone
* have trouble understanding other people’s feelings or talking about their own
feelings
* prefer not to be held or cuddled, or might cuddle only when they want to
* appear to be unaware when people talk to them, but respond to other sounds
* be very interested in people, but not know how to talk, play, or relate to them
* repeat or echo words or phrases said to them, or repeat words or phrases in place
of normal language
* have trouble expressing their needs using typical words or motions
* not play “pretend” games (for example, not pretend to “feed” a doll)
* repeat actions over and over again
* have trouble adapting when a routine changes
* have unusual reactions to the way things smell, taste, look, feel, or sound
* lose skills they once had (for example, stop saying words they were using)

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16
Q

Most scientists agree that __ are one of the risk factors that can make a person more likely to develop ASD

A

genes

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17
Q

Children who have a sibling with ASD are at a __ risk of having ASD

A

higher

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18
Q

ASD tends to occur __ often in people who have certain genetic or chromosomal conditions, such as __ __ __

A

more
fragile X syndrome

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19
Q

When taken during pregnancy, the prescription drugs __ __ and __ have been linked with a higher risk of ASD

A

valproic acid
thalidomide

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20
Q

There is some evidence that the critical period for developing ASD occurs __, __, and __ after __

A

before, during, immediately
birth

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21
Q

Children born to __ parents are at a greater risk for having ASD

A

older

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22
Q

What are some of the other conditions that may co-exist with ASD

A

ragile X syndrome
* Epilepsy and seizure disorders * Visual impairment/blindness
* Hearing impairment/deafness
* Down Syndrome
* Tuberous sclerosis
* Cerebral palsy
* Angelman’s Syndrome
* Eating disorders
* William’s Syndrome
* Prader-Willi Syndrome
* Fetal alcohol syndrome or effect

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23
Q

Have an accurate diagnosis of ASD for a child with a comorbidity can help make important decisions for __ and __

A

treatment, education

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24
Q

What are some of the emotions people experience when their child is diagnosed with ASD

A

shock or denial
anger
guilt
rejection
confusion
fear
isolation
envy
relief

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25
Q

In the DSM-5, ASD must meet criteria A which states

A

persistent deficits in social communication and social interaction across multiple contexts

deficits in social-emotional reciprocity
deficits in nonverbal communicative behaviors used for social interaction
deficits in developing, maintaining, and understanding relationships

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26
Q

In the DSM5, a patient with ASD must meet __ criteria

A

five

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27
Q

In the DSM-5, ASD must meet criteria B which states

A

restricted, repetitive patters of behavior, interests, or activities as manifested by at least two of the following, currently or by history

  • Stereotyped or repetitive motor movements, use of objects, or speech
  • Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior
  • Highly restricted, fixated interests that are abnormal in intensity or focus
  • Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment
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28
Q

In the DSM-5, ASD must meet criteria C which states

A

Symptoms must be present in early developmental period (but may not become fully manifested until social demands exceed limited capacities, or may be masked by learned strategies later in life)

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29
Q

In the DSM-5, ASD must meet criteria D which states

A

Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning

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30
Q

In the DSM-5, ASD must meet criteria E which states

A

These disturbances not better explained by intellectual disability or global developmental delays

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31
Q

Early characteristics of social/ communication signs of ASD may include

A

infrequent response to name
more interest in objects than people
lack of social play
lack of orienting to others
lack of enjoyment of others
lack of interest in peers

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32
Q

Young children with ASD are less likely to __ (give examples)

A

imitate
other children’s play
facial expressions
adult activities
physical actions

33
Q

Skills must be taught __ because children with ASD don’t typically engage __ or learn by __

A

explicitly
socially
watching

34
Q

What are some pre-language characteristics of ASD early diagnosis

A

lack of babbling,
lack of gestures (pointing, waving)
lack of joint attention

35
Q

Define joint attention

A

used to share an experience with others by communicating through eye gaze, gestures, and vocalizations

36
Q

Typically infants in the first year exhibit these signs of joint attention

A

shift their gaze from toys to people
follow other’s point
monitor the gaze of others
point to objects or events to share interest
show toys to others

37
Q

In autsim, first words may __ __ or __ and may not be __

A

develop late
not at all
typical

38
Q

In ASD, children may have __ or __ speech, may have odd or robotic __ and may sound as if…

A

idiosyncratic/ peculiar
intonation
giving a lecture

39
Q

T/F: higher functioning individuals with ASD may have no significant general delay in early language milestones or other cognitive abilities

A

true

40
Q

What are some communication challenges those with ASD might face?

A

May talk excessively about their own special interests
– Perseveration (“stuck” on one idea)
– Decreased abstract language
– Inappropriate social remarks
– Difficulty understanding humor
– Difficulty with conversational skills

41
Q

List some repetitive-sensory mannerisms

A

hand flapping
finger movements
posturing
spinning
head banging

42
Q

Children with ASD may have trouble with __ play and play with toys in a __ or __ way

A

pretend
idiosyncratic / peculiar (line toys up or focus on odd parts)

43
Q

Children with ASD may script and echo, define each of these

A

echo - child may respond to a question or statement by repeating what was said
script - child may imitate commercials or videos

44
Q

Children with ASD may insist on __ or have __ attachments

A

sameness
unusual

45
Q

Children with ASD often have __ interests that are —

A

circumscribed
all consuming, unusal in intensity

46
Q

Restrictive and repetitive behaviors may…

A

be tactilely defensive
see sensations
over-respond or under-respond to sensory stimuli

47
Q

T/F: Intellectual disability and ASD frequently co-occur

A

true

48
Q

How should the distinction between intellectual disability and ASD occur?

A

to make comorbid diagnoses of ASD and ID, social communication should be below that expected for general developmental level

49
Q

What are six early concerns of ASD

A

The child infrequently responds to his or her name when called by the caregiver
The child does not engages in joint attention
the child has trouble with eye contact
the child does not imitate others
the child does not respond emotionally to others
the child does not engage in pretend play

50
Q

T/F: When parents have a concern, they are usually wrong

A

false, 30-54% of parents of children with ASD had concerns before the 1st birthday, 80-90% had concerns by the second

51
Q

What are the next steps after concerns for ASD?

A

child should be referred for developmental and autism screenings
if screening results indicate concerns, the child should be referred to a qualified professional for evaluation and diagnosis

52
Q

Research indicates that __ and __-__ intervention by competent professionals, particularly when partnering with __, can result in positive outcomes for many children with ASD

A

intensive, evidence-based
parents

53
Q

Where are some places you could turn for an evaluation?

A

developmental pediatrician
child psychiatrist
clinical psychologist
occupational therapist
physical therapist
speech/language therapist
social worker

54
Q

What are some assessment tools that may be included in the evaluation process of ASD?

A
  • Childhood Autism Rating Scale (CARS)
  • The Modified Checklist for Autism in Toddlers (M-CHAT) * The Social Communication Questionnaire (SCQ)
  • The Autism Diagnostic Observation Schedule (ADOS)
  • The Autism Diagnostic Interview – Revised (ADI-R)
  • Gilliam Autism Rating Scale (GARS)
  • Psychoeducational Profile, 3rd Edition (PEP-III)
  • Parent Interviews for Autism (PIA)
55
Q

List 8 interventions supported by significant scientific evidence for ASD

A

ABA
Discrete Trial Training (DTT)
Functional Communication Training (FCT)
Pivotal Response training (PRT)
antecedent-based interventions
early intensive interventions
social skills training
cognitive-behavioral therapy (CBT)

56
Q

Define ABA

A

process of applying behavioral principles to change specific behaviors and simultaneously evaluating the effectiveness of the intervention

57
Q

Describe ABA

A

emphasizes both prevention and remediation of problem behavior
significant attention is given to social and physical environment

58
Q

Describe DTT

A

using this intervention, a discriminative stimulus is presented, the child responds, and then the child receives a consequence based on the response
aka “lovaas therapy’

59
Q

Describe FCT

A

behavioral methodology that replaces disruptive or inappropriate behavior with more appropriate and effective communication
communicative functions are determined through FBA and replacement behaviors are taught

60
Q

Describe PRT

A

builds on a child’s initiative and interests - enhances the pivotal learning variables of motivation, responding to multiple cues, self-management, and self-initiation, which serves to influence target behaviors within a natural settingD

61
Q

Describe ABA

A

provides reinforcement or punishment after a behavior occurs
set up antecedent conditions that increase the likelihood of success and reduce the probability of problem behaviors occuring

62
Q

What is social skill straining effective for?

A

specific aspects of social training (eye contact, joint attention, and verbal greetings) can be learned with fouces training

63
Q

T/F: CBT is one of the most widely used non-pharmacologic treatments for individuals with mental and emotional disorders, and its use within individuals with ASD is growing

A

true

64
Q

CBT focuses on __ negative or ineffective patterns of thought and behavior with __ -_ that are effective in __ mood and adaptive functioning

A

replacing
structured strategies
improving

65
Q

List some interventions with emerging or promising evidence for ASD

A

Developmental relationship-based treatment
play therapy

66
Q

List some interventions for ASD with limited scientific evidence

A

sensory integration
auditory integration training
supportive therapies
nutritional supplements
gluten and casein-free diet
facilitated communicaiton

67
Q

What are some interventions that are not recommended for individuals with ASD?

A

holding therapy
secretin
chelation for neurotoxicity

68
Q

What causes Fragile X syndrome?

A

repeat expansion of (CGG)n trinucleotide in the 5’-untranslated region of the fmr1 gene on Xq27.3

69
Q

In Fragile X, the expanded repeat results in _ _ of the fmr1 gene , and as a consequence, the absence of its __ __, __

A

transcriptional silencing
protein product
fragile x mental retardation protein (FMRP)

70
Q

FMRP interacts with a subset of __ including its own and has been postulated to function as a __ __ __ __

A

mRNAs
translation regulator in vivo

71
Q

What are some clinical features of fragile X syndrome?

A
  • moderate to severe mental *
    deterioration of IQ with age
    retardation
  • large ears and prominent jaw
  • age-related increase in the volume of the hippocampus
  • high-pitched and jocular *
    speech
  • increased testicular volume
    (macroorchidism) *
  • finger joint hypermobility
    an age-related decrease in the volume of the superior temporal gyrus
    decreased size of the posterior cerebellar vermis
  • mitral valve prolapse
  • mild dilatation of the
    ascending aorta
  • increased size of the fourth ventricle
72
Q

What is the most common clinical feature of fragile X syndrome?

A

mental retardation

73
Q

Describe the characteristics of fmr1 knockout mouse

A

Absent FMRP
enlarged testicles
long and thin dendritic spines
subtle spatial learning abnormalities
increased rate of cerebral glucose metabolism
increased susceptibility to audiogenic seizure

74
Q

DBP affects __ __

A

neuro-steroidogenesis

75
Q

DBP __ the threshold and __ severity for seizures

A

lowers
increases

76
Q

Autism has a strong __ component

A

genetic

77
Q

DBP is a __ __ __

A

ubiquitous environmental contaminant

78
Q

Gestational exposure to __ induces autism-like behavior in mice

A

DBP

79
Q

DBP __ the expression of key proteins involved in neurosteroidogenesis

A

inhibits

Neurobiology of Adult Brain Disorders (10 decks)

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