Autism Flashcards
definition
persistent deficit in social communication and social interaction across contexts
restricted, repetitive patterns of behavior interests, or activities
prevalence/incidence
children often diagnosed at age 4
boys>girls
CNS vs PNS
CNS
- UMN:cortical, brainstem
- other:basal ganglia, cerebellum, other cortical brainstem or spinal cord
Pathogenesis
atypical minicolumnar structure in cerebral cortex inc cortical thickness and cortical folding in parietal lobe initial overgrowth of the amygdala smaller brainstem inc caudate volume impaired mirror neuron system dec corpus callosum volume inc cerebellar hemisphere volume
atypical functional connectivity
early brain overgrowth in 25-30% of children with ASD (white matter of frontal lobe, temporal lobe, amygdala)
in adults, “underconnectivity” in long range neuronal fibers; “overconnectivity” in short-range neuronal fibers
prenatal risk factors
advanced parental age at birth maternal parental medication use maternal bleeding gestational diabetes being firstborn vs 3 or later born having a mother who was born abroad
other risk factors
positive family history
having certain medical conditions (fragile X, tuberous sclerosis congenital rubella syndrome)
prematurity/low birth weight
disease course
early differences in eye contact and joint attention may be identified
2-5 years: atypical social communication and restricted interests identified; ASD diagnosed
typical lifespan
DSM V diagnostic criteria (must meet all 4 criteria)
persistent deficits in social communication and social interaction across contexts
restricted repetitive patterns of behavior, interests, or activities
symptoms must be present in early childhood
symptoms together limit and impair everyday function
signs that may not be captured in the DSM V
problems with play/imagination shyness/social anxiety language and developmental delays behavioral difficulties/meltdowns poor imitation skills
diagnosis
persistent deficits in social communication and social interaction across contexts
restricted repetitive patterns of behavior, interests, or activities
persistent deficit in social communication (3 of 3 symptoms)
deficits in social-emotional reciprocity
deficits in non-verbal communicative behaviors
deficits in developing, maintaining, and understanding relationships
restrictive, repetitive patterns of behavior, interests, or activities (at least 2 of 4 symptoms)
stereotypical or repetitive speech, motor movements, or use of objects
excessive adherence to routines, ritualized patterns of behavior, or excessive resistance to change
highly restricted, fixated interests that are abnormal in intensity of focus
hyper or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment
early signs of autism
by 6 months: no big smiles or joyful expressions
by 9 months: no communication through sounds or facial expressions
by 12 months: no babbling, no back-and-forth gestures such as pointing or waving
by 16 months: no words
by 24 months: no meaningful two-word phrases
medical management
behavioral interventions/educational
therapeutic intervention
medical intervention
parent support
