Autism

Question 0

What’s the triad of deficit in autism?

Answer 0

Impairment of early language and communication
Impairment of reciprocal social interaction
Restricted interested, and repetitive, stereotyped behaviors

Question 1

Symptoms must start by what age for a patient to be diagnosed with autism?

Answer 1

3 years.

Question 2

What drives the language impairment in autism?

Answer 2

It’s thought to be the absence of a drive to socialize, rather than a primary language deficit.

Question 3

What may drive “savant” abilities in autism?

Answer 3

Restricted interests - e.g. a patient being so focused on calendars that he could what day of the week people were born on.

Question 4

What are 5 common comorbidities of autism?

Answer 4

Anxiety, ADHD, disordered sleep, seizures, and intellectual disability.

Question 5

What made Asperger’s distinct from autism (in the DSM IV)?

Answer 5

In Asperger’s, language capacities are intact.

Question 6

What’s the least severe syndrome on the autism spectrum?

Answer 6

PDD NOS (pervasive developmental disorder not otherwise specified)
-can still have crippling anxiety, though

Question 7

Does the DSM V distinguish between Asperger’s and autism?

Answer 7

No, they’re all just part of autism spectrum disorder.

Question 8

What’s the largest risk factor for autism?

Answer 8

Vaccines.

Just kidding, it’s having a sibling with autism. There’s a 20% chance of recurrence.

Question 9

What, approximately, is the heritability of autism?

Answer 9

“about 70%” (34 - 80% on the slide)

Question 10

List 3 prenatal exposures that are known to be causative for autism?

Answer 10

Thalidomide, Valproic Acid, maternal Rubella infection

Question 11

What might one aspect of pathophysiology of autism at the molecular level be? Why do we think this?

Answer 11

Synaptic dysfunction with too much mGluR activity. Common genetic mutations associated with autism affect mGluR signaling.

Question 12

What’s different about the brain, grossly, in kids with autism at 12 years?

Answer 12

The brain is much bigger (macroencephaly).

Question 13

What are 5 brain areas that are less active in autism?

Answer 13

Fusiform gyrus -> person perception
Superior temporal sulcus -> facial expression perception
Amygdala -> social arousal, attention/salience (if there isn’t co-morbid anxiety)
Superior frontal gyrus -> “theory of mind”
Ventral striatum -> reward/motivation

Question 14

What has the ventral striatum / reward system got to do with autism?

Answer 14

Most people are “addicted” to social interactions, but people with autism don’t seem to get that reward system activation from social interactions.

Question 15

As compared with controls, do people with autism have a greater preference for looking at objects than at people?

Answer 15

Yes, but this doesn’t occur in every person with autism.

Question 16

What’s the difference between “wanting” and “liking” social interaction in the context of autism?

Answer 16

People with autism may find a positive social response from a person pleasing, but they don’t have a drive to make it happen again.

Question 17

What does the “heuristic model” say about autism?

Answer 17

It all starts with a deficit in motivation for /attention to social interactions.
This leads to impaired development of social perception, then impaired social cognition.

Question 18

What’s the implication of the heuristic model for treatment?

Answer 18

If kids with autism are trained to derive pleasure from interpreting social cues, looking at faces, this may lead them to more normally develop social and language skills.