Autism Flashcards
ASD (DSM5)
- persistent deficits in social communication and social interaction (need all 3)
- restricted, repetitive patterns of behaviour, interests and activities (2 of 4 needed)
- umbrella term (autistic disorder, asperger’s syndrome, childhood defective disorder, pervasive developmental disorder)
persistent deficits in social communication and social interaction
- need all 3
- deficits in social-emotional reciprocity
- deficits in non-verbal communication behaviours
- deficits in developing and maintaining relationships
restricted, repetitive patterns of behaviour, interests and activities (2 of 4 needed)
- highly restricted, fixated interests
- stereotyped or repetitive speech, motor movements of use of objects
- hyper or hypo reactivity to new sensory input
- excessive adherence to routines
strengths and weaknesses of DSM5 diagnosis
+ facilitates research and clinical service
- hazy diagnosis boundaries
- combination of genetic heterogeneity and diagnostic uncertainty complicates uncertainty in identifying genes
- diagnosis: a ‘ticket’ for services (pressure to diagnose as patients experiencing difficulties)
- within ASD variability
- some aspects can be diagnosed in children as young as 2, where as other aspects may take longer to resolve (diagnosis appears less stable)
- repetitive behaviours, interests and activities more evident in 3-5 yo compared to 2 yo
- as the disorder can be so variable, it is hard to give a stable diagnosis to everyone
- fragile clinical uncertainty that exists when one is dealing with a behaviourally diagnosed disorder
pro’s of universal screening
- mean age of diagnosis would be reduced
- children wouldn’t be missed
- early intervention = better outcomes
medical model
neurodevelopmental disability
social model
neurodevelopmental difference - only disabling as they have to be in neurotypical world
differences in the brain
- local over-connectivity; long distance under-connectivity
- disruptions severe in later developing regions
- difficulty with information integration
Muller (2008)
Wass (2010)
Muller (2008)
fMRI to identify medium and long distance functional under-connectivity
Wass (2010)
long distance under-connectivity - under functioning integrative circuitry resulting in deficits of integrating information (at neural level)
- e.g. social interaction, language and repetitive restrictive behaviours (demanding integration tasks)
local over-connectivity - hyperspecifism behaviours (very specific)
earlier diagnosis
Jones and Klin (2013) - eye tracking studies - infants later diagnosed with ASD followed the hands of peoples compared to typically developing children who followed eyes (9-24 months)
Elsabbagh et al (2012) - EEG - neural sensitivity in infants due to dynamic eye gaze
- see a face, shift eyes away or towards it
- typical - big difference in neural sensitivity
- Autism - not a big difference
cognitive profile
- theory of mind difficulties (understanding another persons thoughts and beliefs, communication, mentalising)
- executive function abilities (inhibition, planning and logic)
- weak central coherence (perception)
- enhanced perceptual function (see and percieve the world differently)
Kimhi et al (2014)
Kimhi et al (2014)
- range of tasks assessing cognitive shifting (card sort), planning (tower of London), ToM (unexpected location & false belief) and verbal ability
- found that ASD individuals performed worse on EF and ToM tasks compared to control
- EF linked to verbal IQ in all children
- EF, planning and VIQ = ToM
- language ability explained variance in ToM
information
3:1 (male:female)
50% have IQ deficit (<70) [Bertrand et al., 2001]
weak central coherence (perception)
- seeing the parts of information [better as segmenting and spotting small details], having difficulty seeing the bigger picture/global percept)
- reduced global integration - don’t tend to have pop out affect for perceptual meaning
- autistic peoples perception is locally oriented
- better at low level perceptual ability (reduced neural complexity)
- drive for perceptual input
- high order processing optional in autism
