Autism Flashcards
What are the aspects of the triad?
Impairments in communication: Verbal, non verbal
Impairments in social interaction:
Impaired reciprocal interaction. Miss social emotional cues and lack reciprocity.
Lack ‘theory of mind’ (Sally Anne test)
Restricted, repetitive, stereotyped patterns of interests and behaviours.
Tendency not to use objects in intended functional fashion, little imaginative play, stereotyped motor mannerisms.
What are the sub groups of autism?
Pervasive developmental disorders: Childhood autism Atypical autism Rett syndrome Asperger's syndrome
What is childhood autism?
Presence of abnormal or impaired development in reciprocal social interaction and communication.
Restricted, repetitive and stereotyped patterns of behaviour
Abnormal development before 3 years old.
Non specific problems (fears/phobia, sleeping disturbances etc)
What is Aspergers syndrome?
Similar features with autism, with impaired communication and reciprocal interaction, but no general delay or retardation in language or in cognitive development. Most normal IQ.
What is a point that makes it more difficult to diagnose during development?
Normal behaviour at one age may be abnormal at another.
What are some behaviour disorders at early age?
- Feeding problems
- Dislike of physical contact
- Not lifting arms to be lifted
- Not snuggling down when held
- Lack of curiosity
- Lack of eye contact
What is the aetiology?
Exact cause in unknown. Diagnosis is behaviourally defined, but well recognised to be the endpoint of several organic aetiologies.
Gene and environment interaction.
Genetics: Concordance rates in MZ twins between 36-60%.
Polygenic disorder
X-linked- greater prevalence in boys.
What are other potential causative factors?
Diet Pollutants Antibiotics Allergies Vaccines Severe deprivation
Critical period between 4-6 weeks gestation.
What are the psychological theories of autism?
75% of individuals with autism have IQ < 70.
Cognitive deficits are not a consequence of impaired social development.
Theory of mind, executive function, central coherence, systemising theory.
What is the effects of severe psychological deprivation?
Language delay, abnormal social behaviour, sometimes unusual habits and motor stereotypies.
Do not have marked language comprehension difficulties.
What are the diagnostic tools?
- ADOS-2- Autism diagnostic observation schedule. (observation of child- tasks and play based.)
- ADI-R autism diagnostic interview revised
- DISCO
- Based on Nice guideline, clinical assessment, child observation, psychometric testing.
What are some challenges of diagnosis?
Nothing pathogenic Cluster of symptoms important Comorbiditiy Family styles Behavioural patterns change with increases age.
What did the PACT trial find?
The first RCT that showed an intervention that improved autism scores at follow up.
What is the prognosis?
Early symptoms tend to disappear with age.
Severe social/communication impairments tend to remain and overall outlook for severely autistic children is poor.
Bad prognostic factors:
Low IQ, no speech by 7, regression.
