Autism

Question 1

what is autism?

Answer 1

a neurodevelopmental disorder with an organic basis because of the sensory and motor and neurological features of autism.

Question 2

who developed the Theory of Mind?

Answer 2

Baron-Cohen 1985/2005

Question 3

who developed the Central Coherence Theory?

Answer 3

Happé and Frith, 1989

Question 4

what has there been emphasis on behind theories of autism?

Answer 4

the emphasis has been on identifying and describing the psychological mechanisms that link the biological substratum and behavioral manifestation of autism.

Question 5

what is there evidence to suggest that plays an important role in autism?

Answer 5

there is now substantial evidence that an impairment in the ability to recognise that other people have thoughts and that these thoughts are different from one’s own thoughts plays an important role in autism.

Question 6

what does an absence of mentalisation or theory of mind ability mean for those with ASD?

Answer 6

Absence of mentalisation or theory of mind ability deprives the person with autism of key information about the intentions, motives and actions of other people.
this may account for other aspects of autism such as the apparent failure to integrate lower-level perceptual information into higher-level concepts as described by the central coherence theory of ASD, and possibly the preference for the observable and predictable.

Question 7

what are the Pervasive Developmental Disorders/ PPD’s?

Answer 7

• autistic disorder
• asperger’s disorder
• childhood disintegrative disorder/ CDD
• Rett’s disorder
• PDD otherwise not specified (PDD-NOS)

Question 8

What is the Theory of Mind, by Baron-Cohen?

Answer 8

-autistic kids cannot engage in meta-representations, ie. cannot develop ToM
-Problems with ToM ability are manifested in ASD as a central difficulty in understanding and relating to other people, due to an inability to infer the mental state of another person through their speech, actions and non-verbal communication, in particular due to their specific impairments in reading the mind of the eyes, Baron Cohen 2001.
Specific training in using mentalisation techniques has shown but limited success in developing generalisable skills.
Impaired mentalisation is an important factor in disorders such as psychosis, such a direct linkage has not been demonstrated in Asperger’s Syndrome.
…ToM embodies social cognition deficits

Question 9

what research have Baron-Cohen produced in relation to ToM?

Answer 9

• have difficulty understanding mental state words
• don’t show pretend/ symbolic play
• not aware that eye region indicates thoughts/wants
• unable to deceive
• don’t understand non-literal statements

Question 10

Executive Dysfunction Deficit, Bola 2007?

Answer 10

executive function: suppression of incorrect response, ability to retain info in working memory, involved in flexible planning.
- Executive functioning has been identified as impaired in ASD, in particular the ability to generate novel responses together with other impairments in planning and shifting attention, Bola 2007.

Question 11

is there research behind Executive Dysfunction Deficit?

Answer 11

• deficit with frontal lobe, leading to pervasive behaviour
• Executive Dysfunction occurs with other disorders, so by itself it cannot explain autism and may co-occur with ToM deficit
• fails to explain superior skills in certain areas, Savant skills

Question 12

ASD and memory functioning, in relation to executive functioning?

Answer 12

people with ASD seem to have normal abilities with regard to semantic and procedural memory functioning. they often have difficulties in autobiographical memory functioning, manifesting as an impairment in the spontaneous recall of self-experienced information.

Question 13

what is the Weak Central Coherence theory, by Happé and Frith, 1989?

Answer 13

• normal people desire a high-level meaning of information, this feature of human processing is disturbed in ASD
• autism is biased towards local information rather than global
• ppl with autism fail to succumb to visual illusions and fail to use context in reading
• Weak Central Coherence theory predicts good performance with attention to local information, recognise object as a single part
• poor performance at recognising global meaning and integration of parts

Question 14

what are the three complementary theories of autism?

Answer 14

1) Theory of Mind deficit
- social and communication deficits
2) Executive Dysfunction Deficit
- stereotyped behaviours and narrow interests
3) Weak Central Coherence
- special talents and peaks in performance

Question 15

what sensory problems impact upon people with ASD?

Answer 15

• hyperacusis (which is auditory hypersensitivity),
• tactile oversensitivity
• tactile and somatic under-sensitivity including lower pain threshold
• hypersensitivity to sound, especially high pitched frequencies such as those made by babies, sirens, audible reversing indicators on vehicles, explosions, banging, especially of doors.
• such auditory hyperacusis appears to be a ‘hard-wired’ sensory dysfunction that is not readily amenable,
• Clinical psychology experience indicates that attempts to desensitise people with ASD to such signs throigh gradual exposure may result in considerable distress and is not recommended.

Question 16

what are characteristics of autism?

Answer 16

• insistence on sameness
• diff in expressing needs like pointing and gestures
• repeating words instead of responsive language
• showing distress for no apparent reason
• prefers to be alone
• difficulty mixing with others
• not liked to be cuddled/cuddle
• little/ no eye contact
• sustained odd play
• inappropriate attachment to objects
• no real fears of danger
• spins objects
• not responsive to verbal cues and act as if deaf when hearing is in normal range

Question 17

are there genetic tests or biomarkers for ASD?

Answer 17

there are no genetic tests or biomarkers for ASD.

Question 18

what did Wing and Gould in 1979 develop?

Answer 18

Wing and Gould in 1979 developed the concept of the ‘Triad of impairments’ to describe the presentation of children identified as being autistic.

• The Triad included impairments in communication social interaction and imagination.
• The Triad of impairments have been reconceptualised in terms of lifelong deficits onto dimensions of: social communication and restricted and repetitive behaviour.

Question 19

how is the severity of the presentation of autism assessed?

Answer 19

the severity of the presentation is recorded for both the social communication and restricted and repetitive behaviours dimensions over three levels, which are:

1) requiring support
2) requiring substantial support
3) requiring very substantial support.

Question 20

why is autism seen as a fractionated disorder?

Answer 20

Autism is a fractionated disorder; that is the social communication and repetitive and restrictive behavioral elements are possibly genetically separate traits that tend to co-occur, and are not behavioral expressions of a single underlying genetic disorder.

Question 21

have estimates of the prevalence of ASD has changed?

Answer 21

estimates of the prevalence of ASD has changed considerably over the past 20 years, primarily as a result of changes in diagnostic criteria and also due to professional and public awareness of ASD, resulting in more diagnosis being both sought and made:
2-6 cases per 1000; growing rate of 10-17% per year
4:1 male to female ratio can be observed, in itself an indication of the genetic basis of autism
comorbidity.

Question 22

ASD comorbidity?

Answer 22

ASD has been positively identified in conjunction with:

• fragile x syndrome (up to 50%)
• down’s syndrome (up to 39%)
• most commonly associated with ADHD, considerable overlap between ASD and ADHD in symptomatology, including impaired social communication and patterns of restricted behaviour and interests, leading up to 28% of children with ASD meeting diagnostic criteria for ADHD.

Question 23

how do we screen for ASD?

Answer 23

many cases of ASD are potentially identifiable in infancy using instruments such as:
-The Modified CHecklist for Autism in Toddlers, which can be used with infants aged 18 months and above.
-The Infant Toddler Checklist is valid from 9 months upwards.
-The Social Communication Questionnaire can be used on older children aged 5 -11 years.
CHAT/Checklist for Autism in Toddlers

Question 24

are there early signs of ASD in babies?

Answer 24

further evaluation warranted if:

• no babble/coo @ 12mths
• not gesturing @ 12mths
• not say a single word @ 16mths
• any loss in language or social skills @ any age.

Question 25

assessment of ASD?

Answer 25

• The Social Responsiveness scale to assess impaired communication functioning. - The Repetitive Behaviour Questionnaire to assess repetitive restrictive and ritualistic behaviour

Question 26

what is the aim of introducing interventions with those with ASD?

Answer 26

the aim of interventions is to maximise the quality of life of the person with ASD by helping them to develop their skills and abilities and reducing, or at least ameliorating the effect of their comorbid difficulties

Question 27

should we try eliminate ASD symptomatology?

Answer 27

it is vitally important that no attempt be made try eliminate the core presenting features of a person’s ASD. interventions should help people with ASD learn constructive ways to understand and live with the core features of their condition.

Question 28

what did Lewin in 1943 state?

Answer 28

Lewin’s (1943) proposition states that the behaviour of a person at any given time is the result of an interaction between the person and their environment.

Question 29

ASD a product of the maladaptive env they live in?

Answer 29

there is often a poor fit between the environment in which people with ASD find themselves living and their psychological characteristics.
This raises the question of the degree to which ASD related problems are in fact maladaptive responses to autism un-friendly environments and situations.

Question 30

Autism in a nutshell! (part 1)

Answer 30

People with ASD have specific sensory needs: they prefer low levels of stimulation, especially auditory stimulation. A practical example of meeting this need is altering the ambient sensory stimuli that many people with ASD find distressing rather, than teaching people with ASD coping skills to be able to tolerate levels of sensory stimulation.
When stressed, some people with ASD find strong tactile sensory stimulation or restraint reduces their stress level, for example being wrapped in a heavy blanket.
People with ASD see the world predominantly in terms of their own world view and agenda because they cannot imagine orders having a worldview or agenda different from their own. They therefore need others to make their thoughts, wishes, intentions and feelings relevant to them very explicitly because they cannot imagine or guess what others are thinking.

Question 31

Autism in a nutshell! (part 2)

Answer 31

People with ASD need others to accept that they have a relatively rigid personal style. They therefore prefer predictable routines in all aspects of daily living.
They find all transitions from one situation to another stressful and require recovery routines to help lower their arousal levels. When they make transitions from one context to another, for example from home to school, or from one classroom or teacher to another.
People with ASD tend to have restricted interests which they find very fulfilling. It is therefore helpful allow people with ASD to pursue their interests some of the time.
People with ASD process information in a way where their minds automatically focus on details rather than the big picture. it is therefore better to communicate with them in ways that focus on the main things that need to be discussed, and keep reference to unnecessary details to the minimum.
It is also less distressing for them if others are tolerant rather than critical for their concern with details.
People with ASD understand speech literally. it is therefore helpful to keep the use of figurative speech, proverbs and metaphors to a minimum when talking to them and check that they have understood what you intended when you speak with them.
Failure to take account of the psychological characteristics and needs of people with ASD may lead to considerable distress and consequent challenging behaviour or withdrawal. Understanding the psychological characteristics and needs of people with ASD and then designing environments that take account of these characteristics and needs reduces the likelihood of challenging behaviour and enhances quality of life.

Question 32

what can we do to create a learning envrinoment to suit their needs?

Answer 32

• increased opp’s for learning with ABA programme than the typical classroom
• ABA programmes are highly structured
• tailoring to the individual needs means they get their own designed programme
• high staff ratios mean there is more likely a one-to-one learner ratio
• int’s deal with specific barriers to learning