Autism

Question 1

history

Answer 1

Severe and pervasive developmental disorder characterised by impairments in several areas of development

Identified as recognised clinical disorder by Kanner and Asperger over 50 years ago

Kanner “these children have come into world with innate inability to form usually biologically provided affective contact with people”

Question 2

facts

Answer 2

Autistic behaviours should be present before the age 3

Search is for early diagnosis

Better described as spectrum

Asperger’s syndrome at higher end

2/3 child with autism have IQ score in range that identified them as having learning difficulties (<70)

Behavioural diagnosis in accordance with special social, affective and cog profile

Clinical psychs imp!

Question 3

national autistic society’s criteria for diagnosis

Answer 3

Difficulty with social r’ships

Difficulty with verbal communication

Difficulty with non-verbal communication

Difficulty in development of play and imagination

Resistance to change in routine

Question 4

Wing and Gould’s (1979) triad of impairments

Answer 4

Socialisation

Communication

Imagination

Question 5

socialisation

Answer 5

Social isolation and inability to relate to other people

Impairments in joint attention and social orienting

3 groups children (Wing and Attwood, 1987)

• aloof children
• passive children
• active but odd
• formal

Question 6

aloof children

Answer 6

withdrawn, passive, don’t respond socially, no pleasure from social interactions

Question 7

passive children

Answer 7

more socially responsive but very compliant, very passive, no pleasure from social interaction – indifferent

Question 8

active but odd children

Answer 8

interested in social interactions and respond to social stim – don’t understand norms for social behaviour – e.g. ask inappropriate questions

Question 9

formal children

Answer 9

respond in rigid and formal way

Question 10

communication

Answer 10

Elective mutism (no desire to communicate despite being capable of speaking)

Echolalic speech (repeat other’s words/phrases)

Pronoun reversal (confuse I and you)

Lack of prosody (e.g. fall and rise in voice to communicate emotions)

Lack of gesture communication (e.g. nod head to show approval)

Difficulty at ‘reading faces’

Question 11

imagination

Answer 11

Stereotyped movements

Rigid behaviour

Sameness

Resistance to change, routines

Narrow area of interests

Question 12

checklists

Answer 12

Not aware of other people’s feelings

Doesn’t realise when others angry/upset

Doesn’t notice effect of his/her behaviour on other members of fam

Behaviour often disrupts fam life

V. demanding of other people’s time

Difficult to reason with when upset

Doesn’t seem to understand social skills, e.g. persistently interrupts conversations

Doesn’t pick up on body language

Doesn’t appear to understand how to behave when out (e.g. in shops/other people’s homes)

Doesn’t realise if he/she offends people with their behav

Doesn’t respond when told to do something

Cannot follow command unless carefully worded

Question 13

instructions were

Answer 13

For each item, please mark box that best describes child’s behav over past 6 months

Boxes on 3-point scale ‘not true’, ‘quite/sometimes true’ and ‘very/often true’

Question 14

diagnosis

Answer 14

16,000 children screened for autism during 18-month-old developmental check

Use of Checklist for Autism on Toddlers (CHAT – involves parents’ reports and clinician’s observations)

Children who didn’t have pos responses in following CHAT items were at increased risk for having diagnoses of autism (83.3%)
o Protodeclerative pointing
o Gaze monitoring
o Pretend play

Question 15

how many people are autistic?

Answer 15

Ranges from 1/2000 live births through 1-2/1000 live births

Recent ev shows increase – why? – less stigma, more awareness

Boys outnumber girls (4-1) but ratio changes between high v low cog functioning:
o Low cog functioning (ratio of boys to girls is 2-1)
- High cog functioning (ratio boys-girls is 15-1)