Autism Lecture Flashcards
What was the shifting paradigm for Neurodiversity?
Neurodiversity: Natural variation in human neurocognitive function
Leads to
Neurodiversity Paradigm: No one type of brain function is “right” or “best.” Ideal neurocognitive function is socially constructed. Neurodiversity is subject to power inequities, but also a source of creativity and empowerment.
Leads to Neurodiversity Movement: Social movement that seeks civil rights, equality and inclusion for everyone, regardless of neurocogntive function.
Pathology Paradigm
-Perseverate
-Concrete and literal
-Inflexible
-Interpersonal challenges
-Intolerant of unexpected change
-Social communication challenges
-Difficulty with abstract thinking
NeuroDiversity Paradigm
-Detail oriented
-Pattern detection
-Routine driven
-Technologically inclined
-Visual memorization
-Reliable and honest
-Subscribe to rules and routines
Autism Criteria A
Persistent deficits in social communication and social interaction across multiple contexts: Must have all
1) Deficits in socio-emotional reciprocity ranging from abnormal social approach and failure of normal back-and-forth conversation.
2) Deficits in nonverbal communicative behaviors used for social interaction, such as poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; total lack of facial expressions.
- Deficits in developing, maintaining, and understanding relationships, ranging from difficulties adjusting behavior to suit various social contexts.
Autism Criteria B
RRBS (restricted and repetitive behaviors): Two of the following (present or historical)
- Sterotyped or repetitive motor movements, use of objects, or speech
- Instance on sameness, inflexible adherence to routines and ritualized patterns or verbal behavior.
- Highly restricted, fixated interests that are abnormal in intensity or focus
- Hyper-or-Hyporeactivity to sensory input or unusual interests in sensory aspects of the environment
Autism Criteria C
Symptoms must be present in the early developmental period
Autism Criteria D
Symptoms cause clinically significant impairment in social, occupational, or other important areas of functioning
Autism Criteria E
These disturbances are not better explained by intellectual disability or global development delay
Autism Severity Level 3
Requiring very substantial support:
Social Communication: Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning. Minimal response to social overtures.
RRBs: Inflexibility of behavior, extreme difficulty coping with change, other RRBs interfere with functioning
Autism Severity Level 2
Requiring substantial support
Social Communication: Severe deficits in verbal and nonverbal social communication skills, which cause severe impairments in functioning, very limited initiation of social interactions, and minimal response.
RRBs: Inflexibility of behavior, difficulty coping with change, or other RRBs appear frequent enough to be obvious to the casual observer and interfere with functioning in a variety of contexts.
Autism Severity Level 1
Requiring Support
Social Communication: W/O supports are in place, but deficits in social communication cause noticeable impairments. Difficulty initiating social interactions.Unsuccessful response to social overtures of others. May appear to have decreased interests in social interactions.
RRBs: Inflexibility of behavior causes significant interference with functioning in one or more contexts.
Autism Spectrum: Proprioception
Sensing body position, dancing, walking on tiptoes, spinning, dyspraxia
Autism Spectrum: Interoception
Internal sense, hunger, thirst, feeling full, going to the bathroom, awareness of emotions
Autism Spectrum: Emotional Intensity
Meltdowns, shutdowns, overload, situational mutism, hyporeactivity
Autism Spectrum: Communication Differences
Echolalia, Pallialia, Scripting, eye contact, body language, tangential conversion info dumps.
Autism Spectrum: Relationship Differences
Rejection sensitivity, masking, bonding through special interests
Executive Functioning (ASD)
Hyper focus, demand avoidance, hygiene, process complexity, Difficulty changing tasks
Autism Spectrum: SPINS
SPecial INterests, intense research, information hunger collections
Autism Spectrum: Stims
Energy regulation, sensory seeking, repetitive movements
Autism Spectrum: Exteroception
Sensing the outside world, hypersensitive or hypnosensitive
Matt Lowry (2023) Strengths-Based Diagnosis: A-Different social communication evidenced by
1: Difference in communication, tendency to go off on tangents, tendency to talk about special interests.
2: Differences in nonverbal communication. This includes stimming while talking, looking at more interesting things while talking, being bored in conversation and would rather be doing something else.
3: Autistic people tend to be shunned due to differences in communication from neurotypical people. This makes autistic people conditioned to believe that they’re somehow less social (think opposite when at comic con).
Matt Lowry (2023) Strengths-Based Diagnosis: B- RRBs evidenced by at least two of the following
1: Stimming or engaging in echolalia
2: Security in routines: Autistic people do not have a sensory filter, so the world is perceived in a state of chaos
3: SPecial INterests (SPINS) Due to hyperconnected brains, autistic people feel more passionately about what they love.
4: Hyper-Hyporeactivity to stimuli- feeling things more intensely. Monotropism: feeling things less intensely because we tune them out in favor of other stimuli (example: we might go outside without a coat, because we are so focused on the mission at hand)
Matt Lowry (2023) Strengths-Based Diagnosis: C
We’re born with these traits, but we learn how to mask them. Can show up when we’re stressed out
Matt Lowry (2023) Strengths-Based Diagnosis: D
These traits cause other people distress (DSM only considers this when it affects aspects of living, NOT when it’s a daily issue).
Matt Lowry (2023) Strengths-Based Diagnosis: E
Not due to an intellectual disability. Autistic people might do poorly on an IQ test; however, factors like performance or test anxiety, along with lack of experience dealing with autism from the examiner, might indicate lower IQ than actual.
Core Challenges in ASD
-Social Communication
-Social Imitation
-Face perception
-Joint attention
-Communication abilities
-Social attention
-RRBs
Social Emotional Competence
Awareness of own emotional state
Awareness of other’s emotional state
Emotional use of words
Ability to cope with emotional distress
What happens when a child with ASD looks into another’s eyes (Ramachandran)
- The altered connection between the cortex and amygdale distorts the childs response
-The amygdale triggers the autonomous nervous system, raising their heart rate
-Child looks away to reduce stress
Theory of Mind (ASD)
Capacity to imagine or form opinions about the cognitive states of other people
What brings parents into seeking treatment (ASD)
Language and communication
-50% remain mute throughout lifespan
-85% have echolalia
What are two underlying factors of ASD
Instance on sameness (IS)
Repetitive sensory, and motor behaviors (RSMB)
What are comorbid challenges with ASD
Anxiety
Sleep disturbances
Eating disturbances
-Health Conditions
-Fears and response to sensory stimuli
-31% have an intellectual disability
Differential Diagnosis for ASD
-Language disorders
-Childhood-onset schizophrenia
- PTSD
-Other neurodevelopment disorders
Three different patterns of autism
1: Congenital group- atypical behaviors are present from birth.
2: Failure to develop skills: early milestones followed, but development plateaus
3: Period of norma; development, followed by regression and loss of previous skills
Model for Etiological Indicators (ASD)
1) Genetic markers
2) Neuroanatomical abnormalities
3) Information processing impairments
4) Manifestation of behavioral symptoms
Etiology: Genetic Factors (ASD)
-Twin studies
-The broader autism Phenotype
-ASD susceptibility genes
Etiology: Environmental Risk Factors (ASD)
-Prenatal and Perinatal risk factors
-Season of birth
-Maternal and paternal age
-Environmental toxins
-Gene-environment interactions
Genetics and Heritability for ASD
ASD and twins = 38%
Heritability coefficients between 64% and 91%
Shared environmental effects = 7% to 35%
Sibling recurrence 19%
Subthreshold symptoms = 4-20%
Neuroanatomical findings for ASD
-Atypical brain growth and volume
-Limbic system-reduced neuronal cell size
-Corpus Callosum (reduced size)
-Cerebellum decreased
-Prefrontal cortex- decreased functioning
-Brain connectivity problems
Biochemical Markers for ASD
25-50% have very high levels of serotonin
-Unusual patterns of dopamine, norepinephrine and endogenous opioids
Controversy with ASD
Immunizations
Gastro/leaky gut
Heavy Metals
Prenatal Factors (ASD)
- Mothers older than 35-50 years
-Fathers older than 50-55
-Uterine bleeding
-Low birth weight
