Autism spectrum Disorder Flashcards
What is the ICD-11 definition of autism?
– deficits in the ability to initiate and to sustain reciprocal social interaction & social communication
–restricted, repetitive, and inflexible patterns of behaviour and interests
Sub-categories are based on intellectual ability and language:
* Without disorder of intellectual development
* With disorder of intellectual development
Functional language is:
* Mildly impaired, or no impairment
* Moderate impairment
* Absent
Facts about autism?
Disorder/condition, rather than disease
Neurodevelopmental disorder, present from very early stages of life
–Lifelong condition
–“Treatments” and “cures” are non-existent/controversial, but there are several therapies/ support that can help people with ASD
function in everyday life
–Also several comorbid conditions that may require some degree of
treatment
Common signs of autism:
– Difficulties in communication & social interaction (understanding
peoples thoughts, feelings, motives)
– Sensory processing issues (bright lights, loud noises, touch)
– Restrictive interests and/or repetitive movements
– Heightened anxiety (unfamiliar environments/ social events)
– Can include learning/intellectual disability
It is a spectrum disorder, so people will present with a wide range of symptoms from severe deficits to absent/barely noticeable
Asperger’s Syndrome
Asperger’s falls within the ASD criteria for both ICD-11 and DSM-V
Asperger’s is effectively the ‘milder end’ of ASD
* Without intellectual or language deficits
* Deficits in social interaction, behaviour, and language
comprehension
Common signs of autism
Signs of autism in young children include:
–not responding to their name
–avoiding eye contact
–not smiling when you smile at them
–getting very upset if they do not like a certain taste, smell or sound
–repetitive movements, such as flapping their hands, flicking their
fingers or rocking their body
–not talking as much as other children
–repeating the same phrases
Signs of autism in older children include:
–not seeming to understand what others are thinking or feeling
–finding it hard to say how they feel
–liking a strict daily routine and getting very upset if it changes
–having a very keen interest in certain subjects or activities
–getting very upset if you ask them to do something
–finding it hard to make friends or preferring to be on their own
–taking things very literally – for example, they may not understand
phrases like “break a leg”
Common signs of autism in adults include:
–finding it hard to understand what others are thinking or feeling
–getting very anxious about social situations
–finding it hard to make friends or preferring to be on your own
–seeming blunt, rude or not interested in others without meaning to
–finding it hard to say how you feel
–taking things very literally – for example, you may not understand
sarcasm or phrases like “break a leg”
–having the same routine every day and getting very anxious if it
changes
Further signs may include:
–not understanding social “rules”, such as not talking over people
–avoiding eye contact
–getting too close to other people, or getting very upset if someone
touches or gets too close to you
–noticing small details, patterns, smells or sounds that others do not
–having a very keen interest in certain subjects or activities
–liking to plan things carefully before doing them
Restrictive behaviours/strict routine
An example of restricted behaviours: 14 year old will only drink from one very specific cup
Restrictive interests
– People with ASD may develop highly focused interests
– Can be focused on a variety of things, such as music, art,
computers, trains, numbers, postcodes, etc.
– May be general interest, or collecting items
– This can be healthy, in that it gives a focus, something they are
comfortable with, to help them relax and feel happy
– Can be unhealthy if it becomes an obsession
* Unable to stop
* Distressed when trying to resist the behaviour
* Having a significant negative impact on the person or their
family
E.g. Trains
–Darius McCollum
–Diagnosed with Asperger’s syndrome
–Fascinated by trains/public transport
–Repeatedly stole NYC subway trains & buses
UFO’s
–Gary McKinnon
–Was obsessed with looking for evidence of UFOs
–Hacked US government computer systems
–”I almost wanted to be caught, because it was ruining me”
–Diagnosed with Asperger’s syndrome during extradition trial
Repetitive movements
– Can include:
* arm/hand flapping
* tapping fingers
* rocking
* banging head
* jumping
* spinning
– Called “stimming” – self-stimulating behaviour
Movement/coordination issues
–People with ASD may have issues with motor skills/coordination
–Depending on severity, this can be diagnosed as developmental
coordination disorder (dyspraxia)
“Teachers pointed out fine motor problems. He also struggled learning to go up & downstairs & was still going one step at a time, two feet to each step, long after he started school. He couldn’t (and in fact still can’t) ride a bike, do buttons or zips (still the case with zips) and his throwing & catching skills were (and still are) significantly behind his peers.”
Sensory Processing
–Heightened or dampened response to sensory input
–Can include visual, auditory, taste, touch, and pain
–“Paradox of pain in autism. On the one hand, some people with autism can tolerate extreme heat, cold or pressure and seem relatively insensitive to pain. On the other hand, they may experience intense pain from idiosyncratic sources but struggle to communicate it.”
Speech
– Speech development may be delayed, within normal range, or even
appear advanced, or they may remain non-verbal
– Echolalia – repetition without meaning
– Pronoun reversal – e.g. referring to other people as ‘I’, referring to
themselves as ‘you’
– Unusual prosody (rhythm, tone, inflection)
– “It’s masked alot as her speech is ahead for her age but her
understanding isn’t as good as it should be for her age.”
– “At that age the 3 things that really struck me were not responding
to his name, not pointing, & not waving. He also did not speak.”
Meltdowns
Looks like a massive tantrum, but there is a difference
Tantrum:
* Is goal-orientated
* Needs an audience
* Will normally reduce as the child grows up
Meltdown is due to sensory, emotional, and informational overload
* Won’t be stopped by reassurance, distraction, bribes, etc.
* Can be anticipated and/or minimised
* Identify/minimise triggers
* Look for early warning signs
Pathological demand avoidance (PDA)
–Can be considered part of ASD, but does appear distinct from general
Autism/Asperger’s:
–Avoid demands and expectations to an extreme extent
–Can appear excessively controlling and dominating
–May appear relatively sociable, but still with deficits
–Averse to deviations to normal routine
–Might use social strategies (distracting, excuses) to avoid demands
ASD in females
– ASD is more common in males (approx. 3:1)
– Gender/hormone differences might male males more prone to ASD
– ASD impairments in females may be under-recognized
– Females may be better at masking symptoms
– Phenotype may be different in females
– Diagnostic tests are designed to identify ASD in males
From Emma, speech therapist:
–“There’s lots of information emerging about the presentation of ASD
in females. My own experience is reflected in the research,
especially relating to how females mask much more than males, &
also experience higher levels of anxiety.”
Symptoms
“He was obsessed by traffic lights. Failure to follow certain routines
caused a crisis. He was more upset by a commercial that showed a car being crushed than he would have been if another human being had been injured. Pain just didn’t register - even when he had a burn that was bad enough to go to A&E with there was no reaction. He was very easy to wean - he ate anything and everything - and then one day would only eat white foods.”
