Autism Spectrum Disorder Flashcards
Leo Kanner (1943)
Described autism as ‘Autistic Disturbances of affective Contact’
“We must assume that the children have come into the world with innate inability to form the usual, biologically provided affective contact with people.”
Hans Asperger (1944)
Described autism as ‘Autistic Psychopathy’
“The characteristic peculiarity of gaze never fails to be present….They do not make eye
contact… there is a poverty of facial expression & gestures… yet there are many stereotypic movements. The use of language always appears abnormal…..”
DSM 5 Criteria 1
- Clinically significant, persistent deficits in social communication and interactions, as
manifest by all of the following:
–Marked deficits in nonverbal and verbal communication used for social interaction;
–Lack of social reciprocity;
–Failure to develop and maintain peer relationships appropriate to developmental level.
DSM 5 Criteria 2
- Restricted, repetitive patterns of behaviour, interests and activities, as manifested by at least TWO of the following:
–Stereotyped motor or verbal behaviours, or unusual sensory behaviours;
–Excessive adherence to routines and ritualized patterns of behaviour;
–Restricted, fixated interests.
DSM 5 Criteria 3
- Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities).
How is an autistic person diagnosed?
- Collative information from family/social history and co-morbidity
- ASD specific developmental history
- Observational assessment
- Individual profiling (cognitive assessment, communication/speech and language assessment)
What does the Autism Diagnostic Interview - Revised assess
- General orientation
- Early developmental history
- Communication & language
- Social development & play
- Repetitive behaviours & interests
- Other clinical behaviours & special skills
Autism Diagnostic Observation Schedule 2
An interaction and observation assessment for ASD that identifies behaviours of interests and elicits those behaviours
Leekam et al (2006)
Approximately 90% of individuals with ASD experience sensory difficulties
Hyper-responsiveness in ASD
An exaggerated or aversive response to sensory stimuli (e.g., refusal to try new foods, dislike of certain materials, extreme sensitivity to sound
Hypo-responsiveness in ASD
The absence or a diminished response to sensory stimuli (e.g., not responding to name, not responding to pain)
How common is anxiety in ASD?
Anxiety affects around 40% ‐ 50% of children and adults with ASD
Theory of Mind definition
Theory of mind is the ability to attribute mental states to oneself and others and to use such mental state attribution to make sense of behaviour and predict it.
First order Theory of Mind
The ability to understand a person’s mental state (eg “He thinks X”)
Second order Theory of Mind
When theory of mind is applied recursively to understand what someone is thinking of another person’s mental state (e.g., “He thinks that she thinks x”).
Assessments of Theory of Mind
“Sally Anne” and “Smarties Task”
Baron-Cohen et al (1985)
¾ of children with autism have difficulties understanding the minds of others and recognising that other peoples beliefs may be different from their own.
Hoogenhout and Malcolm-Smith (2017)
Theory of Mind predicts severity of ASD
Are Theory of Mind deficits just autism?
Not all autistic people show deficits in Theory of Mind
There are also other atypical groups that show poor performance on Theory of Mind tasks
Criticism of Theory of Mind
There are criticisms related to what Theory of Mind tasks assess
There are inconsistencies in the definition used to characterise advanced Theory of Mind
Central Coherence (typical)
- People usually have a desire to gain a higher‐level meaning
- Everyday tendency to process incoming information in context (i.e. gist)
Processing difficulties in autism
There is a bias towards local processing (an inability yo experience wholes without experiencing the individual parts)
Happe (1996)
Autistic people do not succumb to visual illusions
Happe (1995)
Autistic people fail to use context in reading
Tests autistic people perform better in
Ebbinghaus Illusion and Embedded Figures test
Van der Hallen et al (2015)
Did a meta-analysis of 56 articles of 1,000 ASD participants using a wide range of stimuli and tasks to investigate local and global visual processing in ASD
Results of Van Der Hallen et al (2015)
No enhanced local visual processing nor a deficit in global visual processing.
Analysis reveals a difference in the temporal pattern of the local–global balance, that is, slow global processing in individuals with ASD
Ozonoff et al (1991)
Autistic people have deficits on planning tasks e.g., Tower of Hanoi
Prior et al (1990)
Autistic people have deficits on shifting tasks e.g., Wisconsin Card Sorting Task
Wang et al (2007)
Autistic people have significant working memory impairments, with the visuo‐spaital sketchpad more severely impaired than phonological loop
Christ et al (2007)
Autistic people have impaired performance on inhibition tasks e.g., Flanker task and Go/no‐go task
Kercood et al (2014)
Inconsistent evidence for working memory impairments
Guests et al (2014)
Inhibition problems are often observed in children with ASD, but there is a large variation between studies
Issue with executive function experiments
There are many differences between studies in the tasks used, and some issue of task impurity
What could Theory of Mind be responsible for?
Social and communication impairments
What could executive function be responsible for?
Repetitive behaviours.
AND PATHOLOGICAL DEMAND AVOIDANCE (Goodson, 2018). Autistic children and adolescents with PDA traits appeared to have more EF deficits than non ASD children.
What could weak central coherence be responsible for?
Special talents and peaks in performance
Camouflaging / Compensation / Masking definition
The employment of specific behavioural and cognitive strategies by autistic people to adapt to or cope within the predominately non‐autistic social world
Examples of masking
Examples include supressing repetitive hand movements, forcing eye contact, using conversational scripts, and using learned rules to respond to others’ non‐verbal behaviour.
What is participatory research in autism?
Refers to ways of involving autistic people and their allies (e.g. family members) in making decisions about research.
These decisions can include what research gets done, how it gets done and how research findings are used.
Medical model of ASD
There are suggestions that we need to move away from the medical model/ ‘impairment’ view of ASD
* The ‘impairment’ view may be societally harmful
* There is a clear move towards neurodiversity perspectives and inclusive practices
Spectrum 10K
A study launched in 2021, pioneered by Baron-Cohen, that was meant to look at genetic causes of autism. 12 autistic people were asked about the ethics of the study prior to recruitment, during recruitment there was a large outcry. Baron-Cohen acknowledges more autistic people should have been asked.
