Autism Spectrum Disorder Flashcards
Autism Spectrum disorder
Autism spectrum disorder (ASD) is a term for a group of
neurologic/ developmental disorders described by:
• Lasting problems with social communication and social
interaction in different settings
• Repetitive behaviours and/or not wanting any change in
daily routines
• Symptoms that begin in early childhood, usually in the first
2 years of life
• Symptoms that cause the person to need help in his or her
daily life
The term “spectrum” refers to the wide range of symptoms, strengths,
and levels of impairment that people with ASD can have.
• The diagnosis of ASD now includes these other conditions:
✓ Autistic disorder
✓ Asperger’s syndrome
✓ Pervasive developmental disorder not otherwise specified
• Although ASD begins in early development, it can last throughout a
person’s lifetime.
What causes ASD?
Scientists don’t know the exact causes of ASD
• research suggests that genes and environment play
important roles.
• ASD occurs more often in people who have certain
genetic conditions, such as Fragile X syndrome or
tuberous sclerosis.
• Many researchers are focusing on how genes interact
with each other and with environmental factors, such as
family medical conditions, parental age and other
demographic factors, and complications during birth or
pregnancy.
• Currently, no scientific studies have linked ASD and
vaccines.
Diagnostic Criteria(DSM5)A.
A. Persistent deficits in social communication and social interaction
across multiple contexts, as manifested by the following, currently or
by history :
1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal
social approach and failure of normal back-and-forth conversation; to reduced
sharing of interests, emotions, or affect; to failure to initiate or respond to
social interactions.
2. Deficits in nonverbal communicative behaviours used for social interaction,
ranging, for example, from poorly integrated verbal and nonverbal
communication; to abnormalities in eye contact and body language or deficits
in understanding and use of gestures; to a total lack of facial expressions and
nonverbal communication.
A. Persistent deficits in social communication and social
interaction across multiple contexts, as manifested by the
following, currently or by history (examples are
illustrative, not exhaustive, see text):
3. Deficits in developing, maintaining, and understanding
relationships, ranging, for example, from difficulties adjusting
behaviour to suit various social contexts; to difficulties in sharing
imaginative play or in making friends; to absence of interest in
peers.
• Specify current severity: Severity is based on social
communication impairment
s and restricted repetitive
patterns of behaviour.
B. Restricted, repetitive patterns of behaviour, interests, or activities,
as manifested by at least two of the following, currently or by history:
1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g.,
simple motor stereotypies, lining up toys or flipping objects, echolalia,
idiosyncratic phrases).
2. Insistence on sameness, inflexible adherence to routines, or ritualized
patterns or verbal nonverbal behaviour (e.g., extreme distress at small
changes, difficulties with transitions, rigid thinking patterns, greeting rituals,
need to take same route or eat food every day).
Diagnostic Criteria(DSM5)A.
A. Persistent deficits in social communication and social interaction
across multiple contexts, as manifested by the following, currently or
by history :
1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal
social approach and failure of normal back-and-forth conversation; to reduced
sharing of interests, emotions, or affect; to failure to initiate or respond to
social interactions.
2. Deficits in nonverbal communicative behaviours used for social interaction,
ranging, for example, from poorly integrated verbal and nonverbal
communication; to abnormalities in eye contact and body language or deficits
in understanding and use of gestures; to a total lack of facial expressions and
nonverbal communication.
A. Persistent deficits in social communication and social
interaction across multiple contexts, as manifested by the
following, currently or by history (examples are
illustrative, not exhaustive, see text):
3. Deficits in developing, maintaining, and understanding
relationships, ranging, for example, from difficulties adjusting
behaviour to suit various social contexts; to difficulties in sharing
imaginative play or in making friends; to absence of interest in
peers.
• Specify current severity: Severity is based on social
communication impairment
s and restricted repetitive
patterns of behaviour.
B. Restricted, repetitive patterns of behaviour, interests, or activities,
as manifested by at least two of the following, currently or by history:
1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g.,
simple motor stereotypies, lining up toys or flipping objects, echolalia,
idiosyncratic phrases).
2. Insistence on sameness, inflexible adherence to routines, or ritualized
patterns or verbal nonverbal behaviour (e.g., extreme distress at small
changes, difficulties with transitions, rigid thinking patterns, greeting rituals,
need to take same route or eat food every day).
Diagnostic Criteria(DSM5)A.
A. Persistent deficits in social communication and social interaction
across multiple contexts, as manifested by the following, currently or
by history :
1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal
social approach and failure of normal back-and-forth conversation; to reduced
sharing of interests, emotions, or affect; to failure to initiate or respond to
social interactions.
2. Deficits in nonverbal communicative behaviours used for social interaction,
ranging, for example, from poorly integrated verbal and nonverbal
communication; to abnormalities in eye contact and body language or deficits
in understanding and use of gestures; to a total lack of facial expressions and
nonverbal communication.
A. Persistent deficits in social communication and social
interaction across multiple contexts, as manifested by the
following, currently or by history (examples are
illustrative, not exhaustive, see text):
3. Deficits in developing, maintaining, and understanding
relationships, ranging, for example, from difficulties adjusting
behaviour to suit various social contexts; to difficulties in sharing
imaginative play or in making friends; to absence of interest in
peers.
• Specify current severity: Severity is based on social
communication impairment
s and restricted repetitive
patterns of behaviour.
B. Restricted, repetitive patterns of behaviour, interests, or activities,
as manifested by at least two of the following, currently or by history:
1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g.,
simple motor stereotypies, lining up toys or flipping objects, echolalia,
idiosyncratic phrases).
2. Insistence on sameness, inflexible adherence to routines, or ritualized
patterns or verbal nonverbal behaviour (e.g., extreme distress at small
changes, difficulties with transitions, rigid thinking patterns, greeting rituals,
need to take same route or eat food every day).
Diagnostic Criteria(DSM5) CONT.
B. Restricted, repetitive patterns of behaviour, interests, or activities,
as manifested by at least two of the following, currently or by history:
3. Highly restricted, fixated interests that are abnormal in intensity or focus
(e.g, strong attachment to or preoccupation with unusual objects, excessively
circumscribed or perseverative interest).
4. Hyper- or hyporactivity to sensory input or unusual interests in sensory
aspects of the environment (e.g., apparent indifference to pain/temperature,
adverse response to specific sounds or textures, excessive smelling or
touching of objects, visual fascination with lights or movement).
• Specify current severity: Severity is based on social communication
impairments and restricted, repetitive patterns of behaviour.
C. Symptoms must be present in the early developmental period (but may not
become fully manifest until social demands exceed limited capacities or may be
masked by learned strategies in later life).
D. Symptoms cause clinically significant impairment in social, occupational, or other
important areas of current functioning.
E. These disturbances are not better explained by intellectual disability (intellectual
developmental disorder) or global developmental delay. Intellectual disability and
autism spectrum disorder frequently co-occur; to make comorbid diagnoses of
autism spectrum disorder and intellectual disability, social communication should
be below that expected for general developmental level
Diagnostic Criteria(DSM5) CONT
Note: Individuals with a well-established DSM-IV
diagnosis of autistic disorder, Asperger’s disorder, or
pervasive developmental disorder not otherwise specified
should be given the diagnosis of autism spectrum
disorder. Individuals who have marked deficits in social
communication, but whose symptoms do not otherwise
meet criteria for autism spectrum disorder, should be
evaluated for social (pragmatic) communication disorder
Performance skills problems
Poor communication skills
• Poor social skills
• Poor emotional regulation
• Motor Apraxia
• Poor sensory perceptual skills- overreaction to sound, touch,
taste, smell, atypical visual exploration of objects, Poor
respond to name
Performance patterns
Habits: restricted and repetitive behavior
• Routines: family routines
• Roles: difficult to fulfill their roles
• Rituals : relate to culture, spiritual, religious
client factors
Cognition
• perception
• Praxis
• Sensation
• gait
• posture
• balance
• Coordination
• Imitation
Performance context
Physical environment
• Cultural context
• Personal context
• Temporal context
• Virtual context
Occupational performance in ASD
• ASD may impact any and all occupations
✓ Activities of daily living
✓ Social participation
✓ Play
✓ Sleep
✓ Education
Family’s Problems
Loss of self esteem
• Feelings of shame
• Ambivalence towards the child
• High stress level /Depression
Self-reproach
• Self-sacrifice
• Defensiveness and overprotection
• Denial
• Impact on family life and family functioning
Caregiver Problems
Difficult coping with and accepting a child who is difficult to accept (no
response, tactile defensive, restless, unable to communicate, destructive,
incontinent
• Disappointment and frustration due to slow progress and minimal results
COMPASSION is key
Clinical Management
Multidisciplinary/ interprofesional Approach
Child Psychiatrists
• Educational Psychologists
• Occupational therapists,
• Speech and language therapists
• Dietitian
• Social workers
• Specialist teachers
• Pediatricians, family physicians and nurses
