Autism Spectrum Disorder Flashcards
Core features of Autism (3)
- Impairment in communication (quite common along the spectrum)
- Impairment in social interaction
- Repetitive/Restrictive patterns of behaviors and interests
About …% of children with autism do NOT develop any useful language
50%
Language Impairments (qualitative) examples (3)
(1) Echolalia: repeating things you heard (parroting back)
(2) Preservative speech: Getting stuck on a specific topic
(3) Impairment in pragmatics: Answer question correctly (but very literal sense)
-> The context isn’t taken into account in the same way: leads to miscommunication
Echolalia in ASD
- Important step in language development in kids with ASD
- Help with speech production and comprehension
- Not everyone with ASD has echolalia when they’re younger but it helps
Qualitative impairment in social interaction, examples (5)
(1) Social imitation: Learning from others - social learning impaired (e.g. bobo doll)
(2) Joint attention: Ability to coordinate your attention/focus on a social partner/object of mutual interest
(3) Expressive nonverbal behavior: Hard to get the attention of others onto shared object
=> Hard to engage in nonverbal behavior in a way that people are understanding you
(3) Reciprocity: Doing things for others & getting things back
(4) Social “mind”: Less of a tendency to view others as social partners
(5) Difficulty with Theory of Mind (ToM)
Joint attention in ASD
Non-verbal process when you’re connecting with someone else & then redirecting to another thing
-> Help share your enjoyment of an object → way of social communication that’s impaired
Theory of Mind (ToM) in ASD
Knowing that others have mental states (desires, beliefs, intentions) that state guides their behavior
=> Often assessed via False belief tasks
Development of theory of mind in neurotypical vs ASD kids (age)
4yo!
~100% of neurotypical kids developed ToM
~85% of kids with Down syndrome
~20% of kids with ASD
Repetitive Patterns of Behaviors & Interests, examples: (4)
(1) Self-stimulation (e.g. hand flapping, sniffing…)
(2) Intense, narrow interests
(3) Rigid routines
-> Kids with ASD rly benefit from routines
-> Can become dyregulated if routines are disrupted
(4) Preoccupation with parts of objects
E.g. door of the car - not using it as a car
What function does Self-stimulation occupies in ASD? (3)
3 Theories
- A craving for stimulation to excite their nervous system
- A way of blocking out and controlling unwanted stimulation from environment that is too stimulating
- Maintained by sensory reinforcement it provides
Historical perspectives in ASD
- Once viewed as classic, categorical disorder
- Current research emphasizes autism spectrum
ASD: Categorical or Dimensional? (4)
Dimensional
- Within diagnosis, severity of symptoms vary
- Within diagnosis, language ability varies
- Within diagnosis, ANY level of IQ possible
- Presence of traits in close relatives
DSM-IV vs DSM-5: ASD
- DSM-IV
- Autistic disorder: social interaction; restrictive/repetitive interests, language deficits
- Asperger’s disorder: social interaction; restrictive/repetitive interests
- Pervasive Developmental Delay not otherwise specified (PDD-NOS)
- DSM-5 = Autism spectrum disorder
Why all diagnosis into one spectrum in DSM-5? (4)
- Research indicated that these criteria were being applied inconsistently across clinics
- Distinctions between the groups NOT meaningful
- Everyone diagnosed with one of those disorders should meet criteria for ASD
- Biggest study on this issue found that 91% of children who had DSM-IV Pervasive Dev Delay diagnoses met criteria for ASD
Story behind the term “Asperger’s”
-> Hans Asperger, the psychiatrist for whom the disorder was named, was associated with/sympathetic to the ideals of the Nazi party:
Assessment: Autism Diagnostic Observation Schedule (ADOS) – what does it look like?
- Semi-structured observation (observational tasks)
- Presses: A certain pattern of behavior is likely to appear, e.g., unstructured presentation of toys
Prevalence of autism has … over time
Increased (~3% in the last 25 years)
=> Actual increase in number of children who have autism vs. Better identification and broader definitions?
Gender diff in ASD
4:1 male to female ratio
-> 10:1 male to female ratio in LESS severe ASD
Course of autism
Most often identified by parents in the months preceding child’s 2nd birthday
- Neurotypically developing children are developing rapidly at this age but kids with ASD might be delayed
- Some children display symptoms since birth
- Some children seem to LOSE early developmental milestones — can be for other reasons tho (e.g. malnutrition, injuries… but red flag for ASD)
Diagnoses made around … years are generally stable
2 to 3 years
Efforts to create very early identification tests for ASD (under 2yo). Examples: (2)
(1) Using eye tracking to see what toddlers are looking at
=> Toddlers with autism focus on geometric rather than social images
(2) Brain enlargement (cortical surface) - brain grows faster (synaptic pruning on neurons not used)
=> If growing quicker, bigger pruning (implicated in milestones)
=> Recent data indicate that rate of cortical surface expansion between 6 and 12 months predicts diagnosis of autism at 24 months
Is ASD a transient diagnosis?
Usually lifelong
- Challenges might look diff at diff ages, but mostly lifelong condition
- Less than 50% are as independent as a neurotypical kid
- Variability in trajectories of children with ASD
Strongest predictors of adult outcomes in ASD
- Language
- IQ: More positive outcomes if IQ above 70 vs below
Some kids with ASD have ‘savant syndrome’ and others not. What factors might play?
Unique cognitive/behavior profile in autistic adults with savant syndrome
=> Heightened sensory sensitivity, obsessional behaviours, technical/spatial abilities, and systemising (=drive to identify patterns/relationships/rules about how things happen) define savant syndrome
