Autism Spectrum Disorder Flashcards
what are the three autism assesments?
Structured Behaviour Observations: ADOS-2
Standardized Rating Forms
Structured Interview: ADI-R
Structured Behaviour Observations: ADOS-2
4 modules, based on expressive language abilities
Standardized activities, and ratings of behaviour
Standardized Rating Forms
Interview with teens/adults who are higher functioning
Structured Interview: ADI-R
E.g. M-CHAT, SCQ
Parent/caregiver completes questionnaire about child’s symptoms
Early Identification
Autism is present from birth
Symptoms are usually recognized around 12-24 months, depending on severity
Reliable diagnosis can be made by age 3
Some children show a regression of skills (around 2 years)
what were the different autistic disorders in the DSM-IV-TR
Autistic Disorder Asperger’s Disorder Childhood Disintegrative Disorder Rett Syndrome Pervasive Developmental Disability, Not Otherwise Specified
what is autism called in DSM-5?
Autism Spectrum disorder
DSM-5: Autism Spectrum Disorder
Deficits in social communication and social interaction
Restrictive, repetitive patterns of behaviour, interests, or activities
Onset in childhood
Impairment in functioning
Not better explained by intellectual disability
Autism and Intellectual Disability
Highly comorbid
¾ of people with autism have some sort of cognitive impairment
Social communication skills should be lower than expected based on developmental level to diagnose autism
Uneven profile of abilities (splintered)
Social-emotional reciprocity
Reduced sharing of interests, emotions, or affect
Back-and-forth conversations
Initiating and responding to social interactions
Joint Attention
engaging the attention of another person in a social context
Theory of Mind
ability to think about the feelings and thoughts of another person
Nonverbal communication
Eye contact
Understanding and use of gestures and body language
Facial expressions and nonverbal communication
Integration of nonverbal and verbal communication
E.g. pointing and making a vocalization
ADOS-2: assess eye contact throughout
Social relationships
Making and keeping friends Adjusting behaviour to suit social contexts Pretend play Imitation Lack of interest in peers E.g. doesn’t care about making friends ADOS-2: baby’s bath time
Repetitive behaviour
Motor movements
Lining up objects
Echolalia- repeating words/phrases said by others
Mixing up pronouns- e.g. “you want ice cream”
E.g. spinning wheels on a toy car
ADOS-2: assess repetitive behaviour throughout
Rigidity
Insistence on sameness/adherence to routines
Difficulty with changes or transitions
Rigid thinking patterns
Getting stuck
E.g. upset if parents take a different route to school
ADOS-2: observe behaviour in transitions between activities
Restricted Interests
Limited interests
Interests are abnormal in intensity or focus
Strong attachment or preoccupation with unusual objects
E.g. a child who only plays with trains
ADOS-2: observe child’s choice of toys (or unusual objects)
Sensory aspects
Sensory aspects
Hyper-reactivity to sensory input
E.g. restricted food, not wearing certain clothing, covering ears
Hypo-reactivity to sensory input
E.g. seemingly indifferent to pain
Unusual interest in sensory input
AKA stimming
E.g. sniffing or licking objects, staring at lights or ceiling fan
ADOS-2: child’s use of textured block or yarn
DSM-5: Specifiers
With/without accompanying intellectual impairment
With/without accompanying language impairment
Associated with a known medical or genetic condition or environmental factor
Associated with another neurodevelopmental, mental, or behavioural disorder
With catatonia (psychomotor disturbance)
DSM-5 Severity Specifiers
Level 1: Requiring Support
Level 2: Requiring Substantial Support
Level 3: Requiring Very Substantial Support
Level 1: Requiring Support
Social Communication Difficulty with initiating social interactions, less interest in people, hard time making friends Probably able to speak in full sentences Restricted, Repetitive Behaviour Inflexible behaviour Difficulty switc
Level 2: Requiring Substantial Support
Social Communication
Noticeable social and communication impairments
Limited initiation of social interactions, abnormal responses
Odd nonverbal communication
Restricted, Repetitive Behaviour
Noticeable, frequent restricted/repetitive behaviour
Difficulty managing change
Inflexibility
Level 3: Requiring Very Substantial Support
Social Communication
Severe deficits in communication
Limited initiation and response to social interactions
Few words
Restricted, Repetitive Behaviour
Extreme difficulty coping with change
Restricted/repetitive behaviour interferes with functioning
what are the causes of autism
Various biological/genetic causes
No one identifiable cause in 80-95% of individuals with autism (idiopathic)
Genetics
Larger brains and grey and white matter
Exposure to micro-organisms, toxins, and drugs
genetics of autism
Siblings have a higher chance of also having autism
Heritability estimates of 37-90%
Especially high concordance rates among identical twins
other medical complictions associated with autism
Sleep Disturbances
Sleep less, and have trouble falling and staying asleep
Seizures
6-50% of people with autism have seizures
Eating and Gastrointestinal Difficulties
Restricted diet
Constipation, nausea, etc.
Gluten-Free/Casein Free Diet is not an evidence-based treatment of autism
interventions for autism
Early intervention is key
Applied Behaviour Analysis (ABA)
Early Intensive Behavioural Intervention (IBI)
Pivotal Response Training (PRT)
