Autism Spectrum Disorder

Question 1

what are the three autism assesments?

Answer 1

Structured Behaviour Observations: ADOS-2
Standardized Rating Forms
Structured Interview: ADI-R

Question 2

Structured Behaviour Observations: ADOS-2

Answer 2

4 modules, based on expressive language abilities

Standardized activities, and ratings of behaviour

Question 3

Standardized Rating Forms

Answer 3

Interview with teens/adults who are higher functioning

Question 4

Structured Interview: ADI-R

Answer 4

E.g. M-CHAT, SCQ

Parent/caregiver completes questionnaire about child’s symptoms

Question 5

Early Identification

Answer 5

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)

Question 6

what were the different autistic disorders in the DSM-IV-TR

Answer 6

Autistic Disorder
Asperger’s Disorder
Childhood Disintegrative Disorder
Rett Syndrome
Pervasive Developmental Disability, Not Otherwise Specified

Question 7

what is autism called in DSM-5?

Answer 7

Autism Spectrum disorder

Question 8

DSM-5: Autism Spectrum Disorder

Answer 8

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

Question 9

Autism and Intellectual Disability

Answer 9

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)

Question 10

Social-emotional reciprocity

Answer 10

Reduced sharing of interests, emotions, or affect
Back-and-forth conversations
Initiating and responding to social interactions

Question 11

Joint Attention

Answer 11

engaging the attention of another person in a social context

Question 12

Theory of Mind

Answer 12

ability to think about the feelings and thoughts of another person

Question 13

Nonverbal communication

Answer 13

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

Question 14

Social relationships

Answer 14

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

Question 15

Repetitive behaviour

Answer 15

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

Question 16

Rigidity

Answer 16

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

Question 17

Restricted Interests

Answer 17

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)

Question 18

Sensory aspects

Answer 18

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

Question 19

DSM-5: Specifiers

Answer 19

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)

Question 20

DSM-5 Severity Specifiers

Answer 20

Level 1: Requiring Support
Level 2: Requiring Substantial Support
Level 3: Requiring Very Substantial Support

Question 21

Level 1: Requiring Support

Answer 21

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

Question 22

Level 2: Requiring Substantial Support

Answer 22

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

Question 23

Level 3: Requiring Very Substantial Support

Answer 23

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

Question 24

what are the causes of autism

Answer 24

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

Question 25

genetics of autism

Answer 25

Siblings have a higher chance of also having autism
Heritability estimates of 37-90%
Especially high concordance rates among identical twins

Question 26

other medical complictions associated with autism

Answer 26

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

Question 27

interventions for autism

Answer 27

Early intervention is key
Applied Behaviour Analysis (ABA)
Early Intensive Behavioural Intervention (IBI)
Pivotal Response Training (PRT)