Autism Spectrum Disorder

Question 1

Statistics about autism spectrum disorder ASD

Answer 1

1 in 59 children (in 2018)
1 in 150 (200)
More than 1.5 million americans live with ASD
4.5 times more common in males than in females
one of the fastest growing developmental disorders in the US
no cure

Question 2

What is ASD

Answer 2

A developmental disability that can cause significant social, communication, and behavioral changes
Children learn, behave, interact and communicate differently
-impaired social interaction
-delayed verbal and non-verbal communication
-restricted and repetitive behavior

Question 3

High Functioning Autism

Answer 3

needs support, patient is social and communication skills and repetitive behaviors are only noticeable without support

Question 4

Autism

Answer 4

Needs substantial support, patient is social and communication skills and repetitive behaviors are still obvious to the casual observer even with support in place

Question 5

Severe Autism

Answer 5

Needs a lot of support

behavior, communication skills and social skills impair daily life

Question 6

Risk factors for a child with autism

Answer 6

older age of parents, single gene disorder like rett syndrome, lack of nutrition, vitamins and folic acids, gene mutation/pregnancy issues/immune conditions

Question 7

Pathophysiology (neural)

Answer 7

abnormalities in the cellular configuration in regions
-frontal temporal lobes
-cerebellum
Enlargement of the amygdala and hippocampus
-More neurons in the prefrontal cortex
-Reduced or atypical connectivity in frontal brain regions
-thinning of the corpus callosum, hyperactive or hypoactive posterior superior temporal sulcus, neuro-glial synaptic dysfunction, differential connectivity of medial dorsal/anterior thalamus

Question 8

social hypersensitivity

Answer 8

hyperactive pSTS

Question 9

social dysmotivation

Answer 9

hypoactive pSTS

Question 10

Gene pathophysiology

Answer 10

AT, RA and type 1 diabetes, immune realted genes, epigenetics: MECP2, Candidate genes

Question 11

Environment pathophysiology

Answer 11

MIA, maternal exposure to drugs (SSRI/VPA), prenatal stress, advanced parental age, zinc deficiency, abnormal melatonin synthesis

Question 12

Environment and gene pathophysiology lead to

Answer 12

neuroinflammation: increase in IL-6, 1B, IFN, TNF

inflammation in peripheral blood: Increase of IL-6, 1B, IFN, TNF, GM-CSF and IFN, Th1/Th2

Question 13

Autism Behavior

Answer 13

social communication deficits; restricted or repetitive behavior/interests/activities

Question 14

Brain dysfunction and physiological abnormalities

Answer 14

Altered brain structure
Increased total brain volume/frontal lobe/cerebrum/cerebral white matter
synaptic defects
Immune dysregulation and neuroinflammation
Oxidative stress
Mitochondrial Dysfunction

Question 15

Treatment- meds

Answer 15

no medications to treat of cure but can use medications to manage high energy levels, ability to focus, depression or seizures

Question 16

Treatment-dietary approaches

Answer 16

removing foods, mineral supplement, vitamin supplement

Question 17

Treatment-behavior and communication approaches

Answer 17

applied behavior analysis 
floortime
OT 
Sensory integration therapy 
Speech therapy 
picture exchange communication system

Question 18

Secondary Conditions of ASD

Answer 18

lack of nutrition
physical inactivity
obesity, hypertension and dyslipidemia
cardiovascular and metabolic diseases (all elevated rates compared to typical children)

Question 19

Percentage of adolescents with autism who are obese

Answer 19

31.8%

Question 20

ASD leads to

Answer 20

physiological alterations to obesity/hypertension/dyslipidemia to cardiovascular/metabolic disease

Question 21

exercise testing

Answer 21

proper environment, attractive/predictable, same space, allow time to adapt to new exercise, age-appropriate, good lighting/ventilation, avoid distractions, bright lights, and loud sounds for children with hypersensitivity, good temperature, and appropriate sized equipment

Question 22

General considerations (ASD)

Answer 22

meet the childs need with exercise, keep the explanation simple with visuals, have it organized and set into a routine, ask parents what motivates or helps keep the child on track REWARD and PRAISE

Question 23

Special Considerations

Answer 23

use adaptive equipment due to motor impairment
low functioning might need individual sessions while high function asd can benefit from group exercise
progress is gradually based on individual abilities
give lots of breaks-don’t overwhelm
give lots of time for warm up and cool down
watch for tantrums/self-injurious behavior and nonadherence
enjoyable activities

Question 24

benefits of exercise

Answer 24

improved fitness, motor function, behavior and social implications
promotes self-esteem, increases happiness, positive social outcomes
Good for them to be on a team sport to develop social relationships and to learn to recognize social cues required for sports