Autism Spectrum Disorders Flashcards
Involves what domains?
- Social Interaction
- Communication
- Restrictive, repetitive behaviors, interests activities
Other requirements for ASD criteria?
- diagnosed before the age of 3
- demonstrate 6 to 12 symptoms – at least 2 from social domain, one from communication and one from restrictive behaviors/interests categories
Aspergers disorder
Asperger’s disorder shares social disabilities and restricted behaviors and interests of autism, but language abilities are well developed and intellectual functioning is not impaired.
High Functioning Autism (HFA)
• Autistic disorder but intellectually normal
VS. ASPYS
Aspys show fewer and less severe symptoms
Similar trajectories in outcome
Neuropsychological research show more similar than different
What is Rhett’s Disorder?
typical development, followed by a loss of skills and regression in development.
Lack of social interaction, language, and stereotyped hand movements, including repetitive wringing, “washing,” twisting, clapping or rubbing of the hands in the midline (leading to lack of functional hand use; unsteady gait, and severe to profound mental retardations.
Gene on X chromosome
What is Childhood Disintegrative Disorder?
typical development, followed by a loss of skills and regression in development.
An abrupt and severe regression occurs after at least 2 (and up to 10) years of normal development. After loss of skills, child has all characteristics of sever autism and severe mental retardation.
Rare
What is Pervasive Developmental Disorder (PDD-NOS)?
Label is used for children who experience difficulties in at least two of the three autism-related symptom clusters, but do not meet criteria for any of the other PDDs.
One difficulty within the reciprocal social interaction domain and one symptom from either the communication deficits or repetitive, restricted behaviors domains are required.
Example. Only four DSM symptoms (rule out autism), delay in language onset (ruling out Aspy) and showed no regression in development (Rule out Rett and CDD).
Worth reevaluating due to misdiagnosis
Associated features
- MR - 75% of ASD are ID (however recent studies found a drop in MR and rise in IQ)
- Seizures - 10-15%
- Poor sleeping and eating patterns
- Food allergies
Comomrbidities
o Mood and Anxiety (most common)
• 10% lifetime rate in gen pop.
• More common in higher functioning end
• Social phobia
o Behavior Problems • 69% behavioral difficulties • 25% of ASD history of aggression • Intense reactions to ordinary stressors, such as failure or sensory overstimulation (e.g. screaming, shouting, etc.). • NOT VIOLENT usually
o Attention and Activity Level • 60% poor attention • 40% are hyperacgive • almost 60% met criteria for ADHD. 26% - combined 33% - inattentive 30% of Aspy meet ADHD criteria Hyperactivity diminishes with age Some grow out of social symptoms and look just like ADHD
• Difference from ADHD
ASD → overfocus of attention and internal distractibility
ADHD → underfocused attention and distractibility by external events and stimuli
o Psychosis
• Schizophrenia
Used to be thought to be the same
Hard to disentangle the ritualistic behaviors, unusual verbalization, and social withdrawal that are a part of ASD.
Developmental Course
o Onset before age 3, at two peak periods.
• 2/3 display it with first 2 years of life.
• Less looking at faces or responding to his or her name, pointing, and sharing enjoyment and interests with others.
• Regressive pattern of onset, there is a period of normal development, followed by a change in or loss of previously acquired behavior and the onset of autistic symptoms.
• Plateau vs. regression (1/3 of ASD)
Aspergers
• Hard to detect at younger ages (no language delay)
• Life long and chronic
• Improvement most marked in preschool and early childhood
• Rare to grow out of but happens
• 85-90% at age 2 diagnosis retained diagnosis
• 20% of adults have good outcomes
related to overall cognitive ability (IQ and verbal)
Resources/inteventions
• 12% in college
• 24% of ASD were employed
• Drop in poor outcome
Epidemiology
1 in 88 is the most recent statistic from CDC
Autism and Developmental Disabilities Monitoring (ADDM) Network
11.3 per 1,000
5x more common in boys
Rising prevalence
• Increased awareness
• Better identification
• More sensitive diagnostic tools
We can tell difference between ASD and MR
• Broader classification systems,
DSM casts a broader net.
• Active methods of case ascertainment in epidemiological studies.
Etiology
o Biological mechanisms produce brain changes that lead to the symptoms of autism
o No viable social-environmental hypotheses of autism etiology.
o Genetic factors • Molecular genetics Inconclusive • Twin studies - if one child has ASD then the other will be affected 36-95% of the time. In non IDtwins, it is 0-31% of the time.
o Environment
• Mercury exposure
• Vaccines
Thimerosal
o Neurology
• Brian structure and functioning different
Use brain imaging
Large head, large brain volume
Smaller neuron size and increased cell density in the amygdala
Cite some Twin Studies?
Rosenberg et al (2009), Hallmayer (2011), Happe et al., (2006)
What are the two levels of screening?
Level 1 screening involves routine developmental surveillance by providers of general services for young children, such as pediatricians.
Level 2 evaluation involves a comprehensive diagnostic assessment by experienced clinicians for children who fail the initial screening.
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