Autism Spectrum Disorders

Question 1

Neurodevelopmental disorder characteristics

Answer 1

• = disorder of brain development
• impacts multiple aspects of human fxning
  
  • e.g. social, emotional, cognitive, etc.
• significantly impacts persion’s ability to fxn and/or adapt to demands of environment

Question 2

Examples of neurodevelopmental disorders

Answer 2

• ADD
• ASD
• Fetal alcohol syndrome
• Fragile X
• Down Syndrome
• Retts Syndrome
• Schizophrenia

Question 3

Definition of ASD (DSM-5)

Answer 3

• biologically-based, but behaviorally defined developmental disorder
• qualitative impairments in reciprocal social communication
• repetitive behaviors & restricted interests

Question 4

Examples of impairments in reciprocal social communication

Answer 4

• difficulty w/spontaneous, dynamic back-and-forth shared engagement w/another person
• difficulty w/ well-integrated verbal and nonverbal behaviors

Question 5

Examples of repetitive behaviors/restricted interests

Answer 5

• difficulty w/opennes to novel ideas & activities
• limited ability to unexpected condition
• limited ability to shift attention
• limited ability to modify behaviors based on changes in context

Question 6

Basic Facts about ASD

Answer 6

• probably multiple causal pathways & complex interaction between genetics and environment
• affects ~1/110 individuals; similar rates across cultures
• more common in males
• majority are “high-fxning”

Question 7

Commonly associated conditions in ASD

Answer 7

• anxiety/depression
• attentional problems
• language-based learning disabilities
• motor planning difficulties
• impulsivity
• sleep problems
• GI symptoms
• “picky” eating/self-restricted diet

Question 8

Course/etiology of ASD

Answer 8

• lifelong developmental disorder
  
  • behaviors shift throughout development
  • usually identified between 2-5 yrs
  • more studies needed
• etiology is unknown and likely complex
  
  • genes + environment

Question 9

Genetics of ASD

Answer 9

• heritability ranges from .92 - 1.2 in twin studies
• ~15-20% of cases have known genetic etiology
• possible involvement of epigenetic factors: parental age, neonatal complications, fertility treatments
• risk of having a second child w/autism is greater than expected

Question 10

Factors that increase risk for autism

Answer 10

• sibling w/autism
• children w/known genetic conditions (e.g. fragile X)
• children w/known medical conditions

Question 11

Social and communicative symptoms observed in the first 12 mo.

Answer 11

• dysynchrony w/caregiver
• lack of social smile
• delayed response to name and poor social orienting
• fewer vocalizations
• poor vocal imitation

Question 12

Red flags for Autism in children < 3yo

Answer 12

• lack of appropriate gaze
• lack of warm, joyful expressions with directed gaze
• lack of sharing interest or enjoyment
• lack of response to name when called
• lack of coordination of gaze, facial expression, gestures and sounds

Question 13

ASD symptoms in school-aged children

Answer 13

• Poor social reciprocity
• Impaired social-emotional understanding
• Difficulty modulating and integrating nonverbal behaviors
• If verbal, language is often disordered (overly literal, tangential or associative, difficulty organizing thoughts in a way listener easily understands)
• Restricted/repetitive play
• Insistence on sameness

Question 14

ASD symptoms in older children/adults

Answer 14

• Limited reciprocity (but usually improved from younger days)
• Impaired gestures
• Unusual prosody
• Failure to understand nonverbal behaviors of others
• Difficulty understanding motivations of other people (can be vulnerable/naïve)
• For some, there is much improvement in symptom severity
• For others, there is more functional impairment around puberty
• Mood and anxiety become increasingly relevant in day-to-day interactions