Autism Spectrum Disorders Flashcards
Autism spectrum disorders definition
aka Pervasive Developmental Disorders
Characterized by SEVERE and PERVASIVE impairment in several areas of development
Reciprocal social interaction skills
Communication and language skills
Restricted/stereotyped behaviors, interests, activities
These impairments are evident BEFORE 3 YEARS OF AGE
Often associated with mental retardation and/or other medical conditions
PREVALENCE = 1/100 or higher, and rising
ASD Subtypes
Autistic Disorder
High functioning autism = Asperger’s Syndrome
Rett’s Disorder
Childhood Disintegrative Disorder
Pervasive Developmental Disorder NOS
ASD Brain Development
There is NEVER a period of normal neurodevelopment for a child with ASD –> disrupted subcortical connections, reduced connectivity between regions the fire together, compensatory recruitment of atypical brain regions to complete cognitive tasks
Brain will not look different at birth, but will EXCESSIVELY GROW at ages 1-2 months, and 6-14 months
By 3-4 yrs it will be 10% LARGER, but then normalizes again in adulthood
Some differences in growth include – Disruptions in cortical-subsortical connections leading to recruitment of unusual brain regions, abnormal central serotonin synthesis and plasma serotonin levels, and sudden and excessive brain growth occur between 2-14 months
Factors associated with ASD
Genetics Paternal age Birth injury Prenatal environment Maternal obesity
HIGH CONCORDANCE in MZ TWINS - 90%!!!!
Associated Conditions and ASD
Fragile X (most common cause of mental retardation) – incidence with autism is 10%
Epilepsy – common among those with ASDs
Metabolic Disorders, Turner Syndrome
Other Psych Conditions – ADHD, OCD, MDD, Anxiety, Aggression, Psychosis
ASD and Social Interactions
Social interactions are NOTICEABLY impaired
Often fail to develop peer relationships - a result of their inability to understand or express themselves appropriately in social situations
When we are born, we are “hard-wired” to look at facial-like objects (circles, etc)
Individuals with autism have an IMPAIRED ABILITY to focus on salient facial features
…leads to difficulties identifying social cutes, impairment in non-verbal behavior, and lack of emotional reciprocity (characteristic of the disorder)
REDUCED NEURAL DENSITY in the FUSIFORM GYRUS (brain region of facial recognition) – this area may light up for the mother’s face, but not really for others
ASD and Communication
Deficits in communication
Delay in or lack of development of spoken language, impairment in initiating or sustaining conversation, the use of stereotyped/repetitive/idiosyncratic language, lack of spontaneous or make believe play, or any combination of the above
ECHOLALIA –> may repeat words or phrases they hear around them, over and over
Abnormalities in pitch and intonation
Disturbances in the use of social language (not proficient at “back-and-forth” exchange - just go on without stopping on a single subject, disregarding any pause for exaction)
Irony or non-literal speech can be completely lost on these kids
Stereotyped behaviors and activities
Behaviors, interests and activities are stereotyped and restricted patterns of interest, inflexible adherence to specific and non-functional rules/routines/rituals, stereotyped and repetitive motor mannerisms and persistent preoccupation with parts of objects
Completely fixated on one toy (trains/cars), completely abandoning other toys or topics
Temper tantrums with any small change in routine
Frequent body movements that are repeated (flapping, flicking, etc)
Often, these stereotyped behaviors are EXHIBITED IN TIMES OF STRESS
Asperger’s Syndrome
High functioning autism
M:F of 5:1
Clumsiness and awkwardness of motor movement
At least THREE SYMPTOMS from TWO OF THE DOMAINS (remember - social interaction, communication, behaviors/activities/interests) WITH NO CLINICALLY SIGNIFICANT DELAY IN LANGUAGE
“Looks like autism without communication criteria, but is much more nuanced” – tend to be high functioning and may have strengths in verbal abilities (vocab), but the social use of language still exhibits marked impairment
Often INTERESTED IN HAVING FRIENDS AND INTIMATE RELATIONSHIPS, but they STRUGGLE TO DEVELOP THEM
Best way to treat ASD?
EARLY INTERVENTION!!!!!!!!!!!!!!
Cognitive and academic interventions include – therapy in speech, social skills and behavior
Reward system for targeted behaviors
Educating the family/caretakers
Effective treatment DOES EXIST and involves integrated care via multiple modalities and a great deal of PATIENCE
Prognosis and course
By school age, 50% low functioning, 25% mid functioning, 25% high functioning
Children can improve over course of development, but IQ will REMAIN STABLE
Diagnosis made by age 5 for most, 7 for African Americans and 8.5 for Latinos
