Autistic Spectrum Disorders Flashcards
What are autistic disturbances of affective contact characterised of?
-shortly after birth profound lack of social
engagement
-echolalia, literalness, pronominal reversal
-unusual responses to inanimate environment
-difficulties with change
What is Aspergers?
-males only
-strong language and cognitive skills
-runs in families
-interest in acquiring unusual knowledge
What is the ICD 10 definition of Childhood Autism?
-Qualitative impairments in reciprocal social interaction
-Qualitative impairments in communication
-Restricted/stereotyped patterns of behaviour,interests and activities
What are some examples of abnormalities in reciprocal social interaction?
-Problems orientating to name
-Difficulties with eye contact, body posture, gesture and expression
Insensitivity to other people’s emotions and social context; poorly integrated social, emotional, and communicative behaviour
-Lack of interest in other children/avoidance
-Few friends
-Difficulties sharing excitement
-Not seeking or giving comfort
What are some qualitative abnormalities in communication?
-Language delay without non-verbal compensation
-Limited social chat/two way conversation
-Stereotyped, repetitive use of language
Reduced social-imitative and imaginative play
What are some restricted and repetitive behaviour, interests, and activities?
-Circumscribed interests
-Unusual preoccupations
-Rituals/compulsions
-Motor stereotypies
-Difficulties with change
-Sensory interests or sensitivities
-Onset before 36 months
How is ASD characterised in DSM-V?
ASD is now characterised by two domains:
(1) persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication
(2) restricted, repetitive and inflexible patterns of behaviour, interests or activities, including differences in sensory sensitivities
and interests.
How is autism diagnosed?
- Autism Diagnostic Interview
Clinician administered
Parents/caregivers covering social interaction, communication and restricted behaviours in first 5 years of life
Less reliable with adults (ADI; Lord, 1994) - Autism Diagnostic Observation Schedule
Clinician interview/observation of patient
Adults or children (ADOS; Lord et al, 1999)
Many others + screening instruments
What is the prevalence of autism?
-Childhood autism
Once considered rare = 4 – 4/10,000
Recent estimates:
20 – 40 / 10,000 (Fombonne et al 2003)
-Broad Autistic Spectrum
100 / 10,000 South London (Baird et al 2006)
= 1% of population
ASD and IQ
-50 % of individuals with an ASD have an IQ < 70 (learning disability range)
-This proportion revised downwards from 75%, with increasing recognition of ASD in children with normal IQ
Gender and ASDs
ASDs 4x higher in males (Global Burden of Disease Survey 2010)
Excess in males increases with IQ
Asperger syndrome 10:1 male:female
Note sex ratio slightly lower in studies using active population based case finding than ‘passive’ case-finding studies that use administrative data (Brugha et al 2018)
What are some environmental risk factors?
-Advanced parental age
-Birth trauma (especially hypoxia related)
-Maternal obesity
-Short interval between pregnancies
-Gestational diabetes
-Valproate use during pregnancy
What are some positive aspects of ASD?
-strong persistent interests
-attention to detail
-unusual memory
-fascination with systems and patterns, and ability to concentrate for long periods that may be conducive to creativity and originality
-heightened skills
superior visual functioning
musical processing
What causes atypical social perception and cognition in ASD?
-domain-specific accounts
symptoms result from specific impairments within components of social brain network.
= ‘social first’ hypothesis
-domain-general accounts
atypical brain structure and function are widespread, and apparent social brain differences result from adaptations to earlier widespread changes in brain function.
What are developmental causes of ASD?
-atypical development involving perceptual, attentional, motor, and social systems precede the emerging autism phenotype. Within first year of life:
-presence of head lag when infants are pulled to sit, reflecting delayed motor maturation;
-production of fewer middle consonant types and fewer late consonant types ;
slower attention disengagement
