Chapter 6: Autism Spectrum Disorder Flashcards
Autisim
A complex neurodevelopmental disorder characterized by abnormalities in social communication and unusual behaviors and interests.
ASD
Autism Spectrum Disorder
What is ASD in terms of the DSM-5?
Characterised by significant and persistent deficits in social interaction and communication skills by restrictive patterns of interests and behaviours.
ASD children exhibit preservation of sameness
anxious & obsessive insistence on the maintenance of sameness in daily routines & activities, which no one but the child may disrupt.
Austim vs Intellectual disability
Both are characterised as Neurodevelopmental Disorders in the DSM-5
ASD is defiend as a spectrum disorder
Its symptoms, abilities, and characteristics are expressed in many different combinations and in any degre of severity.
ASD is “All or Nothing’ phenomenon.
What are the 2 symptoms domains of ASD?
- Social communications and interaction
- Restricted, repetitive patterns of behaviour, interests, or activities.
What are the 5 domains for the diagnostic criteria for ASD in terms of the DSM-5?
A: Social communication and interaction
B: Restrictive and repetitive behaviours
C: Symptoms must be present in early developmental period
D: Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning
E: These disturbances are not Intellectual Disability or global developmental delay
Domain A: Social communication and interaction
All 3 required for ASD diagnosis
- Deficits in social-emotional reciprocity - FAILURE of back and forth conversation, reduced sharing of interests, failure to respond to social interactions.
- Deficits in nonverbal communication behaviour used for social interaction - Poorly integrated verbal and nonverbal communication.
- Deficits in developing, maintaining, and understanding relationships - Difficulty adjusting beahviour to social contexts, difficulty making friends.
Domain B: Restrictive and repititive behaviours
AT LEAST 2 types are required for an ASD diagnosis
- Stereotyped/repititive motor movements, use of objects, or speech - lining up toys or flipping objects.
- Insistence of sameness, inflexible adherence to routines, ritualised patterns of verbal or nonverbal behaviour - extreme distress at small changes.
- Highly restricted, fixated interests that are abnormal in intensity/focus - Strong attachment to unusual objects.
- Hyperactivity or Hyporeactivity to sensory input or unusual interest in sensory aspects of the environment - Excessive smelling or touching of objects.
What should people with a deficit in social communication be evaluated for?
If they have no other symptom of ASD, but only have a deficit in social communication. They should be evaluated for PRAGMATIC communication disorder.
Specify if
- With/without accompanying intellectual impairment/language impairment - modifier
- Associated with a known medical or genetic condition/environmental factor
- Associated with another neurodevelopmental, mental, or behavioral disorder -modifier
- With catatonia [immobility]
Specify severity
- Level 1 – Requiring support.
- Level 2 – Requiring substantial support.
- Level 3 – Requiring very substantial support.
Children with ASD can be quite different from one another, we look at 3 factors
- Level of intellectual ability
- Severity of their language problems
- Behaviour changes with age
CORE DEFICITS OF ASD:
A. Social interaction deficits
B. Social Communication deficits
C. Restricted and Repetitive behaviours & interests
Social interaction deficits
o Children with ASD have profound difficulties in relating to other people
o A lack of monitoring of the social activities of others
o A lack of social and emotional reciprocity
o Unusual nonverbal behaviors such as using and processing atypical facial expressions, eye-to-eye
gaze, body postures, and gestures to regulate social interaction
o Impairments in JOINT ATTENTION: The ability to coordinate attention to a social partner and an object or event of mutual interest.
Social communication deficits
- Display serious abnormalities in communication and language that appear early in their development and persist.
- One of the first signs of language impairment = inconsistent use of early preverbal communications (gestures & vocalizations)
- Children with ASD can use protoimperative gestures – gestures/vocalizations used to express needs.
*However, they will not protodeclarartive gestures - gestures/vocalisation ised to direct the visual attention of other people to objects of shared interest .
* Impairments in PRAGMATICS – the appropriate language in social & communicative contexts
Restricted and repetitive behaviours & interests
- They are characterized by their high frequency, repetition in a fixed manner, and desire for sameness in the environment
- Some children may perform stereotyped body movement [such as rocking back and forth]
- A common type of repetitive speech – ECHOLALIA: parrot like repition of words immediately after hearing it.
- Perseverative speech – incessant talking of a topic or incessant questioning
2 dimensions of restrictive repetitive behaviors in children with ASD
- Repetitive sensory and motor behaviors
- Insistence on sameness behaviors
Self-stimulatory behaviors
repetitive body movements/movement of objects
Associated characteristics of ASD:
- Intellectual deficits and strengths
- ID is common within children with ASD
- Intellectual ability of children with ASD varies from Profound disability to Superior ability.
AUTISTIC SAVANTS
Display super-normal abilities in calculation, memory, jigsaw puzzles, music or drawing
Cognitive and motivational deficits
There are two types:
- Specific cognitive deficits in processing social emotional information.
- General cognitive deficits in information processing, planning and attention.
TREATMENT OF ASD:
- Minimise core problems of ASD
- Maximise independence, and quality of life
- Help child and family cope effectively with the problems
