Day 19-20 - ASD Flashcards
About __% of children w autism do not develop any “useful” language
50
What are the 3 examples given in class of qualitative language impairments in autism?
- echolalia
- preservative speech
- pragmatics (don’t account for context)
Theory of mind develops by age __ in NT kids. By that age, __% of kids w Downs and __% of kids w ASD have developed ToM
- 4
- 85%
- 20%
What difference do we see in ASD in terms of visual focus?
- less likely to look at social info on faces (look at chin)
- more likely to look at environment around characters
What were the 3 autism-related diagnoses in DSM4
- autistic disorder (social interaction, restricted/repetitive interests AND language deficits)
- asperger’s disorder (social interaction, restricted/repetitive interests)
- PDD-NOS
What is needed for a diagnosis of autism (A-D)?
A. persistent deficits in social communication/interaction (need all 3 of deficits in social-emotional reciprocity, NV communicative behaviors, and dev/maintenance/understanding of social relationships)
B. Restricted, repetitive interests/behavior/activities (need 2 of 4: stereotyped/repetitive mvmt/speech, insistence on sameness, fixated intense interests, hyper/hypo reactivity to sensory input
C. sx present during early dev period
D. sx cause clinically significant impairment
What are severity labels for ASD in DSM5?
- (1) requiring support
- (2) requiring substantial support
- (3) requiring very substantial support
What is Social Communication Disorder?
- basically just criterion A of ASD
- difficulties in social communication
- restricted, repetitive interests have never been present
What is the ADOS?
- Autism Diagnostic Observation Schedule
- semi-structured observation
- press for certain types of behavior
What is the ADI-R
- autism diagnostic interview reviewed
- often paired w ADOS
- interview w parents/caregivers of child
What is the gold standard assessment tool for ASD?
ADOS
What is the general prevalence of ASD?
1-1,5%
What is the gender ratio in ASD?
- 4:1 male to female
- 10:1 m to f in “high functioning”
When is autism typically identified?
- start noticing around 2nd bday
- usually diagnosed between 2-4y
- diagnoses at 2-3y usually stable!
What are the 2 strongest predictors of adult outcomes in ASD?
- language
- IQ
- __% of youth a ASD meet criteria for ID
- __% meet criteria for severe or profound ID
- __% have splinter skills
- __% display savant characteristics
- 70% of youth a ASD meet criteria for ID
- 40% meet criteria for severe or profound ID
- 25% have splinter skills
- 5% display savant characteristics
What 5 conditions are most commonly comorbid w ASD?
- epilepsy
- ADHD
- conduct problems
- anxiety disorders
- depression
WHat is thimerosal?
- preservative in vaccines
- used to think it was linked to autism
- removed from most vaccines in 2001
- turns out data was fraudulent, Dr. lost his license!
(T/F) complications during birth are ass w ASD
TRUE
(T/F) low vitamin D and heavy metal exposure are linked to ASD
TRUE
ASD has approx __% heritability
83%
__% of siblings of ppl w ASD have ASD
15-20%
What are 3 brain differences in ASD vs NT
- differences in structure of many areas
- decreased activation of mirror neurons
- altered activation of facial recognition area
**not clear if causal
What are 3 “biomedical” treatments of ASD?
- vitamin supplements (C, B6, magnesium)
- gluten-free diet
- secretin (for peptic ulcers but one study found it worked for ASD, other studies since suggest it does NOT work)
Are psychotropic meds used to treat ASD?
- mostly used to treat other psychiatric symptoms (not core features of autism)
- SSRIs for anxiety/OCD symptoms
- Stimulants for ADHD symptoms
- antipsychotics for aggression/agitation
How is oxytocin used in ASD?
- many RCTs demonstrate improvements in social functioning
- more research still needed w bigger trials
- not a panacea
What is Applied Behavior Analysis (ABA)?
- either discrete trial training (conditioning, shape desired behavior) or reinforcing naturally occurring behaviors (eg use of language)
What is Developmental Social Pragmatic (DSP) treatment?
- promote and reinforce any efforts at communication
- not trying to change NV comm to verbal
- more naturalistic interaction
What are the 2 well-established tx for ASD?
- individual comprehensive ABA (20+hrs/week for years, starting before age 5)
- teacher-implemented, focused ABA and DSP (in classroom, less intensive)
(T/F) ABA needs to be 20+ hrs/week to be effective
FALSE, gains from just 6-28 hrs/week!
What does recent evidence from ABA meta-analyses suggest about efficacy?
- generally good but depends what symptoms/outcomes looked at
- language abilities might act as tx moderator (greater lang comp/expression at start leads to bigger gains in intellectual functioning!)
What are the 3 common complaints about ABA?
- historical use of harsh punishment to reduce unwanted stimming behaviors
- dosage of intervention way too much
- ppl in autistic community not sufficiently consulted (are tx goals aligned w what they want or what NT ppl want)
