Day 19-20 - ASD

Question 1

About __% of children w autism do not develop any “useful” language

Answer 1

50

Question 2

What are the 3 examples given in class of qualitative language impairments in autism?

Answer 2

• echolalia
• preservative speech
• pragmatics (don’t account for context)

Question 3

Theory of mind develops by age __ in NT kids. By that age, __% of kids w Downs and __% of kids w ASD have developed ToM

Answer 3

• 4
• 85%
• 20%

Question 4

What difference do we see in ASD in terms of visual focus?

Answer 4

• less likely to look at social info on faces (look at chin)
• more likely to look at environment around characters

Question 5

What were the 3 autism-related diagnoses in DSM4

Answer 5

• autistic disorder (social interaction, restricted/repetitive interests AND language deficits)
• asperger’s disorder (social interaction, restricted/repetitive interests)
• PDD-NOS

Question 6

What is needed for a diagnosis of autism (A-D)?

Answer 6

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

Question 7

What are severity labels for ASD in DSM5?

Answer 7

• (1) requiring support
• (2) requiring substantial support
• (3) requiring very substantial support

Question 8

What is Social Communication Disorder?

Answer 8

• basically just criterion A of ASD
• difficulties in social communication
• restricted, repetitive interests have never been present

Question 9

What is the ADOS?

Answer 9

• Autism Diagnostic Observation Schedule
• semi-structured observation
• press for certain types of behavior

Question 10

What is the ADI-R

Answer 10

• autism diagnostic interview reviewed
• often paired w ADOS
• interview w parents/caregivers of child

Question 11

What is the gold standard assessment tool for ASD?

Answer 11

ADOS

Question 12

What is the general prevalence of ASD?

Answer 12

1-1,5%

Question 13

What is the gender ratio in ASD?

Answer 13

• 4:1 male to female
• 10:1 m to f in “high functioning”

Question 14

When is autism typically identified?

Answer 14

• start noticing around 2nd bday
• usually diagnosed between 2-4y
• diagnoses at 2-3y usually stable!

Question 15

What are the 2 strongest predictors of adult outcomes in ASD?

Answer 15

• language
• IQ

Question 16

• __% of youth a ASD meet criteria for ID
• __% meet criteria for severe or profound ID
• __% have splinter skills
• __% display savant characteristics

Answer 16

• 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

Question 17

What 5 conditions are most commonly comorbid w ASD?

Answer 17

• epilepsy
• ADHD
• conduct problems
• anxiety disorders
• depression

Question 18

WHat is thimerosal?

Answer 18

• 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!

Question 19

(T/F) complications during birth are ass w ASD

Answer 19

TRUE

Question 20

(T/F) low vitamin D and heavy metal exposure are linked to ASD

Answer 20

TRUE

Question 21

ASD has approx __% heritability

Answer 21

83%

Question 22

__% of siblings of ppl w ASD have ASD

Answer 22

15-20%

Question 23

What are 3 brain differences in ASD vs NT

Answer 23

• differences in structure of many areas
• decreased activation of mirror neurons
• altered activation of facial recognition area

**not clear if causal

Question 24

What are 3 “biomedical” treatments of ASD?

Answer 24

• 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)

Question 25

Are psychotropic meds used to treat ASD?

Answer 25

• 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

Question 26

How is oxytocin used in ASD?

Answer 26

• many RCTs demonstrate improvements in social functioning
• more research still needed w bigger trials
• not a panacea

Question 27

What is Applied Behavior Analysis (ABA)?

Answer 27

• either discrete trial training (conditioning, shape desired behavior) or reinforcing naturally occurring behaviors (eg use of language)

Question 28

What is Developmental Social Pragmatic (DSP) treatment?

Answer 28

• promote and reinforce any efforts at communication
• not trying to change NV comm to verbal
• more naturalistic interaction

Question 29

What are the 2 well-established tx for ASD?

Answer 29

• individual comprehensive ABA (20+hrs/week for years, starting before age 5)
• teacher-implemented, focused ABA and DSP (in classroom, less intensive)

Question 30

(T/F) ABA needs to be 20+ hrs/week to be effective

Answer 30

FALSE, gains from just 6-28 hrs/week!

Question 31

What does recent evidence from ABA meta-analyses suggest about efficacy?

Answer 31

• 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!)

Question 32

What are the 3 common complaints about ABA?

Answer 32

• 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)