Intellectual Disabilities and Autism Flashcards
What three criteria must be meet for a diagnosis of intellectual disability?
- Significant deficits in intellectual functioning IQ
What percentage of intellectually disabled also have emotional disturbances?
15-20%
What are the criteria for Mild Intellectual Disability?
- IQ 50/55 to 70
- 85% have IQ less than 70 so adult mental age of 9-12yo
- some/none adult support
- Few signs of brain pathology
- Families of low intelligence and SES
What are the criteria for moderate Intellectual Disability?
- IQ 35/40 to 55
- 10% of those
What are the criteria for severe Intellectual Disability?
- IQ 20/25 to 35
- 3-4% of those
What are the criteria for Profound Intellectual Disability?
- IQ
What are the criteria for Borderline Intellectual Disability?
- IQ 71 to 81
- V Code “Other conditions that may be a focus of clinical attention”
What are deficits in cognitive abilities?
- Attention to stimuli - distracted by irrelevant stimuli eg look at shape colours and not geometric shape
- Short term memory deficits
- Processing speed
What are deficits in adaptive skills?
- Communication
- Social skills - difficulty making and keeping friends, little awareness of social conventions
- Academic skills - understanding signs, labels, etc
- Sensorimotor skills - not related to the degree of intellectual impairment
- Self help skills - training for activities in daily living eg dressing
- Vocational skills: Mild (simplified jobs in open employment), Moderate (Simple jobs in sheltered workshops)
What percentage of cases have the primary cause identified?
25-35%
What gender has higher profound/severe intellectual disability?
Equal males to females
What gender has higher Mild/moderate intellectual disability?
Males>females
What level of intellectual disability has the most organic brain deficit identified?
Mild/Moderate
What SES group has higher profound/severe intellectual disability?
Equal across all groups
What SES has higher mild/moderate intellectual disability?
Lower SES groups
What is the cultural (Family retardation) aeitiology for Intellectual Disability?
- Inadequate language models/stimulation
- Poor diet
- Inadequate medical care
- Lower expectations
What is the Genetic Based Disorders that may cause Intellectual Disability from a Dominant Gene?
Fragile X Syndrome
What is the Genetic Based Disorders that may cause Intellectual Disability from a Recessive Gene?
Phenylketonuria (Pku) heel prick test
What is the infectious disease aeitiology for Intellectual Disability?
- Maternal disease in utero: toxoplasmosis, cytomeagalo virus, rubella, herpes simplex, syphilis
- After birth: meningitis
What is the leading cause of Intellectual Disability?
Accidents
What is the primary treatment for Intellectual Disability?
- Eugenics movement: segregation and sterilisation
- Healthcare measures: vaccinations, Detection/treatment infectious diseases, diagnostic testing
- Genetic counseling
What is the secondary treatment for Intellectual Disability?
Identify children at risk and early intervention eg Project Headstart
What is the tertiary treatment for Intellectual Disability?
- Early intervention
- Mainstreaming
- Teaching strategies: applied behaviour analysis eg backward chaining, play therapy, computer assisted instructions
What three criteria must be meet for a diagnosis of autism?
- Persistent deficits in social communications and social interaction across multiple contexts (social-emotional reciprocity, nonverbal communication behaviours, developing.maintaining and understanding relationships)
- Restrictive, repetitive patterns of behaviour, interests or activities (stereotyped or repetitive motor movements, Insistence on sameness, ritualised patterns of behavour, highly restricted and fixated interests, higher or hyporeactivity to sensory input
- Must be present in the early development period
What percentage of autistic children score an IQ
80%
What two areas of assessment do they score well in?
- Visual spacial skills
- Sensory motor development
Is autism more common in males or females?
Males
What is extreme autistic aloneness?
- no early attachment
- seldom approaches others
- gaze aversion
What percentage of autistic children do not learn to speak?
50%
What is Echolalia?
Echo speech
What is Pronoun reversal?
Refer to self as he/she
What is Neologisms?
Made up words such has head vice for head ache
What is Dysprosody?
Rate rhythm and intonation of speech
What percentage of autistic children make good adjustment to adulthood?
5-17%
What is the Psychological view of the aeitiology of Austism?
- Rejecting parents
- Unrewarding parents
What is the Genetic Factors view of the aeitiology of Austism?
- Higher concordance with sibilings
- Higher concordance with MZ than DZ twins
- Higher learning disabilities in families with autistic children
What is the Neurological Factors view of the aeitiology of Austism?
- Abnormal brainwave patterns that correlate with epileptic seicures
- Rubella (10x higher prevalence)
- Under developed part of cerebellum
- Mirror neurons
- Neuropeptides - attachment and social affiliation
What does Applied Behaviour Analysis (ABA) target?
- Training in cognitive, language and social behaviour
- Acquiring special learning skills
- Reducing rigid and stereotyped behaviour
- Eliminating maladaptive behaviour
- Alleviating family distress
What percentage of autistic children achieved normal functioning with ABA compared to controls?
47% ABA v 2% control and maintained at 8 year followup BUT 40 hours a week contact required for months
What are the drug treatments for Autism?
- Antipsychotics
- Fenfluramine (Stimulant)
- Social Nueropeptides (experimental)
