L4 ASD Flashcards
ASD
Complex neurodevelopmental disorder characterised by:
- abnormal social behaviour
- stereotyped behaviours and interests
Present in early life
Difficulties typically life-long
DSM5 criteria for ASD
A. Deficits in social communication and social interaction across multiple contexts (behaviour)
B. Restricted, repetitive patterns of behaviour, interests or activities (behaviour)
C. Symptoms must be present in early developmental period (onset$
D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning (impairment)
E. Disturbances not better explained by intellectual disability or global developmental delay (exclusionary)
Prevalence of ASD
- around 1% of children
- 4:1 male:female ratio
- average diagnosis age: 5
Comorbid conditions
- Epilepsy (10%)
- ADHD (20%)
- Intellectual disability (50%)
- Anxiety and OCD
Biological Level: Brain
- Abnormal growth in head circumference in infancy
- overall brain size 2-10% larger
- Fewer neurons in amygdala, hippocampus, anterior cingulate and cerebellum
- Abnormal levels of the neurotransmitter serotonin in about 1/3 of cases
Cognitive level: deficits
- deficit in theory of mind
- weak central coherence
- executive dysfunction
- limited inner speech (preference for visuo-spatial representations - “thinking in picturs”)
- “extreme male brain”
Deficit if theory of mind
- “mind blindness”
- unable to conceive of mental states
- difficulty appreciating that other people have thoughts, feelings, beliefs, and percepts distinct from one’s own.
- expressed in failure on false-belief tasks e.g. Sally-Anne task (ASD = blue cupboard cause unable to consider Sally didn’t see Anne move it. Unable to appreciate Sally’s stare of mind. Only recognise their own and what they saw.
Central coherence
- Capacity to use context; to form parts into an integrated whole.
- Autism - weak central coherence
- Weak CC explains limitations such as not using context to disambiguate information (e.g. not using social context to help interpret an ambiguous message; difficulty appreciating irony and humour).
- Weak CC has strengths such as superior performance where processing by parts is an advantage (e.g. Embedded figure tests).
Executive functions
- Higher-level processes responsible for establishing and monitoring a sequence of lower-level processes to achieve a goal
- Individuals with ASD have deficits in EF
Two central psychological dimensions
Empathising: capability for identifying thoughts and emotions in others, and for responding appropriately to them.
Systemising: capability for understanding systems in terms of rules (e.g. Mathematical or technical systems, natural systems, structured social systems, e.g. the law).
Empathising and systemising
- Females tend to be superior on tasks assessing empathising
- Males tend to be superior on tasks tapping systemising.
- Autism = extreme form of male pattern of performance. Low on empathising and high on systemising.
Intervention Goals for ASD
- Minimise core problems
- Maximise independence and quality of life
- Help children and family cope more effectively with the disorder.
General Treatment Strategies
- Engage child in treatment
- Decrease disruptive behaviour
- Teach appropriate social behaviour
- Increase functional, spontaneous communication
- Promote cognitive skills
- Teach adaptive skills to increase responsibility and independence
Applied Behaviour Analysis (ABA)
Intervention based on positive and negative reinforcement.
