Lecture 2 Autism Flashcards
What is the medical model of autism?
Autism is a neurodevelopmental disability, and results in people experiencing difficulties in a range of areas
What is the social model of autism?
Autism is neurodevelopmental difference, and is only disabling as autistic people are required to live in a neurotypical world
What was the issue with the National Autistic Society logo?
From 1963-2002, they had a logo of an upset child on a puzzle piece, indicating that they are handicapped and don’t ‘fit in’
Autistic individuals hit back arguing that they are whole people and there is nothing ‘wrong’ with them
Now has a rainbow ring for the logo
What is NAS’s aim?
Goal is to help to transform lives, change attitudes, and create a society that works for autistic people
What was ‘Autism Speaks’ previously called?
From 1995-2007 was called ‘Cure Autism Now Foundation’ which was considered insulting and hurtful
When was the discovery of autism?
1943: Kanner - first written about, extreme aloneness, delayed language, preservation of sameness
1944: Asperger
1980: Wing’s Triad of Impairments: socialisation, communication, imaginatioin
1980: Included in DSM “infantile autism”
What is the DSM-5 criteria for social/communication elements of ASD?
persistent deficits in social communication and social interaction:
- Deficits in social-emotional reciprocity
- Deficits in developing and maintaining relationships
- Deficits in nonverbal communicative behaviours
Need to see difficulties in all 3 sub areas
What is the DSM-5 criteria for restricted/repetitive patterns of behaviour in ASD?
Restricted, repetitive patterns of behaviour, interests or activities:
- Highly restricted, fixated interests
- Stereotyped or repetitive speech, motor movements, or use of objects
- Hyper or hypo-reactivity to sensory input
- Excessive adherence to routines
Need to see difficulties in 2 sub areas
What does the clinical assessment of ASD involve?
A semi-structured behavioural assessment of communication, social interaction, and restricted & repetitive behaviour/play
What is included under the umbrella term of ASD?
- Autistic disorder
- Asperger’s Syndrome
- Child degenerative disorder
- Pervasive Developmental Disorder - Not Otherwise Specified
What have eye tracking studies shown?
That eye movements in children who were then later diagnosed with autism lost interest in fixating on eyes compared to neurotypical infants
What did studies of video comparison show?
Toddlers with autism had a preference for moving geometric shapes compared to a video of children which they barely looked at
- This finding isn’t highly predictive though
What did studies of neural sensitivity show?
Infant neural sensitivity to dynamic eye gaze is associated with later emerging autism (Elsabbagh et al., 2012)
What are the positives of autism diagnosis?
The current approach to the diagnosis of autism has worked reasonably well in terms of facilitating both research and clinical service
What are the negatives of autism diagnosis?
Hazy diagnostic boundaries
Diagnosis = a ticket for services
The combination of genetic heterogeneity and diagnostic uncertainty complicates efforts to identify autism genes
What would be the pros of having a universal screening for autism?
- Mean age of diagnosis would be lower
- Children wouldn’t be missed and experience difficulty around being different and not knowing why
- Early intervention tends to be associated with “better” outcomes
What would be the cons of having a universal screening for autism?
- Better to deal with problems as they arise, may be minimal problems
- False positive would cause undue stress
- Has ‘treatment’ efficacy really been proven?
What is the diagnostic gender bias in autism?
4: 1 gender ratio male:female
10: 1 in Asperger’s male:female
What has been found about the connectivity in the brain in autism?
There is a local over connectivity and a long distance under-connectivity
Disruptions are more severe in later developing cortical regions
This results in a cognitive style biased towards local rather than global thinking
What is the cognitive profile of individuals with autism?
- ToM difficulties
- Executive function difficulties
- Weak central coherence
- Enhanced perceptual function
What are the key principles of the Enhanced Perceptual Functioning Theory?
- Perception plays a different and superior role in autistic cognition
- Autistic perception is locally oriented
- Better low level perceptual ability is associated with reduced neural complexity
- Drive for perceptual input in early years
- Higher order processing is optional in autism
What is the Research Domain Criteria initiative?
A framework that attempts to link behaviour and cognitive systems to underlying neuro-biological systems and genetic predispositions in a way that cuts across the currently described diagnostic categories
- Because the DSM and ICD lack biological validity
- May pave the way to novel treatments
How is autism heterogeneous?
It is very heterogeneous both in terms of aetiology and phenotypic presentation, it is not one unitary disease condition
What was one of the changes made in the DSM-5?
The heterogeneity is embraced and also diagnosis of ADHD is no longer an exclusionary criteria for ASD, as well as other co-morbidities
