Lecture 8 - Autism Flashcards
General info about Autism
Autism is an umbrella term that covers a range of conditions. They have shared characteristics but HUGE differences ie IQ, social interest, language.
- Aspergers, Rett’s syndrome, Autistic disorder
At the moment seen to be about 1 in 100 with autism. More common in male than females but likely missed in women in our diagnostic tests. 3:1. 50% may also have an intellectual disability (IQ below 69 and functional difficulties in daily living tasks).
Autism – is a neurodevelopmental condition that emerges in early development and is typically life-long
What are there 2 main domains where there are challenges and differences?
1) Social communication challenges 2) Repetitive and restricted areas of interest
Mention some issues around social communication
- Could be differences in social and emotional reciprocity (redued sharing of interests or affect)
- Challenges in non-verbal communication (difficulty understanding / using gestures, eye contact)
- Challenges in developing, maintaining and understanding relationships (difficulty making friends)
What about restrictive and repetitive behaviours
Stereotypes and repetivie movements (line up toys, have things organised)
- An insistence on same-ness, inflexible routines, ritualised behaviour, sometimes overlapped with OCD
- Intense or unusual interests
- Differences in sensory experiences or interests (hyper or hypo sensitivity to sensory input)
Girl says she stimms to find peace and to relax.
How is autism diagnosed?
Always done based on behaviour. Not biology or genes etc.
Not all individuals will show all behaviours.
Also need to gather information across contexts ie home or school
Potential bias of diagnostic tools – gender (Lai et al 2015)
What are some issues around current diagnoses?
- Sometimes people show few symptoms as very good at compensating and this can sometimes explain late diagnosis, especially in women (Mandy 2019)
- Masking strategies are associated with poor mental health (Livingston et al 2019a)
What are some thoughts on what causes autism?
- Genes and biology – it is highly heritable. Possible perinatal factors. Alterations in brain development. Genetic and neuroimaging studies.
-Cognition – Mental processes that direct hoe we experience / process information. Autistic people have different cognition. Need psychological tasks.
-Behaviour – Manifestation of behavioural symptoms, can directly observe behaviour.
Discuss the cognitive approach and autism
- Cognition links biology to behaviour and helps us understand why autistic behaviours occur, biology not very satisfactory way of explaining the process of autism. Cognitive theories can fill in the gaps and say these are the processes that might be going on that lead to this behaviour. We can also measure cognition via psychological tasks.
-Helps understand why austitic behaviours occur (Frith 2012)
-Long task to try and find one cognitive theory that will explain all of autism.
-But for a cognitive account to be satisfactory, it should be universal as much as possible. It should be unique (not apply to conditions that are not autism) and it should have explanatory power.
What are some of the main theories on autism?
Theory of mind (Simon Baron-Cohen)
Weak Central Coherence (WCC)
Bayesian/predictive coding hypotheses
Tell me a bit on the Theory of Mind theory and some limitations
Theory of mind (Simon Baron-Cohen)– there are cognitive differences in the ability to attribute mental states to others (beliefs and desires etc) also known as mindblindness (Happe 2015).
-Sally-Ann Task is associated with this theory – children with autism were most likely to fail this task than neurotypical children or children with down syndrome. So not related to intellectual ability as DS typically lower intellectual ability. Seminal paper. Inability to separate own beliefs an experiences from other people’s. Normally around 4 kids pass the sally-ann test.
Criticism of this is you can hack out the correct response using verbal skills. Happe (1994) has given such critiques.
Triangle task – autism people could not describe the social interaction in the same way as children who were not autistic.
Triangles are great but not ecologically valid.
It is a universal theory? NO.
It is unique? NO – seen in schizophrenia as well. Does it have explanatory power? NO. Very good at doing the social communication side but not so good at explaining the restrictive behaviours routines etc (non -social).
Tell me about Weak Central Coherence Theory and some limitations
Came from idea autistic people have bias for process part of stimuli or the world at expense of the global whole. Same for an image. Thought of as a difference in cognitive style.
Burack – said it might not be autisitic people have difficulty processing whole image but better at processing the detail compared to most people.
- Embedded Figures Test (Shah & Frith 1983)
- Sentence Completion Test (Booth & Happe 2010)
It is universal? NO. Not all autisitic people show differences in global or local processing. Is it unique? No – not well studied but potentially in anorexia. Explanatory power? No – does not explain the social symptoms well but better on the non social part.
What is the sally ann test (theory of mind)
In the test process, after introducing the dolls, the child is asked the control question of recalling their names (the Naming Question). A short skit is then enacted; Sally takes a marble and hides it in her basket. She then “leaves” the room and goes for a walk. While she is away, Anne takes the marble out of Sally’s basket and puts it in her own box. Sally is then reintroduced and the child is asked the key question, the Belief Question: “Where will Sally look for her marble?”[3]
Outcomes: 23 of the 27 clinically unimpaired children (85%) and 12 of the 14 children with Down Syndrome (86%) answered the Belief Question correctly. However, only four of the 20 children with Autism (20%) answered correctly. Overall, children under the age of four, along with most autistic children (of older ages), answered the Belief Question with “Anne’s box”, seemingly unaware that Sally does not know her marble has been moved.[3]
Tell me about Bayesian/predictive coding hypotheses and some limitations
Autistic people find it more difficult to develop these prior expectations so the world is so much more surprising – sensory etc. And this explains why they have an insistence on sameness.
- Brains are constantly interpreting incoming information
- We develop predictions based on prior experiences
- We use these predictions to disambiguate ambiguous incoming information
It is universal? NO – conflicting findings. Unique? No as the same theories have been applied to other conditions. Explanatory power? Maybe. Applied more to restricted behaviour side but does okay for the social one as a lot of social behaviour is based on predictions too.
There is not one single cognitive theory that accounts for autism (Happe et al, 2006).
Tell me details around intervention and support for autism
Interventions and support
There is no treatment for autism and many do not want treatment
Some early interventions like Early Start Denver Model
Some adults choose to go to social skills training as well
Increasing focus on treating mental health problems like CBT for people who are autisitic
Autism links to ADHD, OCD, depression, schizophrenia and psychosis, migraine etc. Big overlap in autism and eating disorders. Says a bit in lecture on easting disorders.
When it comes to MRI lots of studies on this but can ignore the nuances of autism and suggest it is biologically predetermined. Also brain scans would get out of date because our definitions of behaviour are always changing so important to diagnose based on behaviour
What is a summary of this topic?
Summary
* Autism is a heterogeneous and characterised by challenges in social
communication and restrictive repetitive behaviours and interests
* Autism is associated with both genetic and environment factors
* Cognitive theories could help bridge the gap between biology and
behaviour
* However, none have complete and unique explanatory power
* There are no specific treatments for Autism, but there are approaches that
could help support some challenges, e.g. social, emotional, sensory
