Pre Midterm Flashcards
Historical Terms for Intelligence
Current (since 2013): Intellectual disability,
Old: Mental Retardation (mild, moderate, severe , profound) Oldest: Mental Deficiency (dullness, feeblemindedness, idiot, imbecile, moron)
Examples of Autism
Nonverbal and Intellectual Disability: cannot speak, unknown how much language they can understand, can be taught to speak with early treatment (severity dependent)
Not “Speaking” with Cognitive Abilities: cannot speak but have cognitive abilities that aren’t understood by others
Very Verbal: has trouble with self regulating
DSM
A practical, functional, and flexible guide to diagnose and treat mental disorders
DSM-I (1954)
Schizophrenic reaction, childhood type:
•Odd kids that didn’t fit into a category
•Much more likely to develop ASD than schizophrenia at this age
•Vague description: symptoms different due to the plasticity and immaturity of the brain
DSM-II (1968)
Schizophrenia, childhood type:
•Vague description: before puberty, atypical behaviour, failure to develop identity separate from their mothers, immaturity, that may lead to mental retardation which should also be diagnosed
•Refrigerator mothers
DSM-III (1980)
Format differences:
•4x the size, intended to have more scientific support
Pervasive Developmental Disorders:
•Infantile Autism: early onset, typical autism
•Child Onset Pervasive Developmental Disorder: later onset and less severe
•Atypical Pervasive Developmental Disorder: social or language dysfunction without meeting full criteria
Diagnostic Criteria for Infantile Autism
Age of onset under 30 months Severe language development delay If language develops, it's atypical Bizarre reactions to environment Absence of schizophrenic reactions (delusions)
DSM-III-R (1987)
Changes:
•Went from non negotiable checklist to a list of symptoms
•Infantile Autism – Autistic Disorder
•Introduced Rett’s Syndrome, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder– not otherwise specified
Rett’s Syndrome
Rare (1/10,000) Onset: 6-18 months Commonly found in girls Due to low grey matter Found to have no connection to Autism
Childhood Disintegrative Disorder
Rare (1.7/100,000)
Normal development til 3
DSM-IV (1994)
Introduction to Aspergers: normal language (single words by age 2, phrases by age 3), and higher IQ (problem)
DSM-IV-TR (2000)
Continues with primary concerns being social communication, stereotyped/pervasive interests, and social interaction
PDD-NOS problem fixed
DSM-5 (2013)
PDD changes to ASD: Intellectual impairment, accompanying language impairment, and known genetic/medical conditions
Deficits in Social Communication/Interaction (DSM-5)
Social-emotional reciprocity
Reduced interest in peers/failure to initiate social interaction
Reciprocal conversation/maintaining friendship challenges
Reduced sharing and imaginative play
Poor gesture use, eye contact, and facial expression
Restricted/repetitive patterns interests, or activities (DSM-5)
Stereotyped repetitive motor movements, objects, and speech
Highly restricted, fixated interests
Insistence on sameness
Reactivity to sensory input
ASD Severity Rating
Level 1 (requiring support): Can speak in full sentences but lacks social components Level 2 (requiring substantial support): Simple sentences limited in topic choice with odd nonverbal communication Level 3 (requiring very substantial support): rarely initiates interaction just to meet need and only responds to very direct social approaches
ICD-10 (2015)
International Classification of Diseases:
•Developed by the World Health Organization
•Likely to blend Aspergers into ASD
•Structure: PDD (AD, Aspergers, Other Child Disintegrative Disorders, Retts, Other PDDs)
DSM-5 Diagnostic Criteria
Deficits in social emotional-reciprocity
Deficits in nonverbal communicative behaviours
Deficits in Developing, maintaining and understanding relationships
Level of Language
Functional:
•Speech can be spontaneous, echoed, or stereotyped
•Used daily involving 3+ phrases understood by others
Non-Functional:
•Used daily, but cannot use 3+ phrases correctly
•Atleast 5 different words used in the last month
No Speech:
•No more than 5 words known total
Use of Other’s Body
Atypical use of one’s body as an extension of their own, usually occurring with no prior attempt to communicate
Ex: using someone else’s hand to point to something
Stereotyped Utterances and Echolalia
Stereotyped utterances: repetitive phrases coming from self commentary
Echolalia: can be an immediate or delayed repeat of something they’ve heard
Eye Contact
A large factor to pay attention to when diagnosing (not always but very common)
•Not just the eye contact but the function of it (should be flexible and socially modulated)
•ASD: often relies on other parts for social cues (mouths)
Testing Eye Contact
Eye tracking: glasses reading eye patterns
•many ASD patients don’t pick up social cues from eye contact
Reading the Mind in the Eye test:
•Not a diagnostic test
•Given a picture of eyes and have to match a feeling to them
Theories on Eye Contact Avoidance
Intensity (feeling of being naked/embarrassing)
Aggression
Processing capacity (too much at once)
Result: missing social cues (sarcasm)
Social Verbalization/Chat
Good use: chats with clear social quality
Some use: some social response
No use: some speech to alert needs
Reciprocal Conversation
Functional: give and take
Occasional: lacks flexibility, often a monologue
Little/No: conversation doesn’t built (yes/no)
Inappropriate Questions/Statements
Asking embarrassing or inappropriate questions
•Can fail to understand the impact of a comment (you look fat)
•Can be an odd statement (what type of cheese is in your fridge)
Pronoun Reversal
Confusing 1st, 2nd, and 3rd person
Neologisms and Idiosyncratic Language
Neologisms: made up words
Idiosyncratic: words/phrases used by child with ASD that are only understood by them/those close to them
Verbal Rituals
Compulsive quality with ritualized patterns
May involve other people and be disruptive
Gesture Use
Restricted range of conventional (waving) and instrumental (“this big”) gestures
Pointing to express interest/nodding and shaking
Joint attention: pointing while looking at the person of interest (excludes pointing to obtain something)
Nodding and shaking is absent
Social Smiling
Spontaneous smiling at people
Difficult to teach ASD how to smile (so many different types)
Showing/Directing Attention
Must be spontaneous
•Bringing objects (child points, parent gets toy)
•Directing to something (picture in book, plane in sky)
Offering to Share
Must be: spontaneous, not part of a routine, and have a variety of different objects (food, toys)
Enjoyment: ASD often do not share their enjoyment
Offering Comfort:
Spontaneous, unprompted offering of comfort
•Must include a change in facial expression
•ASD: they care, but don’t know how to show it
Quality of Social Overtures
How does the individual seek help
•Common: vocalization, eye contact
•ASD: screaming, yelling
Facial Expressions
Range: past: 6, current: 21
ASD: Emotional expressions that don’t match the situation
•Not a lack of empathy, just can’t piece it together
Social Development and Play
Self controlled and self directed
•Not as prominent in todays society
Solitary Imaginative Play
“True” play not involving direction from an adult
•Pretend play: involves imagination and creativity
•ASD: doesn’t make sense, random, frustration
Imaginative Play with Peers
Spontaneous, creative, imagination, sharing ideas with others, doesn’t follow scripts
•ASD: doesn’t like to play, not engaging
Imitation of Others
Spontaneous imitation often picked up through play
•Cannot be taught or imitation of a film character
Respond to Approaches from Peers
Intrest in peers shown from
•Watching peers
•Wanting to maintain interaction with peers
Group Play with Peers
Factors in group play: spontaneous, flexible, interactive, turn taking
ASD: has trouble not having control/following scripts, or doesn’t have any desire
Friendships
ADI-R: A selective, reciprocal relationship between two persons of approx the same age who seek each other’s company and share activities and interests
Even: friendship needs to be reciprocal
Context: what is the friendship
•ASD often names classmates, cousins, and online friends
•Online: removes ASD common problems
ASD: usually sees friends as immediate and defines them as “anyone who is nice to me
Normative Friendships
Dunbar’s Number
•Correlation between primitive (neocortex) cortex size and group size
• Cognitive limit to knowing each person and how they relate to one another
•150 relationships can be maintained with 5 core relationships
The nature of friendship in children with ASD: a systematic review
Pertaina, Carter, and Stephenson
Children with ASD reported:
•Less friends
•Less contact with friends outside school
•Shorter duration of friendship
•Less companionship (doesn’t mean they’re more lonely)
•Playing video games: primary activity
Social Competence
3 components: •Successful adaptation •Establish relationship •Avoid harm Challenge with measuring SC and ASD: •Variations in: symptom presentation, intelligence, language, social motivation, and behaviours that might impact socialization
Social Disinhibition
Ability to adjust/regulate one’s behaviour depending on context
•ASD: overly friendly, rude, poor application of stranger danger, not responding to social cues
