Quiz 1 Autism Spectrum Disorder Flashcards
What were the three domains of core symptoms initially recognized for Autism Spectrum Disorder?
1) Qualitative impairments in social interaction
2) Impairments in communication
3) Presence of a restricted range of interests and behaviors
What are the now highly regarded symptoms of Autism Spectrum Disorder?
1) Impairment in communication
2) Presence of restricted and repetitive behaviors
Who coined the term “autisim”
Bleuler: he used it originally to describe individuals with schizophrenia who had a loss of contact with reality.
What did Leo Kanner and do?
Independently described childhood disorders involving impaired social relationships, abnormal language, and restricted and repetitive interests.
He also believed that these children had a loss of contact with reality similar to that described by Bleuler, without the concomitant diagnosis of schizophrenia. he noticed that children who fit these symptoms are extremely autistic, lonely, and have an obsessive desire for the maintenance of sameness.
What did Hans Asperger do?
Focused on children’s good language ability before they entered school and spoke like adults. However, despite their good language skills, the children that Asperger studied has impaired conversational skills, and unusual use of volume, tone, and flow of speech.
Who were Bernard Rimland and Eric Schopler?
The first researchers to argue against the theory that parents were responsible for their children’s autism (at the time, autism was believed to be caused by cold-hearted parents).
Rimland proposed that the disorder was due to neurological impairment, and Schopler suggested that rather than treating the parents, the role of intervention was to involve parents as co-therapists working to help their children
What impairments in social communication are affected?
The ability to imitate another person, share a focus of attention with another person, recognize and process faces, and engage in pretend play are all affected and significantly impact one’s ability to learn in a social and nonsocial environment.
What is the hypothesized reason for social impairments in ASD?
That there is an underlying abnormality with the social award neural circuitry.
What does poor imitation ability indicate?
That there may be absent or dysfunctional mirror neurons, which plays a critical role in imitation
What does “shared” and “joint” refer to?
The ability to coordinate attention between interactive social partners with respect to objects or events in order to share awareness of the objects or events.
Why is impairment in the initiation of joint attention is so important?
Failure to coordinate gaze, gesture, and facial expressions as a means of sharing attention with others is among the first symptoms evident in ASD.
What do social attention impairments indicate?
Maybe a reduced sensitivity to the reward value of social stimuli. Furthermore, it has been shown that disruption in brain networks related to reward has been found in individuals with ASD, suggesting that social stimuli do not evoke the same significance and reward value for individuals with ASD
are joint attention and imitation impairments related to social attention?
Yes! Social orienting impairments may lead to joint attention impairments, which leads to delayed language development
Why is Face perception so important?
These abilities are essential for the development of interpersonal relationships, and lack of attention to faces is considered one of the earliest and most reliable indicator risks of ASD.
What does the lack of face recognition in people with ASD indicate?
The neural system related to face processing is less efficient (slower), lacks specificity to faces, and is abnormally represented in the brain.
When does symbolic play (pretending that it is a banana is a phone) start in typical children?
12-22 months, with 20 months being the majority age when children achieve this ability.
What age is the absence of symbolic play an indicator for ASD?
18 months
What do play skills indicate when a child reaches age 8?
Spoken language and cognitive ability.
Do ASD children use symbolic play?
Yes, however, it lacks creativity and playfulness and appears to be more mechanical and repetitive
What type of language do children with ASD display?
atypical language characterized by immediate or delayed echolalia (verbatim repetition of repeated words), abnormal prosody (atypical rhythm, stress, intonation, and loudness), and pronoun reversal (use of “you” instead of “I”)
What are the problems with reciprocal conversation related to?
Difficulties understanding another person’s perspective (theory of mind)
What are RRBs?
Restrictive and Repetitive Behaviors and Interests. These include repetitive motor mannerisms (hand flapping), Repetitive use of objects (lining up toys), inflexible adherence to routine (insistence on driving the same route to school), preoccupations with unusual objects (electrical cords), and unusual responses to sensory information (Visual fascination with lights).
Are RRBs restricted to just ASD?
No! Observed in typical children and children who have been diagnosed with Tourette’s, Down Syndrome, Rett’s Disorder, Parkinson’s, Dementia, Schizophrenia, and intellectual disabilities.
However, RRBs are more frequent in ASD
What are the two categories of RRBs?
Low-level: characterized by repetitive movements
Higher-level: insistence on following more elaborate routines and circumscribed interests.
These two levels are also called (Repetitive Sensorimotor Behaviors and Insistence on Sameness).
Are there any biological markers or tests to indicate ASD?
No! Instead, we must focus on behavioral symptoms and developmental history.
Where is ASD in the DSM?
Neurodevelopmental Disorders with Intellectual Disability, communication disorders (ADHD), specific learning disorders, and motor disorders being co-morbid disorders.
How does the DSM-5 Classify ASD?
By two categories:
1) Persistent deficits in social communication and interactions.
2) The presence of restricted, repetitive patterns of behavior, interests, or activities.
What did the DSM 5 task force conclude about ASD when assessing the diagnosis?
while ASD is stable around age 2, children often change the diagnosis across different DSM-5 subtypes due to changes in social and communication skills.
What is severity based on for ASD?
Social communication impairments and restricted patterns of behavior
What are three symptoms in the SCI category for ASD in the DSM?
A1: Deficits in social-emotional reciprocity
A2: Deficits in nonverbal communication behaviors used for social interaction.
A3: Deficits in developing, maintaining, and understanding relationships.
All three symptoms are required for a diagnosis and must be persistent deficits that are present across multiple contexts
What are the four symptoms for RRBs?
B1: Stereotyped or repetitive motor movements, use of objects or speech.
B2: Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior
B3: Highly restricted, fixated interests that are abnormal in intensity and focus.
B4: Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment.
Two of these four symptoms must be present for a diagnosis of ASD.
What is a new category for RRBs in the DSM?
Sensory processing difficulties:
1) Sensory over-responsivity (negative responses to stimuli such as light and sound).
2) Sensory under responsivity (nonresponse to stimuli such as failure to respond to one’s name).
3) Sensory seeking (engaging actions that provide increased sensation).
When must symptoms be present for ASD according to the DSM?
Early developmental period. The DSM also allows for diagnosis in middle childhood or adulthood, acknowledging that symptoms may not manifest until social demands exceed limited capacities
What are some comorbid symptoms of ASD?
Delayed language
What is a differential diagnosis for ASD?
Social (Pragmatic) Communication Disorder. This diagnosis came due to a group of children who do not display all of the symptoms of ASD but have persistent difficulties with pragmatic language impairments influencing social communication skills.
What did Gibson and Colleagues (2013) find?
Children diagnosed with high-functioning ASD were characterized by greater degrees of pragmatic impairments, increased RRBs, and higher expressive language skills compared to children diagnosed with a pragmatic language impairment
What is the disorder with the highest co-morbidity with ASD?
Intellectual disability, however, co-morbidity might be inflated due to the fact that many assessments rely on imitation, language, and other skills affected by ASD.
When should Intellectual Disability without ASD be considered?
When social difficulties are consistent with developmental level
What are some common comorbid psychiatric symptoms for ASD?
Internalizing disorders (anxiety and depression), as well as externalizing disorders such as ADHD and disruptive behavior disorders
What is the correlation between suicidal ideation for those with ASD?
Children with ASD do not show as much suicidal ideation as children with depression who do not have ASD. However, Mothers of children with ASD showed more suicidal ideation and suicide attempts when compared to mothers of typical children.
Can an individual be diagnosed with both ADHD and ASD?
Yes! Common symptoms include inattention, hyperactivity, and impulsivity.
Those who have both disorders report having higher rates of oppositional behavior.
What are self-injurious behaviors?
Head banging, finger or hand biting, head-slapping, and hair pulling.
These behaviors are often seen when individuals with ASD are frustrated, and there is also increased perceived stress within families
What are Sleep Disturbances?
Individuals with ASD experience sleep disturbance experience symptoms such as difficulty falling asleep, staying asleep, shortened night sleep, and early morning waking.
What is the prevalence rate for ASD?
Historically, 1 individual per 2,500 was diagnosed as having ASD.
In a population-based record review, it was shown that 1 in 68 children aged eight in the USA had ASD in 2010
Is there a sex difference when it comes to ASD?
Yes, Males are often diagnosed 4-5:1 when compared to females.
Affected females are more likely than males to have comorbid intellectual disability and increased behavioral symptoms.
What is the “Broader Autism Phenotype?”
Refers to the idea that relatives of persons with ASD may not have the disorder itself but may express a “lesser variant” resulting from shared genes.
How do Environmental Toxins relate to ASD?
One area of focus for ASD literature is how mercury-based preservatives (Thimerosal) were formerly used in vaccines—however, no substantial proof has been shown that mercury plays a role in ASD.
What are some Neuroanatomical findings for ASD?
Support the notion that ASD is linked to a combination of brain enlargement in some areas and brain reduction in other areas.
When do Infants exhibit symptoms of ASD and what are the early signs?
at the end of the first year of life; temperamental and motor characteristics such as delayed verbal and nonverbal communication; reduced social engagement, smiling, and eye contact; and reduced response to their name being called.
What is the difference Between an ASD diagnosis and Social Communication Disorder?
The significant difference is that individuals who have SCD show SCI (social communication and Interaction symptoms) but do not exhibit RRBs.
In the DSM-IV, what was the percentage of individuals with ASD who had a mild intellectual disability and those who had a severe intellectual disability?
29.3% MIld
38.5% Severe
What is the current co-morbid rate for ASD and Intellectual disabilities?
31%, with higher rates being observed in girls.
What is Joint attention?
The ability to understand social information through the use of nonverbal behaviors (think infant eye contact with parents and directing attention to things through pointing).
Failure to use these skills is the first symptoms of possible ASD
Major Point: Gaze, Gesture, Facial Expressions
What symptoms are exhibited to confirm there is a Medical co-morbidity?
-Sleep Disturbance
-Metabolic issues
-Seizures
-GI Disorders
What symptoms are evident of Psychiatric co-morbidity?
-Depression
-ADHD
-Anxiety
What are symptoms evident of Developmental Co-morbidity?
-Intellectual Disability
-Language Impairment
What are symptoms of Irritability co-morbidity?
-Self-injury
-Tantrums
-Aggression
What is the main Differential Diagnosis for ASD
- Social Communication Disorder
-Intellectual Disability
