Unit 2 - Autism Spectrum Disorder

Question 1

DSM V Autism category

Answer 1

All inclusive autism spectrum disorder: includes autistic disorder (autism), Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified.

Rationale: Because autism is defined by a common set of behaviors, it is best represented as a single diagnostic category

A single spectrum disorder is a better reflection of the state of knowledge about pathology and clinical presentation.

Question 2

2 main domains

Answer 2

1. Social/communication deficits

2. Stereotypical Behaviors - Fixated interests and repetitive behaviors

Question 3

diagnostic criteria

Answer 3

A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history
B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history
C. Symptoms must be present in the early developmental period
D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
E. These disturbances are not better explained by intellectual disability

Question 4

severity in DSM

Answer 4

Severity is based on social communication impairments and restricted repetitive patterns of behavior.

Question 5

*sensory in DSM

Answer 5

Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

Question 6

other specifications

Answer 6

With or without accompanying intellectual impairment
With or without accompanying language impairment
Associated with a known medical or genetic condition or environmental factor
With Catalonia

Question 7

Severity levels

Answer 7

Level 1 - “requiring support”
Level 2 - “requiring substantial support”
Level 3 - “requiring very substantial support”

Question 8

increase prevalence of diagnoses

Answer 8

1. More specifically defined autism spectrum disorder characteristics in DSM-IV
2. Development of better assessments of autism and autism spectrum disorders
3. Physicians, educational psychologist, teachers, and therapists are more knowledgeable of the behaviors of autistic children
4. Development of earlier screenings and tests for Autism
   - CHAT – Checklist for Autism in Toddlers

Question 9

neurologic basis for autism

Answer 9

• Enlarged lateral ventricles
• Increased heart rate variability and increased respiration
• Abnormal nystagmus
• Arousal state irregularities and unusual response to novel stimuli

Question 10

anatomy of brain and autism

Answer 10

• increase in total brain weight/volume
• gray and white matter hyperplasia
• delay in frontal and temporal lobes

Question 11

corpus callosum, limbic system, and cerebellum

Answer 11

• smaller size

- decreased number of purjunke cells, smaller

Question 12

genetic basis for autism

Answer 12

• affects 2-6% of siblings
• greater w/ identical twins than fraternal
• gene research on chromosomes 7, 15, 2, 4, 19

Question 13

other areas being studied for possible links to autism

Answer 13

• perinatal factors
• toxin exposure
• hormone disruption

Question 14

vaccinations

Answer 14

• retracted wakefield study

- no casual link between MMR vaccination and autism

Question 15

other causes?

Answer 15

• environmental
• yeast infections
• intolerance to foods
• PST deficiency
• intractable seizures

Question 16

characteristics within the spectrum

Answer 16

1. Impairment in reciprocal social interactions
2. Impairment in verbal and non-verbal communications and imaginative play
3. Markedly restricted repertoire of activities and interests (stereotypic behaviors)
4. Disturbances of sensory and perceptual processing and associated impairments

Question 17

Receptive and Expressive communication

Answer 17

• deficits in joint attention
• bad at eye contact
• no pointing
• not vocalizing/engaging
• difficulty attending to others and facial expressions
• infrequent crying
• limited understanding of novel info, direction, instruction
• echolalia: child reproduces sounds that are identical to the model in both tone and rate of speech (delayed - repeating from past experience, immediate - repeats what was just said)

Question 18

socialization

Answer 18

• unconventional behaviors
• difficulty with transitions, being soothed by others, understanding reactions, engaging in play
• poor ability to use monologues during play

Question 19

restrictive behaviors

Answer 19

rocking, hand flapping, head banging, biting, throwing, self talk, arranging items in a specific way, putting objects in mouth, persistence etc

Question 20

cognition

Answer 20

• rigid thinking
• difficult to assimilate, modify, and integrate
• think in pictures
• strengths in rote memory
• limited functional object use
• prefers solitary play
• hyperlexia: attending to visual stimulation, stability and consistency in print, decode words

Question 21

task analysis

Answer 21

1. Select a task that develops a needed skill. Consider the sensory, cognitive, language, and social components needed.
2. Break the task into part. Consider which parts should be done by or for the child.
3. Identify needed adaptations.

Question 22

Picture Exchange Communication System (PECS)

Answer 22

• PECS must be done EVERYWHERE - in school, in therapy and at home. NEED / thrive on consistency.
• PECS board is especially important in therapy sessions. Use symbols are cards the child uses in other environments
• The PECS communication book and schedule boards start with pictures and then move to words over time. Initially the pictures may be actual photos of the actual objects the child uses, then may move to more abstract drawings.

Question 23

Applied Behavior Analysis (ABA)

Answer 23

1. The program must be applied.
2. The program must be behavioral. The environment and physical events should be recorded with precision.
3. The program must be analytic.
4. The program must be technological for duplication by another individual.
5. The program must be conceptually systematic.
6. The program must be effective. The program should seek to change the targeted behavior to a meaningful degree.
7. The program should display some generality. A change in behavior should be seen in a wide variety of environments, or should spread to a wide variety of related or similar behaviors.

Question 24

Greenspan’s Floortime

Answer 24

developmental, individual-difference, relationship-based therapy. Floortime is based on the natural development of emotion and human interaction in children. It assumes six milestones of typical emotional and communicative development and attempts, through intensive play and interaction, to guide children through each of these stages.

• building relationships
• DIR approach (developmental, individual-difference, relationship-based)

Question 25

TEACCH (Treatment and Education of Autistic and related Communication Handicapped Children)

Answer 25

physical structure, scheduling, work system, routine, visual structure

Question 26

video modeling

Answer 26

• recording a model engaging in target skills/behaviors

- basic, self, point of view, video prompting