Week 10: Autism Basics Flashcards
Core Features of Autism (3 Things)
Impairment in communication
Impairment in social interaction
Repetitive patterns of behaviors and interests
Impairment in Communication
About 50% of children with autism do not develop any useful language
Qualitative language impairments
- Echolalia (repetitive sounds)
- Perseverative speech (stuck on something)
- Impairments in pragmatic (can understand words but dont understand how they work socially
e.g.
Mom: Can you look at me?
Kid: Yes
Does not look. Is right, he can, does not understand he is supposed to
Impairment in Social Interaction
Qualitative impairment in social interaction
- Social imitation: They do not do this
- Joint attention: do not share attention between a person and an object of mutual interest
- expressive nonverbal behavior: No gestures/wont show how they feel
- reciprocity: No give and take
- social “mind”: Dont interpret the world in social ways
Autism vs language delay
Kids with language delay use gestured etc to communicate
Autistic kids do not
Impairment in Social Interaction
Cannot understand the triangle and circle video where one triangle is a bully
Impairment in Social Interaction
Difficulty with Theory of Mind (ToM)
ToM – knowing that others have mental states
That another person’s minds is different to mine and therefore, they can not know things I know and can be wrong. This belief guides their behavior.
Theory of Mind
Exercise where someone’s thing gets moved without them knowing and they and the kid has to say where the person will look
By approximately age 4, typically developing children are able to do this reliably
100% of typically developing children can do this
85% of children with Down’s Syndrome can do this
20% of children with autism can do this
Repetitive Patterns of Behaviors and Interests
- Self-stimulation (stimming)
- Intense, narrow interests (e.g. transformers)
- Rigid routines (everything structured and is upset if not)
- Preoccupation with parts of objects will not drive a car, just spins the toy’s wheels
Focus on Parts in movies
If you track the eyes of autistic kids in movies, they look at small parts of the scene and not where other’s look. Their interests are different
Autism as a Spectrum
Historical perspectives
- Once viewed as classic, categorical disorder
- Current research emphasizes autism spectrum
Evidence for dimensional spectrum
- Within diagnosis, severity of symptoms vary
- Within diagnosis, language ability varies
- Within diagnosis, any level of IQ possible
- Presence of traits in close relatives (relatives often have autistic traits but do not meet criteria)
Autism: DSM-5 Definition
Significant changes from DSM-IV
DSM-IV
Autistic disorder – social interaction; restrictive/repetitive interests,
language deficits
Asperger’s disorder - social interaction; restrictive/repetitive interests
Pervasive developmental delay not otherwise specified
DSM-5
Autism spectrum disorder
Research indicated that these criteria were being applied
inconsistently across clinics
Distinctions between the groups not meaningful
Everyone diagnosed with one of those disorders should meet criteria for ASD - a lot of people were worried as they might not meet the new disorder and relied on help and funding from their diagnosis
Biggest study of this issue found that 91% of children who had DSM-IV PDD diagnoses met criteria for ASD (Huerta et al., 2012)
But, controversial
Autism Spectrum Disorder
A. Persistent deficits in social communication and interaction, as manifested by:
Deficits in social-emotional reciprocity, e.g., abnormal social approach, failure of normal back-and-forth conversation,
reduced sharing of interests, emotions, affect, failure to initiate or
respond to social interactions
Deficits in non-verbal communicative behaviors used for social
interaction, e.g., abnormalities in eye contact, deficits in
understanding and using gestures, lack of facial expressions
Deficits in developing, maintaining, and understanding
relationships, e.g., difficulties sharing imaginative play, lack of interest in peers
B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following
Stereotyped or repetitive motor movements, use of objects, or speech
Insistence on sameness, inflexible adherence to routines, or ritualized
patterns of verbal or non-verbal behavior
Highly restrictive, fixated interests that are abnormal in intensity and focus
Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment (e.g.,indifference to pain/temperature, excessive smelling)
Symptoms must be present during early developmental period
Symptoms cause clinically significant impairment
For both A and B, severity is rated
(1) Requiring support
(2) Requiring substantial support
(3) Requiring very substantial support (unlikely to live independently as adults)
Social Communication Disorder
Defined by difficulties in social communication
1) Deficits in communication for social purposes
2) Impairment of ability to change contexts to needs of listener (e.g., speaking differently to a child rather than an adult)
3) Difficulties following rules for conversation and storytelling, such as
taking turns in conversation, rephrasing when misunderstood,
knowing how to use verbal/non-verbal signals to regulate interaction
Restricted, repetitive patterns of interest have never been present
Assessment
ADOS
Autism Diagnostic Observation Schedule (ADOS)
Is the gold standard assessment tool
Semi-structured observation
Examiner interacts with child in a series of situations and tasks
Designed to assess social interaction, communication, play and interests
Presses
- A certain pattern of behavior is likely to appear
- We know that children with autism are likely to behave a certain way
- E.g., unstructured presentation of toys (look for preoccupation of parts)
