Week 11/2-20 Autism Flashcards
Sally-Anne Test
Theory of mind task
By age 4 should be able to do it. On average.
100% of of typically developing children can do this
85% of children with Down’s Syndrome can do this, not purely ontellectual
20% of children with Autism can do this, can figure out answer and learn it but not understand it.
Core Features of Autism
Difficulties:
Qualitative impairment in SOCIAL INTERACTION
joint attention (coordinate object and person) eg. Garbage truck (cat blue paw)
expressive nonverbal behavior
social “mind” and reciprocity (his/yours) triangle circle video. Intrept things socially, autistic do not see world in social terms. No share or seek help. Heider and Simmel (1944) film
– Used originally in social psychology experiments
– Adapted for autism research
– Assesses “normal” tendency to attribute social meaning to ambiguous stimuli
-Theory of mind is lacking, idea others have minds,, thoughts feelings different from yours.
Qualitative impairments in COMMUNICAION
No receptive language
echolalia and other repetitions
poor pragmatic use of language
50% do not develop “useful” language
REPETITIVE patterns of behaviors and interests
Self-stimulation, son flap HIT
Intense, narrow interests (piano)
Rigid routines (more extreme than dev. Typic)
Preoccupation with parts of objects
CER
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, any level of IQ possible (giftedness - disabled)
Presence of traits in close relatives
Autism Spectrum Disorder
Research shown 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 (raised parent concern esp. Aspergers, pddnos)
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
Dsm-v diagnosis?
A. Persistent deficits in social communication and interaction, as manifested by: (all needed)
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 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
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 of asd u need to know (stopped lecture here had concert)
Autism Diagnostic Observation Schedule (ADOS)
Semi-structured observation
Examiner interacts with child in a series of situations and tasks
Designed to assess social interaction, communication, play and interests
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
Prevalence of ASD
4 in 10,000 (0.04%) “old” rate
Most recent CDC data is 1 in 68 (1.5%)
Due to better identification and broader definitions of ASD
Cultural and contextual differences
Present cross-culturally and cross-nationally Found at all income levels
Gender differences
4:1 male to female ratio
10:1 male to female ratio in “high functioning” ASD
Developmental course of asd
Efforts to create very early ID tests
Can be identified around age 2, average age of diagnosis is around age 4
Some children display problems since birth
Some children seem to lose early developmental milestones
Prognosis of ASD
Usually chronic (lifelong) and impairing
Strongest predictors of adult outcome Language
IQ
Clinical Correlates and Comorbidity of ASD
Comorbidity
Intellectual disability most common (70%)
Epilepsy next most common (25%) Anxiety/ OCD also common
Intellectual functioning 70% meet criteria for ID
40% meet criteria for severe or profound ID 25% have “splinter skills” above average
5% savants, extreme
Comorbidity
Differentiating autism from ID
Children with ID have
No specific deficit in joint attention
No specific deficit in theory of mind
No specific deficit in pretend play
Social behaviors appropriate for their mental age
Social deficits not there developmentally for Id
