Weeks 6-8 - Autism Flashcards
1
Q
What is meant by the term neurodiversity?
A
The range of individual differences in brain function and behavioural traits, particularly used in the context of autism
2
Q
What is a neurodevelopmental condition?
A
A condition which reflects atypical development of the nervous system
3
Q
What are the causes of neurodevelopmental conditions?
A
An interaction of genetic, neurobiological and environmental influences
4
Q
What kind of changes arise due to neurodevelopmental conditions and how long do they last?
A
- Functioning and behaviour
- Across the lifespan
5
Q
From what age may the signs of autism be detectable?
A
Two years old
6
Q
What is meant by the term ‘critical period’ with regards to development?
A
Stages in the early development where the nervous system is especially sensitive to certain environmental stimuli, absence of which at the appropriate time may have long-term developmental effects
7
Q
What is meant by the term heterogenous (especially when thinking of autism)?
A
No two people’s profiles are alike
8
Q
What are the two main areas of difficulty that form the framework for identifying autism?
A
- Social communicating
- (Broadly) Non-social aspects of thinking and behaviour
9
Q
What are the typical features of the variant of autism known as Kanner’s autism?
A
- Social and communication difficulties
- Often little or no speech
- Markedly restricted and/or repetitive behaviour and interests
- Intellectual disability
10
Q
How many people with autism end up in paid, full time employment?
A
Only one in six
11
Q
What medical problems often co-occur with autism?
A
- Sleep disorders
- Gastrointestinal problems
- Epilepsy (30-50% occurrence, particularly those with more severe autism)
12
Q
What neurodevelopmental problems may co-occur with autism?
A
- ADHD
- Dyslexia
- Language difficulties
- Learning disability
13
Q
What mental health conditions often co-occur with autism?
A
- Bipolar disorder
- Schizophrenia
- Depression
- Anxiety
14
Q
What is a biomarker?
A
A measurable biological, genetic, pathological or physical charactieristic by which a particular condition or disorder can be reliably identified
15
Q
Are there any consistent or universal biomarkers for autism?
A
No
16
Q
How is autism diagnosed?
A
Evaluation of behavioural characteristics
17
Q
Which version of the DSM is currently in use?
A
DSM-5
18
Q
Which version of the ICD is currently in use?
A
ICD-11, which was adopted from 2022
19
Q
What is a notable change regarding autism in both the ICD-11 and the DSM-5?
A
Subtypes of autism, such as Asperger syndrome, are being phased out
20
Q
What are the main classes of symptom for autism as per the ICD-10?
A
Problems in:
- Communication
- Social interaction
- Restrictive, repetitive behaviours and interests
21
Q
What are the main classes of symptom for autism as per the DSM-5?
A
Problems in:
- Social communication
- Restrictive, repetitive behaviours and interests, sensory difficulties
22
Q
Per the ICD-11, at what age must autistic symptoms have appeared for diagnostic criteria to be met?
A
For childhood autism, ‘functional impairment’ in social interaction, or in language use for communication, must have appeared by age 3 years (not applicable to Asperger syndrome)
23
Q
Per the DSM-5, at what age must autistic symptoms have appeared for diagnostic criteria to be met?
A
Social communication difficulties and RRBIs (restrictive, repetitive behaviours and interests) must have been present in early childhood, however ‘functional’ impairment need not be apparent til later
24
Q
In which western country is an autism diagnosis still very problematic?
A
France
25
What is receptive language?
The process of receiving and understanding language which is spoken or written by others
26
Difficulties with receptive language are common in autism. How might this manifest?
- Difficulty in understanding vocabulary or grammar
- Difficulty in distinguishing speech sounds and understanding the meaning of sentences
27
What is expressive language?
Language that a person produces, in written or spoken form
28
Difficulties with expressive language are common in autism. How might this manifest?
- Spoken language may be sparse in vocabulary
- Spoken language may be grammatically or syntactically incorrect
- Difficulty putting thoughts into words
- Using language appropriately in different settings
29
What is the ADI-R?
An interview designed for use with the parents of children or adults who are being assessed for an autism spectrum diagnosis
30
When was autism first formally identified?
1944
31
What is meant by the term ‘prevalence’?
An estimate of the number of people with symptoms which meet the diagnostic criteria for a medical or psychiatric condition, within a defined population, at a particular time
32
In the UK, what is the prevalence of autism?
98 individuals in 10,000
33
What is meant by the term ‘incidence’?
An estimate of the number of NEW people diagnosed with a medical or psychiatric condition within a defined population in any given period (e.g. day/week/month)
34
What might explain a lower prevalence of autism among ethnic minority groups?
- Fear of stigma
- Being unable to afford medical diagnosis / support
35
What is the rate of diagnosis of autism between males and females?
4 : 1 males to females, though raise as high as 9 : 1 if only ‘high functioning’ individuals are counted
36
What is a meta-analysis?
A research method that involves evaluating the existing evidence for a particular topic or theory by pooling and statistically analysing the pooled findings from all relevant research by other researchers
37
What is a systematic-review?
A research method involving evaluating existing evidence for a particular topic or theory by critical review of all relevant findings by other researchers
38
What psychiatric diagnosis is most commonly co-morbid to autism?
Anxiety
39
What is meant by ‘Theory of Mind’?
The ability to understand other people’s mental states - includes the ability to understand another person’s belief about an aspect of reality that may be different from one’s own
40
What is ‘protodeclarative pointing’?
The use of pointing to draw someone else’s attention to an object or item of interest, thus enabling an individual ot share their interest with another
41
What is meant by the term ‘Executive Function (EF)’?
A collective term for mental processes that control behaviour
42
What kind of tasks require Executive Function (EF)?
- Initiation
- Planning and organising
- Working memory
- Behaviour regulation:
- self control
- mental flexibility
43
What other condition may Executive Function problems occur in?
ADHD
44
What is the Behavioural Rating Inventory of Executive Function (BRIEF)?
A survey tool designed to measure executive function skills used in everyday settings and tasks
45
What is meant by the term ‘systemising’ (with regards to autism)?
A flair for or strong interest in approaching fields or topics in a systematic or rule-following way
46
What is the cognitive component of empathy?
Recognising other people’s thoughts and feelings
47
What is the affective component of empathy?
Being caring and responding with feelings
48
Which component of empathy do autistic people tend to express less well?
The cognitive component
49
What is monotropism?
A trait in autism where the individual focuses their attention on objects and topics that are of particular interest to them
50
Who were the two researchers who first described autism in the early 1940s?
- Leo Kanner
- Hans Asperger
51
What does the ‘twin method’ measure?
How frequently a particular condition or characteristic co-occurs in identical twins, compared with non-identical twins
52
What is meant by the term ‘concordance rate’?
A descriptor of the probability that pairs of individuals with shared genes will have the same trait or condition under investigation
53
Children of fathers over what age are more likely to have autism, compared to those with fathers aged 20-24?
45
54
If one identical twin has autism, what is the percentage likelihood that the other twin has it too?
80%
55
What is a single nucleotide polymorphism (SNP)?
A DNA sequence variation that occurs when a single nucleotide (adenine, thymine, cytosine, guanine) in the genome sequence is altered, and that particular alteration is present in at least 1% of the population
56
What is a copy number variant (CNV)?
A CNV is when the number of copies of a particular gene varies from one individual to the next
57
What are candidate genes?
Genes whose functions or locations on a particular chromosome indicate that they might be associated with a condition or disorder
58
What is chromatin?
The complex of DNA and protein that is tightly coiled and looped to form chromosomes
59
What function does the CHD8 gene perform?
It provides instructions for making a protein that regulates gene activity, by a process known as chromatin remodelling
60
What happened to mice whose FMR1 (fragile X syndrome) gene was disrupted?
They showed structural and functional abnormalities to synapses
61
What are key functions of glutamate and GABA?
- Glutamate has an excitatory effect on post-synaptic neurons and is considered crucial in neural plasticity and in cognitive functions such as learning and memory
- GABA has the primary inhibitory afffect on the brain
62
In autistic people, excess growth is particularly noted in which areas of the brain?
- Frontal lobe
- Temporal lobe
63
What is the approximate age range in whcih excess brain growth may be observed in children later diagnosed with autism?
Six months to four years
64
Name two brain regions where excess growth is especially marked in people with autism, and one function which each region plays a role
- Fontal lobes: executive function, logical reasoning/decision making, regulating social and emotional behaviour
- Temporal lobes: long-term memory, processing and interpreting visual and auditory signals, language comprehension
- Amygdalae: forming and storing memories for emotional events
- Cerebellum: generation and coordination of motor movements, language, attention, mental imagery
65
What is the ‘association cortex’?
Regions located within all lobes of the cortex that, through their interlinking, support high level integrative activities such as comparing sensory inputs to stored memories
66
Where is the limbic system located?
Both sides of the thalamus, immediately beneath the medial temporal lobe
67
What has disruption in the orbitofrontal cortex been linked to in autism?
- Challenges in social interactions
- Understanding emotions
- Selecting activities to meet goals
68
What does the orbitofrontal cortex play a key role in?
Decision making
69
What difficulties in autism have altered function in the inferior frontal gyrus been implicated in?
Verbal/non-verbal communication
70
What does the posterior parietal cortex play a key role in?
- Spatial awareness
- Controlling eye movements
- Maintaining attention
71
In autism, atypical activation of the posterior parietal cortex may have what effects?
- Impede the flow of social interaction
- Promote enhanced skills in visual tasks that call for focus on details
72
Where in the brain is the cingulate gyrus?
Wrapped around the corpus callosum
73
What does the anterior part of the cingulate gyrus play a role in?
- Coordinating sensory stimuli with emotions
- Emotional expression
- Bonding
- Regulating aggressive behaviour
- Decision making
74
What does the posterior part of the cingulate gyrus play a role in?
- Spatial orientation of objects
- Mediating between emotions and memories
75
Altered function in the cingulate gyrus may have what effects in autism?
- Social and emotional challenges
- Repetitive behaviour
76
What is the anterior cingulate cortex involved in?
- Coordinating sensory stimuli with emotions
- Emotional expression and bonding
- Regulating aggressive behaviour
- Decision making
77
What is the anterior part of the superior temporal sulcus involved in?
Processing speech
78
What is the posterior part of the superior temporal sulcus involved in?
- Processing faces
- Movement
- Direction of gaze
- Integrating audio and visual information
79
What can atypical functioning in the superior temporal sulcus
Social and theory-of-mind difficulties in autism
80
Where are the fusiform gyri?
They span the lower part of each temporal and occipital lobe
81
What has atypical functioning of the fusiform gyri been linked to?
- Prosopagnosia
- Synaesthesia
82
Which system is the bilateral amygdala integral to?
The limbic system
83
In autism, what has atypical amygdala function been linked to?
- Altered emotional regulation
- Anxiety
84
Atypical function of the hippocampus may lead to what effects in autism?
- Enhanced memory for factural information
- Difficulties recalling or acting upon personally salient events
85
How does the hypothalamus perform its role in controlling emotional expression?
Triggering release of the pituitary hormones oxytocin and vasporessin
86
Atypical functioning of the hypothalamus may lead to what in autism?
Social interaction and emotional difficulties
87
The bilateral thalamus is a hub for what functions?
- Processing and relaying sensory information to cortical areas
- Relaying cortical feedback to movement areas
88
Atypical functioning of the hypothalamus is related to what in autism?
- Regulation of social behaviour
- Sensory hyper- and hypo-sensitivity
- Sleep disturbances
89
Where in the brain is the cerebellum located?
Below the temporal and occipital lobes and posterior to the brain stem
90
Aside from generating and coordinating motor movements, what else does the cerebellum play an important role in?
- Vocalising sounds
- Attention
- Mental imagery
91
In autism, what is atypical functioning of the cerebellum linked to?
Compromised development of social communication skills and executive function
92
The pons is a part of which brain structure?
The brain stem
93
What is the function of the pons?
It relays information to and from the cerebellum, cerebrum and spinal cord
94
What are the basal ganglia involved in the control of?
- Eye movements
- Learning
- Action selection
95
Atypical function of the basal ganglia may lead to what in autism?
Impeded action selection, leading to repetitive activities and difficulty in engaging with others
96
What is heterogenity?
The state of being diverse in character - **e.g. the heterogenity of human populations**
97
In studies focussed on autistic groups with higher IQ, what does the rate of diagnosed females to males rise from and to?
From 1 in 4 to 1 in 8
98
What does the ‘female protective effect’ suggest?
That females have a higher level of protection from the factors causing autism than males - this means that males need a lower level of genetic risk factors than females to develop autism
99
On average, are males or females more severely affected by autism?
Females
100
Define the term ‘camouflaging’.
The situation where individuals copy the behaviours of their NT peers and mask behaviours that would make them stand out as different
101
What percentage of girls with autism are diagnosed before the age of ten, compared to that of boys?
Girls - 20%
Boys - 50%
102
When was the first systematic review and meta-analysis of male/female prevalence differences in autism conducted and how many participants were in the study?
- 2017
- 14 million
103
What is meant by the term ‘interventions’?
A technique or procedure to support and help autistic children/adults to engage with others and to thrive
104
What is meant by the term ‘adaptive functioning skillls’?
The practical skills needed to function in everyday life, including the skills to effectively and independently take care of oneself and to interact with other people
105
In regards to autism, what does the term ‘optimal outcome’ refer to?
A developmental outcome where an autistic person’s symptoms have modified or ameliorated to such an extent that the diagnostic criteria for autism are no longer met
106
When considering a potential new intervention, what are the 5 main areas of consideration?
- Rationale
- Focus
- Ethics
- Method
- Outcomes
107
In the context of psychological studies, what is meant by the term ‘generalise’?
When the response of a result/study is applicable in a different context/situation outside of the one where it was measured
108
What is a multiple-baseline study?
One wher individuals are observed before starting the intervention for different lengths of time to establish a baseline for the targetted behaviour
109
What is the benefit of conducting a multiple-baseline study?
It makes it easier to ascertain that any change is due to the intervention itself
110
What is a confounding variable?
One which can affect experimental and other scientific studies
111
What is meant by the term ‘outcome measure’?
The measure that is defined at the start of a clinical trial as the measure that will be used to asses the impact of the treatment/intervention under investigation
112
What are the advantages of a ‘treatment-as-usual’ group in a study?
- It lowers the chance that participants will lack motivation to be involved
- Helps address ethical issues: there’s a good chance everyone will gain some benefit from the study
- Enables the new intervention to be compared with existing interventions
113
What is the purpose of randomly allocating participants to experimental and ‘treatment-as-usual’ groups in a randomised controlled trial?
It avoids confounding variables which might bias the outcomes
114
What does the term ‘randomised controlled trial’ refer to?
A systematic evaluation of a treatment/intervention where participants are randomly assigned to intervention or control groups
115
What might be problem of evaluating effectiveness of outcomes for interventions in autism?
The heterogenity of autism
116
What does TEACCH stand for?
Treatment and Education of Autistic and Communication-related handicapped Children
117
What is the TEACCH approach?
A ‘whole-person’ approach to education which supports many aspects of functioning
118
What types of aspects of functioning is the TEACCH intervention designed to support?
- Learning
- Behaviour
- Social and communication needs
119
What are some of the key principles of TEACCH?
- Structure, including the person’s environment and clearly defined routines
- Harnessing skills: tailoring support tools to a person’s skills
- Evaluation of individual support needs regularly, including interventions
- Empowering parents by encouraging full participation
- Developing independence and generalising from learning experiences to master a range of situations
120
Why might formal evaluations of TEACCH be difficult?
- It is tailored to the needs of an individual so difficult to identify outcome measures which might be relevant for all participants in a study
- Difficult to set up control groups
121
What is Applied Behavioural Analysis (ABA)?
A group of comprehensive behavioural interventions which employ operant conditioning and reinforcement to shape the person’s behaviour
122
What is Early Intensive Behavioural Intervention (EIBI)?
An intervention for preschool children on the autism spectrum using a range of techniques based on ABA principles
123
What is meant by the term ‘naturalistic intervention’?
Interventions that support the development of target skills within a child’s everyday environment, or naturally occurring situations
124
What is the best and most widely known naturalistic intervention?
Picture Exchange Communication System (PECS)
125
What is Picture Exchange Communication System (PECS)?
An intervention where children are taught to communicate using pictures and other symbols
126
What do antagonists do?
They bind to postsynaptic neuronal receptors, preventing the binding and action of neurotransmitters
127
What behaviours is oxytocin related to?
- Social engagement
- Social reward
128
What behaviours is just vasopressin linked to?
- Social avoidance
- Anxiety
- Defensiveness
- Aggression
- Fear and freezing
129
What behaviours are oxytocin and vasopression jointly linked to?
- Love and bonding
- Sexual behaviour
- Parental behaviour
