Autism slides - Autism Impairment in social Autism...

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Unformatted text preview: Autism: Impairment in social Autism: Impairment in social interactions • Deficits in imitating others, sharing focus • • • • • of attention, orienting to social stimuli Limited sensitivity to social cues Tendency to treat people like objects Little desire for interaction Difficulty processing emotional info Difficulty expressing emotions Communication problems Communication problems • Some children are mute • Some have noncommunicative speech only • • • Pedantic speech Literal understanding Pronoun reversal – Echolalia – Idiosyncratic speech Communication problems Communication problems • • • • • • • Perseverative speech Monotone No understanding of humor or sarcasm Little use of language for social convention Lack of showing or expressive gestures Play lacks social and symbolic function Do not initiate make­believe play Abnormalities in response to the Abnormalities in response to the environment • Need for sameness – True for environment and own behaviors – Narrow patterns of interest – Stereotyped movements – Explosive reaction to changes – Unusual response to sensory stimulation – Sometimes hypersensitive to touch or sound • Overresponsivity Abnormalities in response to the Abnormalities in response to the environment • Underresponsivity – Some children have an unusual tolerance of pain or cold – Self­injurious behaviors – May engage in behaviors that stimulate • Spinning objects • Flashing lights off and on Decreased intellectual functioning Decreased intellectual functioning • • • • Children with autism vary widely in IQ 70% have MR (40% severe to profound) Most have uneven deficits Only children with average and above IQ’s usually have potential to be independent • 25% develop a “splinter skill” • 5% autistic savant (Video clip) Age of onset, prevalence Age of onset, prevalence • Must be diagnosed before 3, but present • • • • from birth 5 per 10,000; 10x more prevalent now than 20 years ago No link with social class or race Boys outnumber girls 4:1 Overlaps with MR, anxiety, seizure disorders Asperger’s disorder Asperger’s disorder • More subtle deficits; higher intellectual and language functioning • DSM­IV difference—no delays in language development and no cognitive deficits • Is it a distinct disorder or at the less severe end of the autism spectrum? Asperger’s disorder Asperger’s disorder • Many of same social problems and stereotyped patterns of interest as autism • Deficits in social use of language or pragmatics (formal, monotone) • Often have obsessive­compulsive tendencies • Restricted communication with others Asperger’s disorder Asperger’s disorder • Less is known about prevalence b/c is new diagnosis and may go undetected • Boys outnumber girls 15:1 • Present from birth, but often not diagnosed until much later • Anxiety and depression are common Etiological theories: Environmental Etiological theories: Environmental factors • Birth complications—probably not primary cause • Rubella in pregnant moms—probably not • MMR vaccination—unlikely as cause Genetic factors Genetic factors • • • Very likely that genetics plays a role Probably not just one gene, but many Risk of having a second child with autism is 15 to 30 times higher • Evidence from twin studies Neuropsychological factors Neuropsychological factors • Neurochemical findings – Research suggests that serotonin, dopamine, norepinephrine, endorphins may play role – Findings are inconsistent • Abnormalities in temporal lobe and cerebellum • Larger amygdalas • Diffuse damage to multiple areas • Larger brain volume • Neuroanatomical findings Prognosis Prognosis • Japanese study (followed 197 children with autism) – 27% were living independently – 47% had developed good language skills and were able to communicate with others – 73% required close supervision – In adolescence, half improved and half got worse Prognosis Prognosis • Outcomes depend on how many cognitive deficits are present and how much language is affected • Lack of speech before 5, IQ < 70, and seizures are poor prognosis • More favorable prognosis for Asperger’s • Early intervention is key ...
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