Autism

1
Autism

• Autism is a lifelong complex neurobiological
  disorder
• Most severe childhood psychiatric condition
• First identified in 1943 by Dr. Leo Kanner
• Dr. Hans Asperger noted a milder form of the
  spectrum that is now called Aspergers Syndrome

2
Pervasive Developmental Disorders

1. Autism
2. Rett Syndrome
3. Childhood Disintegrative Disorder
4. Pervasive Developmental Disorder-Not Otherwise
   Specified (PDD-NOS)
5. Aspergers Disorder

3

• DSM IV Criteria for Autism
• Qualitative impairments in social interaction
• Lack of eye contact and appropriate facial
  expressions and gestures
• Failure to develop normal peer relationships
• Lack of joint attention and emotional reciprocity
• Impairments in communication
• Language delays
• Impairment in the ability to initiate or sustain
  a conversation with others
• Stereotyped and repetitive use of language
• Lack of imaginary play and imitation

4

• Restricted repetitive and stereotyped patterns of
  behavior, interests and activities
• Preoccupation with stereotyped and restricted
  patterns of interest
• Adherence to specific routines or rituals
• Stereotyped and repetitive motor movements (e.g
  hand flapping)
• Preoccupation with parts of objects

5

• Diagnosing Autism
• At least 1 DSM IV criterion before age 3
• Most children assessed at 2.5-5 years
• Concerned when child has not developed language
• Parents report that child was strange as an
  infant
• Early onset symptoms from birth
• Late-onset symptoms at 16-20 months

6

• Incidence of Autism
• Used to be 4-5 out of 10, 000 people.
• CDC now says it is about 1 in 150 individuals
• More common than pediatric cancer, diabetes, and
  AIDS combined.
• Occurs in all racial, ethnic, and social groups
• Affects boys 4-5 X more than girls
• 20 have splinter skills (above average in 1
  area)
• Less than 10 are autistic savants
• extraordinary skills e.g. math, memory, artistic
  abilities, music

7

• Sensory motor delays
• Hearing hypersensitive to certain noises
• Vision staring into space, flapping objects
  before their eyes, looking out of corner of eyes,
  peering close to objects
• Vestibular sensations spinning, staring
• Temperature regulation
• Pain lack of appropriate pain response
• Smell oblivious to foul odors
• Position difficulty maintaining postures
• Taste specific food preferences
• Textures rubbing rough surfaces, preference for
  certain textures

8

• Causes of Autism
• Genetics
• predisposition to autism is inherited
• high concordance rates in identical twins
• increased chance of affected family member
• Brain Abnormalities
• brain stem dysfunction
• Epilepsy, and EEG abnormalities
• ventricle enlargement hydrocephalus
• abnormal serotonin and dopamine levels
• cerebellum abnormalities

9

• Theories
• Executive Function (EF)
• Individuals with autism are impaired on EF tasks
• EF are mediated by frontal lobe, people with
  frontal lobe damage show similar behaviors 
• Theory of Mind (ToM)
• ToM ability to comprehend mental states of
  others, and make inferences and predictions about
  what others will do or believe
• Understand that our own perspective may differ
  from the perspective of someone else

10

• Baron-Cohen, Leslie, Frith (1985)
• Compared autism (11-11), downs syndrome (10-11),
  and normal children (4-5) on a ToM test
•  matched for VMA (5 years)
• Why two comparison groups?

11
(No Transcript)
12

• Results
• 85 normal passed
• 86 downs syndrome passed
• 80 autism failed
• children with autism fail to employ a ToM
• Holroyd Baron-Cohen (1993)
• follow up study with same children at 19.8 years
• Sally-Anne test, Ice Cream Van test (harder)
• 82 failed Sally-Anne test
• all failed Ice Cream Van test
• as teenagers still fail to employ a ToM