Autism Spectrum Disorders - Psychiatry - Lecture Slides, Slides of Psychology

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Autism Spectrum Disorders (ASD) Docsity.com What is Autism? • Four ways to “define” autism – DSM-IV – Parents with a child with autism – Individuals with autism – What we know (i.e. stereotypes of autism) • Let’s take a look at each one to get a more comprehensive idea of this disorder Docsity.com Rhett’s Disorder (299.80) – (A) All of the following: – apparently normal prenatal and perinatal development – apparently normal psychomotor development through the first 5 months after birth – normal head circumference at birth – (B) Onset of all of the following after the period of normal development: – deceleration of head growth between ages 5 and 48 months – loss of previously acquired purposeful hand skills between ages 5 and 30 months with the subsequent development of stereotyped hand movements (e.g., hand-wringing or hand washing) – loss of social engagement early in the course (although often social interaction develops later) – appearance of poorly coordinated gait or trunk movements – severely impaired expressive and receptive language development with severe psychomotor retardation Docsity.com Facts about Rhett’s Disorder • Complex neurological disorder • Genetic in origin • Primarily in girls • Present at birth but more apparent during second year • Second most common cause of severe learning disability in girls • 1:10,000 to 1:23, 000 diagnosed • Period of temporary regression including loss of communication skills, and purposeful hand movements Docsity.com Childhood Disintegrative Disorder (299.10) – (A) Apparently normal development for at least the first 2 years after birth as manifested by the presence of age-appropriate verbal and nonverbal communication, social relationships, play, and adaptive behavior. – (B) Clinically significant loss of previously acquired skills (before age 10 years) in at least two of the following areas: – expressive or receptive language – social skills or adaptive behavior – bowel or bladder control – play – motor skills – (C) Abnormalities of functioning in at least two of the following areas: – qualitative impairment in social interaction (e.g., impairment in nonverbal behaviors, failure to develop peer relationships, lack of social or emotional reciprocity) – qualitative impairments in communication (e.g., delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive use of language, lack of varied make- believe play) – restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, including motor stereotypies and mannerisms – (D) The disturbance is not better accounted for by another specific Pervasive Developmental Disorder or by Schizophrenia. Docsity.com Autistic Disorder (2) qualitative impairments in communication as manifested by at least one of the following: • (a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gestures or mime) • (b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others • (c) stereotyped and repetitive use of language or idiosyncratic language • (d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level Docsity.com Autistic Disorder (3)restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following: • (a) encompassing preoccupation with one or more stereotyped patterns of interest that is abnormal either in intensity or focus • (b) apparently inflexible adherence to specific, nonfunctional routines or rituals • (c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements) • (d) persistent preoccupation with parts of objects Docsity.com Autistic Disorder • (B) Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play. • (C) The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder. Docsity.com Pervasive Developmental Disorder-NOS (299.80) • This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills, or when stereotyped behavior, interests, and activities are present, but the criteria are not met for a specific Pervasive Developmental Disorder, Schizophrenia, Schizotypal Personality Disorder, or Avoidant Personality Disorder. For example, this category includes atypical autism --- presentations that do not meet the criteria for Autistic Disorder because of late age of onset, atypical symptomatology, or subthreshold symptomatology, or all of these. Docsity.com Parents of children with ASD • http://www.autismspeaks.org/sponsoredeven ts/autism_every_day.php • Impact on the family – Social – Financial – Everyday routines • Variable experiences based on an individual child and his/her strengths and weaknesses Docsity.com Anecdotal Stories (www.Autismspeaks. org) Docsity.com Stereotypes about ASD • Head banging • Hand flapping • Non-communicative • Non-verbal • “own world” Docsity.com How is Autism Diagnosed? • Autism Diagnostic Observation Schedule (ADOS; Lord et al) • Autism Diagnostic Interview-Revised (ADI-R; Rutter et al) • Social Communication Questionnaire (SCQ; Rutter et al) • Childhood Autism Rating Scale (CARS; Schopler et al) • Clinical judgment plays a HUGE role – What are the dangers of this? – Potential differential diagnoses (type of language/communication disorder, OCD, anxiety disorder) Docsity.com Benefits of Early Diagnosis • Treatment and intervention effectiveness • Skill acquisition • exposure Docsity.com Skill-Based • Most common methods used by schools • Intent is to develop and support functional demonstration of specific skills rather than to facilitate bonding • Target specific skills to teach to improve functioning in specific areas – Picture Exchange Communication System (PECS) – Facilitated Communication (not recommended) – Assistive Technology – Applied Behavior Analysis (Scientifically Based Practice) – TEACCH Docsity.com Cognitive • Teaching individuals with ASD to monitor their own behavior and performance • Shift control from others to the individuals • Connection between thoughts, feelings and behavior – Social Stories – Social Decision Making Strategies – LEAP (Scientifically Based Practice) Docsity.com Physiological/Biological/Neurological • Address the neurological dysfunctions or problems thought to exist at the core of ASD • Alter way in which neurological system processes information, the manner in which information is received, chemistry and processes associated with sensations, perceptions and emotions – Irlen Lenses (limited support) – Sensory integration (promising practice) – Auditory Integration Training (limited support) – Pharmacology (promising practice) Docsity.com