autism spectrum disorder

why were multiple disorders collapsed into one in the DSM-5?

• no consistent differences between individuals diagnosed with mild autism and those with asperger’s

• not uncommon for different practitioners to diagnose same person with different disorders

  • better inter-reliability

  • can determine better access to services

describe the diagnostic criteria of ASD?

• persistent deficits in social communication and interaction across multiple contexts

  • deficits in social-emotional reciprocity

    • failure of normal back-and-forth conversation

  • deficits in nonverbal communicative behaviors used for social interaction

    • abnormalities in eye contact and body language

  • deficits in developing, maintaining, and understanding relationships

    • difficulties adjusting behavior to suit various social contexts

    • difficulties in imaginative play & making friends

• restricted, repetitive patterns of behavior, interests, or activities

  • repetitive motor movements, use of objects, or speech

  • high restricted, fixated interests that are abnormal in intensity or focus

  • insistence on sameness, inflexible to routines, ritualized patters of non/verbal behavior

  • hyper or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment

• symptoms must be present in the early developmental period

• symptoms cause clinically significant impairment in social, occupational functioning

• not better explained by intellectual disability

what are signs of autism often seen in infancy and early childhood?

infancy

• reduced responsiveness to direct gaze

• reduced joint attention

  • switching of a gaze between something interesting and another person

• sensory sensitivity

  • large reflexive response to bright light

early childhood

• limited attention to faces and voices

• limited drive to share experiences with others (joint attention) or reference others for social information (social referencing)

• atypical verbal and nonverbal communication

• restrictive and repetitive behaviors

what are two language-related issues often seen in young children with ASD?

• pronoun reversals

  • saying "you" instead of "I"

• echolalia

  • repeating words or phrases

are there any developmental considerations in diagnosing ASD?

• monitoring for early signs in social interaction, language, and behavior

• understanding that symptoms can appear at different ages

how accurate is diagnosis at a young age?

• reliably diagnose 40-50% of children at 18 months

define sensory dominance

• tendency to focus on certain types of sensory input over others

  • ex: preference for sights over sounds

define stimulus overselectivity

tendency to focus on one feature of an object or event in an environment while ignoring other equally important features

explain gender differences in ASD

• ratio is about 3:1 for males to females

  • females: fewer repetitive/restrictive behaviors, high internalizing problems

  • males: more externalizing problems, symptoms may be more visible

• 20% of women with anorexia also meet criteria for ASD

what is the main controversy surrounding the "extreme male brain" theory of ASD?

• it may contribute to the underdiagnosis of females

• can promote the stigmatizing idea that people with ASD lack empathy

explain how applied behavior analysis works for ASD treatment

• based on principles of operant conditioning of shaping behavior with reward

• clients and clinicians co-develop a plan of behavioral goals

• goals are broken into smaller tasks which are completed during short period of structured time followed by free time for child

  • works best when structure is high, families are included in skill training

what is the theory of mind

we can guess what others are thinking and how that might differ from what we are thinking

explain how theory of mind plays into the study of ASD

• those with autism = mind blind: they cannot imagine what other might be thinking, or even that others are thinking

• they may be able to learn, remember, and know things about the social word but may not intuitively understand them

due to its variable nature, what kind of diagnostic approach is critical for ASD?

idiographic approach

• focuses on the individual's unique pattern of symptoms, strengths, and difficulties

how common is autism spectrum disorder

• one of most common neurodevelopmental disorders

• affects 1 in 68 children in US

why is autism a spectrum disorder?

refers to the fact that symptoms, abilities, and characteristics are expressed in many combinations across many degrees of severity