Part III: Autism Spectrum Disorder (ASD)

DSM-5 Core Diagnostic Domains

A. Persistent Deficits in Social Communication and Interaction

B. Restricted, Repetitive Patterns of Behavior, Interests, or Activities

Other key diagnostic features 

• Early developmental period 

  • severity = level of support required (level 1, 2, or 3)

A. Persistent Deficits in Social Communication and Interaction

1. Deficits in socioemotional reciprocity (e.g., failure of back-and-forth conversation)

2. Deficits in Nonverbal Communicative Behaviors (e.g., abnormal eye contact, poor body language)

3. Deficits in developing, maintaining, and understanding relationships (e.g., difficulties making friends, absence of interest in peers).

• MUST MEET ALL 3

B. Restricted, Repetitive Patterns of Behavior, Interests, or Activities

1. Stereotyped/Repetitive motor movements, use of objects, or speech (e.g., lining up toys, echolalia) 

2. Insistence on Sameness (e.g., extreme distress at small changes, rigid routines).

3. Highly Restricted, Fixated Interests (abnormal in intensity or focus).

4. Hyper- or Hyporeactivity to Sensory Input (e.g., indifference to pain, adverse response to loud sounds or textures).

• MUST MEET AT LEAST 2 OF 4

Leo Kanner 

Credited with the first description of “infantile autism” and distinguishing it from schizophrenia

• Defined by Autistic Aloneness (inability to form contact) and Insistence on Sameness.

“Refrigerator Mother”

Fully discredited theory that blamed autism on the cold, mechanical, and obsessively intellectual personalities of the parents (a misinterpretation of Kanner’s familial observations).

• THIS IS FALSE

Prognostic Indicators

The strongest positive predictors for a “good” long term outcome are:

1. High IQ (Nonverbal)

2. Communicative Speech by age 5

MMR Vaccine Fraud

Andrew Wakefield’s 1998 Lancet study claiming link between the MMR vaccine and autism was found to be an “elaborate fraud” based on falsified data and financial conflict of interest (Brajser, BMJ)

Non-Verbal Learning Disorder (NVLD): Deficits

• Visual-spatial-organizational skills

• Nonverbal problem solving (often poor motor coordination and social judgment)

Non-Verbal Learning Disorder (NVLD): Strengths

Relative proficiency in rote verbal skills (e.g., vocab, memorization, verbal fluency).

Non-Verbal Learning Disorder (NVLD)

• NOT FORMAL DSM-5

• COMMON CLINICAL PROFILE

• HISTORICALLY OVERLAPPING W ASPERGER’S