Intro to Language Disorders Quiz #3

AUTISM

What is autism?

A neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave (born with it) also known as ASD

Core issues with Autism

• Social communication

• Restricted repertoire of interests and behaviors (scope of interests is narrow)

When is autism typically evident?

In the first few years of life

Current diagnosis now includes children who previously would have been diagnosed with…

Asperger’s Syndrome, Pervasive Developmental Disorder (PDD/NOS), Childhood Disintegrative Disorder

Diagnostic criteria for ASD

A child must meet criteria A, B, C, and D

• A: Persistent deficits in social communication and social interaction across contexts

• B: Restricted, repetitive patterns of behavior, interests, or activities

• C: Symptoms must be present in early childhood

• D: Symptoms together limit and impair everyday functioning

Deficits in social-emotional reciprocity (A)

• Atypical social approach

• Failure of typical back and forth conversation

• Reduced sharing of interests, emotions, and affect (joint attention)

• May include total lack of initiation of social interaction

Deficits in nonverbal communicative behaviors used for social interaction (A)

• Poorly integrated verbal and nonverbal communication

  • Pointing to something, looking at a person, and saying “this!”

• Abnormalities in eye contact and body-language 

• Deficits in understanding and use of nonverbal communication to total lack of facial expression or gestures

Deficits in developing and maintaining relationships, appropriate to developmental level (A)

• Difficulties adjusting behavior to suit different social contexts

• Difficulties in sharing, imaginative play, and making friends

• May have an apparent absence of interest to people

  • Don’t pay attention when people are calling their name 

For Criteria B, 2 of the following must be present

• Stereotyped or repetitive speech, motor movements, or use of objects

• Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change 

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

  • Perseveration: uncontrollable repetition of something

• Hyper or hypo reactivity to sensory input (auditory, visuals, smells…) or unusual interest in sensory aspects of the environment

  • Ex) certain textures, certain sounds, weighted vests

ASD Diagnosis

Does not usually occur until children are preschool age however, it is being diagnosed earlier than before. Diagnosis cannot be made in infancy even though research indicates that some symptoms are there in infancy.

Regression

Many families (about 1/3) report typical development up to a certain point, followed by regression or “loss of function” (usually about 18 months)

Prevalence of Autism

• Used to be rare

• As of 1993 → 1 in 10000 children had autism

• Currently → 1 in 31 children have autism

• Boys are 3x more likely 

Ritualistic behavior (restricted and repetitive)

• Self-stimulation “stimming”

• Rote play skills (lining things up)

• Perseveration and preoccupation

• Resistance to change

Cognition

• Low measured intelligence 

• Deficits in memory, discrimination, and problem solving, and other areas

Sensory

• Hyper/Hypo-sensitivity to stimuli

  • Indifference to pain/temp

  • Adverse response to specific sounds or textures

  • Excessive smelling or touch of objects

  • Fascination with lights or spinning objects

Play

• Rote and inappropriate

• May focus on a portion of an object instead of the whole (hyperfocus on the wheel than the whole bus)

• May not use objects for their intended purpose

• Difficulty with symbolic play (pretending, they like repetitive, unengaging things)

Social deficits

• The “hallmark” of the disorder and the issues here are varied

  • Failure to observe social norms

    • Exclusive/excessive use of stereotyped expressions

    • Failure to use and understand nonverbal cues

    • Difficulty interpreting and using paralinguistic information

      • Monotone or unusual intonation

    • Difficulty establishing a shared frame of reference such as talking about a topic w/o giving appropriate background information

    • Lack of interest in interpersonal contact

    • Difficulty with eye contact (fleeting)

      • Gaze aversion 

      • Eye contact with objects not people