Chapter 6 Autism Disorder

What is Autism Spectrum Disorder (ASD)?

A DSM-5 neurodevelopmental disorder characterized by significant deficits in social communication and interaction skills, and restricted, repetitive patterns of behaviors, interests, or activities.

What does the phrase 'If you've met one person with ASD, you've met one person with ASD' imply?

It suggests that each individual with ASD is unique, displaying a wide variety of symptoms, abilities, and needs.

What are the two core symptom domains of ASD according to DSM-5?

Impairments in social interaction and communication, and restricted repetitive and stereotyped patterns of behavior, interests, and activities.

What is meant by 'preservation of sameness' in children with ASD?

An anxious and obsessive insistence on maintaining consistency in daily routines and activities.

Who defined a milder form of autism known as Asperger's disorder?

Hans Asperger.

What are the three critical factors that contribute to the spectrum nature of autism?

Intellectual ability, severity of language problems, and changes in behavior with age.

What are some common social interaction impairments in children with ASD?

Deficits in social-emotional reciprocity, unusual nonverbal behaviors, lack of interest in relating to others, and limited social expressiveness.

What are protoimperative and protodeclarative gestures?

Protoimperative gestures direct attention to objects of desire, while protodeclarative gestures direct attention to shared interests.

What is echolalia in the context of communication impairments in ASD?

Immediate or delayed parrot-like repetition of words or phrases.

What are some examples of restricted and repetitive behaviors in children with ASD?

Stereotyped body movements, insistence on sameness, and self-stimulatory behaviors like rocking or hand flapping.

What is sensory overresponsivity?

A negative response to or avoidance of sensory stimuli, often seen in children with ASD.

What percentage of children with ASD have co-occurring intellectual impairment?

About 70%.

What is meant by 'weak drive for central coherence' in individuals with ASD?

A tendency to focus on parts of stimuli rather than the whole context, making it difficult to understand social cues.

What is the significance of the Embedded Figure Test for individuals with ASD?

People with ASD tend to score higher on these tests, indicating a weaker central coherence and a greater ability to detect hidden shapes.

What are some common qualitative language impairments in children with ASD?

Pronoun reversals, echolalia, and perseverative speech.

What is the prevalence of nonverbal or minimally verbal individuals with ASD?

25-50% of people with autism are nonverbal or minimally verbal.

What role does early intervention play in the diagnosis of ASD?

It has led to an increase in diagnoses of higher-functioning individuals and a decrease in the average age of diagnosis.

What is the impact of ASD on social-emotional development?

Children with ASD may have difficulty regulating alertness levels, which affects their social communication.

What is the relationship between ASD and cognitive deficits?

Children with ASD may exhibit deficits in processing social-emotional information and understanding others' mental states.

What is meant by 'executive functions' in the context of ASD?

Higher-order planning and regulatory behaviors that help with problem-solving, task performance, and cognitive flexibility.

What are some associated characteristics of children with ASD?

Intellectual deficits and strengths, sensory and perceptual impairments, cognitive and motivational deficits, and medical conditions.

What is the significance of the phrase 'acting as if people weren't there' in relation to ASD?

It describes how children with ASD may appear to lack social awareness and engagement with others.

What is the DSM-5's specification for the severity of ASD?

Severity is specified based on social communication impairments and restricted, repetitive patterns of behavior, categorized into three levels of support needed.

What is the historical view of autism's causes that has been unsupported?

The idea that autism resulted from a child's defensive withdrawal from a cold and hostile parent, known as the 'refrigerator mother' theory.

What is the significance of joint attention in social interaction?

It refers to the ability to coordinate focus on another person and an object of mutual interest, which is often impaired in children with ASD.

What are some common medical conditions associated with ASD?

Children with ASD may have co-occurring medical conditions, such as epilepsy or gastrointestinal issues.

What is Theory of Mind (ToM)?

The ability to understand that other people have their own beliefs, desires, and intentions that may differ from your own.

What is a key characteristic of individuals with Autism Spectrum Disorder (ASD) regarding ToM?

Lack of ToM is one of the most specific characteristics of ASD.

What cognitive deficits are associated with ASD?

Deficits in processing socio-emotional information and executive functioning deficits.

What is the view regarding social motivation in children with ASD?

Children with ASD may have an underlying impairment in social motivation, failing to find social stimuli intrinsically rewarding.

What percentage of children with ASD have a coexisting medical condition?

About 10%.

What percentage of children with ASD experience sleep disturbances?

65%.

What is the prevalence of gastrointestinal symptoms in children with ASD?

50%.

What is the typical head size in infants with ASD?

Infants with ASD start with a smaller than average head size.

What is the most common co-occurring disorder in individuals with ASD?

Intellectual disability.

What percentage of individuals with ASD have a co-occurring disorder?

Over 90%.

What are some extreme self-injurious behaviors (SIB) seen in individuals with ASD?

Head banging, hand or arm biting, excessive scratching and rubbing.

What is the worldwide prevalence of ASD?

Between 1% and 2% of all individuals.

What is the prevalence of ASD in the United States according to the CDC?

1 in 31 (3.2%) of people.

What is the 'extreme male brain theory' of ASD?

It suggests that individuals with ASD fall at the extreme high end of systemizing abilities and the extreme low end of empathizing abilities.

At what age is ASD most often identified by parents?

In the months preceding the child's second birthday.

What is the recommended age for screening children for ASD according to the AAP?

18-24 months.

What is the typical course of development for children with ASD?

They may develop along different pathways, often showing gradual improvements with age.

What factors contribute to better long-term outcomes in children with ASD?

Better language skills, higher intellectual ability, and higher scores on measures of reciprocal social interaction at diagnosis.

What are some identified causes of ASD?

Biologically based neurodevelopmental disorder with multiple causes including genetic influences and brain abnormalities.

What prenatal factors have been associated with an increased risk of ASD?

Parental age, in vitro fertilization, and maternal use of drugs or toxic chemical exposure.

What does current scientific evidence say about vaccines and ASD?

It does not support an association between MMR vaccines or thimerosal and ASD.

What percentage of children with ASD have the Fragile-X anomaly?

2-3%

What is the elevated risk for chromosomal anomalies in ASD individuals?

5%

What condition affects about 25% of children with ASD?

Tuberous sclerosis

What are common characteristics of the broader autism phenotype in family members of children with ASD?

Higher rates of social and language deficits, aloofness, rigidity, and poor verbal comprehension.

What is the concordance rate for ASD in identical twins?

70-90%

What is the heritability estimate for ASD?

90%

What role do environmental influences play in the development of ASD?

They significantly impact the emergence and developmental course of ASD.

What is the relationship between genetic susceptibility and environmental factors in ASD?

Susceptibility may have a moderate genetic heritability component and a substantial shared environmental component.

What is a key characteristic of ASD as a genetic disorder?

It is likely a complex genetic disorder with no single gene identified as relevant for most cases.

What brain abnormalities are associated with ASD?

Cerebral gray and white matter overgrowth, structural abnormalities in the cerebellum and amygdala, and decreased blood flow in frontal and temporal lobes.

What is the significance of the amygdala in children with ASD?

Structural and functional abnormalities in the amygdala are linked to problems with social stimuli recognition and communication impairments.

What are the treatment goals for children with ASD?

Minimize core problems, maximize independence and quality of life, and help families cope effectively.

What percentage of parents of children with ASD report trying multiple therapies?

Parents report trying an average of 7-9 different therapies.

What types of treatments for ASD are often unsupported?

Nutritional supplements, special diets, hyperbaric oxygen therapy, and facilitated communication.

What are some effective strategies for reducing disruptive behaviors in children with ASD?

Rewarding competing behaviors, ignoring the behavior, and mild forms of punishment.

What is the focus of initial treatment stages for children with ASD?

Building rapport and teaching learning-readiness skills.

What is the role of early intervention in ASD treatment?

It should begin as soon as ASD is seriously considered, ideally before age 3, with intensive and structured support.

What types of medications are commonly prescribed for children with ASD?

Antidepressants, stimulants, and antipsychotics.

What is the importance of family involvement in ASD treatment?

Family inclusion is crucial for effective treatment and coping strategies.

What is the purpose of teaching appropriate social behavior in ASD treatment?

To enhance interactions with peers and adults, including joint attention and turn-taking.

What are the characteristics of effective communication training for children with ASD?

Step-by-step approaches that increase vocalizations, teach imitation, and promote functional language use.

What is the significance of executive function interventions in ASD treatment?

They help improve flexibility, goal-setting, and planning, which are crucial for daily living skills.

What are common comorbidities associated with ASD?

Conditions like fragile-X syndrome and other genetic disorders.

What is the impact of shared environmental experiences on ASD susceptibility?

They explain 58% of the variance in susceptibility to ASD.

What is the role of the default mode network (DMN) in children with ASD?

It is involved in higher-order social cognitive processes and is characterized by atypical connectivity patterns.

What is the relationship between ASD and brain connectivity?

Children with ASD show abnormal connectivity across multiple brain regions, affecting social and cognitive functions.

What is the approach to teaching adaptive skills in ASD treatment?

Focus on increasing responsibility and independence in daily activities.