Mental health, theme 1

Autistic spectrum disorder

an umbrella term for all disorders that display autistic-style symptoms across wide range of severity and disability

Characteristics of ASD

1. Impairment of reciprocal social interaction (non-verbal behavior)

2. Impairment in communication (verbal behavior)

3. Impairment in imagination and flexibility of thought

4. Intellectual deficits (70% has intellectual disability & the other 30% has another disability (like speech or behavioral))

Echolalia

the immediate imitation of words or sounds that have just been heard

Pronoun reversal

an impairment in communication in which an individual refers to him/herself as he, she or you (wrong use of pronouns)

Savant syndrome

the phenomenon of extraordinary proficiency in one isolated skill in individuals with multiple cognitive disabilities

5 DSM-5 criteria

• deficits in their social lives because of the impairments in verbal/ non-verbal behavior (first 2 characteristics of ASD)

• Restrictive, repetitive and stereotypical patterns in their behavior and interests (third characteristic of ASD)

• symptoms start in early development

• symptoms cause a significant impairment in important areas of functioning

• symptoms are not better explained by intellectual disability or global development delay=

prevalence of ASD

1.1%, with men being 4 to 1 more likely as females to be diagnosed, so more common

ASD = hard to diagnose because

• the behavior patterns may change with age

• ASD is often comorbid with other disorders like ADHD or epilepsy

• the symptoms may occur with high variations in intellectual disability

biological causes for ASD

• Genetic factors: ASD has a high level of heritability, and it also co-occurs with several known genetic disorders like phenylketonuria, fragile X syndrome and tuberous sclerosis.

• Perinatal factors: some birth complications and pre-natal factors have been linked to increase the change of ASD development —> only a small percentage

• Brain function: Autism is associated with abnormal brain development (they have larger brains and other things etc)

cognitive factors of ASD

• Deficits in executive functioning: people with ASD have poorer problem-solving ability, difficulty planning actions, controlling impulses and attention etc. (ranges in severity)

• Theory of mind deficits: they often lack the ‘theory of mind"‘ which is the ability to attribute human like mental states to others or to understand the intention of others. (caused by the abnormal brain development)

Sally-Anne false belief task

a test or task that can help with assessing theory of mind abilities. (2 girls with marbles and basket/box)

Empathising-systematising theory

a theory of the social and communication difficulties experiences by individuals with ASD —> used to help explain their inabilities and recognize the strengths of people with ASD

difficult to treat people with ASD (5)

• don’t easily tolerate changes in their routine (every intervention is designed to cause change)

• appear to be oblivious to the outside world (don’t like communicating)

• only show interest in a few things (hard to find reinforcers/rewards)

• overselective attention

• difficulties with social encounters

treatments of ASD

• antipsychotic drugs (only with severe symptoms) (2 types)

• Naltrexone

—> conditioning has also been used sometimes to help them learn wanted behaviors.

• Modelling

• Parent-implemented early intervention

antipsychotic drugs

these drugs reduce the repetitive, restrictive and stereotypical patterns in their behaviors and interests, reduce levels of social withdrawal & reduce symptoms of aggression or other challenging behavior (temper tantrums, mood changes etc) —> not everyone responds well to it, has a lot of side effects

2 types:

• Haloperidol: most commonly used for autism

• Risperidone: used for children with autism

naltrexone

can increase social interaction and communication (opioid receptor antagonist)

modelling

the process of demonstrating a required behavior to clients before prompting them to imitate it —> especially helpful with teaching them sign language

parent-implemented early intervention

using parents as effective trainers to teach children with intellectual disability, basic self-help and communication skills —> parents themselves can teach their children

2 defining characteristics of ASD (opposites)

• Empathizing: the ability to recognize another person's state of mind and to respond with an appropriate emotion —> involves understanding the emotional and social world

• Systematizing: the drive to analyze or build a system that follows acknowledged rules (people with ASD tend to score higher on this one)

2 types of empathy

• cognitive empathy: ability to recognize what someone else is thinking or feeling

• affective empathy: having an appropriate emotional response

Camouflaging or masking

people with ASD sometimes try to mask their symptoms of autism by consciously or unconsciously manipulating their behavior in front of others to make a better impression

‘invisible end of the spectrum’

females with autism —> females are more social and better at masking that is why they often fly under the radar and don’t get diagnosed

Double empathy problem (article)

theory that proposes that communication issues between autistic and non-autistic individuals happen both ways