PSY388 Lecture 10/11 - Disorders of Childhood 1 (ASD focus)

Neurodevelopmental Disorders

• Onset during developmental period

• Developmental deficits or differences that result in impairment in personal, social, academic or occupational functioning

• Intellectual disability (ID); Communication Disorders; Autism Spectrum Disorder (ASD); Attention-Deficit/Hyperactivity Disorder (ADHD); Neurodevelopmental Motor Disorders, including Tic Disorders; and Specific Learning Disorders.

• Co-occurring and overlapping conditions

Autism - Impairments in social interaction and social communication

•Social-emotional reciprocity challenges

•Deficits in non-verbal communicative behaviours

•Deficits in maintaining, developing, & understanding relationships

Autism - Repetitive and restricted patterns of behaviour

• Lining toys up, echolalia, idiosyncratic phrases, motor stereotypies

• Insistence of sameness & routines

• Restricted & fixated interests

• Hyper- or hypo-reactivity to sensory input

Autism - general notes

• 1 in 68 individuals UPDATE” 1 in 31 (2025)

• Social Communication challenges, Repetitive Behaviours and Interests

• Some sensory issues

• Some show regression

• Girls with Autism may ‘camouflage’

• Early intervention and appropriate support provide the best outcomes

Polygenic and developmental profiles of autism differ by age at diagnosis

• Zhang et al (2025) Nature

• N = 45,000+ • US, UK, Europe & Australia

• < 6 yo more social-comm, and behav challenges; >10 yo worsening behav challenges and mental health conditions

Social factors in Autism

Cultural factors, access to healthcare, gender, bias, stigma, ethnicity, camouflaging

Regression in Autism

• Loss or reduction of previously acquired skills

• In 20 – 30% of autistic children

• Usually occurs during second year of life

• Approx 76% regain lost skills

• Recovery can be partial, gradual or uneven • Communication trajectories remain variable

Intelligence is an imprecise predictor of functional abilities in diagnosis

The misnomer of ‘high functioning autism’

Camouflaging

• Females are underdiagnosed

• Practitioners overlook subtle social challenges and internalizing behaviors (Dean et al 2016)

• Compensating for and masking autistic characteristics

Is autism “over diagnosed” in Australia? or is it being better identified?

More overall autistic people accessing NDIS

1 in 31 children in VIC ages 1 – 3.5 are autistic

Autism in Aboriginal children

An increase in ASD diagnosis for younger Aboriginal children may reflect a take-up of NDIS services, increased awareness and confidence

What causes autism?

• Genetic

• ‘Environmental’ factors that influence genes - such as Measles & VPA in pregnancy which makes children very likely to develop autism

• Random genetic changes

Autism - Epigenetics & Other factors

• Concordance 50 – 80% for identical twins

• No single cause

• MANY GENES, no one common genetic change

• Older fathers

• Frequent fevers and infections in pregnancy

• No good evidence for/links with vaccines

Autism - Pregnancy Risks/Complications

• (poor) link between acetaminophen use in pregnancy and developmental disorders

• Valproic acid

• NO link between epidurals and Autism

Autism & paracetamol in pregnancy

No association

• Ahlqvist et al 2024

• N = 2.5 million Swedish children

• National records

• Children exposed to Paracetamol during pregnancy vs those who were not

• Sibling control : pairs of siblings, one exposed to paracetamol, the other had not

Autism Psychological theories

• Weak Central Coherence - strengths/hypofocus for detail, miss the big picture

• Executive Functioning - planning, problem solving - keep instructions short & clear - visual aids

• Theory of Mind - M&M smartie box

• Others : Enhanced Perceptual Functioning, Social motivation, Predictive Coding, Intolerance of Uncertainty

Evidence-based Interventions

+incorporate child’s interest