Autism Spectrum Disorder

Autism Causes

Genetics

• Siblings: 15- 20%

• Identical twins: 70- 90%

Early Biology

• Risk ~ prenatal and birth complication

• older parents

Autism Spectrum Disorder

• Once believed/describe as childhood schizophrenia

• Neurodevelopmental condition, present from early childhood and lifelong

• Two core areas

1. Impairment in Social communication

2. Restricted repetitive behaviors

Severity Levels for ASD

1. Level 1: Requiring Support

2. Level 2: Requiring Substantial Support

3. Level 3: Requiring Very Substantial Support

Deficits in Social Interaction (area 1 of ASD)

Deficits in:

• Social imitation (motor or vocal)

• Make-believe play (reciprocity)

• Social expressiveness (facial expressions) 

• Orienting social stimuli

• Responsiveness to others (empathy)

• Processing of emotion information or sharing emotions with other

• Joint social attention

• Ability to see others as social agents

Deficits in Communication (area 1 of ASD)

• Promo-imperative is intact, but impaired proto declarative

• May use instrumental but no expressive gestures

• About 50% of children with autism do not develop any useful language

• Use qualitatively defiant forms of communication (Intonation, patterns of sounds)

• Impairments in pragmatic use of language (literally force hand of others on to objects of interest)

• Difficulty communicating emotion

• Doesn’t understand teasing

Repetitive Behavior and Interests (area 2 of ASD)

• Preservation or abnormal preoccupations

• Ritualistic behavior

• Stereotyped body movements

• Insistence on sameness

• Self-stimulatory behavior

False Belief

Be able to understand that someone has their own belief and it can be wrong, put yourself in other’s shoes

Recommended screening for ASD is at ______ to ______ months

18, 24

Cognitive difference in Autism

1. Theory of mind: perspective-taking from others

2. Executive functioning: planning, flexibility, self-regulation

3. Coherence: weak central coherence, not seeing the whole picture

A. Social Communication (all 3)

1. Social-emotional reciprocity

2. Nonverbal communication

3. Developing and maintaining relationships

B. Restricted, repetitive (2 of 4)

1. Repetitive movements, object use, or speech

2. Sameness and rigid routines

3. Intense, narrow interests

4. Over- or under-reactivity to sensory input

C–E

present early (may not show until social demands exceed capacity), clinically significant

impairment, not better explained by intellectual disability or global delay

Average Age Diagnosis

4 years old

1 in 31 U.S. children

~3.4x more often than girls

Are diagnosed with Autism

True

1 in 45 U.S. adults

• more men than women

• Are diagnosed with Autism

True

____%+ develop typically, then lose words or social skills after; regress ~1 year

25

Applied Behavioral Analysis (ABA)

Reinforcement, skill building, practice across settings for generalization

Discrete trial training

Structured: prompt, response, reinforce, repeat

Incidental / Naturalistic teaching

Uses natural moments (child reaches for toy → practice asking)

Early Start Denver Model

Naturalistic developmental behavioral intervention (NDBI)

Medication

Risperidone, aripiprazole