3. Early Years & Childhood Flashcards
(46 cards)
Describe one challenge of early diagnosis of ASD.
All kids develop at very different rates, which is why it is so tricky. There is a range that is considered typical. If a child comes in with no speech at say 15 months, a good doctor will look at communication more broadly (eg. joint attention, pointing, comprehension of language, responding to their name) rather than just the lack of speech in itself.
When do parents bring their child in for social services?
When an appropriate developmental goal at that stage in their lives are not met. Eg. speech concerns, social concerns (no friends), problems with learning, behavioral control (emotional regulation)
What are the “normative” developmental goals at infancy to preschool stage? (3)
1) attachment to caregivers
2) language
3) differentiation of self from environment
What are the “normative” developmental goals at middle childhood? (4)
1) Role-governed conduct (following rules of society in moral and prosocial domains. self-control and compliance)
2) school adjustment (attendance, appropriate conduct)
3) academic achievement (learning to read and do arithmetic)
4) getting along with peers (acceptance, making friends)
Describe normative social development at 2 months to 12 months. (2,4,6-9,9-12)
2 months - reciprocal smiling, prefers face-like stimuli and speech-like sounds
4 months - spontaneous smiling. vocalizing
6-9 months - joint attention when wanting help, monitoring, expresses happy/sad emotions
9-12 months - follows point; gives objects to adult for help/action; points; stranger anxiety; solitary play
Describe normative social development at 13 months to 24 months
13-18months - functional play, points for interest, shows empathy
18-24 months - pretend play with others, watch other children, parallel play
Describe normative social development at 2-3 years. (4)
- imitate adults’ actions
- starts turn taking
- start to share
- imaginative play
Describe normative social development at 4 years.
- has preferred friends; group play
- labels emotions in self
- understands and tries deception
- wants to please adults
Describe normative social development at 5 years.
Has group of friends
Describe normative social development at 6+ years.
- has best friend
- plays board games; group play
- increase understanding of social rules
Why is ASD a neurodevelopmental disorder?
depending on age and developmental level, the presentations are different. certain behaviors are more important at certain developmental stages. during assessment, we still look at same domains but different presentations.
As a clinical psychologist, if a parent tells you his/her child has little speech at a certain age, how should you check if the child has ASD?
can’t just look at speech alone but the overall behaviors. it’s not just about the number of words they have, but how they are used. if the words are not used socially and communicatively there could be an issue. see if they integrate non-verbal gestures, intonation, eye contact into their speech etc.
Describe “normative” language/communication development at 2 months to 12 months.
2-5months - alert to sound, vocalizes when talked to, squeals, laughs out loud
6 months - start responding to name, babbles, listens to adult and vocalizes when adult stops
7-8 months - shakes head for no, looks towards familiar objects or sounds
9-12 months - orients well to name, first words, imitates sounds
Describe “normative” language/communication development at 12 months to 24 months.
12-18 months - follows one step commands, 5-25 words, names objects, body parts, points, imitates sounds
18-24 months - two words combinations, 25-50 words, follows 2-step commands, refers to self by name
Describe the “normative” language/communication development at 3 years old.
- groups objects
- uses 200+ words
- 3 word sentences
- uses pronouns and plurals
Describe the “normative” language/communication development at 4 years old.
- uses adjectives (eg. big, small)
- follows 3-step commands
- tells stories
- uses “feeling” words
Describe the “normative” language/communication development at 5 years.
- enjoys rhyming
- responds to why?
- retells story with beginning, middle, end
Describe the “normative” language/communication development at 6 years.
- repeats sentences
- describes events in order
- 10,000+ vocabulary
What are some reasons why diagnoses are not usually made til around 4 years old, even though ASD diagnosis at 2 years old is already quite reliable and stable over time? (6)
1) asian culture - kids tend to be more shy and not very social. western psychologists may overscore the kids on autism traits. social communication expectations are different.
2) haven’t gone to school until 4 years old, so behaviors haven’t manifested that clearly for professionals to tease it out. can’t say for sure if it’s autism or just speech and developmental delay
3) service problems. early intervention programmes tend to start around 4 years old. if you give a diagnosis but have little help to offer, it’s induces anxiety for the parent.
4) procedure for assessment takes a bit of time. usually need a series of meetings, interviews, observation, and specialist referral before confirmation of diagnosis.
5) presentation is very diverse and most don’t present all the symptoms at point of visit.
6) parents’ mindset - they may just interpret it as the child being naughty or disobedient. won’t entertain the possibility of autism. blaming the child. girls can be interpreted as shy, boys can be interpreted as being naughty.
What is a problem with retrospective studies based on caregiver reports of autism traits in very young children?
people don’t really unpick early behaviors like pointing. (eg. when did your child first point?) parents rarely take note of such details.
What are some efficient ways that we can track ASD symptoms prospectively at a very young age? (2)
- use existing universal screening systems. regular checkup at health screening done by nurses for signs of ASD.
- baby sibling studies
Can we see ASD signs at 6 months?
Not really. Overt presentations emerge after 6 months, currently only observable from 12 months onwards. If they are there, we can’t spot them yet.
What are some early ASD signs at 12-18 months pertaining to social interaction and communication?
1) little/no initiation of social interaction (eg. showing, pointing, initiation of joint attention)
2) response to social interaction (eg. limited gaze to faces, direct vocalisations, social smiling, social attentiveness to caregiver, response to name, imitation of sounds, words etc.)
Give one example explaining why it is difficult to tease out the ASD signs at 12-24 months?
eg. intense preoccupation with things is part of being a kid! need to do things repetitively to learn! most kids are like that
