Asd Flashcards
what is autism
Commonly associated with triad of impairments:
Social interaction
Communication
Imagination
Children with autism may also experience perceptual abnormalities – over/under sensitivity to sensory stimuli – this can be distressing
Repetitive behaviours (e.g. shredding paper)
Preoccupation with small parts of objects (e.g. wires)
Special interests (e.g. Thomas the tank engine, coronation street, hoovers)
Autism is severe and persistent
ASD DSM V
A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:
1. Deficits in social-emotional reciprocity
2. Deficits in nvc beh used for social interaction e.g. eye contact or lack gestures.
3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); e.g. adjusting beh to different social contexts or imaginative play
B. Restricted, repetitive patterns of behaviour, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behaviour, or excessive resistance to change
3. Highly restricted, fixated interests that are abnormal in intensity or focus
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment
C. Symptoms must be present in early childhood (under 8 ish) but may not fully manifest until social demands exceed limited capacities)
D. impairs everyday functioning.
comorbidity with ASD
Learning difficulties
Fombonne (1999) 42% have severe learning difficulties (IQ below 70)
Medical conditions
Epilepsy, Fragile X, tuberous sclerosis
Special talent/savant
However these may be developed with practice
theories of ASD
Psychodynamic:
Emotional refrigeration hypothesis
Cognitive:
Lack Theory of Mind
Executive Function Deficits
Weak Central Coherence theory
lack of ToM theory
Ability to understand what other people are thinking, or interpret why people act in specific ways
Tested with false belief task:
Baron Cohen et al. (1985) children with autism have extreme difficulty in inferring the beliefs of others.
However…. Substantial number of people with ASD pass TOM tasks (even if a little later than usual)
exec function deficit theory
Planning, cognitive flexibility, initiating appropriate actions, inhibiting inappropriate actions, abstract thinking, rule acquisition
Evidence?
Ozonoff et al. (1991) executive function deficit more robust correlate of autism than TOM.
Explains deficits in imagination, poor executive control (e.g. rigidity and strong liking for repetitive behaviours and insistence on sameness)
However…..explanation is too broad and vaguely defined (e.g. Executive function deficits in ADHD)
weak central coherence theory
Focuses on non-social features of autism such as uneven profile of intelligence
People with autism tend to focus on local features of objects and situations
Evidence?
Shah & Frith (1983)Wechsler/BAS block design
Not modality specific – failure to integrate info in both auditory and verbal domains
However… Correlations between perceptual functioning and measures of autistic symptoms have not been reported
aetiology (genetic) of ASD
Evidence for genetic basis Twin studies (Folstein & Rutter, 1977)
Heritability estimates are as high as 90%
Autism Genome Project (AGP)
evidence for a cog neurobio basis of ASD
45% have abnormal EEG and/or brain scans.
33% + have epilepsy.
25% + show genetic abnormality.
Birth trauma: mothers report more problems during pregnancy and childbirth.
Significant genetic factors – similar frequency rates to genetic conditions such as fragile X
Final common pathway
Higher than normal brain weight and volume (Bauman, 1996) - lack of necessary pruning of neurons? overgrowth of non-neural brain tissue?
Cerebellar hypoplasty (smaller cerebellum) in majority of autistics –linked to learning and attention difficulties?
Structural abnormalities in temporal lobe - linked to social difficulties.
Increased susceptible to neuroinflammation due to differences in immune system (Pardo et al, 2006)
ASD assessment tools
Autism Diagnostic Observation Schedule (ADOS)
Activities/props designed to provide semi-structured opportunities for the child to demonstrate social, communication and play skills (behaviours which are diagnostic of the symptom).
Trained examiner will try to elicit these skills Must observe child’s responses Four modules (only given one based on expressive language level and age)
Restriction:
Observation only (therefore should ideally be used with
ADI)
Autism Diagnostic Interview (ADI-R)
Semi-structured interview for parents/ caregivers
Covers developmental history and current functioning of the person being evaluated
However….only a moderate agreement between ADOS and ADI-R
DISCO
ASD svreening tools
Social communication questionnaire (SCQ)
Childhood Autism Rating Scale (CARS)
Social Responsiveness Scale (SRS)
benefits of vis support
Children with Learning Disability find visual information easier to process than spoken information
Words disappear as soon as they are spoken
Pictures can help children remember sequences of information
Pictures can help explain changes in routines
Pictures can help children to understand new situations
Pictures can help motivate children to do unpopular tasks!
Pictures can help children to understand waiting for activities/treats etc
Pictures help children understand concepts of now and later
Pictures help support children’s understanding of spoken language, e.g. instructions
Pictures can help children’s understanding of abstract concepts e.g. time concepts, emotions
Visuals can develop children’s flexibility to cope with change
intervention: inclusion in school and improving staff understanding
Suitable for high-functioning autism or Asperger’s syndrome
Training to increase staff awareness
Stable, ordered and secure environment essential
Explicit instruction and rules needed
Quiet areas/support bases
Classroom organisation
Avoidance of unnecessary changes/supported transitions
Teaching social skills/anxiety management
Training for all staff focusing on:
Developing knowledge of autism
The impact of autism from the young person’s point of view (Barrett, 2006)
Understanding the impact of the triad of impairments in the classroom
Environmental modifications such as predictability, routines, use of language, social support systems
TEaCCH
Treatment and Education of autistic and related communication handicapped children
Lifetime approach
Focuses on developing communication skills and personal autonomy
Demonstrated to reduce institutionalisation
Highly structured educational environments include: structured day, visual timetables, zoned classroom areas, changes and social interaction and generalisation opportunities built in
PECS
frost and bondy 2002
Visual systems to develop children’s communication
Child taught to exchange picture card for desired item then move on to more abstract skills e.g. commenting
Verbalising while exchanging modelled and encouraged
