autism spectrum disorder

Question 1

what is an autism disorder?

Answer 1

a lifelong condition affecting 1% of the population

Question 2

autism, increase in prevalence:

Answer 2

heightened awareness

broadening of the diagnostic criteria

biological factors (premature birth)

Question 3

DSM 5 key diagnostic criteria

Answer 3

persistent deficits in social communication and social interaction

restricted, repetitive patterns of behaviour, interests, or activities

Question 4

DSM 5 in addition:

Answer 4

symptoms must present in the early developmental period

symptoms cause clinically significant impairment in social, occupational, other important areas of current functioning

these disturbances are not better explained by intellectual disability or global development delay

Question 5

changes in DSM 5

Answer 5

combined the previously different conditions (aspergers, pervasive developmental disorder)

now all pooled together under ASD

Question 6

spectrum condition

Answer 6

it affects people differently and to varying degrees

range of different attributes, any of which may, or may not, occur in any one individual to a greater or lesser extent

Question 6

main characteristics

Answer 6

social impairment

communication impairment

restricted, repetitive patterns of behaviour, interests or activities

Question 7

what is usually the first symptom of autism identified?

Answer 7

social impairment

Question 8

social impairment in toddlers with autism

Answer 8

usually do not want to be picked up and my arch their backs when picked up

Question 9

social impairment difficulties

Answer 9

can have difficulty entering social relationships and predicting others behaviour, or understanding motivations

Question 10

communication impairment

Answer 10

general consensus that language is commonly impaired or absent in people with autism

Question 11

why do autistic people tend to use communication?

Answer 11

for instrumental rather than social purposes

Question 12

what do autistic people tend to struggle to discriminate between?

Answer 12

literal meaning vs sarcasm

Question 13

non verbal communication impairments

Answer 13

struggle to comprehend and use facial expressions

Question 14

what does content of communication tend to be?

Answer 14

repetitive and egocentric

Question 15

4 types of restricted, repetitive patterns of behaviour, interests or activities

Answer 15

a) stereotyped or repetitive motor movements, use of objects, or speech
b) insistence on sameness, inflexible adherence to routines, ritualised patterns of verbal or non verbal behaviour
c) highly restricted, fixated interests that are abnormal in intensity or focus
d) hyper or hypo reactivity to sensory input or unusual interests in sensory aspects of the environment

Question 16

Asperger’s syndrome

Answer 16

considered part of the spectrum by many, others see it as a special sub group or distinct condition

no delay in language development

Question 17

symptoms shown in Asperger’s syndrome

Answer 17

social interaction difficulties

repetitive or stereotypes behaviours

obsessional interests in narrow subjects

Question 18

theory of mind

Answer 18

the ability to put oneself into someone else’s shoes, to imagine their thoughts and feelings

mindreading and mentalisation

Question 19

what does theory of mind allow us to do

Answer 19

make sense of another persons behaviour

can imagine a whole set of mental sets and predict what they might do next

Question 20

sally and ann task

Answer 20

false belief task (ToM task)

attributing false belief: to recognise that other people can have divergent or untrue beliefs about the world

Question 21

sally and ann task results

Answer 21

85% neurotypical children
86% down syndrome children
20% children with autism

Question 22

mindblindness theory

Answer 22

children with ASD are delayed in the development of their theory of mind, leaving them with degrees of mindblindness

cannot explain all non-social characteristics in autism

Question 23

what symptoms of ASD does the mindblindness theory explain

Answer 23

ability to attribute mental states is the basis for social interaction and communication
repetitive patterns of behaviour…. provide predictability

Question 24

the extreme male brain

Answer 24

individuals whose systemising is above average, but who are challenged when it comes to empathy

Question 25

sex differences in typically developing individuals

Answer 25

females perform better on empathising tests males perform better on systemising, the drive to analyse or construct any kind of system

Question 26

how much more prevalent is ASD in males than females?

Answer 26

4 times in autism | 9 times in Asperger's

Question 27

possible causes of ASD

Answer 27

heritability | environmental risk factors

Question 28

evidence for heritability as a cause

Answer 28

covert et al (2015) twin study

Question 29

covert et al (2015) twin study method

Answer 29

twin pairs born 1994-1996 in england and wales 5 different measures with 203- 6,423 twin pairs per measure

Question 30

covert et al (2015) twin study results

Answer 30

monozygotic twins: concordance of 77% to 99% dizygotic twins: concordance of 22%- 65% variance across tools but all significantly higher across assessment tools for monozygotic twins

Question 31

environmental risk factors as a cause

Answer 31

advanced parent age pregnancy and birth complications pregnancies spaced less than one year apart infection during critical periods of early in utero neurodevelopment

Question 32

pregnancy birth complications

Answer 32

extreme prematurity low birth weight multiple pregnancies

Question 33

3 differences in brain growth

Answer 33

1) appear to have slightly smaller brain at birth 2) brain undergoes abnormally quick growth in infancy 3) growth slows significantly by adolescence

Question 34

brain basis of theory of mind (Castelli et al., (2002))

Answer 34

animations of two triangles interacting in different goal directed ways people with ASD has difficulty describing the intentions of a triangle trying to trick/ coax the other

Question 35

brain basis of ToM functional imaging results

Answer 35

similar cerebral blood flow in the visual association cortex lower levels of blood flow in the superior temporal sulcus (STS) and the medial prefrontal cortex

Question 36

fusiform gyrus (face area) in ASD

Answer 36

traditionally thought to be impaired or underdeveloped in people with autism decreased fusiform gyrus activity repeatedly reported in ASD

Question 37

what might decreased fusiform gyrus activity in ASD be a consequence of?

Answer 37

a developmental consequence of early dysfunction of the amygdala and thus reduced salience of facial stimuli in ASD

Question 38

Shultz and colleagues (2005)

Answer 38

found little or no activity in the fusiform face area in people with autism when they were viewing pictures of human faces

Question 39

Event related potentials (ERP) study (Apicella et al., 2013)

Answer 39

suggested the effect may not be due to specific impairment of the FFA but rather dysfunction of neural mechanisms and networks involved in driving and integrating the social information by faces

Question 40

oxytocin

Answer 40

peptide that facilitates pair bonding and increases trust and closeness to others

Question 41

levels of oxytocin in children with autism

Answer 41

lower levels

Question 42

effect of administering oxytocin to individuals with ASD

Answer 42

increased performance in tests of emotion recognition improved performance of adults with high-functioning ASD on a computerised ball-toss game that requires social interactions with fictitious partners increased amygdala activity in response to facial stimuli in people with Asperger's syndrome