Flashcards in Autism Spectrum Disorder Deck (24):
What is ASD?
- Lifelong neurodevelopment disability
- Includes Asperger's disorder & pervasive developmental disorder
How was ASD previously defined?
As a triad of impairments;
2. Social Interaction
3. Restricted and repetitive behaviours and interests
What is DSM-V diagnostic criteria A for ASD?
- Persistent deficits in social communication & interaction across multiple contexts
- Must be pervasive & sustained
For diagnostic criteria A, what must the deficits be manifested by?
1. Deficits in social-emotional reciprocity e.g. abnormal social approach; failure of back/forth conversation; reduced sharing of interests, emotions or affect
2. Deficits in nonverbal communicative behaviours used for social interaction e.g. abnormalities in eye contact & body language
3. Deficits in developing, maintaining & understanding relationships e.g. difficulties sharing imaginative play or in making friends
What is DSM-V diagnostic criteria B for ASD?
Restricted, repetitive patterns of behaviour, interests, or activities as manifested by at least two of the sub-criteria, currently or by history
What is the sub-criteria for DSM-V diagnostic criteria B for ASD?
1. Stereotyped or repetitive motor movements, use of objects, or speech
2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or non verbal behaviour
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 the environment
What is DSM-V diagnostic criteria C for ASD?
Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life
What is DSM-V diagnostic criteria D for ASD?
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning
What is DSM-V diagnostic criteria E for ASD?
Disturbances are not better explained by intellectual disability or global developmental delay. ID and ASD frequently co-occur
Children who demonstrate marked deficits in social communication without the other criteria for ASD diagnosis should be evaluated for what?
Social (pragmatic) communication disorder
What individual clinical characteristics are noted under the diagnosis of ASD?
- With or without intellectual impairment
- With or without language impairment
When is ASD typically recognised?
- 12-24 months but may be seen earlier if developmental delay is severe or later if symptoms are subtle
- Some children have gradual/rapid developmental plateaus or regressions between 12-24 months (red flag for diagnosis of ASD)
How is ASD distributed?
- Across all ethnic & socio-economic groups
- Gender ratio 4:1 male:female
- Prevalence approx 1 in 160
What are the causes of ASD?
- Possible genetic cause
- Identical twins - more likely both have ASD
- Heritability estimates range from 37% - >90% from twin concordance rates
- Links to genetic disorders e.g. Fragile X
- Gender links (more males than females)
- 15% of cases associated with a known genetic marker
What is the prognosis for ASD?
- Non degenerative disorder
- Early intervention teaches compensatory strategies, reading facial expressions in others, addressing behaviour issues
- Presence of ID & language impairment limits outcomes
What is the typical learning style for children with ASD?
- Literal thinking
- Rote memory skills
- Visual learning style (use of visual supports & social stories)
- Learn total concept rather than components
What are the communication strategies for children with ASD?
- Avoid complex language & long sentences
- Avoid talking too much with excess words
- Use consistent vocabulary
- Use appropriate tone, body posture and facial expression
- Express one idea at a time & in the correct order
- Use simple, direct (not figurative) language
- Don’t use questions to give instructions
- Give time for the person to respond before repeating (may have latency response time of up to 30-45 seconds)
- Talk at normal volume with varied intonation
- Use positive rather than negative statements
- Give specific choices
- Provide a structure which may need visual cues
What is the sensory threshold?
- The range in which a person notices sensory input & at which point this becomes overwhelming
- Each person's threshold is different & can vary depending on stress, environment, fatigue, fear etc.
What are the typical behaviours associated with sensory sensitivity?
- Running away
- Covering ears
In response to stimuli such as:
Hair washing, messy play, certain foods or sounds such as vacuum cleaner
What is the typical behaviour associated with sensory avoidance?
Actively avoids activities which feel uncomfortable or painful e.g. certain types of fabric
What are the typical behaviours associated with under-sensitivity?
- Sensory seeking of certain stimuli or substances
- Active regulation
- Poor registration (very inactive, often lies down, seems aloof)
- Passive regulation
What are the strategies for sensory sensitivity?
- Adapt the sensory environment e.g. lighting, amount of equipment
- Allow down time
What are the characteristics of gross motor development in ASD?
- May have early delays in GM development due to cognitive &/or sensory components of the disorder which may impact on child exploring their environment and movement
- Possible neurological impairment affecting
balance & motor planning
- Poor ball skills due to both decreased ocular motor co-ordination & decreased interactions with others
- Difficulty participating in team sports