Exam 2: Mental Health Disorders in Infancy and Early Childhood

Question 1

Uniqueness in infancy

Answer 1

-Rapid brain and behavior development
-Unique state of dependency on others
-Large impact of others’ stressors on child
-Different modes of intervention needed: those that involve caregiver
-Early mental health concerns can have long lasting impacts on lifelong development
tldr: lots of development and dependence on caregiver

Question 2

ASD

Answer 2

Neurobiological disorder characterized by impairments in social communication and restricted/repetitive behaviors

Question 3

ASD Genetics

Answer 3

There is no genetic or biological test to diagnose autism
BUT there is a strong genetic component
-previous refrigerator mother theory (cold mothers) has been debunked
-Higher concordance rate in monozygotic (identicle) twins compared to fraternal twins of autism diagnosis and traits

Question 4

ASD Diagnosis

Answer 4

1. Deficits in social communication and interaction (must have deficits in all three areas for diagnosis: social emotional reciprocity, nonverbal communicative behaviors, and relationships)
2. Presence of restricted or repetitive interests and behaviors (must have deficits in 2 out of 4 areas for diagnosis: Insistence on sameness, stereotypes or repetitive actions, restricted/fixated interests, sensory interests or aversions)

Question 5

Deficits in social communication: social emotional reciprocity

Answer 5

-conversation deficits (might not respond or ask questions in response)
-reduced sharing of interests or emotions
-failure to initiate or respond to social interactions

Question 6

Deficits in social communication: nonverbal communicative behaviors

Answer 6

-poor eye contact
-decreased use of gestures
-restricted range of facial expressions
-unusual prosody, rate, rhythm to speech
-difficulty understanding body language/ proximity

Question 7

Deficits in social communication: relationships

Answer 7

-difficulty in making or keeping friends
-lack of interest in peers
-difficulties sharing imaginative play

Question 8

Restricted/repetitive interests/behaviors: insistence on sameness

Answer 8

-strong preference for routine
-ritualized behaviors

Question 9

Restricted/repetitive interests/behaviors: stereotyped or repetitive actions

Answer 9

• motor movements (hand flapping)
  -use of objects (lining objects up)
  -speech(echolalia: repeating back what was said to them, repeating movie lines)

Question 10

Restricted/repetitive interests/behaviors: restricted/fixated interests

Answer 10

-typical interests that are abnormally strong
-interests that are abnormal in focus

Question 11

Restricted/repetitive interests/behaviors: sensory interests or aversions

Answer 11

-adverse response to specific sounds or textures
-visually examining objects or smelling of objects

Question 12

Heterogeneity of ASD

Answer 12

Different people can have different experiences
“you’ve met one individual with autism… you’ve met one autistic individual”

Question 13

Previous Wing and Gould classification of ASD

Answer 13

definition in the 80s
3 classifications to sparse heterogeneity: aloof, active but odd, withdrawn

Question 14

Previous DSM-IV classification of Autism

Answer 14

Autistic disorder
Asperger’s: no language delays
PDD-NOS: unspecified developmental disorder

Question 15

Behaviorally Defined ASD

Answer 15

behaviorally defined subtypes do not share similar etiology, specific treatment approaches, nor can they be reliably defined

Question 16

DSM-5

Answer 16

2013; autism spectrum disorder

Question 17

Simons Simplex Collection

Answer 17

-3000 families with at least 1 person with autism diagnosis and no one else
-trying to identify genetic contributors to ASD across 12 different sites
-used parent interviews (ADI) and play based observational interaction (ADOS) as diagnostic tools
-Found similar presentation of autism across sites; all were in standard error
-All kids fell in the same parameters but different diagnoses (autistic disorder, PDD-NOS, asperger syndrome)

Question 18

The search for ASD etiology: collaborative linkage study of autism 1999

Answer 18

Looking for families with at least 2 diagnoses
-linkage to chromosome 13 and 7

Question 19

The search for ASD etiology: De Novo Copy Number variations 2007

Answer 19

Looking at individuals with autism with siblings without
Structural change on chromosome 16 arising in individuals with autism

Question 20

The search for ASD etiology: Full scale genome sequencing 2012

Answer 20

Unraveling DNA strands; found 250 genes that were disrupted and not making the proper proteins

Question 21

The search for ASD etiology: MIP (molecular inversion probe) sequencing

Answer 21

Tested for disruption of 44 genes in over 2000 individuals with ASD
-identified recurrent disruptions to these genes
-links to specific phenotypes found**

Question 22

The search for ASD etiology: CHD8 gene

Answer 22

Altering this gene in zebrafish produced similar phenotypes as individuals with autism