chapter 23 autism spectrum disorders debbie phillips kin 583

Chapter 23

Autism Spectrum Disorders

Debbie PhillipsKIN 583

Autism Spectrum Disorder

Neurodevelopmental Disorder Characterized by an impairment in

Social Reciprocity A typical Communication Repetitive Behavior

Disorder categories occur along a continuum.

Synonym for the category is PDD – Pervasive Development Disorder.


The symptoms of Autism Spectrum Disorders

Neurologically Based

Scientific evidence of genetic pre-disposition

Also likely to be gene-environment interactions


Diagnostic categories within the Autism

Spectrum. These are defined by the

presence or absence of behaviors in the

following areas Social Reciprocity

Communication

Repetitive behaviors


Autistic Disorder

Autism is a discrete diagnosis within the ADS.

Defined by a pattern of six symptoms distributed across three areas.

At least two symptoms must be in the area of social reciprocity.

See Table on following slide.


Diagnostic Criteria for Autistic Disorder


Aspergers

Dr. Hans Asperger observed children with typical language who had difficulty with socialization and repetitive behaviors.

Diagnosed if three symptoms - 2 related to Social Reciprocity and one to habitual behaviors – are present.

Considerable overlap between diagnosis of high functioning Autism and Asperger’s disorder.

Children with Asperger’s disorder may not be diagnosed until school age.


Pervasive Development Disorder – Not otherwise specified. (PDD-NOS)

Used to describe children who do not have the number of distributions of symptoms for another diagnosis within the ASD.

Fewer symptoms of autism are present.


Childhood Disintegrative Disorder

CDD is a very rare condition

All aspects of the development are typical until 3 to 5 years.

At this age all domains begin to regress (language, cognitive ability, play, motor skills, bowel and bladder skill deteriorate)

Represents a common final pathway for a number of neurologic insults.


Rett’s Disorder/Syndrome

Involves the loss of previously obtained language and social milestones.

Associated with mutation in methyl-CpG- binding protein 2 and a gene on the X chromosome.

Mostly see in Girls

Affected children lose language and social interest.


Diagnostic Features of Autism Spectrum Disorders

Core symptoms are divided into three areas:

Qualitative- Impairments in Social Reciprocity.

Atypical Communication Development

Atypical Behavior


Causes of Autism Spectrum Disorders.

The Genetics of Autism: Family and Twin Study Candidate Gene Studies Association with Genetic Disorders of know Etiology

(genetic disorders)

Brain Structure and Function in Autism Spectrum Disorders


Causes of Autism Spectrum Disorders Cont.

Obstetric Complications – studies have not strongly shown any specific prenatal or birth complications with the development of ASD.

Environmental Exposures Teratogen – substances that result in birth defects –

maternal medications, drugs of abuse, chemical and radiation.

Vaccinations – significant controversy Infections – Prenatal infections increase the risk


Gender and Autism Spectrum Disorders.

There is a 4:1 male to female predominance of ASD.


Early Identifications of Autism Spectrum Disorders.

Symptoms must be present by 3 years of age.

Delayed language development, repetitive behaviors and atypical social responsivity are common parental concerns.

Early diagnosis is based on the recognition of the core features of ASD as they appear in early childhood.

Atypical development of pretend play, pointing to share interest, use of eye gaze to engage another person in communication and social interest. (as young as 18 months).


Evaluation of the Child with ASD.

Multidisciplinary Assessment

Diagnostic Measures

Laboratory Testing


Associated conditions – ASD may be associated with intellectual disabilities and other conditions. Intellectual Disabilities – ¾ have intellectual disability

Learning Disabilities – Specific impairment in executive function

Epilepsy – about ¼ with ASD

Tic Disorders – Up to 9%


Associated conditions Cont.

Sleep Disorders – 50 to 70%

Gastrointestinal Symptoms – Increase in pain, reflux, diarrhea, constipation and bloating.

Psychiatric Conditions – greater risk for depression, mood disorders, ADD and anxiety.


Genetic Disorders with Autism Spectrum Disorders Tuberous Sclerosis

Fragile X syndrome

Chromosome 15 Deletion


Treatment Approaches Educational

TEACCH

Applied Behavior Analysis

Developmental-Individual Difference-Relationship Base model

Relationship Development Intervention

Classroom-Based Programs


Behavioral Intervention

Pragmatic Language and Social Skills Training

Medication Stimulant Medications Selective Serotonin reuptake Inhibitors Atypical Neuroleptics Mood Stabilizers

chapter 23 autism spectrum disorders debbie phillips kin 583

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