Lecture 1 – Introduction to Autism
Ilan Dinstein
History of AutismIn the past autism was often diagnosed as schizophrenia and individuals were placed in psychiatric asylums.
1943: Dr. Leo Kaner describes 11 cases of autism and promotes the “refrigerator mother” theory.
1944: Dr. Hans Asperger describes Asperger’s syndrome.1964: First discussions of autism as a biological disorder1977: First study showing that autism has a genetic component.1980s: First structured therapy (Applied Behavioral Analysis).1990s: ADOS and ADI standardized diagnostic tests are published.2000s: Large scale biological research into autism begins.
History of Autism1998: Vaccine panic after an article claims a causal relationship
between vaccines and the development of autism.2000: Previously eliminated Rubella, Mumps, and Measles
diseases resurface in Europe and the US. Several children die and others are left handicapped.
2010: The original article is retracted and the physician who authored it loses his medical license.
Current clinical definition – DSM IV TR
Language delay and dysfunctionSocial difficultiesRepetitive behaviors and confined interests
Autism – all threeAsperger – no language delayPDD NOS – mild symptoms
Upcoming definition – DSM V
Language delay and dysfunctionSocial and communication difficultiesRepetitive behaviors and confined interestsSensory abnormalities
Mild, moderate, and severe autism Asperger – no language delayPDD NOS – mild symptoms
Future definitions?
Autism usually means a lot more…
1. 25-70% have low IQ (<70).
2. 20-30% have clinical epilepsy.
3. Over 90% have sensory hypo and hyper sensitivities.
4. Motor clumsiness, balance, and gait problems.
5. Sleeping and digestive problems.
6. Differences in memory and learning.
7. Mood disorders
Extreme heterogeneity
“If you’ve met one person with autism, you’ve met one person with autism”
Example #1 – Rainman (min 18)
Example #2 – Carly
Example #3 – Temple Grandin
Common symptoms
Eye contactJoint attention
Abnormal affectTantrums
Lack of initiationNo imitation
Low responsivenessObsession with order
Difficulty with changesAvoid interactionsOver-sensitivities
RepetitivenessTantrums
“golden standard” behavioral tests
ADOS
CommunicationSocial
Stereotyped behaviors
“golden standard” behavioral tests
ADI
CommunicationSocial
Stereotyped behaviors
Prevalence
The number of children diagnosed with ASD has been rising steadily.
Developmental disorder
Symptoms change throughout life
Behavioral therapies
Applied behavioral analysis (ABA)
Floortime by Greenspan
Actual therapy