Autism - Background Pervasive developmental disorder (PDD) Pervasive developmental disorder (PDD) Differential diagnosis important Differential diagnosis important –Similar symptoms with several disorders –Often considered a “spectrum” disorder

Autism Primary Characteristics Primary Characteristics A.Social relationship problems 1.Nonverbal behaviors 2.Failure to develop peer relationships 3.Lack of spontaneous sharing with others 4.Lack of social or emotional reciprocity

Primary characteristics cont’ A.Language problems 1.Delay in or lack of language development 2.Impairment in ability to initiate or sustain a conversation with others 3.Stereotyped or repetitive use of language B.Stereotypic behaviors –Repetitive motor movements

Additional characteristics 1. Abnormal responses to environment 2. Decreased intellectual functioning Age of onset CoursePrevalence

Differential Diagnosis Childhood schizophrenia Childhood schizophrenia Developmental aphasia Developmental aphasia Mental retardation Mental retardation Asperger’s Disorder Asperger’s Disorder 1.Impairment in social interaction 2.Restricted or repetitive behavior 3.Differences: language, attachment, intellectual

Etiology Many common theories disproved: Many common theories disproved: –Autism as withdrawal to cope with psychological pain –Chronic under-arousal in RAS –Learning of self-stimulation –MMR vaccine  Have looked at assoc. between intro. of vaccine and autism rates in different countries and different points of times Genetics : concordance rates 36 – 95% for MZ and 0-5% for DZ Genetics : concordance rates 36 – 95% for MZ and 0-5% for DZ Neuropsychological factors Neuropsychological factors –Diffuse damage, excess white matter

Treatment/Interventions Medications – help only minority of children Medications – help only minority of children Behavioral approaches Behavioral approaches 1.TEACCH – UNC Chapel Hill –Structured teaching (structuring the environment) –“social story” –Visual information 2.Lovaas’ behavior modification –Intense behavioral therapy –40 hrs. per week, over 2 years Both most effective if initiated early ages (by preschool)