Autism Spectrum Disorders Chapter 23 Debbie Phillips KIN 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.

Autism Spectrum Disorder The symptoms of Autism Spectrum Disorders Neurologically Based Scientific evidence of genetic pre-disposition Also likely to be gene-environment interactions

Autism Spectrum Disorder 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

Autism Spectrum Disorder 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.

Autism Spectrum Disorders Diagnostic Criteria for Autistic Disorder

Autism Spectrum Disorders 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.

Autism Spectrum Disorder 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.

Autism Spectrum Disorders 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.

Autism Spectrum Disorders 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.

Autism Spectrum Disorders Diagnostic Features of Autism Spectrum Disorders Core symptoms are divided into three areas: Qualitative- Impairments in Social Reciprocity. Atypical Communication Development Atypical Behavior

Autism Spectrum Disorders 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

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

Autism Spectrum Disorders Gender and Autism Spectrum Disorders. There is a 4:1 male to female predominance of ASD.

Autism Spectrum Disorders 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).

Autism Spectrum Disorders Evaluation of the Child with ASD. Multidisciplinary Assessment Diagnostic Measures Laboratory Testing

Autism Spectrum Disorders 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%

Autism Spectrum Disorders 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.

Autism Spectrum Disorders Genetic Disorders with Autism Spectrum Disorders Tuberous Sclerosis Fragile X syndrome Chromosome 15 Deletion

Autism Spectrum Disorders Treatment Approaches Educational TEACCH Applied Behavior Analysis Developmental-Individual Difference-Relationship Base model Relationship Development Intervention Classroom-Based Programs

Autism Spectrum Disorders Behavioral Intervention Pragmatic Language and Social Skills Training Medication Stimulant Medications Selective Serotonin reuptake Inhibitors Atypical Neuroleptics Mood Stabilizers