Autism Spectrum Disorder

🔴 Autism Spectrum Disorder

-It is one of the developmental disorders

-Prevalence = 1\110 children
-Found in all Socio-Economic Situation, ethnic, & racial groups

-DSM-5 combines multiple diagnoses into one “Autism Spectrum Disorder” :
*Autistic disorder
*Asperger’s disorder
*Pervasive developmental disorder NOS
*Heller’s syndrome (childhood disintegrative disorder)
*Rett’s syndrome

💡 Asperger’s syndrome
-has problem in socialization + repetitive steryotyped behavior
-no delay in language (normal language)
-intelligence is normal (normal IQ)
-seizures are not a feature
-persists to adulthood
-has a good prognosis

💡Heller’s syndrome
-childhood disintegrative disorder
-a\w normal development until 2 yrs of age -> then gradual deterioration in skill movement + bowel & urine incontinence + deterioration in cognitive function
-has bad prognosis

💡Rett’s syndrome
-main features = autism, learning disability, seizures, loss of speech & skilled movements & irregular breathing
-almost exclusively in girls
-it is rare
-due to genetic problems (on ch. X)
-fatal by adulthood
-unusual hand-wringing movements are a classical feature

✅ Etiology
📍Genetic factors
*Heritability (in 80%) – strong factor
*Twin studies
*Genetic flaw (del. on ch.16)

📍Neurobiological
*Brain size (larger than normal)
*Abnormally sized amygdala -> more difficulties in social behavior & communication

✅ DSM-5 criteria for Autism Spectrum Disorder
(See the picture 👇)

📍Problems in Autism Spectrum Disorder
-Profound problems with the social world

-Theory of mind
*failed to understand that other people have different desires, beliefs, intentions, & emotions (this understanding normally develops in child between age 2 and half – 5 years)

-Communication deficit
*Early language disturbances
*Echolalia (immediate or delayed repeating of what was heard)
*Pronoun reversal (refer to themselves as “he” or “she”
*Literal use of words

-Repetitive & ritualistic acts

✅ Comorbidity :
-IQ < 70 is common

✅ Ix :
-EEG (may detect subclinical epilepsy)
-Poisoning screen
-TFT (to detect hypothyroidism)
-MRI

✅ Rx :
-psychological Rx is better than drugs
-earlier Rx is better

📍Parent training & education

📍Behavior therapy
*The most common is applied behavior analysis (ABA= applied behavior analysis)
= need 20-40hr/week
= idea depend on operating conditionings of learning
= so we apply ABC (antecedent, behavior, consequences)

📍Increasing child motivation & responsiveness (rather than on discrete behaviors)

📍Improve attention & expressive skills (by joint attention & symbolic play)

📍Medications (haloperidol) to treat problem behaviors

✅ Prognosis
-Children with higher IQs who learn to speak before age 6 have the best outcomes

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