Chapter 10 Autism

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Chapter 10Autism COS
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Autistic Disorder

• Impairment in social interaction
• Nonverbal behavior
• Poor peer relationships
• Lack of spontaneous engagement
• Lack of reciprocity
• Impairments in communication
• Spoken language
• Conversation skills
• Odd language (Echolalia/Scripting)
• Imaginary play
• Restricted behaviors/interests
• Odd preoccupation or obsessions
• Abnormal rituals
• Repetitive movements

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Other Developmental Disorders

• Childhood Disintegration Disorder
• Retts Disorder
• Pervasive Developmental disorder

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Aspergers Disorder

• THE GOOD
• Normal language development
• No mental retardation
• THE BAD
• Poor nonverbal skills
• THE UGLY
• More psychiatric outcomes

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Rule out

• Cultural issues
• Trauma
• Language Issues
• Anxiety

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Assessment

• Childhood Autism Rating Scale
• Short rating scale
• Easily completed
• Based on observation
• Subjective
• Autism Diagnostic Inventory
• Structured interview

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Etiology (What causes Autism?)

• Brain abnormalities
• Macrocephaly (Large head)
• Epilepsy
• Mirror Neurons
• Genetic abnormalities
• Fragile X syndrome
• Metabolic Disorders

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Etiology (What causes Autism?)

• Environmental causes
• 1960s refrigerator moms
• Toxins (lead, mercury, etc.)
• Infections (rubella)
• Immunizations
• Allergies

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Etiology (What causes Autism?)

• Polygenic (multiply caused)

Genes
Brain Development
Environment
Metabolism
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Theory of Mind (ToM)

• We are all individuals with distinct thoughts,
  emotions experiences, desires, and motivations
• ToM argues that Autistic children do not
  recognize the separation of self from others
• ToM argues that children with autism are limited
  in their ability and motivation to understand and
  predict the behaviors of other

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Sensory Dysfunction
Children with autism can have problems with their
senses taking in information (Hypersensitive) Too
much (Hyposensitive)
Too little

• Hypersensitive
• Withdrawal behavior
• Rocking/calming behaviors
• Distractibility
• Tantrums
• Repetitive tasks

• Hyposensitive
• Self-stimulatory behavior
• Self-injury
• Disruptive behaviors
• Unresponsive behavior

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Cause Effect

• When I do _____________, then ______________
  happens.
• If I want _____________ to happen, then I need to
  do ___________.

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Treatment

• What are the goals?
• Skills (language and social)
• Behavior (appropriate)
• Motivation

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Treatment (Skills)

• Discrete Trial Training
• present and rehearse short tasks for mastery
• Task Analysis
• Break down larger tasks into smaller parts for
  mastery
• Incidental Teaching
• Use natural situations to teach skills

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Treatment (Skills Behavior)

• Dr. Ivar Lovaas- over 40 years of work and
  research.
• Applied Behavior Analysis (ABA)
• Choose target skills to increase
• Choose target behaviors to decrease
• Uses reinforcement and punishment

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Treatment (Motivation, Skills, Behavior)

• Floortime
• Drs. Stanley Greenspan Serena Weider
• Targets motivation and allows the skills and
  behaviors to follow

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Floortime Goals

• Encouraging engagement
• Increasing two-way communication
• Encouraging expression of feelings
• Promoting logical thinking

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Childhood Onset Schizophrenia (COS)

• Historically applied to children who today would
  be diagnosed ASD
• COS
• a later age of onset
• less intellectual impairment,
• less severe social and language deficits
• hallucinations and delusions, periods of
  remission and relapse

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DSM-IV Features of COS

• Hallucinations- often auditory
• Delusions
• Disorganized speech
• Disorganized or catatonic behavior
• Negative symptoms (e.g., flat affect, alogia,
  avolition)

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Causes of COS

• Current views emphasize a vulnerability-stress
  model
• Preliminary evidence suggest a strong genetic
  contribution in COS, even more so than for adults
• COS appears to be particularly associated with
  family stress
• Neurodevelopmental model does not explain this
  well

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Treatment of COS

• Chronic disorder with a poor long-term prognosis
• Pharmacological treatments often used
• Psychosocial treatments
• social skills training
• family intervention
• educational supports