Autism Update

1
Autism Update

• M. Ellen Gellerstedt, MD, FAAP
• Eastern Maine Medical Center
• May 12, 2009

2
Autism

• Complex neurobehavioral disorder characterized
  by
• Impairment in social interaction
• Impairment in communication
• Restricted, perseverative behaviors, interests,
  and activities

3
Autism DSM-IV

• Qualitative impairment in social interaction as
  shown by at least two (2) of the following
• Marked impairment in nonverbal behaviors
• Failure to form developmentally appropriate
  relationships
• Lack of spontaneous seeking to share enjoyment,
  interests, or achievements with other people
• Lack of social or emotional reciprocity

4
Autism Diagnosis DSM-IV

• Qualitative Impairment in communication as
  manifested by at least one of the following
• Spoken language or gesture
• Ability to initiate or sustain a conversation
• Stereotyped and repetitive use of language or
  idiosyncratic language
• Lack of varied make-believe play or social
  imitative play appropriate to developmental level.

5
Autism Diagnosis DSM-IV

• Restricted repetitive and stereotyped patterns of
  behavior, interests, and activities, as
  manifested by at least one of the following
• Stereotyped and restricted patterns of interest
• Adherence to specific, nonfunctional routines or
  rituals
• Stereotyped and repetitive motor mannerisms
• Preoccupation with parts of objects

6
Pervasive Developmental Disorders

• Autistic Disorder (299.00)
• Aspergers Disorder (299.80)
• Pervasive Developmental Disorder, NOS (299.80)
• Rett Syndrome (299.80)
• Childhood Disintegrative Disorder (299.10)

7
Autism Spectrum Disorders confusing terminology

• PDD vs. PDD, NOS
• Asperger vs High Functioning Autism
• Autism with or without mental retardation
• Autism Spectrum Disorder

8
Explanatory Models

• Theory of Mind
• Mind Blindness
• Others

9
Etiology of Autism

• Probably no single etiology
• Approximately 10 may be behavioral profile
  associated with specific condition e.g.
  Tuberous Sclerosis, Fragile X syndrome, untreated
  phenylketonuria, others
• Probably more than one gene responsible for
  vulnerability

10
Etiology of Autism

• Likely interplay of genetic predisposition and
  precipitating event(s)
• Environmental Infectious Immunologic Other
• Large multisite studies underway to further
  investigate causes

11
What you are looking for

• Atypical use of non-verbal behaviors
• Eye gaze
• Gestures
• Facial expression

12
What you are looking for

• Impaired Spontaneous seeking to share enjoyment
• Joint Attention

13
What you are looking for

• Restricted interests, stereotypies, and
  repetitive behaviors

14
What you are looking for

• Atypical development of spoken language
• Language regression
• Echolalia
• Not turning to name

15
What you are looking for

• Atypical social and emotional reciprocity
• Responding to name
• Orient toward people

16
Specifically

• Does the child respond to parental attention
• Does the child watch the parent for social cues
• Does the child respond to his/her name

17
www.firstsigns.orgOn the Spectrum
18
(No Transcript)
19
Thank You