Autism Spectrum Disorder

How early must a child show delays or abnormal functioning in social interaction, in language, or imaginative play to get a diagnosis of autism?

Before age 3.

What is the range of intelligence for children with ASD?

From profound disability ti above average intelligence.

How many children with ASD do not develop useful language?

Half. Children who do develop language usually do so before age 5.

How many children with ASD have gastrointestinal problems?

50 %. May be related to food selectivity, unusual eating habits, and obsessions ranging from minor to disruptive, or clinically significant feeding problems.

The criterion for autistic disorder is divided into 1, 2 and 3. How many symptoms must the child have overall to receive a diagnosis and how many from category 1, 2 and 3?

6 symptoms (or more) from 1, 2 and 3 is needed for diagnosis. At least two from category 1, and one each from category 2 and 3. Category 1 is: Qualitative impairment in social interaction, as manifested by at least two of four symptoms. Category 2 is: Qualitative impairments in communication as manifested by at least one of four symptoms. Category 3 is: Restricted repetitive and stereotyped patterns of behavior, interests, and activities as manifested by at least one of four symptoms.

How many children with ASD have sleep disturbances?

65 %.

Who was the first to describe the autism in 1943?

Dr. Leo Kanner. Described 11 children with the term early infantile autism. Autism means "within oneself".

When is a diagnosis of ASD usually made?

Usually in the preschool period or later.

Two types of cognitive limitations are proposed to underlie ASD. They are?

1) Specific cognitive deficits in processing social-emotional information 2) More general cognitive deficits in information processing, planning, and attention (executive functions - more profound deficits than in ADHD).

How many children with ASD have a co-existing medical condition that may play a causal role?

10 %.

When is the earliest possible time for a reliable detection of ASD?

12-18 months of age. Currently, a diagnosis made around 2-3 years of age is stable for most children.

How many of siblings of children with ASD also have the disorder?

15-20 %. Many also have unusual personality features, language and social deficits known as broader autism phenotype. the concordance rate in identical twins ranges from 70-90 %.

When was Aperger's disorder first described?

1944 by Dr. Hans Asperger. He may himself may have been on the autism spectrum.

How much more likely is ASD with an increase of 10 years in paternal or maternal age?

22 % greater risk with paternal age. 38 % greater risk with maternal age.

How many children with ASD show normal development for the first year or longer followed by regression?

25 %.

How many children with tuberous sclerosis also have ASD?

25 %.

How many children with ASD have seizures?

25 %. Onset is most often in late adolescence or young adulthood.

How much more common is ASD in boys than in girls?

3-4 times more boys have ASD. When girls are affected they tend to have more severe intellectual impairments.

How much higher is the risk of chromosomal anomalies in children with ASD?

5 %. 2-3 % of children with ASD have a fragile-X anomaly.

How many percent of children with ASD have co-occuring intellectual impairment?

70 %. 40 % have severe impairments (IQ less than 50), 30 % have IQs between 50 and 70 and the remaining 30 % have IQs in the normal to above average range.

How many children with ASD have sensory abnormalities including oversensitivities or undersensitivities to certain stimuli and trouble mixing across sensory modalities?

90 % have trouble in two or three sensory domains. May display Sensory Dominance - the tendency to focus on certain types of sensory over others - or Stimulus Overselectivity - the tendency to focus on one feature of the environment while ignoring other equally important parts. Seems like tunnel vision or hearing.

How high might the heritability of an underlying liability for ASD be?

90 %.

How many children with ASD have a head size that is above average?

90 %. About 20 % have a head size that places them in the upper 3 % of the general population. Smaller than average at birth, rapid growth at 6-12 months.

What is Rett's Disorder?

A severe and disabling neurobiological developmental disorder that predominantly effects females. The girl's mental and social development regresses, weird, stereotyped hand movements. Loss of social engagement happens early on but may return later. Affects only 1 in 10,000-22,000. in 95 % of those affected a specific X-linked gene mutation (MECP2) is found. This mutation is usually lethal to the male fetus. Apraxia is common - 25 % may never walk, and about 50 % of those who do will lose the ability. It has been suggested that Rett's disorder be moved from the category in DSM with autism spectrum disorder since autism symptoms only appear in early childhood after which social interaction develops.

What is autism spectrum disoder (ASD)?

ASD is a complex neurodevelopmental disorder characterized by abnormalities in the social behavior, language, and communication skills, and unusual behaviors and interests.

What is perhaps a better name for pervasive developmental disorder - not otherwise specified (PDD-NOS)?

Atypical autism. PDD-NOS is the most frequently diagnosed disorder on the autism spectrum and the category might be defined to loosely.

The term autism spectrum disorder refers to 3 DSM-IV-TR Pervasive Developmental Disorders (PDDs) all characterized by impairments in social and communication skills and by stereotyped patterns of interests and behaviors. What are these 3 pervasive developmental disorders?

Autistic Disoder Asperger's Disorder Pervasive Developmental Disorder, not otherwise specified (PDD-NOS) Furthermore the category of pervasive developmental disorders also include two rare disorders, Childhood Disintegrative Disorder and Rett's Disorder.

Children with ASD showed what brain abnormality by age 2.5 years when their symptoms began to appear?

Cerebral gray and white matter overgrowth. Almost all brain regions where found to grow at an abnormal rate. Lack of normal connectivity and communication between brain networks seems to be the main problem. Abnormalities have also been found in the cerebellum (smaller), medial temporal lobe, and limbic system structures (enlargement of amygdala), delay in frontal cortex maturation and reductions in the corpus callosum (support abnormalities in connectivity of the brain).

What is Childhood Disintegrative Disorder?

Describes children who prior to age 10 evidence a significant loss of previously acquired skills. This regression follows a period of normal development in the first 2 years of life. Children with CDD show losses in at least two of the following areas: expressive or receptive language, social skills or adaptive behavior, bowel or bladder control, play, pr motor skills. In addition, autism like abnormalities are also present. The disorder is very rare, affecting only 1 in 50,000.

Children with ASD have problems with both processing and expressing...?

Emotional information. Their own bodily expressions of emotion is often characterized by limited spontaneous use of expressive gestures, and bizarre, rigid, mechanical facial expressions.

Children with autism may use instrumental gestures (to get someone to do something), but they fail to use...?

Expressive gestures - conveys feeling.

Which disorders most often accompany ASD?

Intellectual disability and epilepsy. Additional behavioral problems might include ADHD and conduct problems. Self-injurious behavior (SIB) - (sometimes life threatening) self-inflicted damage, like head banging, biting, scratching - is seen. Rates of hospital visits for self-inflicted injuries in children are 7 times higher for children with ASD.

What is the prevalence of ASD?

It is now thought that as many as 1 % have some form of autism spectrum disorder. 22 in 10,000 for autistic disorder. 33 in 10,000 for PDD-NOS. 10 in 10,000 for Asperger's. Thought of as a rare disorder back in the day (4 in 10,000).

Children with ASD show a deficits in the ability to coordinate attention to a social partner and an object or event of mutual interest. This ability is called what?

Joint attention. Typically emerges between 9-14 months. Poor quality of eye contact and smiling during interactions during the first year may be related to deficits in joint attention in the second year of life of children later diagnosed with ASD. Joint attention the predicts later language development at age 20 months, and language, communication and social behavior at 42 months.

Which strategy is used to help children with ASD communicate appropriately?

Operant speech training.

What is the primary problem with language in ASD?

Pragmatics - the appropriate use of language in social and communicative contexts. Makes it difficult to understand the nonliteral parts of a conversation.

What are some qualitative language impairments in children with ASD?

Pronoun reversals - the child repeats personal pronouns exactly as heard, without changing them to suit the situation. Like the answer to "What's your name?" being "Your name is Tim" instead of "My name is Tim". Echolalia - parrot-like repetition of words or word combinations. Perservative speech - incessant talking about one subject and incessant questioning

Children with ASD might point to a stuffed animal she wants that is out of reach. This is demonstrate Protoimperative Gestures - gestures, or vocalizations that are used to express needs. This child might fail using another type of gesture called...?

Protodeclarative gestures - gestures or vocalizations that direct the attention of others to objects of shared interest. The primary point being engaging interaction with others.

What is central coherence?

Refers to the strong tendency for humans to interpret stimuli in a relatively global way that takes the broader context into account. It's been proposed that children with ASD have a weak drive for central coherence.

Research has identified to dimensions of restricted repetitive behavior in in ASD.

Repetitive sensory and motor behaviors. Insistence on sameness behaviors. Stereotyped behaviors may give the child a feeling of control over the environment.

25 % of children with ASD display a special cognitive skill that is above average and well above their own general level of intellect. These special abilities are called...?

Splinter skills or islets of ability in for example math, drawing, spelling, music.

What are self-stimulatory behaviors?

Stereotyped as well as repetitive body movements or movements of objects, for example, hand flapping or pencil spinning. One theory is that these children crave stimulation, and self-stimulation serves to excite their nervous system. Another theory says that the environment may be too stimulating and self-stimulating behavior blocks out and helps control unwanted stimulation. May also just be maintained by reinforcement.

The quality of infant-mother attachment in young children with ASD contributes substantially to...?

The development of the child's play behavior, which important for the development of social skills. The global deficit in children with ASD is not the ability to form attachments but a deficit in the ability to understand and respond to social information.

What is different about the processing of faces and facial expressions in children with ASD?

They may overemphasize one part of the face, such as the mouth, rather than attending to the overall shape or focusing on the eyes as most children do. May reflect a tendency to to attend to stimuli in which sound and motion co-occur.