Autism Spectrum Disorders Overview

Autism Spectrum Disorders

• Autism Spectrum Disorder (ASD) is a broader term for similar disorders.
• The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V) recommends individuals meet three criteria for diagnosis:
  • Persistent deficits in social communication and interaction (marked deficits in nonverbal/verbal communication; lack of social reciprocity; failure to develop/maintain peer relationships).
  • Restricted, repetitive patterns of behavior, interests, and activities (stereotyped motor or verbal behaviors, unusual sensory behaviors, excessive adherence to routines and ritualized patterns of behavior, restricted, fixated interests).
  • Symptoms must be present in early childhood.

Prevalence

• Early large-scale epidemiological surveys of autism found prevalence rates around 1 in 2,500.
• More recent surveys show a prevalence rate of approximately 1 in 110.
• Prevalence rates for autism are four times higher in boys than girls.
• Prevalence rates are higher in the European American population than in Latino or African American populations.

Causal Theories

• Early theories sometimes speculated on parental causes, primarily mothers.
• Today's theories focus on neurological causes:
  • High incidence of brain seizures and cognitive deficits.
  • Disorders of neural networks.
  • Rapid and excessive brain/head growth in early childhood.
• Genetics are a crucial component.
  • If one sibling has autism, the chance of the other sibling also having autism is 15%.
  • This is much more likely (or higher %) in identical twins compared to fraternal twins.
  • Various genetic mutations or duplications are involved, but no single "autism gene" exists.

Identification

• Clinicians use specific criteria focused on communication skills, social interactions, and repetitive/stereotyped behaviors to diagnose autism spectrum disorders.
• The Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) are the gold-standard instruments.
• Early signs may include a lack of big smiles/expressions of joy/warmth by 6 months; a lack of response to one's own name or back-and-forth sharing of expressions by 9 months; and a lack of consistent response to their own name/babbling/gesture by 12 months.

Psychological and Behavioral Characteristics of ASD

• Impaired Social Interaction: Individuals with autism display deficits in social responsiveness.
• Impaired Communication: Children with ASD may lack communicative intent or the desire to communicate socially; joint attention is often impaired.
• Repetitive and Stereotyped Patterns: Stereotyped motor or verbal behaviors are common, including repetitive, ritualistic behaviors like twirling, spinning objects, flapping hands, and rocking.
• Impaired Cognition: Individuals with ASD show varying degrees of cognitive deficits. There are individuals with autism who possess extraordinary skills (autistic savants).
• Abnormal Sensory Perceptions: Individuals with autism may be hyper or hyporesponsive to sensory stimuli, or exhibit synaesthesia.

Asperger Syndrome

• People with Asperger syndrome have difficulties with social interactions (difficulty reading social cues) and communication skills (problems with pragmatics, social uses of verbal and nonverbal communication).

Unifying Theory of ASD

• Executive Functions: Include working memory, self-regulation of emotions, and the ability to plan ahead.
• Central Coherence: The natural inclination to perceive information as meaningful wholes.
• Theory of Mind: The ability to take another person's perspective.

Educational Considerations

• Autism's varied characteristics make remediation difficult; unproven treatments are prevalent.
• Effective educational programming for ASD typically includes:
  • Direct instruction of skills, using structured and directive approaches based on behavioral principles.
  • Instruction in natural settings and natural interactions.
  • Behavior management (FBA and PBIS) focused on supporting positive behaviors rather than punishments.

Examples of Educational Programs

• Pivotal Response Teaching (PRT): Focuses on critical skills (motivation, self-management) for broader skill improvements.

• Picture Exchange Communication System (PECS): A communication system using pictures for those with speech difficulties.

• Educators often use a combination of augmentative and alternative communication (AAC) strategies such as sign language, voice output communication aids, or symbols and pictures to aid in communication development.

• Social Stories (creating social stories) are a way to address inappropriate social behaviors with autistic spectrum disorders students, particularly with adolescents.

Service Delivery Model

• Self-contained classrooms are a common approach; however, inclusion models can be an effective approach.
• Instruction might be individual, one-on-one, or in small groups.

Assessment of Progress

• Two primary areas of assessment are language development and social/adaptive behavior.
• Measurement tools include:
  • The Social Responsiveness Scale (SRS), parent/teacher scale for monitoring progress of social behavior (social awareness, social information processing, social anxiety, social avoidance, reciprocal communication).
  • The Autism Social Skills Profile (ASSP) is a standardized outcome measure that assesses social skills including Social Reciprocity, Social Participation/Avoidance, and Detrimental Social Behaviors.
  • The Childhood Autism Rating Scale (CARS) is frequently used for screening and diagnostic purposes, and evaluating the effectiveness of interventions.

Early Intervention

• Most early intervention programs prioritize children with more severe autism rather than mild forms.
• Emphasizes intensive instructional programming, full school day, and full school year, with repeated sessions as needed for children.

Transition to Adulthood

• Transition programming emphasizes person-centered planning, community-based residential facilities, supported living, and competitive employment.
• Some research notes a continuum from social survival skills to social competence for adolescents and adults with Asperger's syndrome (and autism more generally).

This quiz provides an overview of Autism Spectrum Disorders (ASD), focusing on diagnostic criteria as outlined in the DSM-V. It also discusses the prevalence of autism in different demographics, emphasizing the significant differences between boys and girls. Test your knowledge on these critical aspects of ASD.