ASD - slides.pptx

Autism Spectrum Disorder Description and Etiology Learning Outcomes Describe the key features of autism spectrum disorder (ASD) Explain how the signs and symptoms of this disorder exist along a continuum. Show understanding that the prevalence of ASD varies as a function of children’s...

Autism Spectrum Disorder Description and Etiology Learning Outcomes Describe the key features of autism spectrum disorder (ASD) Explain how the signs and symptoms of this disorder exist along a continuum. Show understanding that the prevalence of ASD varies as a function of children’s gender, ethnicity, and socioeconomic status. List and describe early deficits in social cognition typically shown by infants and toddlers who are later diagnosed with ASD. Description and Epidemiology Autism spectrum disorder Genetic and environmental risk factors Spectrum of signs and symptoms. Unique strengths and ostracism. History Early infantile autism. Autistic psychopathy. Autism spectrum disorder today. Description and Epidemiology Three areas of social communication deficits. Social-emotional reciprocity, nonverbal communication, interpersonal relationships In their own world. Relationships: artificial and one sided; Peer rejection. Restricted, Repetitive Behaviors, Interests, or Activities Four categories of behaviors. Stereotyped or repetitive behaviour, excessive adherence to routines, fixated interests, unusual sensitivity to sensory input Echolalia. Complex ritualistic behaviors. Fascination with idiosyncrasy. Description and Epidemiology Comorbid Disorders: intellectual disability Research: cognitive functioning. Discrepancy in criteria. Comorbid Disorders: Communication Disorders Common comorbid condition. Pronoun reversal. Prosody. Pragmatics. Description and Epidemiology Overall Prevalence Epidemiological data. Boys > girls prevalence Boys > girls IQ scores Boys > girls for profound deficits in IQ Boys < girls social communication problems; sleep and mood problems Girls > boys – social linguistic functioning Hormone differences High income vs low income family. Summary ASD emerges in early childhood. ASD is associated with problems with social communication: including a lack of reciprocity in social interaction, problems with nonverbal communication and a lack of interest in relationships or inability to maintain friendships ASD is known to include a presence of restricted or repetitive behaviours such as stereotyped speech or movement, resistance to change, fixed interests, and sensitivity to sensory stimuli Disorders known to be comorbid with ASD include intellectual disability, language disorders, and behavioural and emotional disorders Boys are more likely to be diagnosed with ASD, but girls tend to show greater impariment Autism Spectrum Disorder Causes and Delays in Social Cogntion Learning Outcomes List and describe early deficits in social cognition typically shown by infants and toddlers who are later diagnosed with ASD. Discuss genetic and epigenetic contributions to ASD Identify brain regions that differ in children with ASD Describe social cognitive deficits in infancy, toddlerhood, and the preschool years that are implicated in ASD Causes Genetics Heritability of autism spectrum disorder. Environmental factors. Autism genome project. Project to scan genomes. Epigenetics Advanced parental age. Grandparental age. The association: paternal age and autism spectrum disorder. Causes Abnormalities in brain structure and functioning. Three brain regions implicated in autism spectrum disorder. Social brain. Synaptic Density and Neural Connections Head circumference. Brain density and volume. Growth dysregulation hypothesis.  Located in limbic system Amygd Social & Emotional functioning ala Reduced amygdala activity for ASD Performance dependent on motivation Fusifor Located underside of temporal lobe m Face processing No increase in activation for ASD Gyrus Impairs social understanding Higher order functions Prefron Children with ASD have deficits in tal executive function cortex Repetitive stereotyped behaviour  Social Joint attention Orientation Social Cognitive Deficits Symbolic play Theory of Mind Summary ASD is heritable There is an increased risk of ASD for children with older parents Children with ASD show abnormal maturation of the cortex and poor neural connectivity Sometimes a smaller amygdala with less activity is associated with ASD Children with ASD often have less activity in the fusiform gyrus which is important for processing faces and social behaviour Underactivity in the prefrontal cortex may be responsible for poor executive function in ASD Joint attention and social orientation are delayed during infancy in children with ASD Difficulties with symbolic play during toddlerhood, and theory of mind in preschoolers are associated with ASD Autism Spectrum Disorder Identification, Prevention, and Treatment Learning Outcomes Describe several evidence-based treatments that improve the social and behavioral functioning of youths with ASD. Provide examples of evidence-based techniques that improve the communication skills of youths with ASD.  Identification, Prevention, and Treatment Identification and Diagnosis Early signs of ASD. Routine screening. Gold standard: diagnosis. Modal age: first diagnosis.  Identification, Prevention, and Treatment Applied Behavior Analysis An evidence-based approach. ABA : principles of learning theory. Early Intensive Behavioral Intervention A behavioral treatment. Common features of different EIBI programs. Discrete trial training. UCLA young autism project.  Identification, Prevention, and Treatment Pivotal Response Treatment Limitations of discrete trial training. Address motivation and self-regulation. Increases motivation and self-direction. Support from data. TEACCH A comprehensive program for youth. Principles: operant conditioning and observational learning. Structured teaching. To improve communication.  Identification, Prevention, and Treatment The Developmental Social–Pragmatic Model Evidence-based approach to treat youths. Focus on social communication skills. Reciprocal Imitation and Joint Attention Training A naturalistic intervention. Improves social communication skills. Joint attention symbolic play engagement and regulation. Autism Spectrum Disorder Identification, Prevention, and Treatment  Identification, Prevention, and Treatment The Early Start Denver Model Combine two approaches. Views autism as developmental disorder. Curriculum, skills, session of the model. Efficacy of ESDM. Augmentative and Alternative Communication Compensate for language deficits. Four components of the system. Choice of components. Picture Exchange Communication System To improve communicative function. Positive reinforcement. Six phases of training.  Identification, Prevention, and Treatment Speech-Generating Devices New options for communication. Visual scene display. Effects of these devices. Medications  Identification, Prevention, and Treatment What Interventions Have Limited Scientific Support? Treatments: lack empirical support. Harmful treatments. Three reasons for selection. Components of evidence-based treatment. Summary Clinicians use the ADOS-2 and ADI-R to formally diagnose ASD Behavioural Interventions for ASD include the Pivotal response treatment and TEACCH Developmental Social Pragmatic models of treatment include RIT, JASPER and ESDM Medication is prescribed to children with ASD to manage challenging behaviour and comorbid mental health problems Effective treatment involves early identification, intensive intervention, structured learning opportunities, low student:teacher ratios, active parenting roles, and progress monitoring