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Download 4053X1 1999 Oct26
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Child Psychopathology Autism Diagnosis and description Etiology and treatment Case Reading for today: Chapter 10 Website addresses Diagnostic criteria for Autism • Impairments in social interaction – deficits in social imitation, joint attention, eye contact, unusual play, orienting to social stimuli • Qualitative impairments in communication – pronoun reversals, echolalia, speech restrictions • Restricted, repetitive, and stereotyped patterns of behavior, interests and activities – perseveration, sameness, self-stimulatory behaviors, flapping • Onset prior to age 3 Box 10.1, 10.2 Associated characteristics • Intellectual strengths and deficits – 80% are mentally retarded, esp. VIQ – 25% have “splinter skills”, 5% “savant” • Sensory and perceptual impairments, stimulus overselectivity • Cognitive deficits, Theory of Mind • Physical characteristics, 25% epilepsy • Family stress is high: What came first? Other Pervasive Developmental Disorders • Asperger’s Syndrome • Later age of onset • Higher verbal mental age • Less language delay • Less social deficit • Poor gross motor coordination • Rett’s Disorder • Girls only • Deceleration of head growth • Loss of hand skills • Severe language deficit • Loss of social engagement Genetic Contributions • About 10% have an identifiable medical condition including Fragile X • Tuberous sclerosis is associated 3-9% of the time • Family and twin studies show strong relationship • There are likely several genetic influences in autism Neuro- and psychobiology • Structural abnormalities in cerebellum, medial temporal, limbic, and frontal lobes – Demonstrated through blood flow analyses • Megalencephaly and increased brain volume in some children • Epilepsy, EEG abnormalities in 50% • Elevated serotonin in 1/3 of individuals • Reticular Activating System and overselectivity Fig. 10.6 Interventions for autism • Low functioning children need behavioral interventions – SIB, self-help skills, social compliance, basic social-emotional behaviors su as eye contact • High functioning children need language, social skills, and preschool behaviors • Most effective treatments are highly structured and skills-oriented – Include family support and early intervention Communication skills • What is appropriate social behavior? What basic skills are important? • Eye contact, introducing yourself, expressing affection, turn-taking in conversations • Reduction of behaviors inconsistent with communication, e.g., flapping • Operant speech training: Imitation, receptive labelling, sign language for some children Case Review: Joey What diagnostic features did you think most important? What kind of intervention is necessary?
