AutismVanessa Mae Carzon & Sarah Jane Calub

Description

Autism is a term for a group of complex disorders of brain development, and falls under the umbrella of pervasive developmental disorders (PDD). It is characterized by difficulties in social interaction, verbal and nonverbal communication, repetitive behaviors, intellectual disabilities, and difficulties with motor coordination and attention.

Autism: the Musical (2008)

BackgroundTerm coined by Swiss psychiatrist Eugene Bleuler in 1912, when he wrote about it in The American Journal of Insanity.

Bleuler thought it was another form of schizophrenia.

Austrian-American psychiatrist, Dr. Leo Kanner, was the first to recognize autism as its own unique mental disorder.

Scientist and pediatrician, Dr. Hans Asperger defined Asperger Syndrome, a specific type of high functioning autism, in 1944.

Austrian-American writer and child psychologist, Dr. Bruno Bettelhiem, developed a theory of “refrigerator mothers” in 1967.

Demographics1 in 110 American children have autism, a 600% increase over the past two decades.

It is three to four times more common in boys than in girls.

About 1 out of 70 boys is diagnosed with autism in the U.S.

The disorder is often seen in identical twins.If one twin has autism, the other has a 63-98% chance to have autism as well.For dizygotic twins, the chance is between 0-10%For siblings, 3%

Signs and SymptomsImpairment in social interaction

Nonverbal behaviorsFailure to develop peer relationshipsLack of spontaneous seeking to share enjoyment, interest, or achievements with others

Impairments in communicationLack of or delay in spoken languageInability to sustain conversation with othersStereotyped or repetitive use of language

Restricted, repetitive & stereotyped patterns of behavior, interests, and activities Hand or finger flapping or twisting or complex whole-body movements

Delays or abnormal functioning in symbolic or imaginative play

PECS

Biological SignsEnlarged portions of autistic brain

Several abnormal genes identified, including ones that may alter brain architecture

Genes may interact with environmental factors

Major brain areas implicated in Autism: cerebellum, cerebral cortex, temporal lobe, amygdala

Research establishes potential biomarkers in Autistic brain utilizing Structural MRI

Neurobiology

Now commonly believed to be caused by widespread abnormalities in brain structure and function that occur prenatally and in early life

Neurodevelopmental trajectory is altered:Cell migrationFormation of neural networksNeurotransmitter systems fail to perform optimallyCommunication between neurons may be impaired

Net result is an overall lack of coordination of sensory, motor, cognitive, language, and other functions resulting in major impairments in behavior and development

Brain OvergrowthRelated to an acceleration of brain growth during first 2 years of life (which then slows and declines)

Suggests pervasive, rather than regionally specific abnormality

Leads to ineffective processing and connectivity

Symptoms of autism not recognized until 2nd or 3rd year of because higher-level functions (such as language and more complex social interaction skills - that require integration) do not emerge until the 2nd or 3rd year of life

Poor Sensory Integration

“Whole brain integration deficit”

Integration of sensory info requires synchronization of multiple brain areas

As processing load increases and working memory or shifting in attention is needed, breakdown becomes exacerbated

Natasha Aldred Illustration “Autistic Brain”

Role of the Frontal Lobe

Presence of stereotypical behaviors may be associated with difficulty with executive functions and inflexibility

Role of the Amygdala

Structural Differences Functional Differences

Larger amygdalae in autistic children than in neurotypical

children

Larger amygdala means increased anxiety, poorer social

and communication skills

In adolescents and adults,amygdalae appear to be same size

or smaller

Early dysfunction related to other symptoms (processing emotions,

distinguishing faces, understanding social stimuli)

Diagnosis

No specific test

Usually, parents are concerned with child’s development and physicians perform a psychiatric exam to rule out schizophrenia, mutism, or mental retardation

DSM-IV criteria

Treatment/PrognosisNo cure for Autism (although many claims have been made)

Early intervention strategies (i.e., Sensory integration therapy)

ABA (Applied Behavioral Analysis) Therapy to correct behaviors

Referred to special support services (OT, PT, speech, etc.)

Special education

Health considerations (Leaky Gut, food allergies, GI issues, GFCF diet)

HippotherapyABA Therapy Son-Rise Program GFCF diet

Case Study #1Temple Grandinborn Aug. 29, 1947

High-functioning AutismDiagnosed with mental retardation at age 2; Began talking at age 4“Nerdy kid” who was teased throughout middle and high schoolHypersensitivity to noise and other sensory stimuliInvented the “squeeze box” at age 18Primarily a visual thinker; words are her second languageMust wear clothes that counteract sensory integration dysfunctionStructured lifestyle to avoid sensory overload

Case Study #2Billy, aged 27, with low-functioning AutismDx at age 4His family took care of him until he was 21, at which age he entered a group home.Billy was very sensitive to the environment around him (i.e. If everyone was calm, he was calm; if someone was anxious or aggressive, he too became anxious and aggressive)Rather than being agitated toward staff members or other residents, Billy would exhibit self-stimulatory behaviors.Calming him down often meant removing him from the environment.Severe reactions occurred at least once a day.REI recording was used to calm Billy down when he was most agitated, which was usually in the afternoon.

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aut.html

Autism Case Study for low functioning autism, anxiety, self-injurious behaviors. (n.d.). Welcome To The Strong Institute. Retrieved November 17,

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DSM-IV Criteria for Diagnosing Autism. (n.d.). Autism Watch. Retrieved November 17, 2011, from http://www.autism-watch.org/general/

dsm.shtml

Hauser, M. (2010, April 29). Temple Grandin - The 2010 TIME 100 - TIME. Breaking News, Analysis, Politics, Blogs, News Photos, Video, Tech

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history-of-autism-pioneers.html

Rapin, I., & Tuchman, R. (2008). Autism: definition, neurobiology, screening, diagnosis. Pediatric Clinics Of North America, 55(5), 1129-1146.

What is Autism? | Autism Speaks. (n.d.). Home | Autism Speaks. Retrieved November 17, 2011, from http://www.autismspeaks.org/what-autism