AUTISM AUTISM By: Pauline Narciso Philip Lai Henry Kang
Dec 25, 2015
OverviewOverview
Pauline– General Survey of Autism– Neural/Chemical Correlates
Philip– Comparison of Consciousness
Henry– Treatments
General NotesGeneral Notes
Autism as a Syndrome: multiple disease entities
Autism is a developmental syndrome:
Common deficit: theory of mind
Bit of HistoryBit of History
1943- Kanner
“extreme aloneness from the beginning of life and anxiously obsessive desire for the preservation of sameness.”
Initial cause: Bad parents
Diagnostic CriteriaDiagnostic Criteria
Severe abnormality of reciprocal social relatedness
Severe abnormality of communication development
Restricted, repetitive behavior, patterns of behavior, interests, imagination
Early onset (before 3-5 years)
Other observed behaviorsOther observed behaviors
Lack of awareness of feelings of othersBizarre speech patternsLack of spontaneous and make-believe playPreoccupation with parts of objectsRepetitive motor movementsMarked distress over changes
Screening Model for Infantile Screening Model for Infantile AutismAutism
Is child’s eye-to-eye contact normal?Is he/she comforted by proximity/body
contact?Does he/she often smile or laugh
unexpectedly?Does he/she prefer to be left alone?
Systematic Feature Systematic Feature ExaminationExamination
Hand stereotypies (strange looking or posturing)
Stiff gaze, avoidance ofLittle reaction to strong, unexpected noisePassive, obvious lack of interest
Disease Entities within AutismDisease Entities within Autism
IABDZapella Dysmaturational subgroupPurine AutismAsperger’s and Autistic Savants
All share common Autistic behaviors
Infantile Autistic Bipolar Infantile Autistic Bipolar DisorderDisorder
Regression after initial normal developmentMeets classical criteria for AutismAutistic symptoms have a cyclical patternPositive family history of BD or Depression
Different from Autistic who later has onset of BD
Zapella Dysmaturational Zapella Dysmaturational subgroupsubgroup
Loss of language after initial normal dev Meets classical criteria Complex tics present Normal neurological exam, normal lab exams Rapid improvement following therapy Reach quasi-normal abilities by age 5-6 After age 6, usually fall into other psycho-
pathological category, ADHD
Purine AutismPurine Autism
Classical criteria metToo high/too low levels of uric acidConstipationGout in family membersSeizures and self-injury in majority“Purine”:abnormal levels of end product
(uric acid) of all purine pathways
Quote on Purine AutisticQuote on Purine Autistic
“the boy was an irritable baby who resisted any change in routine and never looked at people around him. By 2 years of age, the few words he had were rapidly disappearing. He lined up his toys in long straight lines instead of playing with them. He developed pica, teeth-grinding, compulsive biting to the point of bleeding.”
On the functioning end..On the functioning end..
Asperger’s: meet criteria, but have normal IQ functioning
Autistic Savants: special skills in memory, music, math, calendar calc, drawing, and hyperalexia reading.
Theories on contributing Theories on contributing factorsfactors
Unfavorable pre, peri, post-natal factors
Cellular and structural changes in Limbic System (amygdala, cerebellum, and hippocampus)
L-hemi neural substrates fail to develop (loss lang., consciousness, motor planning
Locus Coerulus:Mediates input from senses-underdeveloped
Low mercury levels
Who’s affected?Who’s affected?
1% of general public under the Autism Spectrum
Most often tend to be males
Altered States Compared to NormalAltered States Compared to Normal Resistance to change, Insist on sameness
Strong attachments to objects; Spins objects
Difficulty in mixing with others
Throw Temper Tantrums
Tend not to want to cuddle or be cuddled
Over-sensitivity or under-sensitivity to pain
No fears of danger
Sensory ProcessingSensory Processing Painfully sensitive to certain sounds, textures, tastes,
and smells.
Either too sensitive or less sensitive than normal. Some autistic have difficulty interpreting sensory information.
Like normal these experiences are not hallucinations but based on real experiences.
Some avoid being touched, a gentle touch for most, will hurt or shock autistics.
Some are insensitive to pain, and fail to notice injuries.
EmotionsEmotions
Take major emergencies in stride but become upset over minor disruption.
Unemotional, but can be very emotional when things are important to them.
More candid and expressive with their emotions than normal people.
Small amount will have difficulty regulating their emotions. Individual will have verbal outburst, usually in strange or overwhelming environment.
CommunicationsCommunications
Problem with semantic-pragmatic component, take a statement or question in a literal way.
Ex.) "I'd like coffee with my cereal“
Repeating things that have been heard (echolalia)
Inability to understand body language, tone of voice
Some autistics are mute
Communication Cont.Communication Cont.
Difficult in sustaining a conversation. No normal "give and take" in a conversation
Autistics tend to go on with their favorite subjects and do not give the other person a chance to talk.
People with autism might stand too close to the other person.
Body language, facial expressions, and gestures do not match what they are saying.
AttentionAttentionTrouble handling multiple stimuli of attention.
Very narrow focused attention, can not keep
up with more than one thing at a time.
Shifting attention is a slow process, usually involves pauses or moments of delay.
ProductivityProductivity
Great deal of variety among autistics.
Some autistic may never learn to talk and be dependent throughout their lives.
Others may do well in special supportive settings, working in a sheltered environment.
There are autistics that are fully independent and function fairly well.
Theory of MindTheory of Mind TOM is absent in autistics, can not attribute mental states.
Autistic can not reflect on their own mental states.
Cause abnormalities in social interactions, communications, and imagination.
Understanding mental states of others can allows individuals to make sense of past behavior, allows influence on present behavior and permits prediction of future behavior.
Normal 3 year olds no TOM,
but 4 year olds tend to have a TOM.
Mirror NeuronsMirror Neurons
Tested controls and autistics on 4 different tasks. Researchers compared mu rhythms. At baseline, mu
rhythms will fire in synchrony, large amplitude mu oscillations.
Normal when seeing an action perform will cause mu rhythms to fire asynchronously, therefore resulting in mu suppression.
Mirror Neurons Cont.Mirror Neurons Cont. So mu wave suppression will reflect activity of the
mirror neuron system. In autistics, there was mu suppression in their own
hand movements, but no mu suppression to the observed hand movements.
Autism TreatmentAutism Treatment
Behavioral modification and communication approaches
Dietary and biomedical approaches
Complementary approaches
Behavioral & CommunicationBehavioral & Communication
Applied Behavior Analysis– Rewarded behavior
TEACCH– Understand the world
PECS– Picture exchange
Social Stories– Theory of Mind
Sensory Integration
Biomedical TreatmentsBiomedical Treatments
Medications– Serotonin Re-uptake Inhibitors– Anti-Psychotic Medications
Risperidone
Vitamins and Minerals
Dietary Interventions
RisperidoneRisperidone
Two double-blind, placebo-controlled responses of risperidone– Adults and Children
Serotonin-Dopamine antagonist Effective as a short-term treatment
– Tantrums, Aggression, Self-Injurious Behavior– Interfering repetitive behavior, self-injurious behavior,
sensory motor behaviors, affectual reactions, overall behavioral symptoms
Vitamins & MineralsVitamins & Minerals
Vitamin B– Most common vitamin supplement
Vitamins A and D– Eye contact and behavior
Vitamin C– Improve symptom severity
Dietary InterventionsDietary Interventions
Gluten– Disruption in biochemical and neuroregulatory
processes
Yeast– Behavioral and medical problems
Complementary ApproachesComplementary Approaches
Improving Communication Skills– Music Therapy
Speech Development
– Art Therapy Non-verbal, Symbolic Expression
– Animal Therapy Physical and Emotional Benefits
ConclusionConclusion
Autism is a spectrum
Autistics lack an essential element of consciousness-Theory of Mind
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