Autism and aspergers

• Autism and Aspergers


  • Characterized by delayed / impaired communication + social skills, along with restricted + repetitive behaviours + interests
  • Dysfunction is pervasive = severe + spans a number of areas of childhood development
  • People with autism = oblivious to others
  • Symptoms present before age 3
  • Unlike those with mental retardation, people with autism may not be impaired in all domains
  • About 20% of people with autism have pockets of unique skills relating to art, music, numbers, or calendars, such as ability to identify day of week on which a given date fell, even when date is many years in past

  
• Children with autism


  • Tend to engage in very repetitive play
  • Often display stereotyped behaviors
  • Insist on repeating same behaviors or activities for much longer periods than other children do
  • Become distressed when certain routines are not carried out or completed, to calm themselves down, they may rock themselves
  • Do not go through childhood milestones (language, social, or motor) in a normal fashion
  • May speak with a monotone voice, + rhythm of their speech may be odd
  • Often have a variety of problems with attention + may be impulsive / aggressive
  • More sensitive to sensory stimuli, leading them to shun physical contact with others
• Autistic savants


  People with autism who have pockets of unique skills
• DSM-IV-TR diagnostic criteria of Autistic disorder

  • Qualitative impairment in social interaction
  • Qualitative impairments in communication
  • Restricted repetitive + stereotyped patterns of behaviour, interests + activities
• Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction; (2) language as used in social communication; (3) symbolic or imaginative play
• The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder
• Prevalence of autistic disorder


  • Significantly less than 1% of population has this disorder; prevalence estimates range from 0.02% to o.2%
  • The reported prevalence of autism is increasing at least in part because of earlier diagnosis of disorder

  
• Onset of autistic disorder


  • Symptoms usually arise during infancy + include an indifference or aversion to physical contact, no eye contact or smiles, a lack of response to parents' voices, a lack of emotional attachment to parents, + unusual use of toys
  • DSM-IV-TR criteria, symptoms must arise by age 3
  • Autism may be diagnosed as early as 14 months of age

  
• Comorbidity of autistic disorder

  • Mental retardation is a common comorbid disorder
  • Between 50% + 70% of those with autism also have mental retardation
  • However, some researchers believe high comorbidity is an overestimate particularly because individuals with autism tend to have higher IQs when tested using nonverbal IQ tests
  • Some researchers make a distinction between autism that co-occurs with mental retardation, which leads to a relatively low level of functioning, + autism without mental retardation, which is not generally associated with as low a level of functioning

  
• Course of autistic disorder


  • Children with autism often improve in some areas of functioning during the elementary school years
  • During adolescence, some children's symptoms worsen, whereas other children's symptoms improve

  
• Gender differences in autistic disorder

  Males are 4 to 5 times more likely than females to develop autism
• Asperger's disorder


  • Involves similar types of problems with social interaction + narrowed behaviors
  • Those with Asperger's have language + cognitive abilities that are within normal range + so mental retardation cannot be present
  • Children with Asperger's often have problems with relatively subtle social cues related to language— (indirect or implied meanings behind words)
  • Avoid sustained eye contact, and don't use other nonverbal behaviors, such as facial expressions or body language, in nor- mal ways
  • Because they don't understand social conventions, their behavior can (inadvertently) communicate disinterest in others
  • Whereas autism is characterized by an indifference to others, Asperger's tends to involve a lack of awareness of other people's responses
  • Person with Asperger's doesn't notice— doesn't pick up on social cues that indicate that other person is no longer listening
  • To be diagnosed with Asperger's, individual must have symptoms that impair ability to function at school + care for himself or herself
  • Unlike those with autism, however, children with Asperger's develop in all areas (including language) except social functioning
• DSM-IV-TR diagnostic criteria for Asperger's disorder

  • Qualitative impairment in social interaction
  • Restricted repetitive and stereotyped patterns of behavior, interests, and activities
  • The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning
  • No clinically significant general delay in language
  • No clinically significant delay in cognitive development or in the development of age- appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood
  • Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia

  
• Prevalence of Asperger's disorder

  The estimated prevalence for Asperger's disorder is around 0.25–0.8% depending on exact criteria used, the research methods used, and the population studied
• Onset of Asperger's disorder

  • Although symptoms may emerge during early childhood, often not diagnosed until child is in elementary or middle school because academic performance is normal
  • In some cases, the child's difficulty in social situations is not understood as a deficit but viewed as will ful behavior

  
• Comorbidity of Asperger's disorder

  • Depression + anxiety disorders are most common comorbid disorders
  • Attention-deficit/hyperactivity disorder may also co-occur
  • Asperger's is only pervasive develop-mental disorder that cannot be comorbid with mental retardation—the DSM-IV- TR criteria stipulate normal cognitive development
• Course of Asperger's disorder


  • As children with Asperger's disorder enter adolescence + adulthood they may become aware of their social difficulties + isolation; this awareness may contribute to comorbid depression
  • Many children with Asperger's are able to improve their social skills
  • Asperger's disorder has a good prognosis, + higher individual's IQ, better prognosis
  • Most people with Asperger's are able to work + be self-sufficient
• Gender differences in Asperger's disorder

  At least 5 times more males than females are diagnosed with Asperger's disorder