Lecture 1 – Introduction to Autism

Ilan Dinstein

History of AutismIn the past autism was often diagnosed as schizophrenia and individuals were placed in psychiatric asylums.

1943: Dr. Leo Kaner describes 11 cases of autism and promotes the “refrigerator mother” theory.

1944: Dr. Hans Asperger describes Asperger’s syndrome.1964: First discussions of autism as a biological disorder1977: First study showing that autism has a genetic component.1980s: First structured therapy (Applied Behavioral Analysis).1990s: ADOS and ADI standardized diagnostic tests are published.2000s: Large scale biological research into autism begins.

History of Autism1998: Vaccine panic after an article claims a causal relationship

between vaccines and the development of autism.2000: Previously eliminated Rubella, Mumps, and Measles

diseases resurface in Europe and the US. Several children die and others are left handicapped.

2010: The original article is retracted and the physician who authored it loses his medical license.

Current clinical definition – DSM IV TR

Language delay and dysfunctionSocial difficultiesRepetitive behaviors and confined interests

Autism – all threeAsperger – no language delayPDD NOS – mild symptoms

Upcoming definition – DSM V

Language delay and dysfunctionSocial and communication difficultiesRepetitive behaviors and confined interestsSensory abnormalities

Mild, moderate, and severe autism Asperger – no language delayPDD NOS – mild symptoms

Future definitions?

Autism usually means a lot more…

1. 25-70% have low IQ (<70).

2. 20-30% have clinical epilepsy.

3. Over 90% have sensory hypo and hyper sensitivities.

4. Motor clumsiness, balance, and gait problems.

5. Sleeping and digestive problems.

6. Differences in memory and learning.

7. Mood disorders

Extreme heterogeneity

“If you’ve met one person with autism, you’ve met one person with autism”

Example #1 – Rainman (min 18)

Example #2 – Carly

Example #3 – Temple Grandin

Common symptoms

Eye contactJoint attention

Abnormal affectTantrums

Lack of initiationNo imitation

Low responsivenessObsession with order

Difficulty with changesAvoid interactionsOver-sensitivities

RepetitivenessTantrums

“golden standard” behavioral tests

ADOS

CommunicationSocial

Stereotyped behaviors

“golden standard” behavioral tests

ADI

CommunicationSocial

Stereotyped behaviors

Prevalence

The number of children diagnosed with ASD has been rising steadily.

Developmental disorder

Symptoms change throughout life

Behavioral therapies

Applied behavioral analysis (ABA)

Floortime by Greenspan

Actual therapy