AUTISTIC DISORDER &ASPERGER’S SYNDROME

Jackie MacKellar

MSW Intern

Ohio Elementary

What is Autism?

Autism is a Pervasive Developmental Disorder, so-called because it affects every aspect of a child’s development.

(DSM-IV, 2000)

It is characterized by marked impairment in social interaction and communication, repetitive behavior and extremely narrow interests and activities.

(DSM-IV, 2000)

Deficit Areas

Classic Autism Symptoms

(DSM-IV, 2000; MedlinePlus, 2012)

Impairment in nonverbal communication (such as maintaining eye contact)

Impairment in social interaction and peer relationships Language impairment, include either delay/lack of spoken language or

inability to sustain a conversation Idiosyncratic, stereotyped, and repetitive use of language Sensory symptoms. Including over- and/or under-sensitivity to sight,

hearing, touch, smell, or taste Difficulty with sensory integration and fine motor skills Unusual distress when routines are changed Stereotyped or repetitive movements Narrow interests and activities Lack of imaginative and social play

Asperger’s SyndromeWhat distinguishes Asperger’s Syndrome from Autistic Disorder?

The distinction between a diagnosis of high-functioning autism and one of Asperger’s has always been subjective. It has traditionally been distinguished from Autistic Disorder by the lack of delay in language skills and a somewhat more apparent desire to socially engage.

Proposed changes in DSM-V would remove AS as a separate diagnosis and fold it into Autistic Disorder on the high-functioning end of the spectrum.

Not much.

Asperger’s SyndromeWhile Asperger’s Syndrome is differentiated by generally less severe impairment overall and there is no significant delay or regression of language skills, language usage is atypical and social skills are lacking. Symptoms include:

Trouble understanding social cues and conversational language styles Conversation is one-sided and voice inflection is abnormal Inflexible adherence to a nonfunctional routine or ritual Repetition of movements or words and phrases Difficulties with fine-motor skills and sensory integration A persistent preoccupation with objects or narrowly focused topics of

interest

The Spectrum Approach

The Spectrum Approach

Current Statistics

Median rate of autism is 5 per 10,000 1 in every 110 8-year olds is diagnosed

with autism Rates are more prevalent among

Caucasians than among blacks and Hispanics

Both Asperger’s and Classic Autism are more common in men than women by four to five times

Onset is before age 3, with diagnosis usually taking place between ages 4 and 5

Increased risk among siblings of autistic children (5%)

(DSM-IV, 2000; National Institute of Mental Health [NIMH],

06 Feb 2012)

CAUSES & MECHANISMS

What Causes Autism?

Scientists are still not entirely sure what causes ASD and AS. Some theories:

Genetic Brain abnormalities Environmental factors Some combination of these

(National Institute of Neurological Disorders and Stroke [NINDS], 2005; NINDS, 2009)

Mechanisms

As with the cause of ASD, researchers are uncertain exactly how autism occurs.

Recently, a couple of interesting (and controversial) theories have been advanced by researcher Baron-Cohen.

MechanismsNo, not Borat: His cousin, this guy:

Mind-Blindness Theory that those with ASD/AS

have no or limited theory of mind

Supported by finding that autistic children have difficulty passing the Sally-Anne test even past the age of 4 (the age when most neurotypical children would be able to pass)

(Baron-Cohen, 1985; Baron-Cohen, 1997)

Extreme Male Brain

(Baron-Cohen, 2009)

Defines the male brain as one that privileges systemizing (SQ) over empathizing (EQ)

Postulates that autism is the expression of an extreme version of the male brain

In measures of empathy and systemizing, 65% of people with ASD/AS have an “extreme” male brain

Argues that autistic individuals lack cognitive but not affective empathy

CHALLENGES FOR THE ASD/AS STUDENT

Adverse Effects

Cognitive & Academic Challenges

Poor problem-solving and organizational skills Concrete, literal thinking—difficulty understanding abstract concepts Difficulty differentiating between relevant and irrelevant information Interests that are obsessive and narrowly defined Low social standing among their peers Lack of executive functions results in difficulty shifting focus between

activities, recognizing important information, or understanding the “big picture” (p. 11)

Disinhibited reactions—often react out of emotion or rage rather than logic

(Myles, et al., 2005, p.10)

Social & Communication Challenges

Lack of awareness/understanding of social rules Strange speech patterns, inflections, and echolalia can isolate the student

from his or her peers and encourage teasing Difficulty understanding abstract concepts, idioms, metaphors, sarcasm,

irony, parables, rhetorical questions Lack of eye contact and inability to pick up on and send out appropriate

nonverbals can affect relationships with peers Difficulty interpreting, inferring, or predicting the emotional states of others

can make the child seem self-absorbed or uncaring to others, increasing the difficulty of forming friendships

(Myles, et al., 2005)

Comorbid Conditions Eating disorders, such as anorexia nervosa Digestive/gastrointestinal problems Anxiety Attention Deficit Hyperactivity Disorder (ADHD) Borderline Personality Disorder Depression Obsessive-Compulsive Disorder (OCD) Tourette Syndrome (TS)

Depression is most common in adolescents, perhaps because of increased awareness of social isolation.

(Myles, et al., 2005)

Random Bunny!

ReferencesAmerican Psychiatric Association [APA]. (2000). Diagnostic and statistical

manual of mental disorders of the American Psychiatric Association (4th. ed. Rev.). Washington, DC: Author.

Badcock, C. C., & Crespi, B. B. (2006). Imbalanced genomic imprinting in brain development: an evolutionary basis for the aetiology of autism. Journal Of Evolutionary Biology, 19(4), 1007-1032. doi:10.1111/j.

14209101.2006.01091.x

Baron-Cohen, S. (1985). Does the autistic child have a ‘theory of mind’?. Cognition, 21 (1985), 37-46.

Baron-Cohen, S. (1997). Mindblind. (Cover story). Natural History, 106(7), 62.

Baron-Cohen, S. (2009). Autism: Empathizing-systematizing (E-S) theory. The Year in Cognitive Neuroscience, 1156(68-80).

Medline Plus (U.S. National Library of Medicine). (07 Feb 2012). Autism. http://www.nlm.nih.gov/medlineplus/ency/article/001526.htm

ReferencesMyles, B.S., Hagen, K., Holverstott, J., Hubbard, A., Adreon, D., & Trautman,

M. (2005). Life journey through autism: An educator’s guide to Asperger’s Syndrome. Arlington, V.A.: Organization for Autism Research, Inc.

National Institute of Mental Health (NIMH). (06 Feb 2012). Autism. http://www.nimh.nih.gov/statistics/1AUT_CHILD.shtml

National Institute of Neurologic Disorders and Stroke (NINDS). (2005). Asperger syndrome fact sheet. National Institute of Mental Health. Publication No. 05-5624.

National Institute of Neurologic Disorders and Stroke (NINDS). (2009). Austism fact sheet. National Institute of Mental Health. Publication No. 09-1877