autism gueli e alise
TRANSCRIPT
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AUTISM
UNIVERSITA' DEGLI STUDI DI PALERMO
POLO DI CALTANISSETTA
Ignazio Gueli e Marco Alise
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OverviewWhat is Autism?
Is there more than one type of Autism?
What causes Autism?
How is Autism diagnosed?
What are the characteristics of Autism?What are the most effective approachesto treating Autism? Is there a cure?
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WHAT IS AUTISM?First described by Leo Kannerin 1943 as early infantile autism
children are lockedwithin themselves.
For next 30 years, consideredto be an emotional disturbance
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WHAT IS AUTISM?Today, autism is a severe form of abroader group of disorders
These are referred to as pervasivedevelopmental disorders (later)
Typically appears during the first 3
years of life
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Autism is associated with several other conditions:Genetic disorders. About 1015% of autism cases havean identifiable Mendelian(single-gene) condition,chromosome abnormality(7-15), or other genetic
syndrome. (multifactorial)twinsMental retardation.
Epilepsy, with variations in risk of epilepsy due to age,cognitive level, and type of language disorder.
Several metabolic defects, such as phenylketonuria,are associated with autistic symptoms.
Downs Syndrome
Fragile X Syndrome
http://en.wikipedia.org/wiki/Mendelianhttp://en.wikipedia.org/wiki/Chromosome_abnormalityhttp://en.wikipedia.org/wiki/Mental_retardationhttp://en.wikipedia.org/wiki/Epilepsyhttp://en.wikipedia.org/wiki/Metabolic_defecthttp://en.wikipedia.org/wiki/Phenylketonuriahttp://en.wikipedia.org/wiki/Phenylketonuriahttp://en.wikipedia.org/wiki/Metabolic_defecthttp://en.wikipedia.org/wiki/Epilepsyhttp://en.wikipedia.org/wiki/Mental_retardationhttp://en.wikipedia.org/wiki/Chromosome_abnormalityhttp://en.wikipedia.org/wiki/Mendelian -
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WHAT IS AUTISM?Very likely neurologicalin originnot
emotional, not the refrigerator momThe 'refrigerator mother' label was based on the
assumptionnow discredited among most,mental health professionalsthat autisticbehaviors stem from the emotional frigidity ofthe children's mothers
4 times more prevalent in boys
No known racial, ethnic, or social boundariesNo relation to family income, lifestyle
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WHAT IS AUTISM?
Autism impacts normaldevelopment of the brain in areasof social interactionandcommunication skills
(amygdala, Hippocampus,cerebellum).
Difficult to communicate with
others and relate to the outsideworld.
Occasionally, aggressive and/orself-injurious behavior may be
present.
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WHAT IS AUTISM?
May exhibit repeated bodymovements(hand flapping,rocking).
Unusual responses topeople
Attachment to objects
Resistance to change inroutine
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WHAT ARE THE TYPES?Pervasive Developmental Disorder(PDD).
Autismis one of the 5 PDDs.
All have commonalities incommunication and social deficits
Differ in terms of severity
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1. Autistic DisorderImpairments in social interaction,communication, and imaginative
play.Apparent before age 3.
Also includes stereotyped behaviors,
interests, and activities
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2. Aspergers DisorderImpairments in social interactions, andpresence of restricted interests and
activitiesNo clinically significant general delay inlanguage
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3. Pervasive DevelopmentalDisorderNot Otherwise Specified
(PDD-NOS)
Often referred to as atypical autism
Used when a child does not meet the
criteria for a specific diagnosis, butthere is severe and pervasiveimpairment in specified behaviors
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4. Retts DisorderProgressive disorder which, to date, hasonly occurred in girls.
Period of normal development and thenthe loss of previously acquired skills
Also loss of purposeful use of hands,
which is replaced by repetitive handmovements
Beginning at age of 1-4 years
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5. Childhood Disintegrative
DisorderNormal development for at least thefirst 2 years
Then significant loss of previouslyacquired skills
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Conclusions on TypesAutism is a spectrum disorder
This means that symptoms and
characteristics can present themselves inwide variety of combinations, from mild tosevere
Autistic individuals can be very different from
each otherAutism is still commonly used to refer toany of the 5 PDDs
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What causes (and doesnt
cause) autism?Good agreement in general that autismis caused by abnormalities in brain
development, neurochemistry, andgenetic factors
Bettleheims theory of psychogenesis?
The 'refrigerator mother'
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How is Autism Diagnosed?No definitive medical test
Team uses interviews, observation, and
specific checklists developed for this purpose.Team might include neurologist, psychologist,developmental pediatrician, speech/languagetherapist, learning consultant, etc.
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CHARACTERISTICS1. Communication/Language
2. Social Interaction
3. Behaviors
4. Sensory and movement disorders
5. Resistance to change (predictability)6. Intellectual functioning
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1. Communication/languageBroad range of abilities, from no verbalcommunication to quite complex skills
Two common impairments:
A. Delayed language
B. Echolalia
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A. Delayed language50% of autistic individuals will eventuallyhave useful speech
Pronoun reversal: You want white icingon chocolate cake.
Difficulty in conversing easily with others
Look away; poor eye contact
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B. EcholaliaCommon in very young children (Age 3)
Immediate or delayed (even years)
Is there communicative intent withecholalia?
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2. Social InteractionOne of hallmarks of autism is lack ofsocial interaction
1. Impaired use of nonverbal behavior2. Lack of peer relationships (deafness)
3. Failure to spontaneously share
enjoyment, interests, etc. with others4. Lack of reciprocity
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3. BehaviorsRepetitive behaviors, includingobsessions, tics, and perseveration
Impeding behaviors(impede theirlearning or the learning of others)
Will need positive behavior supports
A. Self-injurious behavior
B. Aggression
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4. Sensory and movement
disordersVery common
Over- or under-sensitive to sensory stimuli
Abnormal posture and movements of theface, head, trunk, and limbs
Abnormal eye movements
Movement disorders can be detected veryearlyperhaps at birth
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5. PredictabilityChange in routine is very stressful
May insist on particular furniture
arrangement, food at meals, TV shows
Symmetry is often important
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6. Intellectual functioningAutism occurs in children of all levels ofintelligence, from those who are gifted
to those who have mental retardationIn general, majority of individuals withautism are also identified as havingmental retardation75% below 70
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InterventionsIndividualization and early interventionare the keys
Positive behavior support
Social stories (music therapy?)
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The end