AUTISM Gueli e Alise

8/13/2019 AUTISM Gueli e Alise

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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
http://it.wikipedia.org/wiki/Immagine:Autism-stacking-cans_edit.jpg


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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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AUTISM Gueli e Alise