PSYC 337 Lecture Notes - Lecture 6: Measles, Ethylmercury, Limbic System
7 May 2018
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Lecture 18 (cont). - Autism
●Intro
○Autism Spectrum Disorder (ASD) → neurodevelopmental disorder featuring deficits in
socialization, impaired communication, and stereotypical behaviour or interests
○First use of the word
■Autism → Greek word “autos” (means self)
■Bleuler coined the terms autism/autistic to explain someone who withdraws from
the outside world into themself
●Also, autismus → to lose a relationship with external world in favour of
leading a life of one’s own world
○Kanner → “Classic autism”
■In 1943, used autism to describe 11 children he was working with who responded
in unusual ways to people/environment
■The main problem of children with autism have an inability to relate to others
and situations from the beginning of life (i.e., not a sudden break with reality)
■Kanner would say the two hallmark features are
●Extreme self-isolation
●Obsessive resistance to change
■“Kanner’s Autism”
●Inability to relate to others
●Extreme aloneness
●Resistance to being picked up/held by parents
●Impaired language for communication purposes (e.g. mutism, echolalia)
●Obsessive desire for repetition and sameness
●Few spontaneous activities (e.g. in play)
●Bizarre and repetitive physical movements
●Intense fascination with objects (e.g. obsession with cars)
●Early specific food preferences
●Extreme fear reactions to loud noises
●Excellent rote memory in some cases
○Asperger’s type
■1944, Hans Asperger described similar condition → children with higher
cognitive skills and overall functioning (intellectually intact), but were
specifically challenged in social understanding
●Intense, narrow interests
●Poor empathy
●Speed unrelated to the topic of conversation
●Behavioural outbursts
●Didn’t understand why people did not behave in ways they wanted
○Childhood Disintegrative Disorder (CDD) → 1908
■Marked regression in multiple areas following at least 2 years of normal
development
■DSM-IV
●At least 2 years of normal development
●Significant loss of previously acquired skills in at least 2 areas of
development
●No specific medical cause/neurodegenerative syndrome
●Deficits in social, communication, and restricted repetitive and
stereotyped patterns of behavior that would be typical of autistic disorder
■More common in boys, less common than autism as typically described
■It is a very rare diagnosis, and it is distinguished from autism by that specific
period of regression
○Rett’s disorder
■Genetic disorder caused by the mutation of MECP2 gene on X chromosome)
■Typically lethal in male fetuses, affects about 1/12-15k female births
■Development of multiple specific impairments after a period of normal
development
●Normal development in first 5 months (shorter than CDD)
●Head circumference decreases relative to how big it should be between 5
and 48 months
●Loss of hand skills between 5-30 months, and unusual behaviours (e.g.
hand wringing)
●Motor skills deteriorate progressively over time (after those 5 months)
●Severe communication deficits
●After onset, interest in social interaction decreases (but develops again
later)
○Pervasive Developmental Disorder - Not Otherwise Specified (PDD - NOS) →
(DSM-IV)
■A subthreshold diagnostic category for people who didn’t really fit other
diagnoses
■DSM-IV criteria
●Pervasive impairment in social interaction
●Pervasive impairment in communication skills OR presence of
stereotyped behaviour, interests, or activities
●Presence of impairment that do not meet the criteria for AD because of
○Late age of onset
○Atypical symptoms
○Subthreshold symptoms
○All of these diagnoses were informally recognized as parts of the autism “spectrum” in
DSM-IV
■Three core characteristics
●Reciprocal social interaction
●Communication
●Restricted and repetitive behaviours
○Since the DSM-5, we have 2 core characteristics
■Social communication AND social interaction
■Restricted behaviour, interests, and activities
●Major changes from DSM-IV to DSM-5
○No more subtypes of ASD; we specify based on severity along the continuum
■We also removed Rett’s disorder, since it has been found to be a genetic disorder
rather than a psychological one
●People with genetic disorders mimicking the symptoms of ASD are still
diagnosed with ASD + their genetic disorder
○Language and social problems are combined
○Symptoms must be present in early childhood
○Three levels of severity
●DSM-5 diagnostic criteria of ASD
Document Summary
Autism spectrum disorder (asd) neurodevelopmental disorder featuring deficits in socialization, impaired communication, and stereotypical behaviour or interests. Autism greek word autos (means self) Bleuler coined the terms autism/autistic to explain someone who withdraws from the outside world into themself. Also, autismus to lose a relationship with external world in favour of leading a life of one"s own world. In 1943, used autism to describe 11 children he was working with who responded in unusual ways to people/environment. The main problem of children with autism have an inability to relate to others and situations from the beginning of life (i. e. , not a sudden break with reality) Kanner would say the two hallmark features are. Resistance to being picked up/held by parents. Impaired language for communication purposes (e. g. mutism, echolalia) Intense fascination with objects (e. g. obsession with cars) 1944, hans asperger described similar condition children with higher cognitive skills and overall functioning (intellectually intact), but were specifically challenged in social understanding.
