Autism
(2-19-15)
Defining Features:
Kanner's Syndrome: Leo Kanner (1943) -- "early infantile autism": 11 children, 17 symptoms, 3 key features:
1. An inability to relate to people, apparent early in life
2. Particular use of language: a failure to use language for interactive conversation, e.g., to communicate
3. An "obsessive desire for the maintenance of sameness" associated with a "limitation in the variety of spontaneous activity"
These three core difficulties remain the basis of most current definitions of Autistic Disorder (DSM 5 altered the previous criteria to "persistent deficits in social communical and social interaction" and "restrictive, repetitive patterns of behavior, interests, or activities"):
Social deficits
"The most essential feature of an autistic disorder is a qualitative abnormality in social interaction." (Harris, 1998, p. 192)
Deficits in Communication
Most frequent presenting concern by parents (Harris, 1998)
Restricted activities
repetitive patterns of movement (stereotypies and mannerisms), resistance to change in routine and environment, preoccupations, constricted repertoires of behavior
Prevalence: originally autism was viewed as a very low frequency disorder:
5 cases per 10,000 is cited as median prevalence rate by DSM-IV-TR (2000)
Using a narrow definition the prevalence rate is approximately 2 per 10,000 (Harris, 1998); for disorders with "autistic-like" symptoms the rate increases to 12 to 15 per 10,000 (Harris, 1998)
The UCLA-University of Utah Epidemiologic Survey of Autism Prevalence Study in 1983 estimated the incidence rate of autism in Utah to be 4 in 10,000.
(Utah Autism and Developmental Disabilities Monitoring (ADDM) Project)More recent reports have suggested much higher prevalence rates
1 in 150 for ASD (autistic spectrum disorders), with some estimates evern higher (1 in 78)
4 - 5 males per each female
(females with Autism more likely to have severe Mental Retardation or show more severe autistic symptoms)
Is the prevalence of autism increasing?
Several recent reports have raised the possibility that the prevalence of autism may be increasing in the United States. This is currently under investigation but there appears to be some support.
issues:
1) definition and changing definitions
2) changing public and professional awareness
Autism was added to the IDEA reauthorization of 1991
early reports of association with SES is now viewed as reflecting a lack of access to services that would have lead to a diagnosis of autism (Tidmarch & Volkmar, 2003)
early association with parental characteristics were inaccurate and probably relected failure to consider "invisible selective factors" in the initial identified clinical samples: "Kanner's big error"
3) milder and borderline cases
Onset: by definition less than 3 years of age
Course: usually continuous
symptoms may change over time
Familial: increased risk among siblings (approximately 3% recurrence risk or "60 to 100 times the base rate in the general population" Harris, 1998, p. 196)
Rate of mental retardation in siblings not elevated
Rate of language (pragmatic communication), social, and cognitive difficulties in siblings is elevated
Associated symptoms:
Mental Retardation in approximately 75% (75-80% Harris, 1998)
Uneven profile of cognitive skills
Savant performances occur in a minority of children with autism
Behavior & emotional problems
aggression, hyperactivity, oppositional behavior
self-injurious behavior
anxiety, fears, sleep, eating disturbance
Movement disturbances: rocking, gesturing
Odd responses to sensory stimuli
Seizures develop in adolescence in approximately 25% of children diagnosed with Autism.
Theories regarding the etiology of autism
| Review Guides | Units| Syllabus| Home |