Peds Exam 3 Autism

85%; 5

rhett syndrome
childhood disintegrative disorder
autism
asperger's disorder
PDD-NOS

-progressive developmental disorder
-caused by spontaneous mutation of gene on X chromosome

mainly seen in females, males extremely rare

1 in 10000-15000 live births

less than 1%

period of normal development after birth
onset 6-18 months (language begins to regress, become socially withdrawn, head growth decelerates)

1. motor problems
-wide gait, walking on tip toes
-non purposeful, repetitive hand movements
-uncoordinated breathing
2. severe language disorder-often nonverbal
-loss of meaningful nonverbal language
-diminished interpersonal interaction
3. seizures
4. curvature of spine

-rare developmental disorder
-characterized by at least 2 years of normal, communicative, cognitive, and motor development after brith followed by a marked regression prior to 10 years of age

unknown, less common than ASD

-expressive, receptive, pragmatic language
-bowel/bladder control
-play skills
-motor skills
-adaptive skills

typical onset at 2-4 years but must be before 10 years

1. qualitative impairments in social interaction
2. qualitative impairment in communication
3. restricted, repetitive and stereotyped patters of behavior and interests

should be noted prior to 3 years of age

eye/face gaze
facial expression
body position
poor/inappropriate use of gestures

poor joint attention
impaired turn-taking

decreased
-poor interpretation and use of facial expressions
-lack of empathy

(ToM) individuals with ASD often have difficulty in this area=social communication effects

(knowing about others)

will vary but may include:
-spoken lang problems
-impaired convo skills
-stereotyped/repetitive/idiosyncratic lang
-echolalia
-can change over time

emphasis on non-functional routines
don't like change
stereotyped movements
limited interests

1943-Kanner described 11 boys as infantile Autism disorder
1944-Asperger described similar w/ higher lang
1960/70s-thought to be psychosis-removed from homes
1980-biological disorder
1994-PDD
today-clear distinctions but there is overlap on spectrum

withdrawal from reality

4 in 10000 children

1-3 of every 500 live births
4x boys
increased risk in siblings

still unknown

less severe form of autism, typically splinter skills not present, and language may be more affected

impairment in developent of reciprocal social skills with some degree of verbal and nonverbal communication impairment.
Tend to be less severely affected than children with autism

no but may be first to notice it-refer to appropriate physician who CAN diagnose it

no make believe/no reciprocal play/no imitative play/often meaningless use of toys

hypo may avoid some stimuli
hyper may seek out some stimuli

segmental phonology and syntax
lexical and syntactic comprehension

non-segmental phonology (prosody)
generalization
pronouns
understanding of non-literal language

qualitative impairment in social interaction

restricted repetitive and stereotyped patterns of behviors and interest
-no clinically significant delay in language
-no dealy in cognitive impairment
-clinically significant disturbance of day-to-day functioning
-mainly deficit in social domain
-may be seen with above average intelligence
-splinter skills
-narrow interests

specific areas of increased skills level above typical individuals

-young children: observations
-older children: norm-referenced assessments but joint-attention impairments may make it unreliable

strenghts

important for services

earlier=better
no 2 ASD same
collatoraition important
need to emphasize generalization
important to teach rules overtly

augmentative and alternative comm
social training groups
play-based therapy