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PSYCH 2AP3 (472)


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McMaster University
Richard B Day

Autism ● Pervasive Developmental Disorders ○ Autistic Disorder ○ Asperger’s Disorder ○ Childhood Disintegrated Disorder ○ Rett’s Disorder (never been diagnosed in any male) ○ Pervasive Developmental Disorder NOS (not otherwise specified) ○ Autism Spectrum Disorders ■ Autistic Disorder ■ Asperger’s Disorder: high functioning end of the autistic disorder ■ Pervasive Developmental Disorder NOS ● Major Symptoms ○ Abnormal or impaired communication: delayed or absent spoken language ■ Individuals who very often do not speak or are very limited ■ Impaired ability to start and maintaining conversations ■ Use stereotyped and repetitive language ■ Abnormal speaking intonation, rhythm (monotonic robotic speech) ■ Idiosyncratic language use: will make up phrases and words that only some can understand ■ They have problems understanding language especially when the language is non-literal ● Questions ● Directions ● Jokes and slang ● sarcasm ○ Abnormal social interaction ■ Fail to cuddle; indifferent to physical contact ■ Infants usually conform to your body shape in order to cuddle, and children with autism do not do that ■ Little interest in establishing relationships ■ No eye contact; don’t respond to name most of the time ■ They don’t seem to notice the social aspect of someone’s presence ■ Unaware of needs and feelings of others (social inappropriateness) ■ No communicative gestures of expressions (i.e. pointing and using hands while conversing) ■ No sharing of favorite things with others (toys, and belongings) ■ Taking preferred objects from others (social insensitivity) ■ If they see something they like they will take it as they are completely ignorant of feelings of other individuals ■ Preference for solitary activities as they are not social ■ Aggressive, hyperactive behavior ○ Restricted, repetitive, stereotyped activities ■ Preoccupation with restricted interests (solitary activities, particular toys,) ● Especially activities that have repetitive natures (spinning tops, stacking blocks) ■ They develop very specific interests as they get older, (memorizing schedules) ■ Repetitively arranging objects in same way ■ Insistence on sameness of routine (wearing the same shirts, touch of OCD when it comes to routines) ■ Stereotyped, ritualistic movements (head banging, spinning, waving) ■ Lack of make believe or imitative play; they do not imagine while they play ○ Hyperactivity, impulsivity, short attention span ○ High tolerance for pain ○ High sensitivity to sensory stimuli ○ Abnormal eating: restricted diet; pica ■ Same cereal, same food ■ Pica: ingestion of non-nutritive substances (clay, dirt) ○ Sleep disturbances: trouble getting to sleep, sometimes excessive sleep ○ Abnormal mood or affect: inappropriate crying and giggling ■ Flat affect: do not seem ups and downs in emotion at all ; very monotonic and their facial expression is very flat ● Prevalence ○ Autistic Disorder: DSM IV(1994): 2-5/10,000 ■ Volkmar(2007): 13/10,000 ○ Asperger’s Disorder: DSM IV(1994): no estimate ■ Volkmar(2007): 3/10,000 ○ PDD-NOS: DSM IV(1994): no estimate ■ Volkmar(2007): 20/10,000 ○ Yeargin-Allsopp et all(2003): 35/10,000 ○ Autism Society of Canada: 50/10,000 ○ Centre for Disease Control in the U.S. (2007): 67/10,000 for just 8 year olds ○ Increased Prevalence ■ Between 1966-1933: 5/10,000 ■ Between 1994-2004: 13/10,000 ■ California, 1987-1998: 270% increase for the Autistic Spectrum ■ Why the increase? ● No specified reason ● Increased awareness of the disorder ● Earlier diagnosis ● Changes in diagnostic practice: people using the criteria differently as it has changed ● Diagnostic substitution: ○ Child meeting two disorders (autism and mental retardation) ■ Can be biased towards autistic diagnosis
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