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Lecture 2

PSYCH 2AP3 Lecture Notes - Lecture 2: Caesarean Section, Solitude, Comorbidity

Course Code
Richard B Day

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| Neurodevelopmental Disorders: Autism Spectrum Disorder |
Most of what people know from autism is from the movie ‘rain man’ and from
temple grandin
oTemple has a high function form of autism
In DSM 3 and 4 autism was a category (involved Asperger’s) but not Asperger’s
is not included in the DSM 5
DSM-5 Diagnostic Criteria
Deficient social interaction, communication:
oDeficits in social emotional reciprocity:
Lack of reciprocal conversation (difficult time responding to others in a way that
reflect what the other person has just said or done)
Reduced sharing of interests, emotions, affect
Failure to initiate or respond to social interactions
oDeficits in nonverbal communication:
Poorly integrated verbal, nonverbal communication
Abnormal eye contact or body language
Deficient use and understanding of gestures
Lack of facial expression and nonverbal communication (don’t use facial
expression and cannot understand them)
oDeficits in developing, maintaining relationships:
Difficulty adjusting behavior to social context
Difficulty sharing imaginative play, making friends (don’t have the ability to
imagine the world in any other way than it literally is)
Total absence of interest in peers
Restricted, repetitive patterns of behavior:
oStereotyped, receptive movements, speech etc.:
Lining up toy (narrow focus on particular actions and behaviors)
Echolalia: tendency to repeat what you’ve just said
Idiosyncratic phrases: words they like to sue again and again that don’t mean
anything to anyone else
oInsistence on sameness of routines or rituals
Things have to be done the way they have always been done
oFixated interests of unusual intensity or focus
E.g. remembering specific facts like baseball bating averages, or stacking blocks
oHypo, Hyperreactivity to sensory input:
Apparent indifference to pain, temperature
Hyper sensitive to specific sounds, texture etc
Excessive smelling, touching of objects (for sensory information)
Fascination with lights, movement

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Criteria for Symptoms
1. Symptoms Present in early developmental period
2. Symptoms cause ‘clinically significant impairment in social, occupational, or other
important areas of functioning
3. Symptoms not better explained by intellectual disability, or global developmental
oIntellectual disability and ASD 70% comorbid
oWith or without intellectual impairment
oWith or without language impairment
Some never talk, some have their language level stuck whenever they stopped
oAssociated with medical, genetic, environmental condition
oAssociated with another mental, behavioral disorder
oWith catatonia (abnormality of movement and behavior arising from a disturbed
mental state
Have autism is highly associated with digestive difficulties (can be part of their
pickiness to foods
Associated Features
Intellectual and/ or language impairment
Motor deficits:
oUnusual gaits
oPoorer motor ability resulting in clumsiness
oat the lower end they are prone to self-injury (e.g. bang there heads on concrete)
o'lowvas' used a cattle prod to shock kids when they did this and they stopped
banging there heads (a lot better then having their kids break their skulls)
Disruptive or challenging behaviors
ocan be aggressive or refuse to do things
Prone to anxiety, depression (adolescent or adults)
Prevalence: Autism Spectrum Disorders Prevalence rising more and more
1% of people have autism
From the graphs we can see there is a
increase in prevalence in south eastern

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Increases prevalence: why?
Between 1966-1993: 5/10,000
Between 1994-2004: 13/10,000
California 1987-1998: 270% increase
1. Increased awareness of the disorder
People are more intuned to the disorder therefore more intuned to the individuals
who may have not been diagnosed before
2. Earlier diagnosis
Now can diagnose children from the age of just 9 months
3. Changes in diagnostic practice
4. Diagnostic substitution
5. Environmental Toxins
Contribution made from ingestion of toxins during prenatal stages
People thought the measles vaccine was related to autism
4-5 times as common in boy than girls
Highest male/female ratio in normal range of cognitive function
Lowest male/ female ratio in extreme low range of cognitive function
oIn order for females to show these symptoms they are usually severe
70% of individuals with ASD are comorbid for at least one other disorder; 40%
with two or more
oanxiety or phobic disorder: 42%
oADHD: 42%
oOppositional Defiant disorder: 28%
Etiology-Psychological Processes
General intellect:
o70% have mental retardation
ono language or abstract reasoning
ogood visuo-spatial processing
ogood attention to detail
oHave rote memory (good a remembering details)
Savant Abilities:
oMathematics, esp. Rapid calculation
oCalendar calculation
Motor development problems:
o60% have dysdiadochokinesia—difficulty in rapid alternating movements
o33% have problems with gait or balance
o15% have abnormal muscle tone –heightened levels of activity in the muscles
o5% have abnormal motor coordination
impaired finger, heel tapping
Hypothesis is that there is
something different about their
brain development that gives
them these special abilities
-or everyone have these abilities
and they are suppressed
-evidence points to us all having
these abilities (evidence from
elderly with dimension) **some
time attain these abilites
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