HLTB02_Lecture_11.docx

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Department
Health Studies
Course
HLTC23H3
Professor
R Song
Semester
Winter

Description
Lecture 11: Neurological Disorders: Autism April 2, 2012 Post-Traumatic Stress Disorder (Lecture 10)  3 main types of symptoms: 1. Re-experiencing the traumatic event 2. Avoiding reminders of the trauma 3. Increased anxiety and emotional arousal Children with Post-Traumatic Stress Disorder exhibit:  Fear of being separated from parent(s)  Losing previously-acquired skills (such as toilet training)  Sleep problems and nightmares without recognizable content  Somber, compulsive play in which themes or aspects of the trauma are repeated  New phobias and anxieties that seem unrelated to the trauma (such as a fear of monsters)  Acting out the trauma through play, stories, or drawings  Aches and pains with no apparent cause  Irritability and aggression Types of Autism  Asperger syndrome: like autism, but milder, with normal language development  Rett syndrome: very different from autism, and only occurs in females  Childhood disintegrative disorder: rare condition where a child learns skills, but loses them by age 10  Pervasive developmental disorder: not otherwise specified (PDD-NOS), also called atypical autism Major Brain Structures Implicated in Autism  Brain stem, cerebellum,, corpus Autism spectrum disorder (ASD)  A range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behaviour (National Institute of Neurological Disorders and Stroke Autistic disorder  Sometimes called autism or classical ASD, is the most severe form of ASD;  A developmental disorder that appears in the first 3 years of life (often recognize symptoms by 18 months),  Affects the brain's normal development of social and communication skills o First recognized and labeled in 1948 by Kanner  ASD varies significantly in character and severity  It occurs in all ethnic and socioeconomic groups and affects every age group  Experts estimate that 3 to 6 children out of every 1,000 will have ASD  Males are 4x more likely to have ASD than females  Genetic factors seem to be important, i.e., identical twins  Similarly, language abnormalities are more common in relatives of autistic children  Chromosomal abnormalities and other nervous system (neurological) problems are also more common in families with autism Children with autism typically have difficulties in:  Pretend play  Social interactions  Verbal and nonverbal communication Regressive Type of Autism  Some children with autism appear normal before age 1 or 2 and then suddenly "regress" and lose language or social skills they previously had Communication problems may include: Response to sensory information:  Cannot start or maintain a social conversation  Does not startle at loud noises  Communicates with gestures instead of words  Has heightened or low senses of sight, hearing, touch,  Develops language slowly or not at all smell, or taste  Does not adjust gaze to look at objects that others are  May find normal noises painful and hold hands over ears looking at  May withdraw from physical contact (is  Does not refer to self correctly (e.g., says "you want water" overstimulating/overwhelming) when the child means "I want water")  Rubs surfaces, mouths or licks objects  Does not point to direct others' attention to objects (occurs  Seems to have a heightened or low response to pain in the first 14 months of life)  Repeats words or memorized passages, such as Play: commercials  Doesn't imitate the actions of others  Uses nonsense rhyming  Prefers solitary or ritualistic play  Shows little pretend or imaginative play Social interaction:  Does not make friends Behaviours:  Does not play interactive games  "Acts up" with intense tantrums  Is withdrawn  Gets stuck on a single topic or task (perseveration)  May not respond to eye contact or smiles, or may avoid eye  Has a short attention span contact  Has very narrow interests  May treat others as if they are objects  Is overactive or very passive  Prefers to spend time alone, rather than with others  Shows aggression to others or self  Shows a lack of empathy  Shows a strong need for sameness  Uses repetitive body movements Major Approached to Defining and Treating Autism 1. Psychoanalytic model (rejection, poor parenting)  First came out after 1948  Put the blame on parents for the way their children were  Eventually the model was not used in the 80s and 90s 2. “Mainline” Biological - neurodevelopmental  Physiological change 3. “Alternative” Biological - biomedical Four tenets have characterized most approaches by researchers emphasizing “mainline” biological origins: 1. The cause of autism is fundamentally biological, not due to parental behaviour o Nature of the cause remains unknown, but a variety of studies has highlighted the importance of genetics. 2. Autism is conceptualized as a spectrum of disorders o In the 1970s, investigators modified Kanner's original (1948) diagnosis to encompass children with greater intellectual and language impairment and also expanded it to encompass higher-functioning kids with labels such as "pervasive developmental disorders" and "autistic spectrum disorders“ 3. If autism represents a spectrum disorder rooted in biology, its treatment must be largely rehabilitative, rather than curative 4. As with other developmental disorders, early referral and intervention offer the greatest hope for a positive outcome (screening, educational programs, support, etc.) “Alternative” biological perspective:  Viewed autism in biomedical terms o Rather than viewing autism as a continuum of disability, it characterized the condition as a heterogenous collection of discrete entities with different etiologies sharing a common presentation o Most importantly, this viewpoint offered hope that at least some forms of autism are not simply treatable, but curable  Most popular: those focusing on special diets, based on studies suggesting that an abnormality in intestinal permeability may admit intestinal toxins or opioids affecting the nervous system at an early age.  These theories recast autism as biomedical in origin and potentially curable in ways that reflect late 20th century hopes in the power of medical technology  Autism Research Institute in San Diego, CA Possible Causes  Mercury poisoning  Diet (allergies)  Body's inability to properly use vitamins and minerals  Digestive tract changes  Vaccine sensitivity Explaining Autism’s Rise… 1. Links to vaccines and other environmental toxins 2. Changes in definition, measurement, and identification of ASD o Its expanded diagnost
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