Psychology 2042A/B Chapter Notes - Chapter 12: Pervasive Developmental Disorder, Autism, Leo Kanner

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Psych 2042A
Chapter 12: Pervasive Developmental Disorders and Schizophrenia
the disorders that are about to be discussed have pervasive problems in emotional,
social, and cognitive functioning, which have a basis of neurobiological abnormality
pervasive developmental disorders (PDD) and schizophrenia are considered
independent from each other but they share a rich history
A Bit of History
these disorders, PDD and schizophrenia were associated with adult psychoses -
disruptive disturbances implying abnormal perceptions of reality
psychotic disturbances were noted by Kraeplin in the 20th century
Bleuler applied the term schizophrenias to these psychotic disturbances in reality,
which involve hearing voices and seeing images that do not exist
some described children with early onset schizophrenia, and other pointed to
syndromes that appeared similar, but not identical, to schizophrenia
some diagnostic terms such as “disintegrative psychoses” and “childhood psychoses”
were used
in 1930 and onwards, childhood schizophrenia served as a general label, while
numerous subcategories were employed
1943 - Leo Kanner: described it as early infantile autism arguing that it was different
from other cases of severe disturbances - which had later onsets
1944 - Hans Asperger - described a group of children whose symptoms overlapped
with Kannerʼs cases
today, autism and Asperger syndrome are viewed as similar disorders
large number of cases appearing before age 3, remarkably low prevalence in
childhood, and increased prevalence in adolescence
a distinction was made between schizophrenia and a group of related disorders -
referred to as PDD today
Schizophrenia is a psychotic disturbance that affects a small number of children, rises
in frequency in adolescence, and increases still more in early adulthood
Pervasive developmental disorders are early-occurring, nonpsychotic disturbances
that are qualitatively deviant from a personʼs developmental level - DSM includes 5
disorders under PDD
Autistic Disorder (autism)
Aspergerʼs Disorder
Rettʼs Disorder
Childhood Disintegrative Disorder
Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)
3 of the PDDs (Autistic Disorder, Aspergerʼs disorder and PDD-NOS) are believe to fall
into a continuum of autism
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Autistic Disorder
DSM Classification and Diagnosis
Kannerʼs early description: communication deficits, good but atypical cognitive
potential, and behavioural problems such as obsessiveness, repititious actions,
and unimaginative play
fundamental disturbance was the inability to relate to people and situations from
the beginning of life
parents describe their children with Autistic Disorder as “self-sufficient”, “like in a
shell”, “happiest when left alone”, and “acting as if people werenʼt there”
Table 12-1 (p.328) shows the symptoms of Autistic Disorder
primary symptoms include impaired social interaction, disturbed communication,
and the presence of restrictive and repetitive behaviours and interests
referred to as triad of impairments - DSM requires 6 symptoms, with all 3
features present
Description: Autismʼs Triad of Impairments
Social Interaction
this can begin very early - even before 1yr, some of the infants are less likely
that others to be visually responsive, less likely to respond to their names, and
more likely to show aversion to being touched by another person
older infants avoid eye contact, fail to respond to others with emotional
expression and positive affect, and show little interest in being held
some exhibit an empty ʻgazeʼ
deficits in joint attention interactions, which in typical youngsters begin right
after 6 months - these interactions include pointing and eye contact
children with autism also imitate the actions of others less than typical youth
lack of attachment to parents - secure attachment evident in the Strange
Situation - all types of attachment have been noted in autistic children
abnormal processing of stimuli is also evident - typical infants are attracted to
the human face and rapidly recognize the face of their mothers
children with autism show impairment in recognizing faces, matching
emotional faces, and memorizing faces
they also process faces in a typical way - ie. autistic children focus on mouth
rather than eyes where typical children do
autistic children do NOT have difficulty processing photos of faces that
appear upside down, whereas typical children do have difficulty
lack of understanding social cues and inappropriate social actions are also
disturbed communication - both verbal and nonverbal- is an aspect of autism
30% of children with autism never develop spoken language
in those who do acquire language with autism, it is often delayed and abnormal
babbling and verbalization may be abnormal in pitch, tone, rhythm
echolalia and pronoun reversal are commonly observed
echolalia - person echoes back what another has said - also observed in
schizophrenia, blindness, and other language disorders
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pronoun reversal - the child with autism may refer to others as I or me, and
to the self as he, she, them, or you
difficulties in syntax, vocabulary, comprehension, and other forms of language
most notable is the deficit in pragmatics, the social use of language
conversations can be characterized with irrelevant details, inappropriate shifts
in topic or disregard of the normal give-and-take of conversation - or there may
be an overall failure to develop conversation
some exhibit hyperlexia - a little-understood feature in which single-word
reading is extraordinary but comprehension of what is read is problematic
Restricted, Repetitive, Stereotyped Behaviour and Interests
atypical and often off behaviours, interests, and activities that are described as
restricted, repetitive, and stereotyped
encompass repetitive motor behaviours, obsession with parts of objects,
preoccupation with restricted interests, and inflexible adherence to routines or
repetitive, stereotyped motor behaviours include rocking; walking on the toes;
whirling; and arm,hand, or finger flapping - occur in autism more severely than
other pervasive developmental disorders
more common in younger children with autism and those with lower
repetitive, obsessive activities and interests - include unusual preoccupations
with aspects of the environment
children may be obsessed with numbers of some object, may compulsively
collect articles or be overly absorbed in hobbies
may adopt motor routines, such as rearranging objects, and insist on
following rituals for eating and going to bed
minor changes in the environment such as rearrangement of furniture or
schedules, can cause them to be very upset
obsessive behaviours may be more common in older children with autism
Description: Autismʼs Associated Impairments
not necessary for the diagnosis of autism, but are usually associated with it
Sensory/perceptual impairments
sensory organs are intact but abnormal responses to stimuli
some appear over sensitive to stimulation
sensory input may be disliked, feared or avoided
undersensitivity may be a more common problem - fail to respond to stimuli
ie. a child may seem unaware of a loud noise but fascinated by the quiet
ticking of a watch - some parents think their child is deaf
Overselectivity - may seem ʻstuckʼ on a particular stimulus while ignoring
competing stimuli, which may implicate attentional processes
Intellectual Performance
70-75% of autism cases show mental retardation (IQ of 70 or below)
there are some who have above average and exceptional intelligence
higher IQ is associated with less severe autistic symptoms, different
educational needs, and greater chance of normal functioning in later life
deficits in abstract and conceptual thinking, language, and social understanding
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