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Chapter 10

Psychology 2320A/B Chapter Notes - Chapter 10: Stuffed Toy, Chromosome Abnormality, Antipsychotic


Department
Psychology
Course Code
PSYCH 2320A/B
Professor
Elizabeth Hayden
Chapter
10

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Chapter 10: Autism Spectrum Disorders and Childhood-Onset Schizophrenia
Autism Spectrum Disorders (ASD)
Autism/Autism spectrum disorder (ASD) complex neurodevelopmental disorder characterized by
abnormalities in social behaviour, language and communication skills, and unusual behaviours and interests
Description and history:
o ASD refers to three DSM-IV-TR pervasive developmental disorders (PDDs) all characterized by
significant impairments in social/communication skills and by stereotyped patterns of interests and
behaviours:
Autistic disorder
Asperger’s disorder
Pervasive developmental disorder, not otherwise specified (PDD-NOS)
o Historically, autism and childhood-onset schizophrenia (COS) were thought of as a single condition; now
recognized as separate disorders, recent research suggests that there may be more overlap between
two disorders
DSM-IV-TR: Defining Features of Autism
Diagnostic criteria for autistic disorder:
o Qualitative impairment in social interaction
o Qualitative impairments in communication
o Restricted repetitive and stereotyped patterns of behaviour, interests, and activities
In addition to core symptoms, autistic disorder must also show delays/abnormal functioning in social
interaction, in language, or in imaginative play prior to age 3
Autism is defined as a spectrum disorder, because its symptoms, abilities, and characteristics are expressed in
many different combinations and in any degree of severity
Children with ASD not only vary in their social abilities, language, and behaviour, but may also display features
not common to ASD most commonly, intellectual disability and epilepsy
Three critical factors contribute to the differences in children with ASD:
o Level of intellectual ability
o Severity of language problems
o Behaviour changes with age
Core Deficits of ASD
Social impairments
o Profound difficulties in relating to other people
o Deficits in many skills crucial for social development lack of monitoring of the social activities of
others, lack of social/emotional reciprocity, unusual nonverbal, lack of social interaction, lack of interest
and/or difficulty relating to others, and a failure to share enjoyment/interests with others
o Social expressiveness/sensitivity to social cues are limited, recognition of complex emotions and mental
states is impaired and little sharing of experiences or emotions takes place
o Have great difficulty integrating social, communicative, and emotional behaviours required to greet a
familiar person
o Display atypical processing of faces/facial expressions
o Display impairments in joint attention ability to coordinate attention to a social partner and an object
or event of mutual interest
Joint attention involves making a social connection with another person by directing that
person’s attention to objects or people by pointing, showing, and looking, and by
communicating shared interest
Children with ASD show little desire to share interest/attention with another person for the
sheer pleasure of interaction
o Deficit seems to be in their ability to understand and respond to social information
o Own bodily expressions of emotion are often characterized by limited spontaneous use of expressive
gestures, and bizarre, rigid, or mechanical facial expressions
Communication impairments

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o Display serious abnormalities in communication and language that appear early in their development
and persist
o Atypical early vocalizations are a sensitive indicator of heightened risk for ASD symptoms in infant with
family history
o One of the first signs of language impairment is the inconsistent use of early preverbal communications
Example: child with ASD may point to a stuffed animal she wants that is out of reach
Demonstrating protoimperative gestures gestures/vocalization used to express needs
however, child fails to use protodeclarative gestures gestures/vocalizations that
direct visual attention of other people to objects of shared interest
o Primary purpose of protodeclarative gestures is to engage other people in interaction
Requires social attention and implicit understanding of what other people are thinking these
abilities are lacking in children with ASD
o As many as half of all children with ASD do not develop useful language rely on primitive forms of
communication
Children with autism use instrumental gestures to get someone to do something for them, but
fail to use expressive gestures to convey feelings
o Children with ASD who develop language usually do so before age 5
Rhythm and intonation of their speech is often unusual
Lack of social chatter failure to use language for social communication
Communication is described as nonsensical, silly, incoherent, and irrelevant
Pronoun reversals occur when the child repeats personal pronouns exactly as heard, without
changing them to suit the situation
Echolalia parrot-like repetition of words or word combinations that she/he has heard, can be
either immediate or delayed
o Primary problem is children with ASD display profound impairments in pragmatics appropriate use of
language in social and communicative contexts
Restricted and repetitive behaviours and interests
o Behaviours are characterized by high frequency, repetition in a fixed manner, and desire for sameness in
the environment
o Self-stimulatory behaviors stereotyped as well as repetitive body movements or movements of
objects
Associated Characteristics of ASD
Intellectual deficits and strengths
o About 70% of children with autism have co-occurring intellectual impairment
o Approx. 40% have severe to profound impairments with IQs less than 50, and 30% have mild to
moderate impairments with IQs between 50 and 70
o Remaining 30% have average intelligence or above
o Intelligence assessed using WISC-IV
Relatively low score on verbal subtests such as comprehension
Relatively high scores on nonverbal subtests involving short-term memory or specific patterns
o Low intellectual ability associated with more severe symptoms and poorer long-term outcomes
o Despite intellectual deficits, small but significant number of children with ASD develop splinter skills, or
islets of ability special talents may be in spelling, reading math, music or drawing
As many as 25% display special cognitive skill that is above average for general population
Special abilities of a few children with ASD has been viewed as a side effect of abnormal brain
functioning, rather than a reflection of genuine intelligence
Sensory and perceptual impairments
o 90% or more have problems in two or three sensory domains that continue well into adulthood
o Includes oversensitivities or undersensitivities to certain stimuli, overselective and impaired shifting of
attention to sensory input, and impairments in mixing across sensory modalities
o May display sensory-perceptual deficits such as:
Sensory dominance tendency to focus on certain types of sensory input over others
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Stimulus overselectivity tendency to focus on one feature of an object or event in the
environment while ignoring other important features
Cognitive and motivational deficits
o Two types of cognitive limitations proposed to underlie ASD are:
Specific cognitive deficits in processing social-emotional information
More general cognitive deficits in information processing, planning and attention
o Deficits in processing social-emotional information
Mentalization (also known as theory of mind, ToM) awareness of other people’s and one’s
own mental states
ToM hypothesis of ASD begins with the premise that the ability to read intentions,
beliefs, feelings and desire of others from their external behaviour has adaptive
significance in human evolution
Primary problems of individuals with ASD stem from a deficit in their ToM mechanism
o General deficits
Display a general deficit in higher-order planning and regulatory behaviours
These processes, called executive functions, permit us to maintain effective problem
solving by inhibiting inappropriate behaviours, engaging in thoughtful actions, sustaining
task performance and self-monitoring, using feedback and flexibility shifting from one
task to another
Presence of general deficit in executive functioning is suggested by difficulties in
cognitive functions
Another general cognitive deficit is weak drive for central coherence refers to strong tendency
of humans to interpret stimuli in relatively global way that takes broader context into account
Those with ASD tend to process information in bits and pieces rather than looking at the
big picture
Mental conditions and physical characteristics
o Small percentage have coexisting medical condition that may play causal role in their disorder
Include motor and sensory impairments, seizures, immunological and metabolic abnormalities,
sleep problems and gastrointestinal symptoms
o About 25% or more experience seizures
o Sleep disturbances are common, occurring in about 65% of children with ASD
o Children with ASD are usually described as having a normal or attractive physical appearance, and they
do not display visible physical deviations
o As many as 90% have a head size that is above average
More common in higher-functioning individuals and distinguishes them from individuals with
intellectual disability, language disorder and ADHD
Accompanying disorders and symptoms
o Two disorders that most often accompany ASD are intellectual disability and epilepsy
o Additional behavioural/psychiatric symptoms may include ADHD and conduct problems
o Some also engage in extreme and sometimes life-threatening self-injurious behaviour (SIB)
May occur for several reasons self-stimulation, to gain attention, or to eliminate unwanted
demands, or it may occur for no apparent reason
Rates are 7 times greater than for typically developing children
Prevalence and Course of ASD
Prevalence rate of 1% (100 per 10,000) for all forms of ASD
Found in social classes and identified worldwide
3-4 times more common in boys than in girls
o Sex difference is most apparent among children with IQs in the average or above range, as high as 10:1
in higher-functioning individuals
o Among children with ASD and profound intellectual disability, numbers of boys and girls are similar
o Although girls are less affected by ASD, when they are, they tend to have more severe intellectual
impairments
Simon Baron-Cohen (2002) extreme male brain theory of ASD
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