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Autism Spectrum Disorder - Coggle Diagram
Autism Spectrum Disorder
Early Signs of Autism
Development Milestones Indications
By 12 months
No back-and-forth gestures (Pointing, Showing, Reaching).
Not answering to their name when called.
No babbling
By 7 months
No big smiles or other warm, joyful expressions.
No back-and-forth sharing of sounds smiles or other facial expressions.
By 18 months
No first words
No simple pretend play
By 24 months
No two-word meaningful phrases
Lack of interest with other children
Any loss of speech, babbling or social skills = Signs of regression, cause for immediate referral.
Signs of Autism
Inappropriate playing with toys
Inability to relate to others
Hyperactivity or Passiveness
Inappropriate laughing or crying
Poor speech or lack of speech
Oversensitive or undersensitive to sound
Strange attachment to objects
Lack of awareness of danger
Difficulty dealing with changes to routine
Epidemiology of Autism
~
Prevalence in Malaysia: 1.6/1000
Prevalence in USA: 1% of population.
symptoms typically recognized during 12-24 months old
Early developmental delays.
Lack of social interaction in the first year.
Comorbidity: 1) Intellectual impairment, 2) ADHD, 3)Structural language disorder, 4) Specific learning difficulties, 5) Anxiety disorders, 6) Depressive disorders, 7) Medical conditions e.g. Epilepsy, Sleep problems & Constipation.
Etiology of ASD (Gene): 1. Heritability estimates of around 0.80, 2) Monozygotic twins 47~90% concordance rate; Dizygotic 0-20%. 3) Deletion on chromosome 16.
Etiology of ASD (Neurobiological): 1) Brain size larger than normal when grown up. 2) "Overgrown" areas include the frontal, temporal, and cerebellar (language, social, emotional).
Etiology of Autism
Genetic factors
Twin studies
47 to 90% concordance rates for Monozygotic twins (identical twins)
0-20% for Dizygotic (fraternal twins)
Heritability estimates around 8.0
Genetic flaw
Missing chromosome 16
Neurobiological factors
Though the brain size normal size at birth, brains of autistic adults and children and larger than normal
Pruning of neurons may not be occurring
“Overgrown” areas like frontal, temporal and cerebellar which are linked to language, social and emotional functions
Abnormally sized amygdala predicted more difficulties in social behaviour and communication
Treatment
Function behaviour analysis,
Understand triggers of challenging behaviors
Coach appropriate coping behaviors
Goal,
Reduce ritualistic & aggressive behavior
Enhance communication, cognitive, & self-care
Applied behaviour analysis,
Discrete trial training
Naturalistic approach / Incidental training
Functional behaviour analysis,
Understand triggers of challenging behaviors
Coach appropriate coping behaviors
DSM-5 Criteria
A. Persistent deficits in social communication and social interaction across multiple contexts
Deficits in social-emotional reciprocity,
Deficits in nonverbal communicative behaviors used for social interaction, ranging
Deficits in developing, maintaining, and understanding relationships,
B. Restricted, repetitive patterns of behavior, interests, or activities
Stereotyped or repetitive motor movements, use of objects, or speech
Insistence on sameness,
Highly restricted, fixated interests that are abnormal in intensity or focus
Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment
Severity Levels
Level 1
Have difficulty understanding nonverbal cues, such as facial expressions or body language, and may struggle with sarcasm or humor
Level 2
•Require substantial support to function in daily life.
•They may have difficulty initiating or maintaining social interactions, and may struggle with verbal and nonverbal communication.
•Able to construct simple sentences
Level 3
•Require very substantial support to function in daily life.
•They may have little or no verbal communication, and may rely on nonverbal communication, such as gestures or pointing.