1 / 39

AUTISM

AUTISM. By: Pauline Narciso Philip Lai Henry Kang. Overview. Pauline General Survey of Autism Neural/Chemical Correlates Philip Comparison of Consciousness Henry Treatments. General Notes. Autism as a Syndrome: multiple disease entities Autism is a developmental syndrome:

adamma
Télécharger la présentation

AUTISM

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. AUTISM By: Pauline Narciso Philip Lai Henry Kang

  2. Overview • Pauline • General Survey of Autism • Neural/Chemical Correlates • Philip • Comparison of Consciousness • Henry • Treatments

  3. General Notes • Autism as a Syndrome: multiple disease entities • Autism is a developmental syndrome: • Common deficit: theory of mind

  4. Bit of History • 1943- Kanner • “extreme aloneness from the beginning of life and anxiously obsessive desire for the preservation of sameness.” • Initial cause: Bad parents

  5. Diagnostic Criteria • Severe abnormality of reciprocal social relatedness • Severe abnormality of communication development • Restricted, repetitive behavior, patterns of behavior, interests, imagination • Early onset (before 3-5 years)

  6. Other observed behaviors • Lack of awareness of feelings of others • Bizarre speech patterns • Lack of spontaneous and make-believe play • Preoccupation with parts of objects • Repetitive motor movements • Marked distress over changes

  7. Begins when… • 80% of cases began as “Infantile Autism”

  8. Screening Model for Infantile Autism • Is child’s eye-to-eye contact normal? • Is he/she comforted by proximity/body contact? • Does he/she often smile or laugh unexpectedly? • Does he/she prefer to be left alone?

  9. Systematic Feature Examination • Hand stereotypies (strange looking or posturing) • Stiff gaze, avoidance of • Little reaction to strong, unexpected noise • Passive, obvious lack of interest

  10. Disease Entities within Autism • IABD • Zapella Dysmaturational subgroup • Purine Autism • Asperger’s and Autistic Savants • All share common Autistic behaviors

  11. Infantile Autistic Bipolar Disorder • Regression after initial normal development • Meets classical criteria for Autism • Autistic symptoms have a cyclical pattern • Positive family history of BD or Depression • Different from Autistic who later has onset of BD

  12. Zapella Dysmaturational subgroup • Loss of language after initial normal dev • Meets classical criteria • Complex tics present • Normal neurological exam, normal lab exams • Rapid improvement following therapy • Reach quasi-normal abilities by age 5-6 • After age 6, usually fall into other psycho-pathological category, ADHD

  13. Purine Autism • Classical criteria met • Too high/too low levels of uric acid • Constipation • Gout in family members • Seizures and self-injury in majority • “Purine”:abnormal levels of end product (uric acid) of all purine pathways

  14. Quote on Purine Autistic • “the boy was an irritable baby who resisted any change in routine and never looked at people around him. By 2 years of age, the few words he had were rapidly disappearing. He lined up his toys in long straight lines instead of playing with them. He developed pica, teeth-grinding, compulsive biting to the point of bleeding.”

  15. On the functioning end.. • Asperger’s: meet criteria, but have normal IQ functioning • Autistic Savants: special skills in memory, music, math, calendar calc, drawing, and hyperalexia reading.

  16. Unfavorable pre, peri, post-natal factors Cellular and structural changes in Limbic System (amygdala, cerebellum, and hippocampus) L-hemi neural substrates fail to develop (loss lang., consciousness, motor planning Locus Coerulus:Mediates input from senses-underdeveloped Low mercury levels Theories on contributing factors

  17. Who’s affected? • 1% of general public under the Autism Spectrum • Most often tend to be males

  18. Altered States Compared to Normal • Resistance to change, Insist on sameness • Strong attachments to objects; Spins objects • Difficulty in mixing with others • Throw Temper Tantrums • Tend not to want to cuddle or be cuddled • Over-sensitivity or under-sensitivity to pain • No fears of danger

  19. Sensory Processing • Painfully sensitive to certain sounds, textures, tastes, and smells. • Either too sensitive or less sensitive than normal. Some autistic have difficulty interpreting sensory information. • Like normal these experiences are not hallucinations but based on real experiences. • Some avoid being touched, a gentle touch for most, will hurt or shock autistics. • Some are insensitive to pain, and fail to notice injuries.

  20. Emotions • Take major emergencies in stride but become upset over minor disruption. • Unemotional, but can be very emotional when things are important to them. • More candid and expressive with their emotions than normal people. • Small amount will have difficulty regulating their emotions. Individual will have verbal outburst, usually in strange or overwhelming environment.

  21. Communications • Problem with semantic-pragmatic component, take a statement or question in a literal way. Ex.) "I'd like coffee with my cereal“ • Repeating things that have been heard (echolalia) • Inability to understand body language, tone of voice • Some autistics are mute

  22. Communication Cont. • Difficult in sustaining a conversation. No normal "give and take" in a conversation • Autistics tend to go on with their favorite subjects and do not give the other person a chance to talk. • People with autism might stand too close to the other person. • Body language, facial expressions, and gestures do not match what they are saying.

  23. Attention • Trouble handling multiple stimuli of attention. • Very narrow focused attention, can not keep up with more than one thing at a time. • Shifting attention is a slow process, usually involves pauses or moments of delay.

  24. Productivity • Great deal of variety among autistics. • Some autistic may never learn to talk and be dependent throughout their lives. • Others may do well in special supportive settings, working in a sheltered environment. • There are autistics that are fully independent and function fairly well.

  25. Theory of Mind • TOM is absent in autistics, can not attribute mental states. • Autistic can not reflect on their own mental states. • Cause abnormalities in social interactions, communications, and imagination. • Understanding mental states of others can allows individuals to make sense of past behavior, allows influence on present behavior and permits prediction of future behavior. • Normal 3 year olds no TOM, but 4 year olds tend to have a TOM.

  26. Mirror Neurons • Tested controls and autistics on 4 different tasks. • Researchers compared mu rhythms. At baseline, mu rhythms will fire in synchrony, large amplitude mu oscillations. • Normal when seeing an action perform will cause mu rhythms to fire asynchronously, therefore resulting in mu suppression.

  27. Mirror Neurons Cont. • So mu wave suppression will reflect activity of the mirror neuron system. • In autistics, there was mu suppression in their own hand movements, but no mu suppression to the observed hand movements.

  28. Autism Treatment • Behavioral modification and communication approaches • Dietary and biomedical approaches • Complementary approaches

  29. Behavioral & Communication • Applied Behavior Analysis • Rewarded behavior • TEACCH • Understand the world • PECS • Picture exchange • Social Stories • Theory of Mind • Sensory Integration

  30. Biomedical Treatments • Medications • Serotonin Re-uptake Inhibitors • Anti-Psychotic Medications • Risperidone • Vitamins and Minerals • Dietary Interventions

  31. Risperidone • Two double-blind, placebo-controlled responses of risperidone • Adults and Children • Serotonin-Dopamine antagonist • Effective as a short-term treatment • Tantrums, Aggression, Self-Injurious Behavior • Interfering repetitive behavior, self-injurious behavior, sensory motor behaviors, affectual reactions, overall behavioral symptoms

  32. Risperidone Cont. • Figure 1: Mean Scores for Irritability

  33. Risperidone Cont. • Figure 2: Change in Severity of Overall Symptoms

  34. Vitamins & Minerals • Vitamin B • Most common vitamin supplement • Vitamins A and D • Eye contact and behavior • Vitamin C • Improve symptom severity

  35. Dietary Interventions • Gluten • Disruption in biochemical and neuroregulatory processes • Yeast • Behavioral and medical problems

  36. Complementary Approaches • Improving Communication Skills • Music Therapy • Speech Development • Art Therapy • Non-verbal, Symbolic Expression • Animal Therapy • Physical and Emotional Benefits

  37. Conclusion • Autism is a spectrum • Autistics lack an essential element of consciousness-Theory of Mind

  38. References • Autism Society of America. <http:// www.autism-society.org>. • Bauman, Margaret L. and Kemper, Thomas L., eds. The Neurobiology of Autism. Baltimore: John Hopkins UP, 1994. • Centers for Disease Control. <http://www.cdc.gov>. • Coates, Sheila and Richer, John, eds. Autism The Search for Coherence. Philadelphia: Jessica Kingsley Publishers, 2001. • Gabriels, Robin L. and Hill, Dina E., eds. Autism-From Research to Individualized Practice. Philadelphia: Jessica Kingsley Publishers, 2002. • Gilberg, Christopher. Diagnosis and Treatment of Autism. New York: Plenum Press, 1989. • Gilberg,Christopher and Coleman, Mary. The Biology of the Autistic Syndromes. London: MacKeith Press, 2000. • Happe, F. “Theory of Mind and Self.” Ann. N.Y. Acad. Sci 1001 (2003): 134- 144. • Harris, J.C. “Social neuroscience, empathy, brain integration, and neurodevelopmental disorders.” Physiology & Behavior 79 (2003): 525-532. • McCraken, James T. et al. “Risperidone in Children With Autism and Serious Behavioral Problems.” The New England Journal of Medicine 347 (2002): 314-321.

  39. References Cont. • McDougle, Christopher J., et al. “A Double-blind, Placebo-Controlled Study of Risperidone in Adults With Autistic Disorder and Other Pervasive Developmental Disorders.” Arch Gen Psychiatry 55 (1998): 633-641. • McQueen, JM and Heck, AM. “Secretin for the treatment of Autism.” Ann Pharmacother. 36 (2002): 1294-1295. • Millward, C., et al. “Gluten- and casein-free diets for autistic spectrum disorder.” Cochrane Database Syst Rev. 2 (2004): CD003498. • Pineda, Jamie. Home page. <http://www.bci.ucsd.edu/~pineda/CNL_WEBPAGE/index.html>. • Pfeiffer, SI, et al. “Efficacy of vitamin B6and magnesium in the treatment of autism: a methodology review and summary of outcomes.” J Autism Dev Disord 28 (1998): 580-581. • Schopler, Eric and Mesibav, Gary. High-Functioning Individuals With Autism. New York: Plenum Press, 1992. • Sterling, Lisa. Home page. 2002 <http://darkwing.uoregon.edu/~sterling>. • Strock, Margaret (2004). Autism Spectrum Disorders (Pervasive Developmental Disorders). NIH Publication No. NIH-04-5511, National Institute of Mental Health, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, 40 pp. <http://www.nimh.nih.gov/publicat/autism.cfm>.

More Related