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AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS LECTURE OUTLINE History and background Diagnostic features Other pervasive developmental disorders Etiology Treatment. AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS History and background Originally called Kanner’s (1943) syndrome
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AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • LECTURE OUTLINE • History and background • Diagnostic features • Other pervasive developmental disorders • Etiology • Treatment
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • History and background • Originally called Kanner’s (1943) syndrome • Very low prevalence rates – Szatmari & Mahoney (1993) estimate < .1% in Canada • But highly dysfunctional and disabling condition • More common in boys than girls (4:1)
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • Diagnostic features • Social development • extreme autistic aloneness, avoid eye contact, lack of social interaction • non-responsive to social envirnoment, more interested in mechanical objects • odd behaviours – rhythmic rocking, preservation of sameness, non-compliance
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • Diagnostic features • Language acquisition • 50% mute • lack of meaningful communication • echolailia • pronoun reversal
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • Diagnostic features • Attention, perception, cognition • stimulus overselectivity • low IQ • savants • lack of independent functioning
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • Related disorders • Asperger disorder • Rett syndrome • Child disintegrative disorder
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • Etiology • Psychogenic – Bruno Bettelheim (1967), The empty fortress – “refrigerator mother” • Biological • neurobiological factors – high rates of seizures, prenatal infections and birth complications • brain impairment – several areas implicated, not just a single area
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • Etiology • genetics – Folstein & Rutter twin study (1978) – for cognitive impairment, 36% concordance rate for DZ twins, 82% concordance rate for MZ twins; for autism, 0% concordance rate for DZ twins, 36% concordance rate for MZ twins
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • Treatment • biomedical • psychodynamic • intensive behavioural treatment
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • Treatment – Lovaas program • original work in the 1960s at UCLA with children who had been institutionalized • used shaping, positive reinforcement, and punishment • many gains in social and language skills • but once returned to hospital, children regressed
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • Treatment – Lovaas program • 1979-84 – work with very young autistic children; treatment more intensive for longer periods of time; parent training component • More enduring positive outcomes than in original study
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • Treatment – Lovaas program • 3 groups • Intensive treatment (n=19) - > 40 hours per week of 1:1 treatment • Minimal treatment (n=19) - < 10 hours per week of 1:1 treatment • Control group (n=21) – referred to other services available to autistic children in the community
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • Limitations of Lovaas research • small sample sizes • no external evaluations, need for replication (these are in progress) • variability in response to treatment
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • SUMMARY • Autism is a very rare, but a very disabling disorder of childhood • Biological factors are involved, but no one single factor appears to be the causal agent
AUTISM AND PERVASIVE DEVELOPMENTAL DISORDERS • SUMMARY • In spite of biological basis, there are encouraging findings from studies of intensive behavioural intervention for children with this disorder • Unfortunately, these treatments are not widely available