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Understanding the History and Evolution of Autism Diagnosis and Treatment

This lecture delves into the historical context of autism, tracing its diagnostic evolution from the early misconceptions that associated it with schizophrenia to modern understandings of its biological and genetic components. Key milestones will be discussed, including Dr. Leo Kanner's introduction of autism in 1943, the emergence of Asperger's syndrome, and the development of standardized diagnostic tests like ADOS and ADI in the 1990s. It also addresses the impact of misinformation, such as the vaccine-autism controversy, and highlights the diverse manifestations of autism spectrum disorder (ASD) in individuals today.

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Understanding the History and Evolution of Autism Diagnosis and Treatment

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Presentation Transcript

  1. Lecture 1 – Introduction to AutismIlan Dinstein

  2. In the past autism was often diagnosed as schizophrenia and individuals were placed in psychiatric asylums. 1943: Dr. Leo Kaner describes 11 cases of autism and promotes the “refrigerator mother” theory. 1944: Dr. Hans Asperger describes Asperger’s syndrome. 1964: First discussions of autism as a biological disorder 1977: First study showing that autism has a genetic component. 1980s: First structured therapy (Applied Behavioral Analysis). 1990s: ADOS and ADI standardized diagnostic tests are published. 2000s: Large scale biological research into autism begins. History of Autism

  3. 1998: Vaccine panic after an article claims a causal relationship between vaccines and the development of autism. 2000: Previously eliminated Rubella, Mumps, and Measles diseases resurface in Europe and the US. Several children die and others are left handicapped. 2010: The original article is retracted and the physician who authored it loses his medical license. History of Autism

  4. Language delay and dysfunction Social difficulties Repetitive behaviors and confined interests Autism – all three Asperger – no language delay PDD NOS – mild symptoms Current clinical definition – DSM IV TR

  5. Language delay and dysfunction Social and communication difficulties Repetitive behaviors and confined interests Sensory abnormalities Mild, moderate, and severe autism Asperger – no language delay PDD NOS – mild symptoms Future definitions? Upcoming definition – DSM V

  6. 25-70% have low IQ (<70). 20-30% have clinical epilepsy. Over 90% have sensory hypo and hyper sensitivities. Motor clumsiness, balance, and gait problems. Sleeping and digestive problems. Differences in memory and learning. Mood disorders Autism usually means a lot more…

  7. Extreme heterogeneity “If you’ve met one person with autism, you’ve met one person with autism”

  8. Example #1 – Rainman (min 18)Example #2 – CarlyExample #3 – Temple Grandin

  9. Eye contact Joint attention Abnormal affect Tantrums Lack of initiation No imitation Low responsiveness Obsession with order Difficulty with changes Avoid interactions Over-sensitivities Repetitiveness Tantrums Common symptoms

  10. ADOS “golden standard” behavioral tests Communication Social Stereotyped behaviors

  11. ADI “golden standard” behavioral tests Communication Social Stereotyped behaviors

  12. The number of children diagnosed with ASD has been rising steadily. Prevalence

  13. Developmental disorder Symptoms change throughout life

  14. Behavioral therapies Applied behavioral analysis (ABA) Floortime by Greenspan Actual therapy

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