Broadly speaking, what is ASD?
A neurodevelopmental disorder characterized by social communication struggles as well as restrictive and repetitive behavior
Prior to the DSM 5, ASD was classified into 5 different disorders under the terms “pervasive developmental disorders”.
List them from least to most severe
- Asperger’s disorder
- Pervasive developmental disorder
- Autistic Disorder
- Rett’s syndrome (almost only females)
- Childhood disintegrative disorder
What are the 4 categories of etiological factors for ASD?
- Genetics
- Pre/perinatal complications
- Epigenetics
- Neurobiology
Outline the etiological factors for ASD from a genetic point of view
- combination of genes likely responsible (no single gene)
- strong genetic variability; 96% and 27% concordance in identical and fraternal twins respectively
Outline the etiological risk factors for ASD that arise from pre- and perinatal complications
Prenatal:
- ma/paternal general health (diabetes, BMI/hypertension in mothers)
- older parents (>30 years)
Perinatal:
- in-utero expose to substances (pollutants, drugs, meds)
- premature birth
- low birth weight
- birthing trauma
- poor APGAP scores
What are epigentics?
- changes in genes/gene expression w/out changes in DNA sequence
- enviro can change way genes are expressed
Outline the etiological factors for ASD from an epigenetics point of view
- EPGs significantly influence expression of ASD
- the gene/environment interaction may account for variations in severity and uniqueness of ASD in different individuals
How could improvements in the understanding of epigenetics improve ASD outcomes
identification of accessible ASB epigenetic biomarkers
- ENABLES TOOLS TO LOWER…
child age at first ASD diagnosis
- THEREBY DECREASING
age at start of behavioral interventions (and this severity of adult ASD)
Outline the etiological risk factors for ASD from a neurobiological point of view
Fewer neurons in amygdala (emotion and fear - influences stress hormone cortisol)
- soc/behav difficulties may stem from heightened fear/anx
Less Oxytocin (social communication, trust fear reduction)
Facial exp processing:
ASD indis focus on mouth region and individuals facial features, controls focus on eyes and whole face scans
What are the three most prominent diagnostic criteria for ASD?
A. Continuous impairments in social communication and interaction
B. Restricted, repetitive patters of behavior/interest/activity
C. Symptoms must occur during early development
What are the levels of severity in ASD?
Level 1: Requiring support
- w/out support, soc deficits and inflexible behavior cause significant impairments
Level 2: Requiring substantial support
- even w support, soc defs and inflexi behavior noticeable to observers
Level 3: Requiring very substantial support
- sever defs in soc comm and inflexi behav
- may produce few intelligible words
- only social initiation if to communicate basic needs
What are the three treatment routes for ASD
- Pharmacological
- Psychological
- Alternative
Outline pharmacological treatment for ASD
Antipsychotics
- manage irritability/aggression
- can cause weight gain/nausea
Antidepressants
- considered helpful with repetitive and restrictive behavior, but this is disputed
Outline psychosocial treatments for ASD
early intervention skills training
behavioral and cognitive therapies (aggression/irr/dep)
- best used in combo with meds
parental psychoeducation
What are some of the alternative treatments for ASD?
yoga (regulate)
animal assisted therapy (comm/soc engagement)
music therapy (anx/dep)
*best used in plan that incorporates traditional methods
Males are 4 time more likely to be diagnosed with ASD than females. Why might this be?
Different exhibition in females
- bias DCs
- better at masking than males
- restrictive interests less odd
- internalized symptoms
Female protective effect
- have bio/gen resilience to ASD, need higher gene/enviro load to develop ASD
Evolution (primary care giver, develop resilience to conditions that hinder roles
Link between ASD and GD?
Indis with ASD more likely to have gender dysphoria, often reporting non-binary/fluid experience
Due to social/cognitive differences associated w autism?
What are some considerations surrounding the SA context when it comes to ASD?
- standard lack of MHC workers for recognition/diagnosis
- missed diagnoses due to poor MHC and western normed scales
- ASD individuals aren’t accommodated for in mainstream schools, and special needs schools are overcrowded
- no gov supplies therapy/special education programs to develop skills
- stigma and misunderstanding of disorder abounds
What are three controversies centered around ASD?
- Vaccines as causes
- Applied behavioral analysis (ABA) for treatment: just encourages masking and conformity (can be rigid and restrictive)
- Perceptions of ASD indis as either severely disabled or with exceptional abilities
