Autism Spectrum Conditions (eBook)

Table of Contents 6
Preface 10
Section 1: Characteristics, Identification, and Diagnosis 12
Section 2: Diagnosing Autism 48
Section 3: Frequency 70
Section 4: Development and Outcome 78
Section 5: Causes and Risk 104
Section 6: Treatment of ASC 152
Section 7: Specific Treatment Approaches in ASC 182
Section 8: Pharmacological Treatments of ASC 212
Section 9: School, Education, Employment, and Independent Living 234
Section 10: Legal Issues, Organizations, and Resources 260
Appendix 282

Difficulties in social communication are then an essential part of ASC. Such problems can be broken down into different subdomains, including social reciprocity, eye contact, smiling in response to another, directing attention, greeting, empathy, and offering and asking for comfort. Imitation, peer relationships, and social initiative with peers and adults are other key aspects of social interaction (Anderson, Oti, Lord, & Welch, 2009). Communication problems are seen in virtually all children with ASC (Fodstad, Matson, Hess, & Neal, 2009). These might include reduced babbling, speech delay (either of phrases or single words), and unusual speech patterns, such as echolalia, pronoun reversal, and making up words. There are significant difficulties in the pragmatics of communication, such as poor conversation skills, unusual inflection, and little expression of emotion in speech. In addition to these verbal communication difficulties, almost all children with ASD have nonverbal communication difficulties: They do not use gestures, will not point at objects close by or far away, and won’t nod or shake their head.

There are, finally, many examples of repetitive stereotyped behaviors (Szatmari et al., 2006; Lam, Bodfish, & Piven, 2008; Richler, Huerta, Bishop, & Lord, 2010). These include preoccupations with parts of objects (e.g., playing with a toy but not in the way in which it was meant to be played). Fascinations with concrete sensory experiences, such as smell, sight, touch, and taste, are also common. Older children with ASC often have extremely intense, circumscribed interests, such as specific cartoons and shows on TV such as the Weather Channel, and unusual hobbies and interests, such as listening to thunderstorms or reading science fiction. Repetitive motor movements, such as flicking one’s fingers in front of the eyes, flapping one’s hands, or running back and forth in a certain pattern, are also common, particularly among younger children with ASC. Rituals, such as an insistence on doing things in a particular way, are also not uncommon and should be differentiated from resistance to change, which signifies children not wanting to go from one activity to another, particularly if they are interested in that activity. This is a common problem in young children in general and is often confused with ASC. A lot of research has gone into trying to understand how to characterize cognitive delays so often seen in children with ASC. Delays in expressive and receptive language are common, but children with Asperger syndrome do not show such language problems (Williams, Botting, & Boucher, 2008). Indeed, Asperger syndrome is characterized by an absence of clinically significant cognitive and language delay (Woodbury-Smith, Klin, & Volkmar, 2005). Perhaps a more parsimonious explanation of cognitive difficulty that virtually all ASC children share is a difficulty with abstract, metaphorical thinking, as opposed to more rote thinking or concrete understanding, which they are able to do well (Williams, Goldstein, Minshew, 2006). The more complex the cognitive operation, the more abstract, the more metaphorical, the more difficulty the ASC child will have with learning that concept, with understanding it, and with being able to perform certain roles.

Another active area of research has focused on trying to understand the fundamental deficit associated with ASC. Various theories have been proposed and studies undertaken to test the extent to which difficulties in joint attention, theory of mind (ToM), executive dysfunction, weak central coherence, and shifting and disengaging attention might be a unifying paradigm to understand children with ASC (Happé & Frith, 2006; Martin & McDonald, 2003; Miller, 2006; Landry & Bryson, 2004)). It now seems apparent that there will not be a single explanation or a single cognitive model for the disorder, but rather that different components of the condition might be associated with different cognitive models (Happé & Ronald, 2008). For example, a lack of ToM may be a good explanation for some of the social difficulties that children with ASC experience but some other model would need to be proposed for the preference of repetitive, stereotyped behaviors, such as weak central coherence (Mandy & Skuse, 2008).

References

Anderson, D. K., Oti, R. S., Lord, C., & Welch K. (2009). Patterns of growth in adaptive social abilities among children with autism spectrum disorders. Journal of Abnormal Child Psychology, 37, 1019–1034. American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington DC: American Psychiatric Association.
Fernell, E., Hedvall, A., Norrelgen, F., Eriksson, M., Höglund-Carlsson, L., BarnevikOlsson, M., ... Gillberg, C. (2010). Developmental profiles in preschool children with autism spectrum disorders referred for intervention. Research in Developmental Disabilities, 31, 790–799.
Fodstad, J. C., Matson, J. L., Hess, J., & Neal, D. (2009). Social and communication behaviours in infants and toddlers with autism and pervasive developmental disordernot otherwise specified. Developmental Neurorehabilitation, 12, 152–157.
Fombonne, E. (2005). Epidemiology of autistic disorder and other pervasive developmental disoders. Journal of Clinical Psychiatry, 66, Suppl. 10, 3–8.
Georgiades, S., Szatmari, P., Zwaigenbaum, L., Duku, E., Bryson, S., Roberts, W., ... Mahoney, W. (2007). Structure of the autism symptom phenotype: A proposed multidimensional model. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 188–196.
Happé, F., & Frith, U. (2006). The weak coherence account: Detail-focused cognitive style in autism spectrum disorders. Journal of Autism and Developmental Disorders, 36, 5–25.
Happé, F., & Ronald, A. (2008). The “Fractionable Autism Triad:” A review of evidence from behavioural, genetic, cognitive and neural research. Neuropsychological Reviews, 18, 287–304.
Jones, C. R., Happé, F., Golden, H., Marsden, A. J., Tregay, J., Simonoff, E., ... Charman, T. (2009). Reading and arithmetic in adolescents with autism spectrum disorders: Peaks and dips in attainment. Neuropsychology, 23, 718–728.
Lam, K. S., Bodfish, J. W., & Piven, J. (2008). Evidence for three subtypes of repetitive behavior in autism that differ in familiality and association with other symptoms. Journal of Child Psychology and Psychiatry, 49, 1193–1200.
Landry, R., & Bryson, S. E. (2004). Impaired disengagement of attention in young children with autism. Journal of Child Psychology and Psychiatry, 45, 1115–1122.
Lecavalier, L., Gadow, K. D., DeVincent, C. J., Houts, C., & Edwards, M. C. (2009). Deconstructing the PDD clinical phenotype: Internal validity of the DSM-IV. Journal of Child Psychology and Psychiatry, 50, 1246–1254.
Mandy, W. P., & Skuse, D. H. (2008). Research Review: What is the association between the social communication element of autism and repetitive interests, behaviours and activities? Journal of Child Psychology and Psychiatry, 49, 795–808.
Martin, L., & McDonald, S. (2003). Weak coherence, no theory of mind or executive dysfunction? Solving the puzzle of pragmatic language disorders. Brain and Language, 85, 451–466.
Matson, J. L., & Shoemaker, M. (2009). Intellectual disability and its relationship to autism spectrum disorders. Research in Developmental Disabilities, 30, 1107–1114. Miller, C. A. (2006). Developmental relationships between language and theory of mind. American Journal of Speech and Language Pathology, 15, 142–154.
Richler, J., Huerta, M., Bishop, S. L., & Lord C. (2010). Developmental trajectories of restricted and repetitive behaviors and interest in children with autism spectrum dis orders. Development and Psychopathology, 22, 55–69.
Rogers, S.J. (2009). What are infant siblings teaching us about autism in infancy? Autism Research, 2, 125–137.
Snow, A. V., Lecavalier, L., & Houts, C. (2008). The structure of the Autism Diagnostic Interview-Revised: Diagnostic and phenotypic implications. Journal of Child Psy chology and Psychiatry, 50, 734–742.
Szatmari, P., Georgiades, S., Bryson, S., Zwaigenbaum, L., Roberts, W., Mahoney. ...
Tuff, L. (2006). Investigating the structure of the restricted, repetitive behaviours and interests domain of autism. Journal of Child Psychology and Psychiatry, 47, 582–590.
Szatmari, P., Merette, C., Bryson, S. E., Thivierge, J., Roy, M. A., Cayer, M., & Maziade, M. (2002). Quantifying dimensions in autism: A factor-analytic study. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 467–476.
Williams, D, L,, Goldstein, G., & Minshew, N. J. (2006). Neuropsychologic functioning in children with autism: Further evidence for disordered complex informationprocessing. Child Neuropsychology, 12, 279–298. Williams, D., Botting, N., & Boucher, J. (2008). Language in autism and specific language impairment: Where are the links? Psychological Bulletin, 208, 944–963.
Woodbury-Smith,M., Klin, A., & Volkmar F. (2005). Asperger’s syndrome: A comparison of clinical diagnoses and those made according to the ICD-10 and DSM-IV. Journal of Autism and Developmental Disorders, 35, 235–240.
Zwaigenbaum, L. (2010). Advances in the early detection of autism. Current Opinion in Neurology, 23, 97–102.
Zwaigenbaum, L., Bryson, S., Lord, C., Rogers, S., Carter, A., Carver, L., ... Yirmiya, N. (2009). Clinical assessment and management of toddlers with suspected autism spectrum disorder: Insights from studies of high-risk infants. Pediatrics, 123, 1383–1391.