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James Durbin

On American Idol Season 10

Diagnosed with Asperger and Tourette’s Syndrome at age 10

Used music as a coping mechanism and to escape from bullies

Dan Aykroyd

Actor

Diagnosed with Asperger and Tourette’s Syndrome

Diagnosed in late 80’s after his wife convinced him to see a doctor

Heather Kuzmich

On America’s Next Top Model Cycle 9

Used her diagnosis of Asperger Syndrome to inspire younger girls in her shoes to follow their dreams

Alexis Wineman

Won Miss Montana and went on to compete in Miss America

Was diagnosed with Autism at age 11

Brought awareness to the entire spectrum of Autism

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Hans Asperger (1944)

Originally described Asperger as “autistic personality disorder”

Lorna Wong (1970’s)

British psychiatrist who specialized in ASD

Discovered that Leo Kanner’s descriptions of understanding and diagnosing autism did not accurately do so for children and adults in her clinic

Helped coin the term Asperger Syndrome and name it a separate category

Leo Kanner (1943)

Described children in his case study as, “who reacts to affection and hostility, to acceptance and rejection, to approval and disapproval, to patience and irritability as any other child would.”

Later referred to his observations as autism

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Lacking “Theory of Mind”

“Ability to recognize and understand thoughts, beliefs, desires, and intentions of other people in order to make sense of their behavior and predict what they are going to do next.”

Difficulty with empathy

Weak Central Coherence

Children with Autism can be good at attending to detail, but have a hard time understanding the “big picture”

Difficulties with focus and finishing tasks

Because the children focus too much on paying attention to detail instead of worrying about finishing the assignment

Impaired Executive Function

“Executive function”

Organizational & planning abilities

Working memory

Inhibition & impulse control

Time management & prioritizing

Using new strategies

Children with autism have a difficult time exercising the use of their executive function

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Early and Regressive/ Late-Onset Signs of Aut

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Early and Regressive/ Late-Onset Signs of Aut

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The first signs of autism may be challenging to detect because they often seem like typical difficulties of the first year, such as sleep and feeding problems. However, a very young child with ASD may not be interested in social activities, and will instead prefer to explore objects that provide pleasurable sensory experiences. Specific objects may intrigue the child, or they may be mesmerized by sensations such as wind blowing in their face or turning wheels.

Parents may notice their child does not imitate their actions or repeat activities that caused the parent to positively respond (laugh, smile, praise, etc.). Eye contact is generally brief, and the child is often happy in solitude. Changes and surprises are not enjoyed. The child may also lack imaginative play and demonstrate distress while trying to communicate.

Intervention

Parents who are concerned may seek opinions from a team of multidisciplinary professionals, including therapists and specialists in developmental disorders, and pediatricians. These professionals confirm the signs of ASD by examining the child with a thorough assessment of their abilities, behavior, and developmental history.

Regressive or Late-Onset Autism

Although major symptoms are present as early as the first year, many children may not demonstrate concern until they are in their second or third year. These children often develop typically in motor, linguistic, and cognitive abilities. They also appear typical in their spoken vocabulary, take interest in others, and develop imaginative play. However, the signs of autism may appear in a matter of months or even weeks, in which parents may see regression of their abilities. Their motor and self-care skills are usually not affected, but there is little difference in behavior between a child who demonstrated signs of autism in their first year. Additionally, late-onset autism is reported to be present in 20-40% of cases.

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There are three levels of Autism Spectrum Disorder, described in the table below:

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Autism Spectrum Disorder (ASD) can be tricky to define and diagnose. Although ASD has wide and versatile symptoms, the characteristics of ASD can be loosely summarized. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), ASD is described by the following traits:

1)    Persistent deficits in social communication and social interaction across multiple contexts.

2)    Restricted, repetitive patterns of behavior, interests, or activities.

3)    The symptoms are present in the early developmental period and

4)    Cause clinically significant impairment in social, occupational, or other important areas of current functioning.

5)    These disturbances are not better explained by intellectual disability or global development delay. Social communication should be below that expected general developmental level.

Additionally, certain specifiers are used to give a more detailed description of the person’s individual disability. Most commonly these descriptors are:

1)    With or without accompanying intellectual and/or language impairment

2)    Association with a known medical, genetic condition, or environmental factor

3)    Association with another neurodevelopmental, mental, or behavior disorder or catatonia

4)    Severity of expression from Level 1 to Level 3 based on the level of support needed for social communication and restricted, repetitive behaviors

5)    A marked deterioration in movement abilities with a slowing and “freezing” of movement mid-action, known as catatonia

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Causes of Autism Spectrum Disorder (ASD)

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Causes of Autism Spectrum Disorder (ASD)

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Genetics: Research shows that parents who have a child with Autism have a 18-22% chance of having another child with Autism. Research also states that individuals with Autism have abnormalities on chromosomes 2, 7 , 15, 16, and/or 19. These chromosomal abnormalities may not be inherited but they can affect genetic material.

Neurology: Individuals with ASD often have different levels of serotonin and dopamine than a person with a typical brain. Proper medication that modifies serotonin and dopamine, can be beneficial for mood and emotion management. Magnetic resonance imaging (MRI), has shown that individuals with ASD have larger brains which affects socialization and communication skills, and cognition.

Possible Errors of Metabolism: Children who have phenylketonuria (PKN), can develop an accumulation of phenylalanine which leads to intellectual disability, similar to ASD. It has been hypothesized by some researchers that metabolic errors can impact Autism.

Autoimmune Disorders: Recent research suggests that Type 1 diabetes, rheumatoid arthritis, asthma, Crohn’s disease, and celiac disease in mothers may lead to a correlation between children having Autism.

Gender Differences: Although ASD is diagnosed four times more in males than in females, the ratio is 2:1. Girls often are not diagnosed until their adolescent years, and can go under the radar per say, because they often use strategies such as imitation to blend in with those who do not have ASD.

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Research suggests that during adult years about 10% of individuals with ASD Level 1 are not impaired in their social or occupational lives. Abilities can improve over time for individuals with ASD; their growth is not set in stone or limited.

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Six Aspects of Autism Spectrum Disorder (ASD)

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Six Aspects of Autism Spectrum Disorder (ASD)

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Social Reasoning: Social reasoning for children with Autism will differ for each individual. To explain ways children with Autism may express social interaction and reasoning one can look at the spectrum. At one end of the Autism Spectrum is a child who avoids social interaction, and who may have trouble with social interaction and social reasoning. In the middle of the there are children who are engage in social interaction with encouragement but typically for a reward, and others who want to interact with others but have trouble understanding social cues, behavior, and script. At the other end of the spectrum there are children who want friendship, but as mentioned previously have trouble reading social cues.

Language Abilities: Not all individuals with Autism will use verbal language, or gestural language. Some children with Autism may require a prompt to say a word verbally. According to DSM-5, children in ASD Level 1 have striking verbal fluency and vocabulary, but often have trouble with the pragmatics of conversation, auditory discrimination, and auditory processing.

Cognition: Autism is considered a neurodevelopmental disorder, but not all parts of the brain function differently than a typical brain, and at times function in more advanced ways than individuals with typical developing brains. Certain individuals with Autism may be more concerned with sensory rather than the functioning or symbolism of objects.

Special Interests: Children with ASD often have special interests such as preoccupation with parts of objects (e.g. batteries, windshield wipers), and acquiring facts and information about specific topics and concepts.

Sensory Sensitivity: Some children with ASD may feel overwhelmed by sensory information, and it may feel like an overload/explosion of noises and visual sensations. Children with ASD may also show a lack of responsivity to certain sensory experiences (e.g. walking in sub-zero temperature water, not communicating pain for physical injuries).Some children with ASD may develop coping strategies that are not always safe (e.g. running through traffic to get away from a loud store).  Sensory meltdown: is a term for when sensory experiences are overwhelming and unavoidable.

Expression and Management of Emotions: Cognitive behavior therapy has been modified to help children with ASD who have mood disorders and/or trouble expressing emotions (e.g. anxiety, despair, anger) be able to manage their emotions.

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Type of Autism included in the DSM-5 (2013) diagnostic manual

Considered to be on the “high functioning end of the spectrum”

Shows up as difficulty in social situations/interactions, limited range of interests, repetitive behavior

Challenges with nonverbal behavior

ie. eye contact, reading facial expressions, gestures

Possible delayed motor development

Do not typically have delayed language/cognitive development

Diagnosis is often a result of school/workplace issues

Many are diagnosed w/ ADHD due to difficulty focusing

Cognitive behavior therapy is often used to help adults

Helps teach social/conversation skills, self-control of emotions, etc…

Social support programs for children include:

Highly structured

Group programs

Speech/language therapy

Occupational & physical therapy

Medication

ie. selective serotonin reuptake inhibitors (SSRIs), antipsychotics and stimulants