Child Psychopathology Autism Diagnosis and description Etiology and treatment Case Reading for today: Chapter 10

Diagnostic criteria for Autism Impairments in social interaction deficits in social imitation, joint attention, eye contact, unusual play, orienting to social stimuli Qualitative impairments in communication pronoun reversals, echolalia, speech restrictions Restricted, repetitive, and stereotyped patterns of behavior, interests and activities perseveration, sameness, self-stimulatory behaviors, flapping Onset prior to age 3 Box 10.1, 10.2

Associated characteristics Intellectual strengths and deficits 80% are mentally retarded, esp. VIQ 25% have “splinter skills”, 5% “savant” Sensory and perceptual impairments, stimulus overselectivity Cognitive deficits, Theory of Mind Physical characteristics, 25% epilepsy Family stress is high: What came first?

Other Pervasive Developmental Disorders Asperger’s Syndrome Later age of onset Higher verbal mental age Less language delay Less social deficit Poor gross motor coordination Rett’s Disorder Girls only Deceleration of head growth Loss of hand skills Severe language deficit Loss of social engagement

Genetic Contributions About 10% have an identifiable medical condition including Fragile X Tuberous sclerosis is associated 3-9% of the time Family and twin studies show strong relationship There are likely several genetic influences in autism

Neuro- and psychobiology Structural abnormalities in cerebellum, medial temporal, limbic, and frontal lobes Demonstrated through blood flow analyses Megalencephaly and increased brain volume in some children Epilepsy, EEG abnormalities in 50% Elevated serotonin in 1/3 of individuals Reticular Activating System and overselectivity Fig. 10.6

Interventions for autism Low functioning children need behavioral interventions SIB, self-help skills, social compliance, basic social-emotional behaviors su as eye contact High functioning children need language, social skills, and preschool behaviors Most effective treatments are highly structured and skills-oriented Include family support and early intervention

Communication skills What is appropriate social behavior? What basic skills are important? Eye contact, introducing yourself, expressing affection, turn-taking in conversations Reduction of behaviors inconsistent with communication, e.g., flapping Operant speech training: Imitation, receptive labelling, sign language for some children

Case Review: Joey What diagnostic features did you think most important? What kind of intervention is necessary?