AUTISM.Sensory Processing Other observed behaviors

Other observed behaviors�

1. AUTISMAUTISM
By:
Pauline Narciso
Philip Lai
Henry Kang

2. OverviewOverview
Pauline
–General Survey of Autism
–Neural/Chemical Correlates
Philip
–Comparison of Consciousness
Henry
–Treatments

3. General NotesGeneral Notes
Autism as a Syndrome: multiple disease
entities
Autism is a developmental syndrome:
Common deficit: theory of mind

4. Bit of HistoryBit of History
1943- Kanner
“extreme aloneness from the beginning of
life and anxiously obsessive desire for the
preservation of sameness.”
Initial cause: Bad parents

5. Diagnostic CriteriaDiagnostic Criteria
Severe abnormality of reciprocal social
relatedness
Severe abnormality of communication
development
Restricted, repetitive behavior, patterns of
behavior, interests, imagination
Early onset (before 3-5 years)

6. Other observed behaviorsOther observed behaviors
Lack of awareness of feelings of others
Bizarre speech patterns
Lack of spontaneous and make-believe play
Preoccupation with parts of objects
Repetitive motor movements
Marked distress over changes

7. Begins when…Begins when…
80% of cases began as “Infantile Autism”

8. Screening Model for Infantile Screening Model for Infantile
AutismAutism
Is child’s eye-to-eye contact normal?
Is he/she comforted by proximity/body
contact?
Does he/she often smile or laugh
unexpectedly?
Does he/she prefer to be left alone?

9. Systematic Feature Systematic Feature
ExaminationExamination
Hand stereotypies (strange looking or
posturing)
Stiff gaze, avoidance of
Little reaction to strong, unexpected noise
Passive, obvious lack of interest

10. Disease Entities within AutismDisease Entities within Autism
IABD
Zapella Dysmaturational subgroup
Purine Autism
Asperger’s and Autistic Savants
All share common Autistic behaviors

11. Infantile Autistic Bipolar Infantile Autistic Bipolar
DisorderDisorder
Regression after initial normal development
Meets classical criteria for Autism
Autistic symptoms have a cyclical pattern
Positive family history of BD or Depression
Different from Autistic who later has onset
of BD

12. Zapella Dysmaturational Zapella Dysmaturational
subgroupsubgroup
Loss of language after initial normal dev
Meets classical criteria
Complex tics present
Normal neurological exam, normal lab exams
Rapid improvement following therapy
Reach quasi-normal abilities by age 5-6
After age 6, usually fall into other psycho-
pathological category, ADHD

13. Purine AutismPurine Autism
Classical criteria met
Too high/too low levels of uric acid
Constipation
Gout in family members
Seizures and self-injury in majority
“Purine”:abnormal levels of end product
(uric acid) of all purine pathways

14. Quote on Purine AutisticQuote on Purine Autistic
“the boy was an irritable baby who resisted
any change in routine and never looked at
people around him. By 2 years of age, the
few words he had were rapidly
disappearing. He lined up his toys in long
straight lines instead of playing with them.
He developed pica, teeth-grinding,
compulsive biting to the point of bleeding.”

15. On the functioning end..On the functioning end..
Asperger’s: meet criteria, but have normal
IQ functioning
Autistic Savants: special skills in memory,
music, math, calendar calc, drawing, and
hyperalexia reading.

16. Theories on contributing Theories on contributing
factorsfactors
Unfavorable pre, peri,
post-natal factors
Cellular and structural
changes in Limbic
System (amygdala,
cerebellum, and
hippocampus)
L-hemi neural substrates
fail to develop (loss
lang., consciousness,
motor planning
Locus
Coerulus:Mediates
input from senses-
underdeveloped
Low mercury levels

17. Who’s affected?Who’s affected?
1% of general public under the Autism
Spectrum
Most often tend to be males

18. Altered States Compared to NormalAltered States Compared to Normal
Resistance to change, Insist on sameness
Strong attachments to objects; Spins objects
Difficulty in mixing with others
Throw Temper Tantrums
Tend not to want to cuddle or be cuddled
Over-sensitivity or under-sensitivity to pain
No fears of danger

19. Sensory ProcessingSensory Processing
Painfully sensitive to certain sounds, textures, tastes,
and smells.
Either too sensitive or less sensitive than normal. Some
autistic have difficulty interpreting sensory information.
Like normal these experiences are not hallucinations but
based on real experiences.
Some avoid being touched, a gentle touch for most, will
hurt or shock autistics.
Some are insensitive to pain, and fail to notice injuries.

20. EmotionsEmotions
Take major emergencies in stride but become upset over
minor disruption.
Unemotional, but can be very emotional when things are
important to them.
More candid and expressive with their emotions than
normal people.
Small amount will have difficulty regulating their
emotions. Individual will have verbal outburst, usually in
strange or overwhelming environment.

21. CommunicationsCommunications
Problem with semantic-pragmatic component,
take a statement or question in a literal way.

Ex.) "I'd like coffee with my cereal“
Repeating things that have been heard (echolalia)
Inability to understand body language, tone of
voice
Some autistics are mute

22. Communication Cont.Communication Cont.
Difficult in sustaining a conversation. No
normal "give and take" in a conversation
Autistics tend to go on with their favorite
subjects and do not give the other person a
chance to talk.
People with autism might stand too close to
the other person.
Body language, facial expressions, and
gestures do not match what they are saying.

23. AttentionAttention
Trouble handling multiple stimuli of attention.

Very narrow focused attention, can not keep
up with more than one thing at a time.
Shifting attention is a slow process, usually
involves pauses or moments of delay.

24. ProductivityProductivity
Great deal of variety among autistics.
Some autistic may never learn to talk and be dependent
throughout their lives.
Others may do well in special supportive settings,
working in a sheltered environment.
There are autistics that are fully independent and
function fairly well.

25. Theory of MindTheory of Mind
TOM is absent in autistics, can not attribute mental states.
Autistic can not reflect on their own mental states.
Cause abnormalities in social interactions,
communications, and imagination.
Understanding mental states of others can allows
individuals to make sense of past behavior, allows
influence on present behavior and permits prediction of
future behavior.
Normal 3 year olds no TOM,
but 4 year olds tend to have a TOM.

26. Mirror NeuronsMirror Neurons
Tested controls and autistics on 4 different tasks.
Researchers compared mu rhythms. At baseline, mu
rhythms will fire in synchrony, large amplitude mu
oscillations.
Normal when seeing an action perform will cause mu
rhythms to fire asynchronously, therefore resulting in
mu suppression.

27. Mirror Neurons Cont.Mirror Neurons Cont.
So mu wave suppression will reflect activity of the
mirror neuron system.
In autistics, there was mu suppression in their own
hand movements, but no mu suppression to the
observed hand movements.

28. Autism TreatmentAutism Treatment
Behavioral modification and
communication approaches
Dietary and biomedical approaches
Complementary approaches

29. Behavioral & CommunicationBehavioral & Communication
Applied Behavior Analysis
–Rewarded behavior
TEACCH
–Understand the world
PECS
–Picture exchange
Social Stories
–Theory of Mind
Sensory Integration

30. Biomedical TreatmentsBiomedical Treatments
Medications
–Serotonin Re-uptake Inhibitors
–Anti-Psychotic Medications
Risperidone
Vitamins and Minerals
Dietary Interventions

31. RisperidoneRisperidone
Two double-blind, placebo-controlled responses
of risperidone
–Adults and Children
Serotonin-Dopamine antagonist
Effective as a short-term treatment
–Tantrums, Aggression, Self-Injurious Behavior
–Interfering repetitive behavior, self-injurious behavior,
sensory motor behaviors, affectual reactions, overall
behavioral symptoms

32. Risperidone Cont.Risperidone Cont.
Figure 1: Mean Scores for Irritability

33. Risperidone Cont.Risperidone Cont.
Figure 2: Change in Severity of Overall
Symptoms

34. Vitamins & MineralsVitamins & Minerals
Vitamin B
–Most common vitamin supplement
Vitamins A and D
–Eye contact and behavior
Vitamin C
–Improve symptom severity

35. Dietary InterventionsDietary Interventions
Gluten
–Disruption in biochemical and neuroregulatory
processes
Yeast
–Behavioral and medical problems

36. Complementary ApproachesComplementary Approaches
Improving Communication Skills
–Music Therapy

Speech Development
–Art Therapy

Non-verbal, Symbolic Expression
–Animal Therapy

Physical and Emotional Benefits

37. ConclusionConclusion
Autism is a spectrum
Autistics lack an essential element of
consciousness-Theory of Mind

38. ReferencesReferences
Autism Society of America. <http:// www.autism-society.org>.
Bauman, Margaret L. and Kemper, Thomas L., eds. The Neurobiology of Autism.
Baltimore: John Hopkins UP, 1994.
Centers for Disease Control. <http://www.cdc.gov>.
Coates, Sheila and Richer, John, eds. Autism The Search for Coherence. Philadelphia:
Jessica Kingsley Publishers, 2001.
Gabriels, Robin L. and Hill, Dina E., eds. Autism-From Research to Individualized
Practice. Philadelphia: Jessica Kingsley Publishers, 2002.
Gilberg, Christopher. Diagnosis and Treatment of Autism. New York: Plenum Press, 1989.
Gilberg,Christopher and Coleman, Mary. The Biology of the Autistic Syndromes.
London: MacKeith Press, 2000.
Happe, F. “Theory of Mind and Self.” Ann. N.Y. Acad. Sci 1001 (2003): 134-144.
Harris, J.C. “Social neuroscience, empathy, brain integration, and neurodevelopmental
disorders.” Physiology & Behavior 79 (2003): 525-532.
McCraken, James T. et al. “Risperidone in Children With Autism and Serious
Behavioral Problems.” The New England Journal of Medicine 347 (2002): 314-321.

39. References Cont.References Cont.
McDougle, Christopher J., et al. “A Double-blind, Placebo-Controlled Study of
Risperidone in Adults With Autistic Disorder and Other Pervasive Developmental Disorders.”
Arch Gen Psychiatry 55 (1998): 633-641.
McQueen, JM and Heck, AM. “Secretin for the treatment of Autism.” Ann Pharmacother. 36
(2002): 1294-1295.
Millward, C., et al. “Gluten- and casein-free diets for autistic spectrum disorder.” Cochrane
Database Syst Rev. 2 (2004): CD003498.
Pineda, Jamie. Home page. <http://www.bci.ucsd.edu/~pineda/CNL_WEBPAGE/index.html>.
Pfeiffer, SI, et al. “Efficacy of vitamin B6and magnesium in the treatment of autism: a
methodology review and summary of outcomes.” J Autism Dev Disord 28 (1998): 580-581.
Schopler, Eric and Mesibav, Gary. High-Functioning Individuals With Autism. New York:
Plenum Press, 1992.
Sterling, Lisa. Home page. 2002 <http://darkwing.uoregon.edu/~sterling>.
Strock, Margaret (2004). Autism Spectrum Disorders (Pervasive Developmental Disorders). NIH
Publication No. NIH-04-5511, National Institute of Mental Health, National Institutes of
Health, U.S. Department of Health and Human Services, Bethesda, MD, 40 pp.
<http://www.nimh.nih.gov/publicat/autism.cfm>.