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AUTISTIC
 DISORDER
         By,
Abilittin James Benitto
Definition

 Autistic disorder, also known as
childhood autism, infantile autism, or
early infantile autism, is by far the best
known of the pervasive developmental
disorders. characterized by
disturbances in social interactions,
language and communication, and the
presence of stereotyped behaviors and
interests.
“Qualitative impairment in social interaction,
communication, restricted repetitive and
stereotyped patterns of behavior, interest and
activities, delays in abnormal functioning”.
                        - DSM IV
 “A pervasive developmental disorder
characterized by a total lack of responsiveness to
people, gross language developmental deficits or
distortions, bizarre responses to environmental
aspects e.g. resistance to change or peculiar
interest in an animate or inanimate object”.
              - American Psychiatric Association,
(1980).
It is a severe pervasive disorder of emotions, speech and
behavior starting in early childhood after a brief period of
normal development.

Onset : Delays social interaction, language, or play by
age or abnormal functioning in 3 yr

Sex Ratio : Studies based on both clinical and
epidemiological samples have suggested a higher
incidence of autistic disorder in boys than in girls.

Prevalence: 1/1000
Etiology and Pathophysiology
Currently, the precise etiology and
pathogenesis of Autism is unknown, organic
brain insult is suggested.
Strong evidence for genetic bases for the
disorders.
The condition was always caused by a
“refrigerator” mother who was not responsive
to the child's emotional needs.
Removal of the child from the family.
Continue..

Studies of twins indicated high concordance,
especially for monozygotic twin pairs, with
reduced concordance for fraternal, or dizygotic,
same-sex twin pairs.
In families of approximately 2 to 3 percent of
autism among siblings.
prenatal, perinatal, and neonatal complications.
congenital rubella.
Features:
  1. Inability to relate:

 No emotional interaction with people.
  Emotional responses to parents, strangers and
     inanimate objects are the same.
   Gaze avoidance is a characteristics feature.
continuing

  2. Language impairment:

 Interpersonal verbal communication is markedly
    affected.

  3. Preoccupation with certain objects and rituals
  with resistance to change (e.g. the same food).
continuing
 4. Other features:
Labile mood and non-specific anger and fear.
Overactivity and distractibility.
Disturbed sleep.
Varying degrees of mental retardation are
 present in 75 % of cases.
Epilepsy may develop in adolescence in 20 – 25
 % of severe cases.
Enuresis and encopresis may occur.
Social interaction
Qualitative least two interaction, as
manifested by at impairment in social of the
 following:
 • Marked impairment in the use of multiple
 nonverbal behaviors (e.g. eye-to-eye gaze)
 • Failure to develop peer relationships
 appropriate to developmental level
 • Lack of spontaneous seeking to share
 enjoyment with other People.
 • Lack of social or emotional reciprocity
Communication
Qualitative communication as manifested by at least
 one of the impairments of following:
 • Delay in, or total lack of, the development of
 spoken language
 • Marked impairment in initiating or sustaining a
 conversation with others, in individuals with
 adequate speech
 • Stereotyped and repetitive use of language
 • Lack of varied, spontaneous makebelieve, or
 imitative play
Behavior
Restricted, stereotyped patterns of behavior, as
  manifested by one repetitive, and of the
  following:
  • Preoccupation with one or more stereotyped or
  restricted patterns of interest
  • Adherence to nonfunctional routines
  • Stereotyped and repetitive motor mannerisms
  • Persistent preoccupation with parts of objects
Mood and affect of the autistic children -
exhibit sudden mood changes with bursts of
laughing or crying for a no apparent reason .

 Improper response to sensory stimuli -
Autistic children may be over responsive or
under responsive to sensory stimuli and mostly
they are deaf. Autistic children injure themselves
very severely and not cry, enjoy music and
vestibular stimulation such as spinning, swinging
and up and down movements.
Assessment and Differential
              Diagnosis
  There are no diagnostic laboratory tests for A D.
  The diagnosis of Autism first involves
  completing a comprehensive psychiatric
  examination.

History
  Particular attention to Developmental phases of
  language, social interactions, play
  Family history of psychiatric and neurological
  disease
Physical examination
  search for, Neurological problems, Cardiac
  problems, Congenital anomalies, Skin lesions or
  abnormalities, etc..
Psychological evaluation
  Autism Diagnostic Interview-revised, Autism
  Diagnostic Observation Schedule
  Cognitive testing (e.g., Differential Abilities
  Scales)
  Vineland Adaptive Behavior Scales
  Speech and language evaluation,Audiological
  evaluation
  Visual acuity evaluation
Course and Prognosis

  Autistic disorder is a lifelong disability,

 Varies depending on several factors such as IQ,
     language development, and early treatment.
  About 15 % can lead independent life.
   About 50 % can acquire some useful speech but
     continue to have disturbed behaviour and cold
     emotions.
Treatment
 No specific treatment
Goals for Treatment
Advancement of normal development, particularly
 regarding
 cognition, language and socialization
 Promotion of learning and problem solving
 Reduction of behaviors that impede learning
 Assistance of families coping with autistic
 disorder
Psychosocial interventions
Educational
Curricula that target communication
Behavioral techniques
Structured milieu
Vocational interventions such as speech
training
other specialized and language therapy,
physical therapy and occupational therapy
Social skills training
Individual psychotherapy for high-functioning
individuals
Psychopharmacology

 No pharmacological agent has proved
 curative

Certain medications may be of benefit for
specific symptoms such as self-injury,
aggression, stereotyped movements, and over
activity.
THANK YOU




       Presented
           By
Abilittin James Benitto

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Autism. ajb

  • 1. AUTISTIC DISORDER By, Abilittin James Benitto
  • 2. Definition Autistic disorder, also known as childhood autism, infantile autism, or early infantile autism, is by far the best known of the pervasive developmental disorders. characterized by disturbances in social interactions, language and communication, and the presence of stereotyped behaviors and interests.
  • 3. “Qualitative impairment in social interaction, communication, restricted repetitive and stereotyped patterns of behavior, interest and activities, delays in abnormal functioning”. - DSM IV “A pervasive developmental disorder characterized by a total lack of responsiveness to people, gross language developmental deficits or distortions, bizarre responses to environmental aspects e.g. resistance to change or peculiar interest in an animate or inanimate object”. - American Psychiatric Association, (1980).
  • 4. It is a severe pervasive disorder of emotions, speech and behavior starting in early childhood after a brief period of normal development. Onset : Delays social interaction, language, or play by age or abnormal functioning in 3 yr Sex Ratio : Studies based on both clinical and epidemiological samples have suggested a higher incidence of autistic disorder in boys than in girls. Prevalence: 1/1000
  • 5. Etiology and Pathophysiology Currently, the precise etiology and pathogenesis of Autism is unknown, organic brain insult is suggested. Strong evidence for genetic bases for the disorders. The condition was always caused by a “refrigerator” mother who was not responsive to the child's emotional needs. Removal of the child from the family.
  • 6. Continue.. Studies of twins indicated high concordance, especially for monozygotic twin pairs, with reduced concordance for fraternal, or dizygotic, same-sex twin pairs. In families of approximately 2 to 3 percent of autism among siblings. prenatal, perinatal, and neonatal complications. congenital rubella.
  • 7. Features: 1. Inability to relate:  No emotional interaction with people.  Emotional responses to parents, strangers and inanimate objects are the same.  Gaze avoidance is a characteristics feature.
  • 8. continuing 2. Language impairment:  Interpersonal verbal communication is markedly affected. 3. Preoccupation with certain objects and rituals with resistance to change (e.g. the same food).
  • 9. continuing 4. Other features: Labile mood and non-specific anger and fear. Overactivity and distractibility. Disturbed sleep. Varying degrees of mental retardation are present in 75 % of cases. Epilepsy may develop in adolescence in 20 – 25 % of severe cases. Enuresis and encopresis may occur.
  • 10. Social interaction Qualitative least two interaction, as manifested by at impairment in social of the following: • Marked impairment in the use of multiple nonverbal behaviors (e.g. eye-to-eye gaze) • Failure to develop peer relationships appropriate to developmental level • Lack of spontaneous seeking to share enjoyment with other People. • Lack of social or emotional reciprocity
  • 11. Communication Qualitative communication as manifested by at least one of the impairments of following: • Delay in, or total lack of, the development of spoken language • Marked impairment in initiating or sustaining a conversation with others, in individuals with adequate speech • Stereotyped and repetitive use of language • Lack of varied, spontaneous makebelieve, or imitative play
  • 12. Behavior Restricted, stereotyped patterns of behavior, as manifested by one repetitive, and of the following: • Preoccupation with one or more stereotyped or restricted patterns of interest • Adherence to nonfunctional routines • Stereotyped and repetitive motor mannerisms • Persistent preoccupation with parts of objects
  • 13. Mood and affect of the autistic children - exhibit sudden mood changes with bursts of laughing or crying for a no apparent reason . Improper response to sensory stimuli - Autistic children may be over responsive or under responsive to sensory stimuli and mostly they are deaf. Autistic children injure themselves very severely and not cry, enjoy music and vestibular stimulation such as spinning, swinging and up and down movements.
  • 14. Assessment and Differential Diagnosis There are no diagnostic laboratory tests for A D. The diagnosis of Autism first involves completing a comprehensive psychiatric examination. History Particular attention to Developmental phases of language, social interactions, play Family history of psychiatric and neurological disease
  • 15. Physical examination search for, Neurological problems, Cardiac problems, Congenital anomalies, Skin lesions or abnormalities, etc.. Psychological evaluation Autism Diagnostic Interview-revised, Autism Diagnostic Observation Schedule Cognitive testing (e.g., Differential Abilities Scales) Vineland Adaptive Behavior Scales Speech and language evaluation,Audiological evaluation Visual acuity evaluation
  • 16. Course and Prognosis Autistic disorder is a lifelong disability,  Varies depending on several factors such as IQ, language development, and early treatment.  About 15 % can lead independent life.  About 50 % can acquire some useful speech but continue to have disturbed behaviour and cold emotions.
  • 17. Treatment No specific treatment Goals for Treatment Advancement of normal development, particularly regarding cognition, language and socialization Promotion of learning and problem solving Reduction of behaviors that impede learning Assistance of families coping with autistic disorder
  • 18. Psychosocial interventions Educational Curricula that target communication Behavioral techniques Structured milieu Vocational interventions such as speech training other specialized and language therapy, physical therapy and occupational therapy Social skills training Individual psychotherapy for high-functioning individuals
  • 19. Psychopharmacology No pharmacological agent has proved curative Certain medications may be of benefit for specific symptoms such as self-injury, aggression, stereotyped movements, and over activity.
  • 20. THANK YOU Presented By Abilittin James Benitto