Existential counselling for people with autism spectrum disorder precongress ...Dilemma consultancy
Limit situations in autism: aloneness, alienation, lack of autonomy. How can a counsellor help a person with ASD to tackle them--and what can we learn from people with an ASD
DSM5 focusses more on nonverbal communication in autism spectrum disorder diagnosis, but does not specify what it is about nonverbal communication that is affected. In this presentation, I explain the reflexive nature of nonverbal communication, and why I call this the 'interbrain'. I also provide another explanation for dysempathy in ASD: the inability to recall empathic feelings
Existential counselling for people with autism spectrum disorder precongress ...Dilemma consultancy
Limit situations in autism: aloneness, alienation, lack of autonomy. How can a counsellor help a person with ASD to tackle them--and what can we learn from people with an ASD
DSM5 focusses more on nonverbal communication in autism spectrum disorder diagnosis, but does not specify what it is about nonverbal communication that is affected. In this presentation, I explain the reflexive nature of nonverbal communication, and why I call this the 'interbrain'. I also provide another explanation for dysempathy in ASD: the inability to recall empathic feelings
Abnormal Psychology: Neurodevelopmental DisodersElla Mae Ayen
Group of conditions with onset in the developmental period.
Disorders typically manifest early in development.
often before the child enter grade school
characterized by developmental deficits that produce impairments of personal, social, academic or occupational functioning.
PERVASIVE DEVELOPMENTAL DISORDERS: includes Autism, Asperger's syndrome, Rett's syndrome, Atypical autism, other childhood disintegrative disorders and their screening and management.
Proof version: Bishop, D., & Rutter, M. (2008). Neurodevelopmental disorders: conceptual approaches. In M. Rutter, D. Bishop, D. Pine, S. Scott, J. Stevenson, E. Taylor & A. Thapar (Eds.), Rutter's Child and Adolescent Psychiatry (pp. 32-41). Oxford: Blackwell.
Autism & Related Disabilities is a developmental disorder that affects the brain's normal development of social and communication skills. It is also known as a complex developmental disability. Austin Journal of Autism & Related Disabilities is an open access, peer reviewed scholarly journal committed to publication of unique contributions concerned with Autism & Related Disabilities.
Austin Journal of Autism & Related Disabilities accepts original research articles, review articles, case reports, clinical images and rapid communication on all the aspects of Autism & Related Disabilities.
Section 5 - Classification, Diagnosis and AssessmentSimon Bignell
Section 5 - Classification, Diagnosis and Assessment
'Autism, Asperger's and ADHD' module by Simon Bignell - Lecturer in Psychology at University of Derby.
Neurodevelopmental disorders: are our current diagnostic labels fit for purpose?Dorothy Bishop
Slides from a talk given at University of Western Australia on Tuesday 2nd October 2012, This lecture was co-hosted by the ARC Centre of Excellence in Cognition and
its Disorders and the Institute of Advanced Studies, University of Western Australia
This slide is part of a collection of exam revision slides from Atypical Child Development. The slides have been created by me, and based on several different research papers. The slides were created for essay exam.
Abnormal Psychology: Neurodevelopmental DisodersElla Mae Ayen
Group of conditions with onset in the developmental period.
Disorders typically manifest early in development.
often before the child enter grade school
characterized by developmental deficits that produce impairments of personal, social, academic or occupational functioning.
PERVASIVE DEVELOPMENTAL DISORDERS: includes Autism, Asperger's syndrome, Rett's syndrome, Atypical autism, other childhood disintegrative disorders and their screening and management.
Proof version: Bishop, D., & Rutter, M. (2008). Neurodevelopmental disorders: conceptual approaches. In M. Rutter, D. Bishop, D. Pine, S. Scott, J. Stevenson, E. Taylor & A. Thapar (Eds.), Rutter's Child and Adolescent Psychiatry (pp. 32-41). Oxford: Blackwell.
Autism & Related Disabilities is a developmental disorder that affects the brain's normal development of social and communication skills. It is also known as a complex developmental disability. Austin Journal of Autism & Related Disabilities is an open access, peer reviewed scholarly journal committed to publication of unique contributions concerned with Autism & Related Disabilities.
Austin Journal of Autism & Related Disabilities accepts original research articles, review articles, case reports, clinical images and rapid communication on all the aspects of Autism & Related Disabilities.
Section 5 - Classification, Diagnosis and AssessmentSimon Bignell
Section 5 - Classification, Diagnosis and Assessment
'Autism, Asperger's and ADHD' module by Simon Bignell - Lecturer in Psychology at University of Derby.
Neurodevelopmental disorders: are our current diagnostic labels fit for purpose?Dorothy Bishop
Slides from a talk given at University of Western Australia on Tuesday 2nd October 2012, This lecture was co-hosted by the ARC Centre of Excellence in Cognition and
its Disorders and the Institute of Advanced Studies, University of Western Australia
This slide is part of a collection of exam revision slides from Atypical Child Development. The slides have been created by me, and based on several different research papers. The slides were created for essay exam.
A power point presentation on Autism Spectrum disorders I created in collaboration with a team of three other graduate students at the University of Dayton.
Topic 5 - Classification, Assessment and Diagnosis 2010Simon Bignell
Autism, Asperger's and ADHD
Topic 5 - Classification, Assessment and Diagnosis.
The views expressed in this presentation are those of the individual Simon Bignell and not University of Derby.
Analyze the current DSM-V criteria for Autism Spectrum Disorders, develop skills to be an effective collaborator and support school based teams in interventions.
How should we judge the value of different therapies? Clearly some work better in the short haul, particularly focussing on symptom relief, and some are better at the long haul, where the changes that are might be expected are more secular. Much less is known about what such secular changes are although it has been suggested that they are schemata rather than thoughts, deeper levels of the personality, personality disorders, emotional dispositions, unconscious forces, factors that affect well-being or life-satisfaction in contract to happiness, moods and not emotions, or relationship styles rather than specific relationships.
The lack of clearly specified long haul outcomes means that the effectiveness of psychotherapy over the long term remains difficult to evaluate. In the short-term, using symptom scores as an outcome, most accepted psychotherapy methods produce the same gains although methods that make symptoms their first focus produce these changes more quickly.
The Joze Jancar memorial lecture on Neurodevelopmental psychiatry given at the 2012 Annual residential conference of the Faculty of Intellectual Disability of the Royal College of Psychiatrists
Psychotherapeutic approaches to helping adults with intellectual disability a...Dilemma consultancy
DSM-5 is likely to provide a dimensional approach to ASD with two main dimensions: social communication disorder, and repetitiveness. ID/ language impairment adds a further dimension. I shall start my talk with a consideration of how a psychotherapeutic orientation can be relevant to these neurodevelopmental dimensions as well as associated neurodevelopmental disorders, particularly ADHD. However, the main value of a psychotherapeutic approach is in relation to the emotional difficulties associated with ASD and ID, and I shall consider particularly the consequences of bullying, exploitation, and marginalization with special attention on the management of anxiety and of seeking to make an impact on others.
An overview of the positive role of anxiety, and how the work of modern European philosophers can inform a unique approach to helping people face up to, and therefore work through, their fear of fear
Emmy's thoughts about the well being and happiness, and the contribution of psychotherapy to it. A presentation given to the Worcester Therapeutic Training Network in February 2010
Psychological disorder in people with Autism Spectrum DisordersDilemma consultancy
An overview of the mental health problems of people with Asperger syndrome: a workshop originally given to senior staff of the National Autistic Society
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
1. So you can diagnose an autism spectrum disorder. But is that enough? Possible endophenotypes of autism spectrum Digby Tantam
2. Proposed DSM-V criteria for ASD Must meet criteria A, B, C, and D: A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: 1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction, 2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures. 3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of interest in people
3. Proposed DSM-V criteria for ASD Must meet criteria A, B, C, and D: A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: 1. Social-emotional reciprocity (mechanics of social interaction) 2. Nonverbal communication 3. Developing and maintaining relationships
4. Proposed DSM-V criteria for ASD Must meet criteria A, B, C, and D: A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: 1. Social-emotional reciprocity (mechanics of social interaction) 2. Nonverbal communication 3. Developing and maintaining relationships Nonverbal impairment Deficits in social-emotional reciprocity (‘rules’ of social interaction) Possible impairment in social relationship formation
5. What changes from DSM-IV Merging of AS with ASD and disintegrative disorder Lamented by Aspies Disintegrative disorder is progressive Disappearance of Rett syndrome Probably heralds separation of syndrome and aetiology, which is welcome Possible increase in age criterion May raise later confusion with schizophrenia (again) Disappearance of the triad Lamented by Wing, Gould, and Gillberg(Research Autism paper) because of Falck-Ytter who argue that social interaction and But still mixing primary impaired in social interaction with its effects in social relationship Verbal communication disappears Some Aspies think it reduces possible of Autism Spectrum Condition
7. Scanpaths complex: mouths not always chosen over eyes, other factors e.g. eye aversion, need to disambiguate language
8. Proposed DSM-V criteria for ASD Must meet criteria A, B, C, and D: A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: 1. Social-emotional reciprocity (mechanics of social interaction) 2. Nonverbal communication 3. Developing and maintaining relationships Nonverbal impairment modulated by anxiety? Deficits in social-emotional reciprocity (‘rules’ of social interaction) modulated by context? Possible impairment in social relationship formation
9. Proposed DSM-V criteria for ASD (cont) Must meet criteria A, B, C, and D: B. 1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases). 2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes). 3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). 4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities) D. Symptoms together limit and impair everyday functioning.
10. Proposed DSM-V criteria for ASD (cont) Must meet criteria A, B, C, and D: B. Stereotypies No more common than in ID. Link with social isolation. Dopamine mediated. Non-specific? Routines, rituals OCD, Most common absence in PDD-NOS. Anxiety-related Special interests Attention, but also with satisfaction, and cognitive phenotype Linked with clumsiness Hyper-or hypo-reactivity to sensory input Identity ? But may be absent C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities) D. Symptoms together limit and impair everyday functioning.
11. Major remaining problem Heterogeneous syndrome Geared to categorical diagnosis (good for services) but not to dimensional approach Dimensions, cognitive phenotypes, are more useful for advice and remediation Dimensions, endophenotypes, are likely to be more important in genetic studies
12.
13. “Here, we report that quantitative trait analyses of ASD symptoms combined with case-control association analyses using distinct ASD subphenotypes identified on the basis of symptomatic profiles result in the identification of highly significant associations with 18 novel single nucleotide polymorphisms (SNPs). The symptom categories included deficits in language usage, non-verbal communication, social development, and play skills, as well as insistence on sameness or ritualistic behaviors” Hu, V. W., Addington, A., & Hyman, A. (2011). Novel autism subtype-dependent genetic variants are revealed by quantitative trait and subphenotype association analyses of published GWAS data. PLoS ONE, 6(4), e19067.
14. “We present evidence from our own twin studies, and review relevant literature on autism and autistic-like traits in other groups. We suggest that largely independent genes may operate on social skills/impairments, communication abilities, and RRBIs, requiring a change in molecular-genetic research approaches”. Happe, F., & Ronald, A. (2008). The 'Fractionable Autism Triad': A Review of Evidence from Behavioural, Genetic, Cognitive and Neural Research. [Article]. Neuropsychology Review, 18(4), 287-304.
17. Tantam, Cordess, HolmesTotal amount of gazing, controls=people with ASBut gaze plus some other happening on the face of another person was different
18. Tantam, D. Characterizing the fundamental social handicap in autism. ActaPaedopsychiatrica, 55, 83-91, 1991 Gaze reflex 1 Focus on eyes (but means suppression of agonistic response) Gaze reflex 2 Follow other’s gaze to its destination
21. Tantam, D. Characterizing the fundamental social handicap in autism. ActaPaedopsychiatrica, 55, 83-91, 1991 Gaze reflex 1 Focus on eyes (but means suppression of agonistic response) Gaze reflex 2 Follow other’s gaze to its destination Gaze reflex 3 Follow direction of other’s gaze back to their eyes to detect their expression
23. CONCLUSIONS: This study provides preliminary evidence of impaired neural connectivity in the corpus callosum/cingulum and temporal lobes involving the inferior longitudinal fasciculus/inferior fronto-occipital fasciculus and superior longitudinal fasciculus in ASDs. These findings provide preliminary support for aberrant neural connectivity between the amygdala, fusiform face area, and superior temporal sulcus-temporal lobe structures critical for normal social perception and cognition. Jou, R. J., Jackowski, A. P., Papademetris, X., Rajeevan, N., Staib, L. H., & Volkmar, F. R. (2010). Diffusion tensor imaging in autism spectrum disorders: preliminary evidence of abnormal neural connectivity. Australian And New Zealand Journal Of Psychiatry, 45(2), 153-162
24. Chiu, P. H., Kayali, M. A., Kishida, K. T., Tomlin, D., Klinger, L. G., Klinger, M. R., et al. (2008). Self responses along cingulate cortex reveal quantitative neural phenotype for high-functioning autism. Neuron, 57(3), 463-473.
25.
26. “Attributing behavioral outcomes correctly to oneself or to other agents is essential for all productive social exchange. We approach this issue in high-functioning males with autism spectrum disorder (ASD) using two separate fMRI paradigms. First, using a visual imagery task, we extract a basis set for responses along the cingulate cortex of control subjects that reveals an agent-specific eigenvector (self eigenmode) associated with imagining oneself executing a specific motor act. Second, we show that the same self eigenmode arises during one's own decision (the self phase) in an interpersonal exchange game (iterated trust game). Third, using this exchange game, we show that ASD males exhibit a severely diminished cingulate self response when playing the game with a human partner. This diminishment covaries parametrically with their behaviorally assessed symptom severity, suggesting its value as an objective endophenotype. These findings may provide a quantitative assessment tool for high-functioning ASD.” Chiu et al, 2008
27. Gaze reflex 1 and 2 provide training in where to look and facilitate focussed social development
28. People with AS lack gaze reflex 1 or at least look at geometric shapes preferentially (Pierce) do not attribute animation to shapes, do not treat machines as people
29. Schippers, M. B., Roebroeck, A., Renken, R., Nanetti, L., & Keysers, C. (2010). Mapping the information flow from one brain to another during gestural communication. Proceedings of the National Academy of Sciences, -.
31. Learning to look at the right things But this may represent requirement to disambiguate language: mouth looking is more common in some children and some cultures Mouth looking may be more common in people with SLI, and not in people with ASD
32.
33. The Wright brothers Synchrony Armies, churches, organizations, and communities often engage in activities for example, marching, singing, and dancing that lead group members to act in synchrony with each other.….Across three experiments, people acting in synchrony with others cooperated more in subsequent group economic exercises, even in situations requiring personal sacrifice. Our results also showed that positive emotions need not be generated for synchrony to foster cooperation. In total, the results suggest that acting in synchrony with others can increase cooperation by strengthening social attachment among group members Wiltermuth and Heath, 2009, Psychological Science
36. I am looking at what you are looking at, and we both know that Each of us is paying attention to it. So we have the same things on our mind: Our mental contents are shared
37. How do we know who has high social status? Pride They attract looks
38. Not something I have to think about, or send a particular Message. So unlike speaking: more like just being connected ‘The interbrain’
40. Palinkas, LA, Suedfeld, P Psychological effects of polar expeditions. Lancet 2008; 371: 153-63.
41. Who is Jake? Look him up in the brain index: the cache of all the information about experiences with Jake
42. Superior temporal cortex and PFC network in gaze shifting: Nummanmaa et al Figure 2. Brain regions showing positive change in coupling with the right pSTS (red to yellow) and FG (blue to turquoise) while viewing gaze shifts versus opening/closing the eyes. Areas that showed a change in coupling with both FG and pSTS are shown in green. Mean coordinates of the pSTS and FG source regions used in the connectivity analyses are shown as red and blue spheres, respectively. Maps are thresholdedatP < 0.005, unc. for visual inspection, and the color bars denote the Tstatistic range. FEF, frontal eye field; FG, fusiform gyrus; IPS, intraparietal sulcus; MFG, middle frontal gyrus; SMG, supramarginal gyrus; STG, superior temporal gyrus; pSTS, superior temporal sulcus.
43. Looking at the right things Inferring things from other’s gaze direction
44. Falling prevalence of ASD in boys and men based on community survey of Sheffield city (pop. 400 000) N=124
45. Falling prevalence of ASD in boys and men based on community survey of Sheffield city (pop. 400 000) N=124 Secondary peak of fathers?
46. Exposure to social situation? Mimicry? Evidence of drama? ABA? Esp gaze direction Teach people to look Teach people to control odd behaviour
48. Stereotypies are an indication of intellectual disability, as is the poverty or complexity of interests
49. Endophenotypes within non-verbal impairment With dyspraxia (is this the nonverbal element?) VIQ>PIQ ‘Typical’ Asperger syndrome More ‘temporal’ With impaired narrative ability and possibly other SLI (is this the social interaction element) PIQ>VIQ ‘Atypical AS’ or PDD-NOS More ‘frontal’ Association with ADHD
50. Typical Asperger syndrome: NV expressive impairment Unusual manner, gives immediate impression of idiosyncrasy due to impaired nonverbal expressiveness Makes contact on own terms May discuss unusual or particular interests Problems with unexpected or unclear situations 19/08/2011
53. Associations with ‘typical’ ASD Clumsiness Topographical disorientation Unusual deployment of attention on environment: seeing the trees, not the word Sociolinguistic impairment: concrete language, failure to understand some humour (puns OK) Catastrophic reaction to social demand, e.g. conflict, loud noise, change Problems in making friends
54. Treatment methods for typical ASD ABA and other methods of capturing engagement may work in children Remedial gymnastics has effect on social difficulties? Mimicry (but not imitation) e.g drama therapy
55. Atypical Asperger syndrome: a new clinical syndrome and linked to impaired social interaction? Primary abnormality is impaired social interpretation May be conspicuous lack of a theory of mind Lack of internal narrative Ability to make relationships but not to keep them May be behavioural problems (‘pathological demand avoidance’) Lack of persuasiveness and ‘social influencing power’
56. The language of the eyes Who is being shot? Terrorists or partisans?
57. Empathy disorders Psychopathy in which there may be: An impairment of response to threat expressions A turning off of normal empathic responsiveness Autistic spectrum disorders An impairment in the response to all nonverbal expression, with a consequent reduction in emotional responsiveness
58.
59. Cognitive and affective empathy Fifty-two boys (25 aggressive and 27 non-aggressive) were compared for levels of aggression and for cognitive and affective empathy as expressed during a group interview involving bibliotherapy. Aggressive boys showed half the level of affective empathy as non-aggressive boys, although the groups did not differ in cognitive empathy Study of cognitive and affective empathy in aggressive boys(Schechtman, Z. (2002) Cognitive and affective empathy in aggressive boys: implications for counselling. International Journal for the Advancement of Counselling, 24, 211-. Although both groups can appear uncaring, our findings suggest that the affective/information processing correlates of psychopathic tendencies and ASD are quite different. Psychopathic tendencies are associated with difficulties in resonating with other people’s distress, whereas ASD is characterised by difficulties in knowing what other people think JONES, A. P., HAPPÉ, F. G. E., GILBERT, F., BURNETT, S. & VIDING, E. 2010. Feeling, caring, knowing: different types of empathy deficit in boys with psychopathic tendencies and autism spectrum disorder. Journal of Child Psychology and Psychiatry, 51, 1188-1197 4 July 07 10th. European Congress of Psychology
60. Aggression and empathy Increased perspective taking reduces aggression (Richardson et al, 1994,Empathy as a cognitive inhibitor of interpersonal aggression. Aggressive Behaviour, 20, 276-289) Secondary inhibition (Feshbach and Feshbach, 1969) results from seeing the fear (Blair) or disgust (Nichol) in the other and acts to mitigate aggression (de Paul et al, 2006, Aggression inhibition in high- and low-risk subjects for child physical abuse: effects of a child’s hostile intent and the presence of mitigating information, Aggressive Behaviour, 32, 216-230 Actress Janet Leigh from the shower scene in Hitchcock's Psycho
61. Narrative coherence Inability to hold up against persuasion: A lack of an internal narrative “I could have done that” Acceptance of strongest narrative, or authority’s narrative, of most recently repeated narrative Link with theory of mind Bright-Paul, A., C. Jarrold, et al. (2008). Autobiographical memory Bruck, M., K. London, et al. (2007) www.existentialacademy.com 61
62. Coping with a lack of identity Fads ‘Obsessive’ relationships Lack of identity in many people with ASD Adopting identity wholesale Joining charismatic groups Moving places and work Searching for identity ‘Transexualism’ ‘Aspie’ Identities off the peg Gangster Professor Teddy bear 2 Nov 2010 Seeing the light – or ticking the box?
63. Other endophenotypes that may be more common in atypical ASD Dyslexia Speech and language impairment, with reduced understanding of speech Dysexecutive syndrome The consequence of ADHD?
67. A particularly wide ranging tool kit Readiness to consider the most intense emotional issues and in the next moment, the most practical and cognitive ones Having a clear grasp of the individual in front of you, not just in life experience, or temperament, but in cognitive abilities Be aware of shame and shaming The limitless potential of social control by shaming Seeing the light – or ticking the box?
68. Contributors Sheffield survey Myles Balfe Ting Chen Mike Campbell submitted to Autism Bullying project Paul Naylor Jenny Wainscot Jenna Williams 15 medical students International Journal of Psychology Parents, teachers, and people with Asperger syndrome Sheffield Asperger Parents Action Group Seeing the light – or ticking the box?
69. Consequences of bullying Passive failure to be included Reduced use of community resources (social exclusion) Experience of being unwanted/marginalized Active rejection , blaming, scapegoating Stigma as a means of keeping threatening Other at a distance Bullying Painted Bird by Edward Gafford, inspired by the novel ‘Painted Bird’ by JerzyKosiński, itself based on what has been claimed is a fictive war-time experience of the author in Poland
70. Does social exclusion lead to functional movement impairment Is there a difference in the amount of physical activity of pupils with AS compared to others? Mean number of steps per hour: AS group = 902, control group = 1312 (t= -2.645, p = .027) Seeing the light – or ticking the box?
71. Where were people with AS in Sheffield? Most living at home, even above 30. Most had difficulties coping with changes in everyday environments Difficulties moving between places (for example using public transport) Most common places frequented were libraries and cinemas Seeing the light – or ticking the box?
72. Bullied pupils and those with SEN report feeling unhappier and have less commitment to school than pupils who are not bullied and have no SEN. For pupils with SEN or no identified SEN, the risk of being bullied declines by approximately 9 per cent each chronological year. Pupils bullied in Year 9 (13-14-year-olds) are much more likely to drop out of school at Year 11 (15-16-year-olds) than those who were not bullied. This trend is even more pronounced for pupils with SEN. Prevalence of bullying in secondary school by SEN type: Analysis of combined NPD and LSYPE data files. Naylor, P., Dawson, J., Emerson, E., and Tantam, D. (2011) N=15 770 13-14 year olds in mainstream school
73. Factors that might influence empathy suppression by people with AS Lack of emotional empathy Neurotypicals are united, and do not deserve empathy Uproar Lack of a shared social contract: ‘dissociation’ Lack of social influencing power Seeing the light – or ticking the box?
74. Abuse How many people with ASD have been abused? Difficult to establish but possibly a significant no. Suspicion should be raised by deterioration in behaviour, sexual disinhibition, regression Interviewing may be unreliable as people with ASD may not have a clear cut conception of abuse or even of sexually inappropriate behaviour People with ASD may feel that sexual favours are a fair exchange for social contact Need institutional policies for monitoring Friday, 19 August 2011 Lunch-time meeting, Brandon Unit, Leicester
75. Relationships Not being attractive (more often in heterosexual men) Being empathic Being too compliant (more often in women or some homosexual men) Not being able to sustain relationship Knowing what someone wants without them saying Anxiety about failing in relationships May find images or masturbation more attractive than actual people Unreciprocated attraction Stalking Sexual threatening behaviour Inappropriate sexual touching May flip into aggression towards sexually attractive others Abusive/ inappropriate/intimidating relationships Coercive sexuality Friday, 19 August 2011 Lunch-time meeting, Brandon Unit, Leicester
76. Medication for psychiatric disorder Changing circumstances esp power and influence Post aggression feedback Identification of mounting tension Prevention of reinforcement
77. Dealing with lack of empathy Prevention of exploitation Modelling Empathy training?
80. Emotional problems in adolescents and adults with Asperger syndrome(findings from Sheffield survey) Self-harm: thoughts 50%, actual 11% Violence: threats 83%, actual 34% Bullied 90%, 30% currently (includes adults) Majority have anxiety-related disorder
81. Empathy disorders Psychopathy in which there may be: An impairment of response to threat expressions A turning off of normal empathic responsiveness Autistic spectrum disorders An impairment in the response to all nonverbal expression, with a consequent reduction in emotional responsiveness 4 July 07 10th. European Congress of Psychology
83. Aggression and empathy Increased perspective taking reduces aggression (Richardson et al, 1994,Empathy as a cognitive inhibitor of interpersonal aggression. Aggressive Behaviour, 20, 276-289) Secondary inhibition (Feshbach and Feshbach, 1969) results from seeing the fear (Blair) or disgust (Nichol) in the other and acts to mitigate aggression (de Paul et al, 2006, Aggression inhibition in high- and low-risk subjects for child physical abuse: effects of a child’s hostile intent and the presence of mitigating information, Aggressive Behaviour, 32, 216-230 Actress Janet Leigh from the shower scene in Hitchcock's Psycho
84. Cognitive and affective empathy Fifty-two boys (25 aggressive and 27 non-aggressive) were compared for levels of aggression and for cognitive and affective empathy as expressed during a group interview involving bibliotherapy. Aggressive boys showed half the level of affective empathy as non-aggressive boys, although the groups did not differ in cognitive empathy Study of cognitive and affective empathy in aggressive boys(Schechtman, Z. (2002) Cognitive and affective empathy in aggressive boys: implications for counselling. International Journal for the Advancement of Counselling, 24, 211-. Although both groups can appear uncaring, our findings suggest that the affective/information processing correlates of psychopathic tendencies and ASD are quite different. Psychopathic tendencies are associated with difficulties in resonating with other people’s distress, whereas ASD is characterised by difficulties in knowing what other people think JONES, A. P., HAPPÉ, F. G. E., GILBERT, F., BURNETT, S. & VIDING, E. 2010. Feeling, caring, knowing: different types of empathy deficit in boys with psychopathic tendencies and autism spectrum disorder. Journal of Child Psychology and Psychiatry, 51, 1188-1197
85. Does empathy lead to violence, either through an increase in aggression or a reduction in violence inhibition? Correlational studies link low empathy and increased aggression Empathy ‘mitigates aggression’ (Bjorkqvist, Osterman, & Kaukiainen, 2000) But aggressive two year-olds may actually show more empathy than non-aggressive two years olds (Gill & Calkins, 2003) Distinction between affective and cognitive empathy? 4 July 07 10th. European Congress of Psychology
87. Indicators of violent reoffending: the new OASys Violence PredictorPhilip Howard, Senior Research OfficerJackie Seaton, Senior Probation OfficeOffender Assessment and Management UnitNOMS, Ministry of Justice for England and Wales Sections 1-12 1: offending information [criminal history] 2: [current] offence analysis 3: accommodation 4: education, training and employability 5: financial management and income 6: relationships 7: lifestyle and associates 8: drug misuse 9: alcohol misuse
88. Friday, 19 August 2011 Lunch-time meeting, Brandon Unit, Leicester What motivates aggression in AS? Doing the right thing Being accepted, perhaps in a deviant group Utilization behaviour Effort at communication Catastrophic reaction Asserting dominance Modelling Tension relief Hypomania, depression "This is my son” 4 year old artist from Art Gallery on OASIS home page
90. Psychological disorders associated with AS(many of these disorders probably greater in more able group) 2 ‘Attachment disorder’ (disorganized in ADHD) 7 Polymorphous anxiety: encopresis, checking, sleep disturbance, ‘shyness’ 11-13 Surge of anxiety-related problems including OCD, dysmorphophobia, panic disorder 16-18 Secondary depression, social phobia >16 Progressive social withdrawal often attributed to schizophrenia Late adolescence bipolar disorder Brief ‘cycloid’ psychoses Non-psychotic hallucinoses >18 ‘Catatonia’ >25 Paranoid states >35 Social withdrawal, isolation, relationship disrepair
92. Friday, 19 August 2011 Lunch-time meeting, Brandon Unit, Leicester Grief May be absent or delayed May be more for places or times than people Grieving over lost childhood is common Reflected in interests In wanting to be with younger people Ruminations Ruminations also serve to put past right Lack of emotional as opposed to cognitive coping
93. Owen Thor Walker Home schooled from aged 13 because of bullying, provided code to cyber crime syndicate that took £10.3M from private bank accounts (he got £15,500 in payment for botnet code). New Zealand judge did not impose a custodial sentence because of the effect on his career, but fined him £5000. Subsequently hired by TelstraClear, a telecomms company, to act as security consultant
96. That’s as far as we go, folks So, thanks for listening
Editor's Notes
1) Endophenotypes must be reliable and stable traits (reliability and stability).2) Endophenotypes must show evidence of genetic influences (heritability).3) Endophenotypes must be associated with the behavioural trait or disease of interest (phenotypic correlation).4) The association between endophenotype and trait of interest must derive partly from the same genetic source (genetic correlation).5) The association between the endophenotype and the trait of interest must be theoretically meaningful (causality). Gottesman & Gould, 2003 (see attached) developed more specific criteria for endophenotypes for psychopathology: 1. The endophenotype is associated with illness in the population.2. The endophenotype is heritable.3. The endophenotype is primarily state-independent (manifests in an individual whether or not illness is active).4. Within families, endophenotype and illness co-segregate.5. The endophenotype found in affected family members is found in nonaffected family members at a higher rate than in the general population. In terms of genetic influences, all of the above means that:- Endophenotypes must show evidence of genetic influences (heritability). This doesn’t imply they should be 100% heritable, but there should be evidence that they are at least partly influenced by genes (e.g. based on findings from twin/adoption or family studies).- The genetic influences on the endophenotype should (partly) overlap with the genetic influences on the condition of interest. In the current study, it is thought that the genetic influences on the (reduced) brain response to happy faces may tell us something about the genetic vulnerability for autism as a clinical condition. Once again, these genetic influences don’t have to have 100% penetrance.- It is hoped that the endophenotype is a more reliable/stable trait that may be easier to measure than the complex behavioural phenotype of autism (see criteria 1 de Geus). If the endophenotype can be measured more reliably (i.e. less measurement error), and it is a less complex trait, the idea is that the endophenotype may be influenced by less genes, and you would thus increase the power to detect the genes involved. Of course the latter is a hypothesis: It may be that very many genes are involved in the brain response to happy faces. It may also be that this response is not so reliable after all (do we know anything about test-retest reliability of this measure?).- Mikes important study gives a first clue that ‘response to happy faces’ could be a promising endophenotype for autism. Further studies (including reliability studies, and ideally some twin studies to explore the heritability of the endophenotype) should evaluate whether the measure truly passes the test for a good endophenotype. Of course the true litmus test would be a molecular genetic study using the measure.
Anatomy lesson of Dr. Tulp
Jennie Pyers and a colleague
Bright-Paul, A., C. Jarrold, et al. (2008). "Theory-of-Mind Development Influences Suggestibility and Source Monitoring. [Article]." Developmental Psychology44(4): 1055-1068. According to the mental-state reasoning model of suggestibility, 2 components of theory of mind mediate reductions in suggestibility across the preschool years. The authors examined whether theory-of-mind performance may be legitimately separated into 2 components and explored the memory processes underlying the associations between theory of mind and suggestibility, independent of verbal ability. Children 3 to 6 years old completed 6 theory-of-mind tasks and a postevent misinformation procedure. Contrary to the model's prediction, a single latent theory-of-mind factor emerged, suggesting a single-component rather than a dual-component conceptualization of theory-of-mind performance. This factor provided statistical justification for computing a single composite theory-of-mind score. Improvements in theory of mind predicted reductions in suggestibility, independent of verbal ability (Study 1, n = 72). Furthermore, once attribution biases were controlled (Study 2, n = 45), there was also a positive relationship between theory of mind and source memory, but not recognition performance. The findings suggest a substantial, and possibly causal, association between theory-of-mind development and resistance to suggestion, driven specifically by improvements in source monitoring., (C) 2008 by the American Psychological Association Bruck, M., K. London, et al. (2007). "Autobiographical memory and suggestibility in children with autism spectrum disorder." Dev.Psychopathol.19(1): 73-95. Two paradigms were developed to examine autobiographical memory (ABM) and suggestibility in children with autism spectrum disorder (ASD). Children with ASD (N = 30) and typically developing chronological age-matched children (N = 38) ranging in age from 5 to 10 years were administered an ABM questionnaire. Children were asked about details of current and past personally experienced events. Children also participated in a staged event, and later were provided with true and false reminders about that event. Later, children again were interviewed about the staged event. The results from both paradigms revealed that children with ASD showed poorer ABM compared to controls. Generally, their ABM was marked by errors of omission rather than by errors of commission, and memory was particularly poor for early-life events. In addition, they were as suggestible as the typically developing children. The results are discussed in terms of applied and theoretical implications
Thomas Hobbes the social contract
Lev Vygotsky with daughter: inner speech guides action. Inner speech is one way of understanding theory of mind: what a person would say if they were there. May be particularly absent in ADHD