Autism• Autism is a lifelong complex neurobiological

disorder

• Most severe childhood psychiatric condition

• First identified in 1943 by Dr. Leo Kanner

• Dr. Hans Asperger noted a milder form of the spectrum that is now called Asperger’s Syndrome

Pervasive Developmental Disorders

1. Autism

2. Rett Syndrome

3. Childhood Disintegrative Disorder

4. Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)

5. Asperger’s Disorder

DSM IV Criteria for Autism:

1. Qualitative impairments in social interaction• Lack of eye contact and appropriate facial

expressions and gestures• Failure to develop normal peer relationships • Lack of joint attention and emotional reciprocity

2. Impairments in communication• Language delays• Impairment in the ability to initiate or sustain a

conversation with others• Stereotyped and repetitive use of language • Lack of imaginary play and imitation

3. Restricted repetitive and stereotyped patterns of behavior, interests and activities

• Preoccupation with stereotyped and restricted patterns of interest

• Adherence to specific routines or rituals• Stereotyped and repetitive motor movements (e.g

hand flapping)• Preoccupation with parts of objects

Diagnosing Autism:

• At least 1 DSM IV criterion before age 3• Most children assessed at 2.5-5 years• Concerned when child has not developed

language• Parents report that child was “strange” as an infant• Early onset: symptoms from birth• Late-onset: symptoms at 16-20 months

Incidence of Autism:• Used to be 4-5 out of 10, 000 people.• CDC now says it is about 1 in 150 individuals• More common than pediatric cancer, diabetes, and AIDS

combined. • Occurs in all racial, ethnic, and social groups• Affects boys 4-5 X more than girls

• 20% have splinter skills (above average in 1 area)• Less than 10% are ‘autistic savants’

– extraordinary skills: e.g. math, memory, artistic abilities, music

Sensory motor delays• Hearing: hypersensitive to certain noises• Vision: staring into space, flapping objects

before their eyes, looking out of corner of eyes, peering close to objects

• Vestibular sensations: spinning, staring• Temperature regulation• Pain: lack of appropriate pain response• Smell: oblivious to foul odors• Position: difficulty maintaining postures • Taste: specific food preferences• Textures: rubbing rough surfaces, preference for

certain textures

Causes of Autism

Genetics:• predisposition to autism is inherited• high concordance rates in identical twins• increased chance of affected family member

Brain Abnormalities:• brain stem dysfunction• Epilepsy, and EEG abnormalities• ventricle enlargement & hydrocephalus• abnormal serotonin and dopamine levels• cerebellum abnormalities

Theories

Executive Function (EF):• Individuals with autism are impaired on EF tasks• EF are mediated by frontal lobe, people with frontal

lobe damage show similar behaviors 

Theory of Mind (ToM):• ToM – ability to comprehend mental states of

others, and make inferences and predictions about what others will do or believe

• Understand that our own perspective may differ from the perspective of someone else

Baron-Cohen, Leslie, Frith (1985)

• Compared autism (11-11), downs syndrome (10-11), and normal children (4-5) on a ToM test–  matched for VMA (5 years)

• Why two comparison groups?

Results:• 85% normal passed• 86% downs syndrome passed• 80% autism failed• children with autism fail to employ a ToM

Holroyd & Baron-Cohen (1993)• follow up study with same children at 19.8 years• Sally-Anne test, Ice Cream Van test (harder)• 82% failed Sally-Anne test• all failed Ice Cream Van test• as teenagers still fail to employ a ToM