Autism spectrum disorder

1. Autism spectrum disorder

DR. VOLOVIK GALINA

2. Autism spectrum disorder

The essential features of autism spectrum
disorder are persistent in reciprocal social
communication and social interaction (criterion
A) and restricted’ repetitive patterns of
behavior, interests or activities (criterion B).
These symptoms are present from early
childhood and limit or impair everyday
functioning (criteria C and D).

3. History

1867 – Henry
Maudsley noted a
group of very young
children with severe
mental disorder
(marked deviation,
delay and distortion in
development)
1943 – Leo Kanner
“Autistic disturbance
of affective contact”
coined the term –
infantile autism.
1944 – Hans Asperger
described a syndrome
that he named
“Autistic psychopathy”
1980 – children with
autistic spectrum
disorder were
diagnosed with
childhood
schizophrenia.

4. Epidemiology

Prevalence – 1% of the population

5. Developmental and course

Symptoms are typically recognized during the second year of life
but may be seen earlier that 12 month.
Some case presenting a lack of interest in social interaction in the
first year of life.
Some children experience developmental plateaus or regression,
with a gradual or rapid deterioration in social behaviors or use of
language such losses are rare in other disorders and may be a
useful “red flag” for autism spectrum disorder.

6. Sex distribution

Boys : Girls
5 : 1
4-
Girls with autistic
disorder are more
likely to have more
severe mental
retardation.

7. Risk and prognostic factors

Presence or
absence of
intellectual
disability.
Epilepsy, is
associated with
greater
intellectual
disability and
lower verbal
ability.
Language
impairment
(functional
language by age 5
years is a good
prognostic sign).
Additional mental
health problems.

8. Environmental

Low birth
weight
Fetal
exposure to
valproate
Parents age
Nonspecific risk
factors

9. Genetic and physiological factors

Heritability – 37%-90%
Linkage analyses have
demonstrated that regions of
chromosomes 7,2,4,15,19 are
likely to contribute to the
genetic basis of autism.
Fragile-X syndrome –
associated with autism, 1%
of children with autism also
have fragile-X syndrome.

10. Differential diagnosis

Rett syndrome
Selective mutism (early development is not typically
disturbed, social reciprocity is not imaired).
Language disorders and social (pragmatic)
communication disorder.
Intellectual disability without autism spectrum
disorder.
Stereotypic movement disorder
ADHD
Schizophrenia

11. Comorbidity

70% of
individuals with
autism spectrum
disorder may
have one
comorbid
mental disorder.
Intellectual
impairment
Structural
language
disorder
40% may have
two ore more
comorbid
menatal
disorder.

12. Diagnostic features

A – Persistent deficits in social
communication and social interaction
across multiple contexts as manifested by
the following-
Deficits in social –
emotional
reciprocity
Deficit in nonverbal
communicative
behaviors used for
social interaction
Deficit in
developing,
maintaining, and
understanding
relationships

13.

B – Restricted repetitive
patterns of behavior,
interests or activities:
Stereotyped
or repetitive
motor
movements
use of objects
or spech
Inflexible
adherence to
routines,
ritualized
patterns of
verbal and
nonverbal
behavior
Hyper- or
hyporeactivity
Restricted,
to sensory
fixated
input or
interests that
unusual
are abnormal
interest in
in intensity or
sensory
focus
aspects of the
environment

14.

C – Symptoms must be present in the early
developmental period
D – Symptoms cause clinically significant
impairment in social occupational or other
important areas of current functioning
E – These disturbance are not better
explained by intellectual disability or global
developmental delay

15. Diagnosis

CARS –
Child
Autistic
Rating Scale
ADOS-G –
Autism
Diagnostic
Observation
Schedule Generic

16. Treatment

17.

Psychopharmacologic trials
• No specific medications
• Reducing hyperactivity,
obsessions and compulsive
behaviors, irritability,
aggression and self-injurious
behaviors

18.

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