Professional Documents
Culture Documents
vaccine
controversy over MMR?
3 in 1 vaccine measles, mumps, rubella
2-3 times 12-15 months/ 4-6 yrs and 11-13 yrs (US)
Wakefield (Lancet, 1998) advocated a link between MMR v and
autism
Other research has shown that there is NO link
Kaye (BMJ, 2001)
DSM V: An overview
People with ASD tend to have communication deficits, such as
responding inappropriately in conversations, misreading nonverbal
interactions, or having difficulty building friendships appropriate to
their age.
In addition, people with ASD may be overly dependent on routines,
highly sensitive to changes in their environment, or intensely
focused on inappropriate items.
Again, the symptoms of people with ASD will fall on a continuum,
with some individuals showing mild symptoms and others having
much more severe symptoms.
This spectrum will allow clinicians to account for the variations in
symptoms and behaviors from person to person
Theory of Mind and Empathy
ToM is the ability to attribute mental states to others, to infer what
someone else is thinking or feeling. It is one of the two major
components of empathy, sometimes known as 'cognitive empathy'.
The other major component is known as 'affective empathy', or the
drive to respond with an appropriate emotion to someone else's
mental states. Our work is showing that both components of
empathy may be impaired in autism and Asperger Syndrome.
Simon Baron-Cohen
http://www.autismresearchcentre.com/research/project.asp?id=1
Normal development & communication
Most children have innate preferences for social attentiveness
which allows them to develop pre-verbal social skills
(attend to "faces", follow gaze, communicative noises, facial
expressions)
The use of gestures (e.g. pointing at objects) leads to shared
communication and shared perspective
Normal communication allows the child to share in the perceptions
and thoughts of those around them - to make sense of the world
They get to feel safe, knowing what others intentions are and what
their mood is (empathy).
Socio-affective processing:
Brain systems
and emotion
processing
AUTISM IS DEFINED BY
AN ABSENCE...
Comparison with
normal, nondisabled
development
revealed a
characteristic
"Triad of
Impairment" in
individuals with
Autism
A major point of
difference can be seen in the development of turn taking and
gesturing
And from a person with autism:
"I really didn't know there were people until I was seven years old. I
then suddenly realised that there were people. But not like you do. I
still have to remind myself that there are people...I never could have a
friend. I really do not know what other people do with other people,
really".
Donald Cohen (1980 p.388)
Principle thing in autism is panic through not knowing what people
expect of you .
Intensive interaction type of therapy. Differential reinforcement of
incompatible behavour.
And from someone who works with people with autistim:
"...it is not uncommon to feel that one is faced with a strangeling
who moves on another plane of existence, a person with whom one
cannot connect"
Hobson, (p.2, 1993)
Aspergers syndrome..
Prof. Temple Grandin is one of the few experts on animal welfare
who is categorically respected, from those affiliated with the animal
Biological causes
Autism has major biological roots
genetics: 91% concordance in MZ twins, nearly 0%
DZ twins and about 3% of siblings of people with
autism are also affected (= 60 - 100 fold more than
expected)
OR
Illness, rubella, meningitis, tuber sclerosis,
encephalitis as a direct cause in a significant number
of people and there are often signs of increased
neurological abnormality (EEG, MRI)
Aspergerswhat is the concordance rate for brothers, etc? from father?
10,000 synapses in the human brain per neurone, 150,000,000,000
neurone cells
Synapses
Development of synapses occurs at an astonishing rate during
childrens early years in response to experiences:
At peak, cerebral cortex of toddler may create 2 milllion Synapses
per sec.(zero to three, 1999)
By time children
3years, brains will have
approx. 1,000 trillion synapses
(many more than they need).
Some strengthened, but many
gradually discarded.
This pruning = normal part of
development (Shonkoff &
Phillips,2000). By adolescence,
approx. half
synapses have
been discarded.
Remainder exist throughout individual
life.
Prefrontal cortex = reasoning.
Phases of development.
Goals of Intervention
Provide with adaptive skills for engaging and making sense of
greater part of the world and promote independence
Relieve symptoms of anxiety, frustration, and possibly, difficult
behaviour
Especial emphasis on communication skills
Difficulties for interventions
.The very things you hope to change.
Rigidity with routines: educational approaches rely on
changing routines
Usual rewards not rewarding, e.g. social praise etc., for
encouraging participation: the search for rewards is difficult
Earlier intervention will be most effective in creating slight change in
the disorder.
Age 3 or 4, critical
Advise for parents is critical, to show what the best cause of action is.
Issue with finding rewards.
Evidence that there are links between autism and schizophrenia!
Summary
Autism <-> Aspergers constitutes a biologically based cognitive
disability
manifest in disorders in social and language development and in
rigidity in thought and behaviour patterns
puts people at risk of being learning disabled
in contrast with other learning disability conditions, there is not
necessarily a "global" deficit of skills
Each individual has her/his own pattern of abilities and may have
more or less "autistic features" and hence more or less difficulties
in coping with the ever so social world
Definitely possible relationships with autism being possible
schizophrenia in childhood.
Cultural differences can find autism difficult, not known in some
countries.
Aspergers syndrome, condition affecting people with average or above
average intelligence.
Alan Turing, Aspergers syndrome?
Lack of appreciation of social cues.
Shades into eccentric normality.