Transcript Name of presentation

Asperger’s Syndrome and Autism
&
Engineering and Computing
Felicity Millman
Autism History
• Pre 1943 - described as emotionally disturbed or
intellectually disabled
• 1943 - Autism / Kanners Syndrome described by Dr Leo
–
Kanner
- Aspergers syndrome described by Dr Hans
Asperger
• 1970’s - Pervasive Developmental Disorder
accepted in the US
• 1980 – Autism included in the DSM as a diagnostic
category
• 1994 – Aspergers Syndrome included in the DSM IV.
What are Autism
and Asperger’s?
• DSM-IV classification (APA, 1994).
– 1. Qualitative impairments in communication
– 2.Qualitative impairment in social interaction.
– 3. Restricted, repetitive and stereotyped
patterns of behaviour, interests and
activities
(APA, 1994).
Pervasive Developmental
Disorders
Autism
Social
interaction
Asperger’s
Communication
Imaginative
play
Childhood Disinteregrative
Disorder
Pervasive Developmental Disorder
Not Otherwise Specified: including
Atypical Autism
Autism in the Lifespan
• Autism is a complex behavioural syndrome
– onset in childhood
– lasting throughout the lifespan
The Autism Epidemic?
• Autism is a prevalent disorder
– estimates ranging from approximately 0.7 –
76 per 10000 individuals (Bauman & Kemper, 2004).
– Rates of diagnosis have increased over the
last 20 years, however this is not a true
increase in prevalence.
MMR and Autism?
• The MMR childhood vaccination has been
anecdotally but not scientifically associated
with onset of autism
– Coincidence of timing
– An immune response to the vaccination?
– Exposure to thermisol (mercury)?
Behavioural Associations
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intellectual disability
seizure disorders
abnormalities of motor behaviour
impaired motor planning
abnormal responses to sensory stimuli
including pain, touch and noise.
sleep and eating disturbances
mood and affect disturbances
self-injurious behaviour
aggression and hyperactivity
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(Bauman & Kemper, 2004, Schreck, Williams and Smith, 2004).
Biological Associations
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auditory processing disturbances
seizure disorders
food and environmental sensitivities
larger head circumference
increased white matter in the brain
reduction in number of Purkinje cells in the brain
gastrointestinal dysfunction,
hyperserotoninemia
abnormal lymphocyte functions.
hormones / neurotransmitter levels.
Autism
Heritability:
• Autism is recognised as highly heritable
– classical autism concordance rates are
approximately 60% for Monozygotic twins and
0% for Dizygotic twins.
• Gender bias: 4 males to each female
affected.
• High rates of twins with Autism.
Autism genetics
• Regions on every chromosome have
been implicated in Autism at various
stages.
– Most commonly associated:
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5HTT (serotonin transporter)
17q11-12
GABRB3 (GABA receptor B3)
15q11-13
RELN (reelin protein)
7q22-33
C4B and HLA (immune system) 6p21.3
OXTR (oxytocin receptor)
3p25-26
Autism Genetics
• Autism is polygenic.
– There is no single causative gene for Autism.
• Genes work in a system
– No gene exists or act alone
• Environment may have effect on gene
– Penetrance and expressivity.
Autism diagnosis
• Symptom clustering?
• Genetic associations?
• Autism Subtypes?
Autism Diagnosis:
• Reconfiguration of understanding of disease
status over last 50 years:
Dementia praecox
Childhood schizophrenia
Autism
Pervasive Develop Disorder
• How good is our current classification?
– Should we only be using classical symptoms
for diagnosis or should we also include
associated symptoms?
Autism Interventions
• Behavioural
– Applied Behavioural
Analysis
• Diet
• Complimentary and
Alternative Medicine
• Medications
– Antidepressants
– Atypical Antipsychotics
– Anti- epileptics
– Melatonin
Prognosis
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Level of functioning
Co morbidities
Family functioning
Early Intervention
Support and funding.
Impacts of Autism
• Financial Costs
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Medication
Behavioural intervention
Education
Hospitalization
Parental care
Respite care
• Social Costs
– Time
– Limited activities
– Family structure
Autism, Asperger’s and
Profession
• Parents and grandparents of children who
are Autistic or Asperger’s are overrepresented in the fields of:
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Engineering
Physics
Accounting
Computer Programming
Science
Autism, Asperger’s and
Profession cont.
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Folk physics and folk psychology
Hyper-male (extreme male brain theory)
Systemizing and empathising
Assortive mating theory
Jobs for people with autism spectrum
disorders.
Understanding Autism
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Prevention
Early intervention and treatment
Genetic Counseling
Understanding of other disorders ie
Schizophrenia
• Quality of life for individuals with ASD
and their family members.
Questions ?