Transcript Causes of Autism Spectrum Disorder

Neurodevelopmental
Disorders
Neurodevelopmental disorders new combination of
disorder in the DSM-5
Overview of Neurodevelopmental
Disorders
 Developmental disorders
 First diagnosed = infancy, childhood, adolescence
 Attention deficit hyperactivity disorder (ADHD)
 Specific learning disorders
 Autism spectrum disorder
 Intellectual Disability
Attention Deficit/Hyperactivity Disorder
(ADHD)
 Central features
 Inattentive
 Hyperactive
 Impulsivity
 DSM-5 differentiates two categories of symptoms
 Problems of inattention
 Problems of Hyperactivity and impulsivity
Attention Deficit/Hyperactivity Disorder
(ADHD)
 Impairments
 Behavioral
 Cognitive
 Social
 Academic
ADHD: Statistics
 Prevalence
 3% to 9% worldwide
 11% of children in the U.S. aged 4 to 17
 Onset 3 or 4 years
 Boys : Girls = 3:1
 Possible cultural construct
ADHD: Statistics
 Adults with ADHD
 Lower level jobs
 2.5 fewer years of education
 More likely to be divorced, have substance use
problems and antisocial personality disorder
 High risk behaviors
 High comorbidity
 ODD
 Mood disorders
ADHD: Causes
 Genetics
 Familial component
 Copy number variants—CNVs
 Dopamine
 DRD4, DAT1, DRD5 genes and Ritalin
 Norepinephrine
 GABA
 Serotonin
ADHD: Causes
 Neurobiological contributions
 Smaller brain volume
 3-4%
 The role of toxins
 Allergens and food additives
 No evidence
 Maternal smoking
 Increases risk
 Interacts with genetic predisposition
ADHD: Causes
 Psychosocial and social factors
 Negative responses
 Teachers
 Peers
 Adults
 Peer rejection
 Low self-esteem
 Poor self-image
Treatment of ADHD
 Treatment of two fronts
 Psychosocial intervention
 Improving academic performance, decreasing
disruptive behavior, and improving social skills
 Behavioral interventions before medication
 Parent training
 Social skills training
 Biological intervention
Treatment of ADHD: Biological
 Goals
 Reduce impulsivity and hyperactivity
 Improve attention
 Stimulants
 4 million currently treated
 Ritalin
Treatment of ADHD: Biological
 Other Medications
 Adderall
 Strattera
 Tenex
 Clonidine
Treatment of ADHD: Biological
 Effects of medications
 Improve compliance
 Decrease negative behaviors
 Do not affect learning and academic
 performance
 Possible abuse issues
 Side effects
 Psychopharmacogenetics
 The study of how your genetic makeup influences
your response to certain drugs
Autism Spectrum Disorder
 Autism spectrum disorder (ASD) is a
neurodevelopmental disorder that, affects how one
perceives and socializes with others
 DSM-5 combined the following into Autism spectrum
disorder (ASD)
 Autistic disorder
 Asperger’s disorder
 Childhood disintegrative disorder
 Rett disorder is now diagnosed as ASD with a
qualifier
Autism Spectrum Disorder
 Pervasive developmental disorder “Not otherwise
specified” dropped in DSM-5
 Social (Pragmatic) Communication was added to the
DSM-5
Autism Spectrum Disorder
 Two major characteristics of ASD
 Communication and social interaction
 Restricted, repetitive patterns of behavior,
interests, or activities
 Three levels of severity
 Level 1— “Requiring support”
 Level 2— “Requiring substantial support”
 Level 3— “Requiring very substantial support”
 Described qualitatively and, as yet, has no
quantitative equivalent
Autism Spectrum Disorder
 Impairment in social communication and social
interaction
 Fail to develop age-appropriate social relationships
 Social communication and social interaction
 Joint attention
 Deficits in nonverbal communication
 Prosody
Autism Spectrum Disorder
 Impairment in social communication and social
interaction
 25% never acquire speech
 Echolalia
 Conversational impairments
Autism Spectrum Disorder
 Restricted, repetitive patterns of behavior, interests, or
activities
 Restricted patterns
 Behaviors
 Interests
 Activities
 Maintenance of sameness
 Stereotyped and ritualistic behaviors
Autism Spectrum Disorder : Statistics
 Prevalence:
 1 in every 50 births
 Male to female estimate being 4.4 to 1
 IQ interaction
 38% intellectual disabilities
 Occurs worldwide
Causes of Autism Spectrum Disorder :
Psychological and Social Dimensions
 Historical views
 Failed parenting
 Perfectionistic, cold, and aloof
 High socioeconomic status
 Higher IQs
 Lack of self-awareness
 Limited self-concept
 Behavioral correlates
 Echolalia
 Self-injury
Causes of Autism Spectrum Disorder :
Biological
 Significant genetic component
 Familial component
 20% risk of second child with autism
 100 fold increase in risk
 Numerous genes on a number of our
chromosomes involved
 Oxytocin receptor genes
 Bonding and social memory
 Older parents increased risk
Causes of Autism Spectrum Disorder :
Biological
 Neurobiological influences
 Amygdala
 Larger size at birth = higher anxiety, fear
 Elevated cortisol
 Neuronal damage
 Similar size when older
 Fewer neurons
 Oxytocin
 Lower levels
Causes of Autism Spectrum Disorder :
Biological
 Neurobiological influences
 Vaccinations
 Mercury
 No increased risk
 Negative effect of not vaccinating
Treatment of Autism Spectrum Disorder
 Psychosocial treatments
 Behavioral approaches
 Skill building
 Reduce problem behaviors
 Communication and language training
 Increase socialization
 Naturalistic teaching strategies
 Early intervention is critical
Treatment of Autism Spectrum Disorder
 Biological treatments
 Medical intervention has had little positive impact
 Decrease agitation
 Tranquilizers
 SSRIs
Treatment of Autism Spectrum Disorder
 Integrated treatments
 Preferred model
 Multidimensional, comprehensive focus
 Children
 Families
 Schools
 Home
 Community and social support
Prevention of Neurodevelopmental
Disorders
 Early intervention
 At-risk children, families
 Head Start Program
 Educational
 Medical
 Social supports
 Genetic screening
 Detection and correction
 Prenatal gene therapy