CSD 115 1st EditionLecture 17Outline of Last Lecture I. Receptive vs. Expressive Languagea. Receptiveb. ExpressiveII. Differences vs. Delays vs. Disordersa. Differencesb. Delaysc. DisordersIII. Developmental vs. Acquireda. Developmental Language Impairmentb. Acquired Language ImpairmentIV. AssessmentV. Common Language Impaired Problemsa. Late Talkersb. Specific Language ImpairmentOutline of Current Lecture I. Common Language Impaired Problems Continued a. Autism Spectrum Disordersb. Intellectual Disability/Down SyndromeCurrent LectureAutism Spectrum Disorders- Complex developmental disorders that can cause problems with thinking, feeling, language, and the ability to relate to others. - Neurological disorder- Symptoms and severity of symptoms are different in each person. - First diagnosed in childhood. - About 1 in 88 children is diagnosed with autism. - 3-4 times more common in boys than in girls. - It is a lifelong disorder - Definition recently changed in May 2013o American Psychiatric Association formed Neurodevelopmental Disorders Work Group to consider revisions to 2006 definitiono Reasons inconsistent unreliable use of termsThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute. Misdiagnosis and underdiagnosis common which can lead to a denial of benefits- APA Definition (DSM-4;1996): impairment in reciprocal social interaction with severely limited behavior, interest, and activity repertoire- Three domains of autism symptoms:o Social impairmento Language/communication impairmento Repetitive/restricted behaviors - Set of pervasive developmental disorders including: o Autistic Disordero Asperger syndromeo PDD-NOS - pervasive developmental disorder-not-otherwise specified o Childhood Disintegrative Disorder - NEW APA Definition (DSM-5; 2013) - o Eliminates previously separate categories of autistic disorder, Asperger’s disorder,childhood disintegrative disorder and pervasive developmental disorder (not otherwise specified) o Dissolves them into one diagnosis called autism spectrum disorder. According tothe APA, this represents an effort to more accurately diagnose all individuals showing the signs of autism.o Now only two domains of autism symptoms: Social communication impairment Restricted interest/repetitive behavior (now includes hypo or hyper reactivity to sensory input or unusual interests in sensory aspects of the environmento The change eliminates 4 categories of disorders, instead there is just 1 diagnosiso Now there are only 2 domains instead of 3- Diagnosis requires:o Person exhibits 3 deficits in social communicationo At least 2 symptoms in restricted range of activities/repetitive behaviorso Symptoms can be present or reported in past historyo Symptoms should be reported in terms of  Known genetic cause Level of language disability Level of intellectual disability Presence of medical conditions- Verbal Impairments associated with ASD:o Poor pragmatic skills: poor eye contact, delayed gestures and speech, lack of interest in communicating with otherso Language regression: normally developing vocabulary suddenly stops and is losto Echolalia common: immediate or delayed repetition of language just spoken by someone elseo Unusual prosody patterns: can talk really loud, fast, uneven tone, loud then quietand vice versa, fast then slow or slow then fast, etc.- NOTE: Children with ASD who develop functional verbal communication by the age of 5-6 have better prognosis for future learning and communicating verbally.- Social (pragmatic) Communication Disordero DSM-5 added this as a new category (NOT INCLUDED IN ASD)o Individuals with deficits in the social use of language, but not the restricted interests or repetitive behavior (some previously diagnosed with PDD-NOS may fit better here than in ASD) Intellectual Disability/Down Syndrome- (Formerly Mental Retardation)- Definition: o Substantial limitations in present functioningo Significantly sub-average intellectual functioning o AND related limitations in two or more adaptive areas, such as: communication, self-care, social skills, self-direction, functional academics, etc.- NOTE: Affects 3% of population/90% mild – they live & work independently - Down Syndromeo Cause: genetic - extra 21st chromosomeo Clinical features Flaccid muscle tone Flat facial profile Distinctive facial features Short stature Intellectual disability Congenital Heart deficits Eye, hearing, and dental problemso Speech-Language Symptoms Typical sequence of development but slower; consistent with IQ Expressive syntax significantly impaired –  Small expressive vocabulary/good receptive vocabulary Very expressive when telling stories Speech is imprecise; rapid rate of speecho At risk Populations Biological risks: prematurity, low birth weight, and prenatal exposure to drugs and alcohol Environmental risks: neglect or abuse, poverty, and multiple births The more risk factors present, the more likely difficulty learning language will occur Robust biological or environmental factors can provide a protective effect for