PSYC 4620 Lecture 10 Outline of Last Lecture II. Pervasive Developmental DisordersIII. Autism Spectrum Disordera. Statisticsb. Important termsc. Developmental courseIV. Diagnostic Considerationsa. Impairmentb. Common appearance/featuresc. More considerationsOutline of Current Lecture V. Autism Spectrum Disordera. More on appearance/featuresb. Etiologyc. Assessmentd. TreatmentCurrent LectureII. Autism Spectrum Disordera. More on appearance/featuresi. Apparent disregard for both typical social rules and perspectives of others1. Unaware of own impact (not uncaring)ii. “Obsessions”iii. Rigid/ black & white thinkingiv. Sensory issues (integration and over/under problems)v. Odd speech1. Rote verbal, flat, etc2. Sing-songb. Etiologyi. Genetic basis is strongest (ASD – highest variance accounted for by genes)1. **Most inheritable of all psychopathologies2. Atypical brain growth and organization patternsa. Do not follow same developmental brain patterns that kidsnot on the spectrum showThese 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.3. Problems with observations, empathy and processing4. Familial spectrum concordance5. Neurological soft signsa. Something atypical that cannot be pinpointed to one specific spot6. Some support for CNS/Sensory issuesa. Know that CNS is involved somehow, but not much more than that7. Less support serotonin/dopamine hypothesesii. Reciprocalc. Assessmenti. Should have physical health monitored as well1. Accidents/self injury2. Allergies, asthma3. Some diseases/syndromes are more likely to occur with children diagnosed with ASDii. Cognitive1. IQ and Adaptive (functioning in everyday living across major areas)a. Adaptive functioning areasi. Occupationalii. Vocationaliii. Social skillsiv. Educational/Academicb. Want to test with Nonverbal to be most accuratec. Bayley and Standford-Binet are good choices for IQi. Typical pattern similar but usually flatter than ADd. Bracken is good for Achievemente. ADES/VABS composites tend to be below 70 but must checkiii. Behavioral1. Basically same instruments as ADa. Have to watch out for false positives on Child Inventories2. Lookout for hyperactivity, inattention (lower functioning) and depression/anxiety, social problems (higher functioning)iv. Syndrome-Specificv. Syndrome-Clinician1. ABC is widely researched2. **CARS (Childhood Autism Rating Scale) – most commonly/widelyuseda. Includes clinician observation and caregiver report of child behaviorb. Strong reliability and validityvi. IQ and Neurophysical1. Usually but not always (Dylan) Verbal IQ>Performance IQ (ex from book)a. Communicate better than doing an action2. Usually better at crystallized knowledgea. Memorizing facts, knowing definitions (things you might learn in school)b. Children with lower functioning IQs on the spectrum can be very good climbers, dancers, more flexible (PIQ)c. Fluid knowledge – things you learn in the moment (more physical than cognitive)3. Want to assess nonverbal reasoning, motor skills, visual-spatial skills, etc to assess degree and compare to verbal, rotea. Matrices on K-ABC or K-BIT, Finger Tapb. Vocabulary, CVLT, etcvii. Achievement will typically show similar1. Higher on reading than matha. Handwriting and comprehension are often low but compensated ford. Treatmenti. Parent Intervention1. Stress management/supporta. Especially important for family members2. Psychoeducation (especially address frequent/common misconceptions) – VERY important3. Contingency managementa. Manipulating punishments/reinforcements so maladaptivebehavior is ignored and desired behaviors are attainedii. Behavioral Interventions1. Negative behavior modificationa. Starts with functional analysis2. Readiness skills (often through Discrete Trial Training – operant conditioning)a. Includes blocks for attending, imitation, compliance, etc3. Social behaviors (also often DTT)4. Language skills (again, frequent use of DTT)a. Also communication boards, PECs, etc5. Motivation and monitoringiii. Considerations include: IQ, age, reinforcement concerns*, deficits in social learning*, goalsiv. Self-stimulating and/or* SIB1. Best addressed through antecedent management, DRO and RP but sometimes time-out, ignoring, positive practice, and/or punishment* helpsv. Medications1. Antipsychotics are most commona. Not FDA approved, but decrease aggressive behaviors (mellows)vi. Referral to other professionals1. Speech/language pathologists2. Sensory integrationvii. Do know that failure to play and talk by age 5 is associated with poor prognosis1. If you do not receive treatment by age 5, or get intensive (40 hours a week or more) intervention prognosis does not look