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Fundamental differences most common in _____ perhaps due to access to health care |
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We don’t know if everyone’s using the same _____. |
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Autism as a term was first used officially in 1911 by _____ who used it for describing symptoms of people with schizophrenia who were non-responsive to outside environment. |
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First true credit for describing children goes to _____ and his 1943 published article “Autistic Disturbances of Affective Contact” |
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(1944) _____: described Autistic tendencies in article “Autistic Psychopathology of Childhood” o this was only translated to English in 1991. o (this is why Kanner gets most of the credit) |
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Autism used to be referred to as _____ for a few decades. |
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(1958) o psychodynamically oriented o Basic premise: problems in psyche o There is no mention of autism as a distinct and separate diagnosis from 295 → psychosis “Childhood Schizophrenia” |
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(1968) o No change; it is still part of 295 o Still a psychodynamic orientation |
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(1980) o Moving away from psychodynamic model to a medical model o Distinction between abnormal vs. normal o First time –“ Infantile Autism” appears; it fell under Pervasive Developmental Disorders (PDD) o Still used the 1920 criteria for PDD |
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• Onset by 30 months of age • General lack of responsiveness • Deficits in language development • Bizarre Speech • No delusions or hallucinations (exclusion criteria) |
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(1987) o The term “Infantile Autism” was replaced by “Autistic Disorder” and was still under PDD with the same criteria |
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(2000) o MAJOR CHANGES o PDD became a much small category that included: • Autism • Asperger’s • PDD NOS • Rett’s Disorder • Childhood Disintegrative Disorder
o 3 blocks of Autism • Deficits in language & communication • Deficits in social development & interaction • Stereotypes of Behavior |
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(2003, May) o Main purpose was to improve diagnostic practices & therefore to improve accuracy. o In the DSM IV there was a muddling of diagnosing behaviors that qualified for more than one block, to remedy this the DSM V merged the first 2 blocks. o The diagnostic criteria collapsed avg. communication and social deficits o The Umbrella of PDD is now – Autistic Spectrum Disorder • PPD NOS & Aspergers are now merged inot ASD o Rett’s Disorder was removed because it has a known etiology (it is a genetic disorder) o Childhood Disintegrative Disorder (CDD) was removed completely. |
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DSM V Diagnostic Criteria |
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• I. Delays in Social behaviors/communication o Deficits in language and Communication o Unable to express wants/needs o Poor eye contact o Don’t Recognize Social Cues o Sing-song tones o Bizzare speech mannerisms o Isolated Play o Aversion to socialization o Deficits in social reciprocity • II. Repetitive, restricted behaviors/interests o Echolalia o Hyperactivity o Repetitive Behavior (i.e., lining up toys) o Resistance to change o Transitioning issues • Brian Ineata -> FBA (functioning) -> avoiance from activity OR wants to continue activity o Fixated on specific topics • III. Abberant Behavior: behavior that is inappropriate to context (e.g., eating nonedible items) o Agression o SIB (self-injury behaviors) o Feces smearing o Sleep, Eating and feeding problems o Eloping/bolting o Stripping |
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DSM V Severity Specifiers |
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• Level One – “Requiring Support” • Level Two – “Requiring Substantial Support” • Level Three – “Requiring very substantial support” |
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Number of new cases of some disease in a specified time period (e.g., one year). |
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the total number of cases in a given population at a point in time |
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rare, but chronic (e.g., cancer) |
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Low incidence/high prevalence: |
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common, short-term (e.g., the common cold) |
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High Incidence/low prevalence |
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High Incidence/high prevalence |
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this is the first time numbers were collected because it was the first time there is a distinct category |
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DSM III 2-4/10,000 1/2,500 |
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DSM III-R 4-5/10,000 1/2,000 |
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CDC 90/10,000 1/110; 1/70 boys |
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Interpret the prevalence data as Myth |
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1) Diagnostic practices have changed a. Diagnostic substitution 2) Public Policy regarding treatment has changed a. Access to services therefore advantageous to have the diagnosis |
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Interpret the prevalence data as Epidemic |
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3) Better/more accurate diagnosis (earlier numbers are inaccurately low because we had no idea what it was & that the autistic population were always higher but would maybe get another diagnosis.) 4) Awareness (Acceptance) 5) True increase in Autism a. Environmental precipitators |
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linked to autism due to mercury derivatives |
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Literacy/Language Disorders ^ in 1980, v in 1990 Autism v in 1880, ^ in 1990 o Covariance is studied o There has also been data that has not seen any covariance and seen an increase in both |
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CDC figueres in 2010 – 1/68 |
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Threats to validity, therefore generalize with caution o Data are not meant to be representative of the US & of certain states in which the data was obtained o 8 year olds only – substantial sampling problem o comparisons with other CDC reports should be done with caution (You can’t compare for example 2010 and 2008 numbers because data collection methods differ for each year)
Eric Fombonne → meta-analysis • “You can’t interpret anything from these data” |
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