Chapter 10 Autism and Childhood Onset Schizophrenia
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Transcript of Chapter 10 Autism and Childhood Onset Schizophrenia
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Chapter 10
Autism and Childhood Onset Schizophrenia
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Historical Background of Autism
Autism and childhood-onset schizophrenia were previously lumped together as a single condition
In 1943, Kranner coined the term “early infantile autism”
Kranner believed autism resulted from an inborn inability to form loving relationships with other people and described parents of these children as being cold and detached
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
DSM-IV Criteria for Autism
Impairments in social interaction Impairments in communication Restricted repetitive and stereotyped patterns of
behavior, interests, and activities Delays or abnormal functioning is social interaction,
social communication, or symbolic or imaginative play prior to age 3
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Autism as a Spectrum Disorder
The symptom patterns and characteristics of autism are expressed in many different combinations and degrees of severity
Three factors contribute to the spectrum nature of autism: children with autism may possess any level of
intellectual ability children with autism vary in the severity of their
language problems the behavior of children with autism changes with
age
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Core Characteristics
Social impairments include deficits in: social imitation make-believe play social expressiveness orienting to social stimuli responsiveness to others processing of emotional information or sharing
emotions with others joint social attention ability to see others as social agents
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Core Characteristics (cont.)
Communication impairments include: may use protoimperative, but not protodeclarative
gestures may use instrumental, but not expressive gestures about 50% of children with autism do not develop
any useful language use qualitatively deviant forms of communication impairments in the pragmatic use of language difficulty communicating emotion and engaging in
narrative discourse
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Core Characteristics (cont.)
Watch the following video clip about Christina. Because Christina is basically a non-verbal child, the teacher’s aid describes how she uses a communication book as a vehicle to express her needs
What is the role of the communication book for Christina?
What aspects of autism are exemplified in this clip?
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Figure 10.1 Instrumental and expressive gestures: Children may use gestures to get others to do something for them but not to convey feelings.
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Figure 10.2 Children with autism have difficulty with the pragmatic use of language.
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Core Characteristics (cont.)
Repetitive Behaviors and Interests: perseveration or abnormal preoccupations ritualistic behavior stereotyped body movements insistence of sameness self-stimulatory behavior
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Core Characteristics (cont.)
Watch the following video about Rebecca, a first-grader with autistic disorder. Rebecca’s teacher discusses her adjustment to school. Rebecca illustrates some of the classic emotional difficulties seen in autistic disorder
How does Rebecca’s behavior in school illustrate the discomfort with changes in routine that many autistic individuals exhibit?
What specific psychological strategies do Rebecca’s teachers use to encourage more appropriate behavior in the classroom?
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Associated Characteristics
Intellectual Deficits and Strengths about 70% of autistic children are mentally
retarded, with particular weaknesses in verbal IQ about 25% have splinter skills and 5% have
savant abilities Sensory and Perceptual Impairments
oversensitivities or undersensitivities to certain stimuli
sensory dominance stimulus overselectivity
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Associated Characteristics (cont.)
Cognitive Deficits difficulty understanding social situations impairments in the ability to understand others’
and their own mental states (Theory of Mind) deficits in executive functions lack of drive for central coherence
Physical Characteristics development of epilepsy in 25% abnormally large head circumference in 20%
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Associated Characteristics (cont.)
Family Stress raising a child with autism is stressful may be frustrated and experience delays in
receiving help parents may be socially ostracized by friends and
strangers Accompanying Disorders and Symptoms
most often associated with MR and epilepsy other common co-occurring symptoms include
hyperactivity, learning disabilities, anxieties, mood problems, self-injurious behavior
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Differential Diagnosis
Children with MR but not autism do not display deficits in joint attention or theory of mind, and are often able to display social behaviors appropriate for their mental age
Compared to children with developmental language disorders, children with autism use more deviant forms of language, display less spontaneous social conversation, and show greater impairments in nonverbal communication
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Prevalence
16 children per 10,000 Occurs in all social classes and cultures 3-4 times more common in boys; when girls are
affected they tend to have more severe intellectual impairments
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Developmental Course
Most often identified around age 2 Often gradual improvements with age, but likely to
continue to experience many problems Usually a chronic and lifelong condition IQ and language development are the strongest
predictors of adult outcomes
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Causes of Autism
Sometimes problems during pregnancy and birth Genetic Influences
family and twin studies suggest the heritability of an underlying liability to autism is above 90%
non-autistic relatives of individuals with autism display higher than normal rates of social, language, and cognitive deficits that are similar in quality to those found in autism, but are less severe
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Causes of Autism (cont.)
Brain Abnormalities elevated rates of epilepsy and EEG abnormalities
in about 50% of individuals with autism suggest abnormal brain functioning
observed deficits suggest involvement of multiple brain regions at both cortical and subcortical levels
structural abnormalities in frontal lobe cortex, cerebellum, medial temporal lobe, and related limbic system structures
decreased blood flow in the frontal and temporal lobes
elevated blood serotonin in 1/3 of cases
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Treatment of Autism
Comprehensive treatment programs often include: early intervention techniques to reduce self-injurious, self-
stimulation, or other disruptive behaviors teaching social and communication skills interventions that involve the parents to the
greatest degree possible interventions to help the parents cope with the
demands of having a child with autism
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Treatment of Autism (cont.)
Dr. Mark Durand’s research program, as discussed in the following video, deals with motivation behind problem solving and how communication training maybe used to lessen such behavior
What are the specific strategies that the teacher’s aid uses to successfully persuade Christina to stop crying?
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Other PDDs
Asperger’s Disorder (AD) characterized by major difficulties in social interaction and
by unusual patterns of interests and behaviors in children with relatively intact cognitive and communication skills
compared to autism, children with AD seem to have higher verbal mental age, less language delay, and greater interest in social contact
prevalence about 2.5 per 10,000; boys more likely to be affected
better long-term outcome than for autism brain abnormalities in the cerebellum and limbic system
similar to those for autism, but less severe
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Other PDDs (cont.) Rett’s Disorder
neurological developmental disorder characterized by: deceleration of head growth loss of previously acquired purposeful hand skills and
development of stereotyped hand movements loss of social engagement appearance of poorly coordinated gait or trunk
movements severely impaired language development psychomotor retardation
prevalence about 1-4 per 10,000 females caused by specific X-linked gene mutations found in more
than 80% of those affected poor long-term prognosis
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Other PDDs (cont.)
Childhood Disintegrative Disorder characterized by a significant loss of previously
acquired language, social skills, and adaptive behavior prior to age 10
regression follows a period of apparently normal development
only occurs in about .2 per 10,000 children symptoms, degree of impairment, and outcomes
similar to those of children with autism (except age of onset and the period of normal development)
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Childhood Onset Schizophrenia (COS)
Historically, the term “childhood schizophrenia” was applied to children who today would be diagnosed with autism and other PDDs
In comparison to autism, COS is associated with a later age of onset, less intellectual impairment, less severe social and language deficits, hallucinations and delusions, periods of remission and relapse
COS is not distinct from adult schizophrenia, rather, it is a more severe form
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
DSM-IV Features of COS
Hallucinations- often auditory Delusions Disorganized speech Disorganized or catatonic behavior “Negative” symptoms (e.g., flat affect, alogia,
avolition)
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Prevalence and Course
Extremely rare in children under age 12 Estimated prevalence about .14 - 1 per 10,000
children COS twice as common in boys (gender differences
disappear in adolescence) Gradual onset- 90% show a clear history of
behavioral and psychiatric disturbances prior to onset of psychosis
High comorbidity with conduct problems and depression
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Causes of COS
Current views emphasize a vulnerability-stress model Preliminary evidence suggest a strong genetic
contribution in COS, even more so than for adults COS appears to be particularly associated with family
stress
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe Chapter 10: Autism and Childhood Onset Schizophrenia
Treatment of COS
COS is a chronic disorder with a poor long-term prognosis
Pharmacological treatments, particularly antipsychotic medications, may be used to help control psychotic symptoms
Psychosocial treatments, such as social skills training, family intervention, and educational supports are also important