autismus vortrag

8/3/2019 autismus vortrag

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Presentation

David Bonar - 2011 - AG Hanisch


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Autism Spectrum Disorder: ASD

- A very short introduction -

http://www.examiner.com/images/blog/replicate/EXID2195/images/brain-puzzle.jpg

What it is not,What it is,and what it looks like.


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Myths and Facts 1/12

autism is a disease autism is a hardwiredinteraction style,

an atypical but humancondition


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autism is a rare condition autism is a commoncondition

prevalence ranging from

1:1000 to 1:100

realistic: 1:250, hard toestimate number of

unreported cases andwrong diagnoses


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autism is a childhoodcondition

autism is a lifelongdevelopmental disability

no cure

children with autismgrow up to be adultswith autism


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autism is a newphenomenon

first description of childwith autism 1799 by JeanItard

(wild boy of Aveyron)


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people with autism lookdifferent from otherpeople

autism is an invisibledisability no visiblephenotype, no mark of

cain


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autism is result ofemotional deprivation oremotional stress

autism is due to parentalrejection or cold,unemotional parents

complex developmentaldisability involvingorganic abnormalities in

the functioning of thebrain, possiblyexacerbated byenvironmental factors

the causefor autism hasnothing whatsoever todo with the way parentsbring up their children


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autistic people have noemotions and generallylack empathy

autistic people havestrong emotions, buthave problems

identifying andcommunicating them

perceived lack ofempathy usuallyreciprocal


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people with autism wishto avoid social contact

people with autism areoften keen to makefriends but, due to their

disability, find this highlydifficult and frustrating


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autism is a mentalretardation

autism encompasses thewhole range of mentalperformance

IQ tests not designed forASD


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people with autismcannot be educated

appropriate structuredsupport can helpindividuals with autism

reach their full potential


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Dustin Hofmann plays anautistic person in the movieRain Man

inspired by Kim Peek

Opitz-Kaveggia-Syndrome(X-chomosomal aberration), andnotautism

symptoms: hyperactivity, mentalretardation, severe constipation,severe hypotonia, partial or

complete loss of the corpuscallosum

savant ability

http://www.thelostogle.com/2011/01/19/gentle-readers-olivia-munn-how-to-lose-weight-and-rain-man/various-oscar-winners-

retrospective-1930-to-1987/

http://www.adelaidenow.com.au/news/breaking-news/man-who-inspired-hit-rain-man-movie-dies/story-e6frea73-1225812941644


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What is ASD?

essential criteria for ASD

(DSM-IV, ICD-10)

1. qualitativelyrestricted socialinteraction

2. qualitativelyrestrictedcommunication

3. limited repetitive, stereotypebehavior patterns concerning

interests, activities, work pervasive developmentaldisorder PDD

differential diagnosis by anautism specialist essential

Autistic spectrum disorder (ASD)is a condition that affects how thebrain functions. It affects how aperson communicates with, andrelates to, other people. It also

affects how theymake sense ofthe world around them.

A person who has autism is said tohave autism SPECTRUMdisorder. This is because thesymptoms of autism (and their

individual intensity) canvaryhighly from person to person, andeach can range from mild to verysevere. ASD is always a severehandicap.

A.C.Baker Deputy Director Disability October 2006A.C.Baker Deputy Director Disability October 2006


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ASD statistics

commorbidity of ASD

ADHD / ADD anxiety disorders depression bipolar disorder genetic disorders (i.e. tuberous sclerosis)

chromosome defects mental retardation metabolic defects epilepsy / seizures

sleep disorders Tourette syndrome obsessive compulsive disorder (OCD) mutism

significant increase in minor physical abnormalities anorexia nervosa schizophrenia alexithymia

prosopagnosia self-harm allergies auto-immune diseases

severe increase in suicide rate (average in population ca.1% of all causes for death) especially with Aspergersyndrome adults

=> differential diagnosis mandatory

average prevalence in population

ADHD boys 9 %, girls 3 %

anxiety disorder 7 %

depression 11 % (male:female ratio 1:2)

bipolar disorder 3 %

Kanner Syndrome

Kanner syndrome: IQ < 70

Asperger syndrome: IQ > 70PDD-NOS: not quite ASD


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ASD statistics

prevalence of ASD

1 out of 110 childrenis diagnosed with

ASD (0.9 %) in UK 1 in 70 boys (1.4 %) 1 in 315 girls (0.3 %)

ratio approx. 4:1

National Center on Birth Defects and DevelopmentalDisabilities 2010

http://www.iancommunity.org/cs/ian_research_reports/ian_research_report_13 22.06.2011

KannerSyndrome


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4 scientifically observable levels of ASD

1. genetics (main cause)

2. physiology: neurodevelopment

3. inner world: perception and cognitive style4. interaction: social, emotional, executive

functions


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ASD genetics

twin studies: comparison of monozygotic

and dizygotic twins heritablity range between

36% and 95.7% for MZ0% and 23.5% for DZ

=> highly heritable,

environmental influenceunknown

vulnerability

genes

environmental

influence

ASD risk factors


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ASD genetics

no single gene model, eachASD individual with potentiallyunique genetic assets

theory: synergetic multi-gene

interactions, each genecontributing to vulnerability

overlapping genetic influenceswith many other disorders

to date: over 100 affected

genes found; each account foronly a small percentage ofpeople with autistic traits(not representative; preliminary data)

examples:

neurexin 1 (NRXN1) helps gluetogether neurons at the synapse

synaptic ras GTPase activating

protein 1 (SYNGAP1) mentalretardation

tuberous sclerosis 1 (TSC1) corticaldysplasia

insulin-like growth factor 2 (IGF2)

neurogenesis 7-dehydrocholesterol reductase

(DHCR7) brain development

neurofibromin 1 (NF1) learningdeficits

Catalina Betancur 2010 - Etiological heterogeneity in autism spectrum disorders:

More than 100 genetic and genomic disorders and still counting


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ASD neurologic development larger heads than the general population (Aylward, et al., 2002) brains of toddlers with autism 10 % larger than same-aged peers

continue to be larger than matched aged peers throughout life(Courchesne et al., 2001, Herbert et al., 2003)

but: no difference in head size at birth (Lainhart et al., 1997)

early overgrowth of neurons, glial cells, accompanied by

lack of synaptic pruning (Nelson et al., 2001)

extra tissue that causes the increase in sizenot well utilized or organized (Aylward et al., 2002)

increase in gray-matter volume particularly in the temporal lobes(Herbert et al., 2002; Rojas et al., 2002).

smaller amounts of white matter compared to gray matter intoddlers and adolescents

reduced size of the corpus callosumin adults

(Hardan, Minshew & Keshava, 2000)

difficulties with inter-regional signal integration(white matter) (Horwitz et al., 1988)

all regions potentially affected:

larger brain, higher gray matter volume,

disrupted white matter cellular columnshttp://www.apa.org/Images/brain-autistic-volume_tcm7-96758.gif


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ASD and cognitive tasks

fMRI of brain activation: scanssystematically report changes in

activation of some brain regions

self-reflection test: objective 1: think about how words

naming traits describe oneself

objective 2: think about whether thewords are generally positive or negative

=> interpretation: restricted use,

restricted interplay of distant regions=> changes in activation pattern evidence

alternative, often inadequate, yetsometimes successful, brainorganization and utilization

(here: concerning self-reflection) http://www.technologyreview.com/computing/24602/page2/


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ASD perception: filter deficiency

pos. neg. pos.

overlap

filters sensitivity of sensory subcategories perceived input levelautistic

neuro-typical

input

*

*

**

**

***

***

** median

* hypersensitive

*** hyposensitive

https://reader009.{domain}/reader009/html5/0506/5aee53de1807c/5aee53ed285db.jpg

http://worldmusic-usa.com/wp-content/uploads/2010/10/BSS-Audio-Opal-FCS-966-Graphic-Equalizer-300x81.jpg

hypersensitivity

hypervision hypertactility

hyperhearing hypertaste/smell

compensation of sensory stress by

stimulation (superimposed) isolation, sensory depravation

physical barriers, insulation medication (i.e. on GABA-system)

PAIN!

paradox reaction


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ASD behavior

There is no stereotype ASDbehavior! but:

communication literal, logical, pedantic, blunt,

hurtfully frank, idiosyncratic,

unusual inflection problems with non-verbal

communication (weak centralcoherence )

wrong emotional affect timing (rhythm of taking turns)

less pragmatic use of language(adapting use to context)

social relationships insufficient emotional competence:

overwhelming emotions

insufficient ability to read emotions insufficient social competence:

theory of mind, inability to takesomeone elses perspective

unbalanced introversion/extraversion impulsiveness/erratic behavior social situations often seen as fake,

ridiculous; frustrating to learn to fit inand act like one enjoys


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ASD behavior

executive functions inflexible routines, ritualised

behaviors, problems coping withchange

difficulties generalizing

information to new situations control issues: tenacity,

perseveration, stubborness problems in making and

executing plans unusual response to stimuli

risk aversion due to sensoryoverload, high anxiety, stress

attention deficits, one trackmind

"Reality to an autistic person isa confusing, interacting massof events, people, places,

sounds and sights. Thereseems to be no clearboundaries, order or

meaning to anything. A largepart of my life is spent just

trying to work out thepattern behind everything.

- A person with autism

A.C.Baker Deputy Director Disability October 2006A.C.Baker Deputy Director Disability October 2006


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Thank you for your attention deficit!


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Hypersensitivity to light

https://reader009.{domain}/reader009/html5/0506/5aee53de1807c/5aee540aea93c.jpg 10.10.11

without sunglasses with sunglasses

You

I


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http://img.wallpaperstock.net:81/fat-schneemann-wallpapers_11980_1152x864.jpg 10.10.11

Light refraction effect

You I


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ASD neurologic development

cerebral cortex

amygdala

hippocampus

basal ganglia

brain stem

corpus callosum

cerebellum

corpus callosum: hemispherecommunication

cerebellum: motor activity, balanceregulation, body movements, coordination,

muscles used while speaking

brain stem: cerebral signal relay station

cerebral cortex: higher mental functions,general movement, perception, behavioralreactions, impulse control

amygdala: emotional responses

hippocampus: short term memory

basal ganglia: regulates automatic

movementhttp://mentalhealth.gov/images/pubs/brain-structures-autism.gif


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ASD and cognitive style

blue: region for object recognition red: region for face recognition

http://www.wrongplanet.net/postt142060.html


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ASD and cognitive style

test: theory-of-mind

http://www.post-gazette.com/images4/20080917Brain_autism.gif


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heuristic:

top-down

bottom-up

http://psycnet.apa.org/journals/neu/7/3/images/thumb_neu_7_3_325_fig1a.jpg

autismus vortrag

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