autism

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AUTISTIC DISORDER By, Abilittin james benitto

Definition: 

Definition Autistic disorder, also known as childhood autism, infantile autism, or early infantile autism, is by far the best known of the pervasive developmental disorders. characterized by disturbances in social interactions, language and communication, and the presence of stereotyped behaviors and interests.

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“Qualitative impairment in social interaction, communication, restricted repetitive and stereotyped patterns of behavior, interest and activities, delays in abnormal functioning”. - DSM IV “A pervasive developmental disorder characterized by a total lack of responsiveness to people, gross language developmental deficits or distortions, bizarre responses to environmental aspects e.g. resistance to change or peculiar interest in an animate or inanimate object”. - American Psychiatric Association, (1980).

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It is a severe pervasive disorder of emotions, speech and behavior starting in early childhood after a brief period of normal development. Onset : Delays social interaction, language, or play by age or abnormal functioning in 3 yr Sex Ratio : Studies based on both clinical and epidemiological samples have suggested a higher incidence of autistic disorder in boys than in girls. Prevalence: 1/1000

Etiology and Pathophysiology: 

Etiology and Pathophysiology Currently, the precise etiology and pathogenesis of Autism is unknown, organic brain insult is suggested. Strong evidence for genetic bases for the disorders. The condition was always caused by a “refrigerator” mother who was not responsive to the child's emotional needs. Removal of the child from the family.

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Continue.. Studies of twins indicated high concordance, especially for monozygotic twin pairs, with reduced concordance for fraternal, or dizygotic, same-sex twin pairs. In families of approximately 2 to 3 percent of autism among siblings. prenatal, perinatal, and neonatal complications. congenital rubella.

Features: : 

Features: 1. Inability to relate:  No emotional interaction with people.  Emotional responses to parents, strangers and inanimate objects are the same.  Gaze avoidance is a characteristics feature.

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continuing 2 . Language impairment:  Interpersonal verbal communication is markedly affected. 3. Preoccupation with certain objects and rituals with resistance to change (e.g. the same food).

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continuing 4. Other features:  Labile mood and non-specific anger and fear.  Overactivity and distractibility.  Disturbed sleep.  Varying degrees of mental retardation are present in 75 % of cases.  Epilepsy may develop in adolescence in 20 – 25 % of severe cases.  Enuresis and encopresis may occur.

Social interaction: 

Social interaction Qualitative least two interaction, as manifested by at impairment in social of the following: • Marked impairment in the use of multiple nonverbal behaviors (e.g. eye-to-eye gaze) • Failure to develop peer relationships appropriate to developmental level • Lack of spontaneous seeking to share enjoyment with other People. • Lack of social or emotional reciprocity

Communication : 

Communication Qualitative communication as manifested by at least one of the impairments of following: • Delay in, or total lack of, the development of spoken language • Marked impairment in initiating or sustaining a conversation with others, in individuals with adequate speech • Stereotyped and repetitive use of language • Lack of varied, spontaneous makebelieve, or imitative play

Behavior: 

Behavior Restricted, stereotyped patterns of behavior, as manifested by one repetitive, and of the following: • Preoccupation with one or more stereotyped or restricted patterns of interest • Adherence to nonfunctional routines • Stereotyped and repetitive motor mannerisms • Persistent preoccupation with parts of objects

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Mood and affect of the autistic children - exhibit sudden mood changes with bursts of laughing or crying for a no apparent reason . Improper response to sensory stimuli - Autistic children may be over responsive or under responsive to sensory stimuli and mostly they are deaf. Autistic children injure themselves very severely and not cry, enjoy music and vestibular stimulation such as spinning, swinging and up and down movements.

Assessment and Differential Diagnosis: 

Assessment and Differential Diagnosis There are no diagnostic laboratory tests for A D. The diagnosis of Autism first involves completing a comprehensive psychiatric examination. History Particular attention to Developmental phases of language, social interactions, play Family history of psychiatric and neurological disease

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Physical examination search for, Neurological problems, Cardiac problems, Congenital anomalies, Skin lesions or abnormalities, etc.. Psychological evaluation Autism Diagnostic Interview-revised, Autism Diagnostic Observation Schedule Cognitive testing (e.g., Differential Abilities Scales) Vineland Adaptive Behavior Scales Speech and language evaluation,Audiological evaluation Visual acuity evaluation

Course and Prognosis: 

Course and Prognosis Autistic disorder is a lifelong disability,  Varies depending on several factors such as IQ, language development, and early treatment.  About 15 % can lead independent life.  About 50 % can acquire some useful speech but continue to have disturbed behaviour and cold emotions.

Treatment: 

Treatment No specific treatment Goals for Treatment Advancement of normal development, particularly regarding cognition, language and socialization Promotion of learning and problem solving Reduction of behaviors that impede learning Assistance of families coping with autistic disorder

Psychosocial interventions : 

Psychosocial interventions Educational Curricula that target communication Behavioral techniques Structured milieu Vocational interventions such as speech training other specialized and language therapy, physical therapy and occupational therapy Social skills training Individual psychotherapy for high-functioning individuals

Psychopharmacology: 

Psychopharmacology No pharmacological agent has proved curative Certain medications may be of benefit for specific symptoms such as self-injury, aggression, stereotyped movements, and over activity.

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Thank You Presented by, Abilittin james benitto