Autism Spectrum Disorders (ASD)

by Brian Alverson, MD

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    00:01 In this lecture, we will discuss autism spectrum disorders.

    00:05 So we often call this a spectrum because this spectrum described a variability of severity of illness in patients with autism.

    00:16 So on one side, we can think of very mild autistic behaviors and these patients are sometimes described as having Asperger’s syndrome.

    00:25 They are very functional, they may hold down very important jobs, but they have certain behaviors that are similar to patients who have more severe disease.

    00:35 Patients may have mild autism, where they’re reasonable functionally.

    00:38 Or they may have very severe autism with pervasive developmental delay and need assistance lifelong.

    00:46 So this is how we think of this spectrum.

    00:51 I’d like to talk specifically about the characteristics of autism along that spectrum, the similarities that exist.

    00:58 In general, these patients experience difficulties with reciprocal social interaction.

    01:05 They may have difficulties with communication with others and they may exhibit repetitive or restricted behaviors.

    01:12 They have very focused interests or certain activities that they really have to do a lot and at the neglect of other activities that may be important.

    01:23 So an example of difficulties with social interaction include things like impairment of nonverbal communication.

    01:31 It turns out that our ability to interact with people relies in a lot of ways on our own eye to eye contact, our gestures, our facial expressions.

    01:42 And these are all impaired in patients with autism spectrum disorders.

    01:48 This can result in poor peer relationships and these patients tend to not want to spontaneously seek to share enjoyment.

    01:58 So if you look at this picture, this is a child autism who is being taught to point to things.

    02:05 Think about that for a little bit.

    02:07 Basically, these patients may not seek to share an experience like others do.

    02:13 So a young child, we often pick this up because these children don’t point to things.

    02:19 If I’m interested in something and I point to it, what that means is a I want others to share in that interesting aspect of whatever it is I’m pointing to.

    02:27 And these children don’t seek to share experiences.

    02:31 They may lack social or emotion reciprocity.

    02:35 So they don’t want to have that experience reinforced with others.

    02:40 These patients may also have difficulties with communication.

    02:43 This can present as language delay, an inability to sustain a conversation, they may have stereotype or repetitive language.

    02:52 In severe cases, they’ll say the same thing over and over and over again.

    02:56 And this may result in poor quality of play with other children, which can further make difficult the social ostracization of these children.

    03:06 So in addition, they may have stereotype or repetitive pattern of interest.

    03:12 They may like to line things up perfectly or have a certain activity, which is the same thing over and over and over again.

    03:19 They may be inflexible or need to adhere to a certain ritual or certain way they get ready in the morning.

    03:26 First, my shoes, then brush my teeth, and they can’t do it the other way around.

    03:31 They may exhibit repetitive motor mannerisms.

    03:34 Certain almost tics, but not really, just repetitive motor movements that they need to do to keep themselves organized.

    03:44 And they may become preoccupied with parts of objects.

    03:48 A child may be interested in a certain – like the tag on a stuffed animal, but not the stuffed animal themselves.

    03:56 So we’re seeing a lot more of autism and the epidemiology is important to understand because it’s not clear for just making the diagnosis some more or if there’s something significant going on.

    04:07 Right now, it seems to be affecting about 1 in 110 children.

    04:11 So this is a common problem.

    04:13 It does affect boys more than girls by about a 4:1 ratio.

    04:17 And that ration is reduced to 2:1 for severe autism.

    04:21 And there is a high risk for siblings so there’s some genetic predisposition.

    About the Lecture

    The lecture Autism Spectrum Disorders (ASD) by Brian Alverson, MD is from the course Child Development and Behavior.

    Included Quiz Questions

    1. They don’t spontaneously seek to share their enjoyment.
    2. They have good peer relationships with others with autism.
    3. They point to different objects frequently.
    4. Emotions are easily identified by facial expressions.
    5. They have good eye-to-eye contact.
    1. Language delay and inability to sustain a conversation
    2. Good peer relationships
    3. Spontaneously seek to share enjoyment
    4. Have good eye-to-eye contact and point to new stuff
    5. Good quality of play with other children
    1. They do not exhibit repetitive motor mannerisms.
    2. It affects boys more frequently than girls.
    3. There is a high risk in patients with a family history of ASD.
    4. Inflexible adherence to routines
    5. There is some genetic predisposition.

    Author of lecture Autism Spectrum Disorders (ASD)

     Brian Alverson, MD

    Brian Alverson, MD

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    Excellent lecture
    By Jalil Z. on 12. March 2021 for Autism Spectrum Disorders (ASD)

    Excellent lecture. It is quite an important topic in pediatrics. I learned new things additionally to my university lectures.