autism asperger

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Autism, Aspergers & ADHD (6PS048)

ADHD, Autism & Aspergers (6PS052)

Simon Bignell

Psychology, School of Science2

Outline.

Summary Lecture of the module content.

Draw your own conclusions based on evidence.

Most importantly, to have an opinion you can

defend. Recap the lecture content with recommended reading.

Draw out themes.

Try to reach some conclusions about the relations

between ASD and ADHD. More time for questions.


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Learning Outcomes Of This

Lecture.

On completion of the lecture and with independent study

you should be able to:

1. Give an overview of the key issues covered in themodule.

2. Express an opinion on the multiple relations

between Autism, Aspergers and ADHD .


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Lectures. Lecture 1 Module Introduction.

Lecture 2 ADHD and Hyperkinetic Disorder.

Lecture 3 Autistic Disorder (Classic Autism).

Lecture 4 Asperger's Disorder.

Lecture 5 Classification, Assessment & Diagnosis.

Lecture 6 Aetiology.

Lecture 7 Comorbidity.

Lecture 8 Treatment For ADHD.

Lecture 9 Treatment For Autism. Lecture 10 Autism, Asperger's and ADHD.

Lecture 11 Revision & Exam Tips.


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Lecture 2 ADHD and Hyperkinetic

Disorder.

Content: Symptoms of ADHD.

Inattention.

Hyperactivity/Impulsivity.

Prevalence.

Comorbidity.

Developmental course of ADHD.

Consequences of ADHD.

Lifespan.

Controversy.


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Lecture 2 ADHD and Hyperkinetic

Disorder.

Key Points from Lecture:

First described around 100 years ago.

Problems with Attention, Hyperactivity & Impulsivity.

Affects 2-5% of school age children in UK.

Exists on a degree of severity. Boys are six times more likely to be referred for help than girls.

Almost always occurs with other disorders/problems.

Reading

Barkley, R.A. et. al. (2002). International Consensus Statement(January 2002). Clinical Child and Family Psychology Review,

5(2). p.89-111.


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Psychology, School of Science 8

Lecture 3 Autistic Disorder

(Classic Autism).


First described around 65 years ago.

Exists as a spectrum, a continuum, a syndrome with various

degrees of impairment

Affects communication, social interactions, and strange behaviourthat impair education performance.

Generally evident before age 3.

A life-long pervasive developmental disorder with genetic

susceptibility.

Reading

Frith, U. & Happe, F. (1994) Autism: Beyond Theory of Mind.

Cognition, 50, pp.115-132.


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Content:

What is Aspergers Disorder?

Symptoms of Aspergers.

How Aspergers was first recognised.

Characteristics of Aspergers Disorder.

How is Aspergers different from Classic

Autism.


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A higher-functioning form of Autism characterised byimpairments in the social domain, some impairment in thebehaviour/interests domain.

No significant delays in cognitive or language skills.

Motor clumsiness, especially in younger children.

Aspergers tend to desire to interact with others, but dont knowhow to in an appropriate way.

May live very successful independent lives in appropriate jobsettings.

Not so easy to spot Aspergers Disorder.

Reading Baron-Cohen, S. (1999). The Extreme-Male-Brain Theory ofAutism. In Tager-Flusberg, H, (ed) NeurodevelopmentalDisorders. MIT Press (1999).


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Lecture 5 Classification,

Assessment & Diagnosis.

Content:

What is Classification?

DSM-IV-TR / ICD-10.

How does assessment happen in the UK?

How is a diagnosis of Autism, Aspergers or

ADHD made?


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Lecture 5 Classification,

Assessment & Diagnosis.


Diagnosis has to be made on a behavioural basis.

Variations in symptoms and severity of impairments.

DSM-IV (APA, 1994) & ICD-10 (WHO, 1994).

Pervasive Developmental Disorder.

Attention-Deficit and Disruptive Behavioural

Disorders.

Missed diagnosis and misdiagnosis.

Multiple referral routes.

Pressures on LEA resources.

Multiple assessment protocols and diagnostic tools.


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Lecture 6 Aetiology of ADHD &

Autism.

Content: What is ADHD?

Theories of ADHD.

Response Inhibition Theory.

Diet. Scepticism towards ADHD.

What is Autism?

Theories of Autism.

Theory of Mind deficit.

Executive Function (Dysfunction) deficit.

Weak Central Coherence.


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Lecture 6 Aetiology of ADHD &

Autism.

Key Points from Lecture: The causes of ADHD are not fully known.

Likely to have multiple causes and complex interactions.

Good evidence for genetic component.

Evidence of structural and functional brain abnormality.

Barkleys Theory of Response Inhibition in ADHD. Theory of Mind deficit. Executive Dysfunction. Weak Central

Coherence.

Reading Barkley, R.A. et. al. (2002). International Consensus Statement (January

2002). Clinical Child and Family Psychology Review, 5(2). p.89-111.

Rajendran, G. & Mitchell, P. (in press). Cognitive Theories of Autism.Developmental Review.

Frith, U. & Hill, E. (2004) Understanding Autism: Insights From Mind and BrainIn Autism: Mind and Brain, ed. Frith, U. & Hill, E. Oxford, Oxford UniversityPress, pp.1-19.


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Lecture 7 Comorbidity in ADHD

and Autism.

Content:

A refresher: DBDs & PDDs.

Why is comorbidity important?

Are ADHD And Autism Really That

Different?

Comorbid conditions.

What might this overlap of symptomssuggest?


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Lecture 7 Comorbidity in ADHD

and Autism.


A large number of medical conditions are very oftenassociated with ADHD and/or Autism.

High overlap between ADHD and ASD symptoms.

ADHD and Autism are generally described as separatedisorders with separate genetic aetiologies.

Most genetic studies exclude cases of Autism fromstudies on ADHD and vice versa.

Reading Gillberg, C., & Billstedt, E. (2000). Autism and Asperger syndrome:

Coexistence with other clinical disorders.Acta PsychiatricaScandinavica, 102, 321330.


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Content:

Clinical Symptoms.

Intervention Development.

Considerations for interventions in ADHD.

Non-pharmacologic Treatments.

MTA.

Medication


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Conduct problems and symptoms of ADHD may hinder treatmentand/or assessment.

All strategies do not fit all children.

Medication is the treatment of choice for ADHD following MTA.

The MTA studies suggest that theres very little benefit from anypsychotherapeutic treatment on core symptoms.

Stimulant treatment is easily available in the community andbehavioural treatment is not. But opinion remains divided.

Reading

The MTA Cooperative Group. (1999). A14 Month Randomized ClinicalTrial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder.Archives of General Psychiatry, 56. p.1073-1086.


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Lecture 9 Treatment For Autism.

Content:

Autistic Disorder.

Treatment for Autism Spectrum Disorder.

Medication. Behavioural Interventions.

Other Treatments.

Problems of treatment.

Parent advocacy groups.

Prognosis.


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Lecture 9 Treatment For Autism.


Many different types of behavioural interventions for ASD.

Early intervention is most beneficial.

Treatment depends on the individual.

Most effective treatment for the disorder is highly structuredand intensive Applied Behavioural Analysis (ABA).

Problems treating people with Autism, communication, non-compliance, comorbidity, intellectual/emotional immaturity.

Reading

Lovaas, O. I. (1987) Behavioral treatment and normaleducational and intellectual functioning in young autisticchildren. Journal of Consulting and Clinical Psychology, 55,3-9.


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Themes.

Misdiagnosis vs. Missed diagnosis. Behavioural/Cognitive vs. Pharmacological treatment.

Normal vs. Pathological behaviour.

Continuum vs. Categorical classification.

Academia & Parental viewpoints. Aetiological vs. Symptomatological.

Evidence-based vs. Anecdotal-based methods.

Acceptance vs. Rejection of Disorder.

Mild vs. Severe degrees of impairment.

Increasing incidence vs. Better awareness.


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Relation between ASD & ADHD.

ADHD

Usually spotted in

school.

Normal IQ. Often pragmatic

language problems.

High comorbidity

with other problems.

Often mistaken forbad behaviour.

Classic Autism

Early onset

IQ tends to be lower

Often fail to developspoken language

Problems with non-

verbal

communication

Tend to be adept atbasic motor skills

Aspergers

Later onset

Higher range of

IQ

No language

deficit

Non-verbal

communication

problems less

severe

Clumsiness in

basic motor skills


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Conclusions.

Autism and ADHD : No single cause; no single cure.Hence: A spectrum, a continuum, a syndrome.(debatable?)

Its easier to spot Autism at the low-functioning end of

the spectrum. ADHD is often diagnosed because of ODD/CD.

Although poor parenting does not cause ADHD (orAutism) it can make things worse.

ADHD is a preferable diagnosis to Autism. Behavioural (ASD) and Pharmacological (ADHD)treatments can be effective but may not address cause.


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"We are not born to suffer. We are born to thrive. If

you live in a dry area and your garden receives

little water, you plant plants which like dry soil. But

when you are given a plant that likes wet soil, you

don't kill it, you water it, you spend one of your1440 minutes each day watering that plant.

Because you know, that given the right care, that

little bit of effort can produce spectacular blooms.

And so it should be with children like us."Joshua Muggleton, age 17

Accessed at http://mugsy.org/josh/

autism asperger

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