Autism

KULIAH BLOK XVI

FK UMP 2015

Autism is a behavioral syndrome of

neurologic dysfunction, ccharacterized by :
Qualitative impairments in reciprocal social
interaction,
Qualitative impairments in verbal &
nonverbal communication,
Presence of stereotypic, restrictive, and
repetitive patterns of behavior, interest, and
activities

Currently grouped under Pervasive

Developmental Disorders (PDDs) in the
DSM-IV :
Autism
Asperger disorder
PDD Not Otherwise Specified (PDD-NOS)
Childhood Disintegratif disorder
Rett syndrom

Prevalence is 16 - 40 cases/10.000
schoolaged children,

More boys than girls are affected

(3-4 : 1 )

No predilection for any racial, ethnic, or

socioeconomic group

 No

known etiology can be

found in 80 90 % case

 Genetics
Brain disease (TORCH infections)
Dev. Brain abnormalities (microcephaly,
hydrocephalus)
Metabolic diseases (PKU, MPS)
Postnatally acquired destructive disorder
(Encephalitis, Meningitis)
Lead encephalopathy
Neoplasm
Genetic disorder (Tuberous sclerosis, fragile X
Syndrome)

 Although

there has been much

debate over the past decade
about possible link between
vaccines or dietary factors and
the onset of ASD, research
studies have not supported
these as causal factors

Abnormal neurochemical findings

abberant of dopamine functioning
increased level of serotonin
Abnormal neuroradiologic findings
deficit in RAS
structural cerebellar changes
forebrain hippocampal lesion
abnormalities in the prefrontal &
temporal lobes area

Severe deficit in reciprocal social

interaction, eg.
Delayed or absent social smile, failure to
antisipate interaction with caregivers,
lack of attention to a primary caregivers
are often evident in the first year of life
In todlers, deficiencies in imitative play
and a relative lack of interest in
interactions with others
Eye contact is minimal or absent

Impairments in communication
Language development is quite delayed,
nondeveloped or poorly developed verbal
and nonverbal communication sklills
Echolalic
Abnormalities in speech pattern
Impaired ability to sustain a conversation

Behavioral peculiarities,
Stereotypical body movements, restrictive,
and repetitive pattern of behavior (twirling,
hand-flapping)
A marked need for sameness
Self-injurious behavior
Tempertantrum

Abnormal patterns of eating and sleeping

Unpredictable mood changes
Bizzare responses to sensory stimuli
Mouthing of objects
Diminished responses to pain
About 60 - 70% have IQ below 70

1. Impaired reciprocal social interaction

(at least 2).
- Lack of social or emotional reciprocity
- Impaired ability to make peer friendships
- Lack of seeking of share enjoyment or
interest
- Absent or impaired imitation
- Absent or abnormal social play

2. Impaired communication and imaginative

activities (at least 1)
- Absent communication
- Abnormal nonverbal communication
- Absent imaginative activity
- Abnormal speech production
- Abnormal speech content
- Inability to initiate or sustain conversation

3. Restricted repertoire of activities &

interest (at least 1)
- Stereotiped body movements
- Persistent preoccupation with object
- Distress with environmental change
- Insistence on following routines
- Restricted range of interest

Hearing impairment
Developmental language disorder
Asperger disorder
PDD-NOS
Retts syndrome
Childhood disintegrative disorder
Schizophrenia
Undifferentiated mental retardation

Impairments in social interaction and

restricted interest/ repetitive behavior

Should not have significant delays in

cognitive, language, or self-help skills

Impairment in reciprocal social interaction

along with ipairment in communication
skills, or restricted interest or repetitive
behaviors
Do not meet full criteria for autism due to
mild or atypical symptoms

Typical development for at least 2 years

followed by regression in at least 2 of the
following 3 areas :
Social interaction
Communication
Behavior

A genetic syndrome caused by mutation on

the X chromosome
Affecting girls almost exclusively
Development proceeds normally until 1
years, at which time language & motoric
development regress and microcephaly
becomes appearant

A. Early intervention : Special education

communication & social skill
behavioral management
occupational therapy
sensory integration intervention
diet terapi
B. Antipsychotic medications.
- Risperidon, haloperidol, pemoline
C. Support for families

Autism is lifelong disorder.

Major determinant of prognosis are :
Presence or absence of an underlying dis.
of the brain and its acceptability to
treatment
Speech by age 5 years
Intelligence

5 10 % will become independent adults

25 % will show notable developmental

progress

65-70 % will continue to be substantially

impaired and required a high level of
going care

SELAMAT BELAJAR