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