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    neuropediatri

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF or read online from Scribd
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    4 views3 pages

    Tugas Baca Echolalia

    Uploaded by

    zaki
    neuropediatri

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF or read online from Scribd
    Flag for inappropriate content
    of 3
    Autistic Spectrum Disorders Deborah . Hirtz, Ann Wagner, and Pauline A. Filipek The autistic spectrum disorders (ASD) represent a wide contin: tuum of associstedcognisne and neurobehaviora dics, inl ing deficits in socallation and communication, with esticted {0d repetitive. pattems of behaviors [American Psychiat ‘Nsnciston, 199, 2000). Thetermsautism andautisic spectrum ddsordsts ae wed this chapter and ‘efor tothe broader umbrela of pervasive developmental disor ders (PDD), as defined by the Fourth Ftion ofthe Diagnostic ‘and tistical Manual of Mental Dondr| American Psybiatic ‘Asocaton, DSM-IV, 1994; DSM-IV-TR, 200). Historical Perspective of the DSM [ivo and Freeman, 1978; Rarer and Hero, 1977] In the DSM-III [American Poyhiatic Assocation, 1980) the term “autism” was include forthe fist time, and was cleady differentiated from childhood schizophrenia ad other paychosss under a new diagnostic umbrela of pervasive ‘kevdopmental disorders the posible PDD diagnoses incu the terms infantile autism (onset before age 30 months) and childhood-onst pervasive disorder (onset after age 30 months), with each further subelasfied a full syn drome present or residual state. The DSM-IIR [American Dyychiatrc Association, 1987] broadened the spectrum of PDD and narrowed the specific diagnoses to two: autistic dis- fonder and PDD ~ not otherwise specified (PDD-NOS). The DSM-IV [1994] and DSM-IV-TR [2000] incloded five possible under the PDD umbrdllst aut diordsr Asper= fxs disorder, childhood disintegrative disorder, Ret’s sy rome, and PDD-NOS/arypical autism. With an anticipated Publication date of 2013, DSM-V [in pres] will most Bkely liminate the term PDD ana nstad will se atic spectrum Aisonders asthe umbrella tem, with atistc disorder and ay ‘eal autsm asthe two posible diagnostic categories (hoe 1). Clinical Features of ASD All individuals on the autistic spectrum demonstrate deficits in three core domains reciprocal social interactions verbal and nonverbal communication, and restcted and repetitive be- haviors or interests [American Pachiatac Asocizuon, 1994, 2000). There is marked variability in the severity of symptoms across patients, and cognitive function an range’ fom 638 profound mental retardation through the superior range on ‘conventional 1Q tess. Symptoms and sign arediscussedin de- {all inthe DSM-IV, inthe monograph edited by Rapin [196], in the Wing Aut Disorders Interview Checklist ~ Revised [Wing 19%], and in numesous additional publications [Alen ‘a8; Alen abd Rapin, 1992; Barbaro and Dissanayake, 2009, Filipe et al, 1989, Greenspan et al, 2008 Rapin. and “Tuchman, 200% Zwvaigenbaum ea, 2009] (Box 48-2). Qualitative Impairment in Social Interactions ‘The criteria inthis domain refer toa qultarveimpairmentin repre soil inteacions, otto the absolut lack of al Ivor. Bchavion range from total lack of awareness of nother person to the pesace of ey onto that not wd to modoate soc intractionsThe qualitative nate of his tnd the communication domains wete fis ince inthe Ds (199). ‘Asinfants some attic chikiren donot typ theiamnsor chang postr in antipaionofbeng held. They mayor may ‘ot cudie or even fen when held nd often do na oko ‘ile when making a socl approach The characteris i= ‘shd-ak nlp play that is sen in pial veloping ints and toddlers seen missing Typically developing infants and toddlers ofen tke gest delight iv sing thir newsond “oie” finger t request orto shows thse with ASD wualy <> not pint to requestor showshare. Older children often do ‘nt pir things out ous eye contacto share te pleasure of ‘ecg someting with another person, which i led joint Stenom or sci referencing. Some chien do make eye contact offen only in bef dances butts eyecontactsusuaynotusedo getsomeanss ‘Ntetion Others may ke inappropriate eve wat ingsomeone dis hea to gent their eyes Autivbchiren ‘may appar to ignore «fila or unfair person becaise Gf lnk of socal inert. Some dhidran do make sci Sproat though theircomematnnal tura-tkingor mode tion of eecomtat ifn rosy impaired. At the opposite frome. of social Ineractons, some. cikien tay ake indiscriminate approaches to strangers (eg, climb tno the {amines lap before the parent bas entered the room be une Sfvare of paycologe barry ore scribd a 2 cil that continuous and inappropriately “ges in you fac”) ‘Some chien wih atm nat hte or interest in other dren ov adults and poets to play aloe, amy fom thers Others play with ads nearby o it om the outs Stother childs pay and engage in pal! payor simply tevtch the other shlden Soon hdr volver dren designated, aen mpotiive. play, But often only at © copy 02 Hater. gh ee 640 __Part Vil_Neurodevelopmental Disorders — Ddayed echoblia or scripts refers tothe use of highly nt ‘lized phrases that have Been memorized, suchas from videos, television, commercials or overheard conversations. The or fia of this sercoypic language does not necessarily have to Declearly identifiable. Many older autistic children incorpor the scripts nan appropriate conversational context, which can fe much of their speech a rehearsed and often more fuent ‘ality relative tothe rest oftheir spoken language. Children ko demonstrate dicufties with pronouns on other words that change in moaning with conte and they offen reverse [pronouns or refer wo themselves in the third person o by name. (Others may useliteral idiosyncratic phrases or neologisms. Ver bal autistic children may speak in detailed and grammatically correct phrases, which are none the less repetitive, concrete, and pedantic. Ifa childs ansers to questions seem to "miss the point” further history and conversation with the child should he dicted because thin also hallmark of attic an guage dct ‘Some autistic children do not appropriatly use miniature ‘objects, animal, or dos in pretend play. Others use the mi fatares in 3 repetitne, mechanical ishion without evidence of ‘representational pay. Some highly verbal children may invent a fantasy word that becomes the sole focus of repettive play. ‘A classic example ofthe lack of appropriate play isthe fueat futitic preschooler who “plays” by repeatedly reciting Soliloquy of the old witch scene verbatim from Besuty and the Beas while manipulating dollhouse characters in sequence precisely acconfing to the script. When given the sime miniature figures and dollhouse but instructed to ply some thing ther than Beauty and the Best, this child i incapable lof yntheszing any other pay scenatia, Restricted, Repetitive, and Stereotypic Patterns of Behaviors, Interests, and Activities ‘Some verbal autistic chilirem ask the same question repeated, regards of what replys given, or they engage in highly eepet itive perseverative play. Others are preoccupied with sped in teests tht are highly unostal. For example, many children are fascinated with dinosaurs, but autistic children may amass hhaustive facts about every conctivable type of dinosaur and out which museums house which particu fossils these children often repeatedly “share” their knowledge with others, ‘egal ofthe others’ interest or suggestions to the contrary. “Many autistic eildron are so preoccupied with “sameness” in their home and school environments or routines that lithe ‘ain be changed without prompting a tantrum or other emo tional disturbance. For example, some insist that all home far hishings remain inthe same position, that all clothing to be 8 particular color, or that only one speci set of favored sheets bbe used on the ed. Others may eat only from a specific plate ‘when sitting in a specific char in a specific room, which may not necesarily be the kitchen or dining room. Some children may insist om being naked while in the home but insist on sweating shoes to the dinner table This infesbility may also Dertan to famiiar routines, such a taking only a certain route ‘school, entering the grocery stare only by one speciic door, for never stopping or tuming around after the car stats ‘moving, Many parents may notbe aware that they are flowing ‘certain rituals to avoid the emotional upheaval, oF they maybe {ware but ae to embarrass to volunteer such information, Within this conta, some children have distinct hehavioral repertoires that they use to sustain sameness even when not imposed externally. By adulthood, many ofthese rituals may ‘eras to more classic obsesive-compulsive symptoms. Some children have obvious Seretypical movements, such as florid hand-

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