Diagnosing autism spectrum disorder | Mental health | NCLEX-RN | Khan Academy

Diagnosing autism spectrum disorder | Mental health | NCLEX-RN | Khan Academy


– [Voiceover] So Autism Spectrum Disorder is this really broad
disorder where the affected person has trouble communicating and interacting with other people. And they also have this
sort of restrictive and repetitive behavior where they can be really restrictive with their interests, maybe only showing interest
in one or two activities and repetitive with their behaviors or maybe the routines
that they need in place. And while we’re not entirely sure yet what causes Autism Spectrum Disorder, we do have a few clues that we’ve kind of picked up over the years that are helping us try to figure out what the cause is. So we know that if kids
have a family member, someone who they share
some of their DNA with, also known as a blood relative, if one of their family members
has Autism Spectrum Disorder, well they have a higher chance of also having Autism Spectrum Disorder. And we also know that boys are more likely than girls to develop
Autism Spectrum Disorder. So both of these suggest to us that maybe genetics is playing part of a role in the development of Autism Spectrum Disorder. And we also know that
the older the parents are when they have their kid, the higher the chances that the kid will
have Autism Spectrum Disorder. And that kind of points to
a genetic cause as well. So those are some of the clues we have, but we’re still trying to
figure out the whole puzzle when it comes to the cause
of Autism Spectrum Disorder. So if we suspect that a kid might have Autism Spectrum Disorder, how might we go about confirming or diagnosing Autism Spectrum Disorder? Well, for Autism Spectrum Disorder there really isn’t a test like
a blood test or a scan or anything like that that we
can use to make the diagnosis. So what we have to do instead is really look for the signs of
Autism Spectrum Disorder. The trouble with
communicating and interacting and the restrictive and
repetitive behaviors. So you can imagine that diagnosing
Autism Spectrum Disorder can be a little tricky,
and that sometimes it can take quite a while for
a diagnosis to be made. So to help us with diagnosing
Autism Spectrum Disorder, there’s actually a really useful manual sort of like a guidebook
that we use called the Diagnostic and Statistical
Manual of Mental Disorders, or what we often shorten to the DSM. So let’s actually pull
up what we would find if we cracked open the DSM and checked out the criteria for diagnosing
Autism Spectrum Disorder. Now something that I should mention here is that the most current
version of the DSM which is the fifth edition, so the DSM 5. Well when it came out a few years ago, there were actually some big changes made to Autism Spectrum Disorder. So in the DSM 4, the
older version of the DSM, there were several different
Autism Spectrum Disorders including Autistic Disorder,
Asperger’s Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder and now in the DSM 5
all of these different Autism Spectrum Disorders have kind of been merged into one spectrum disorder. Autism Spectrum Disorder, and this was done because kids with these different disorders, they really do fall along a spectrum, and the hope was to make diagnosing a
child a bit more accurate. So now in the DSM 5 there’s just one Autism Spectrum Disorder
and kids will fall in different places along this spectrum. Okay, so the current requirements for diagnosing Autism Spectrum Disorder are split up into two main categories and these categories, they’re actually the main signs of Autism
Spectrum Disorder. So the first category that
we would find in the DSM is persistent deficits in social communication and interaction. And this just basically
means that the child’s social development is not quite tracking along the way it should be. So a child would have to display issues with their social interactions in order for us to consider diagnosing them with Autism Spectrum Disorder. And there are actually a few specific ways that a child would need to show this, this deficit in social
communication and interaction. So the first one here is deficits in social and emotional reciprocity. Now reciprocity is when two people do something for each other,
so in a social situation this is kind of the back and
forth flow of a conversation where we respond to each
other in similar ways. So maybe someone smiles at
you and says good morning. Well, you would likely do the same. You would return their smile and say good morning back to them as well. And when you do that, you’re returning, you’re reciprocating their emotions and their social gestures. So having trouble with
understanding and using this sort of social and
emotional reciprocity is one of the communication
deficits that we would need to see in someone in order to diagnose Autism Spectrum Disorder. And it’s not simply because
they don’t want to say hi. I’m sure everyone’s got someone they’re not stoked to say hi to, but it’s because the
reciprocation it doesn’t really occur to them as a
social requirement, if you will. Now another sign that we would need to see in order to diagnose
Autism Spectrum Disorder is some sort of deficit in developing and maintaining relationships. And here we’re talking about relationships with peers, with people
around the same age. Because it’s actually not uncommon for kids with Autism Spectrum Disorder to befriend people who are
younger or older than them, but then still struggle with building relationships with people their own age. And the last sign that
we would need to see under this social
communication and interaction category here is some sort of deficit in nonverbal communication. So this means that the person would have trouble understanding and using things like hand gestures and eye contact and facial expressions
when they’re communicating. So that’s the fist
category that would need to be checked off before
you would consider diagnosing someone with
Autism Spectrum Disorder. And that makes sense, right? Because trouble with social communication and interaction is one of the main signs that we see in someone with
Autism Spectrum Disorder. So there’s one more
main category that also needs to be checked off before we can officially make a diagnosis
of Autism Spectrum Disorder. And as you might have guessed, this category is one
of the other main signs of Autism Spectrum Disorder, and that’s restrictive and repetitive
behavior and interests. So you might remember that for a kid with Autism Spectrum
Disorder, there are a few different ways that they might show this, this restrictive and repetitive
behavior and interests. So they might have
really fixated interests. Maybe they’re only really
interested in one or two activities and they show
no interest in any others. They might be really
strict about following routines or rituals, or maybe they really struggle with change. They might have repetitive
sounds or movements or behaviors that they perform. Or maybe they react to stimulation like bright lights or
loud sounds a bit more or a bit less than what we would expect. So these are the two main categories that we would need to check off in order to diagnose Autism Spectrum Disorder. And there are two little things that I should also mention that the DSM requires from a kid in order
to make that diagnosis. So one is that all of these behaviors, they start coming on when the
kid is in early childhood. And the other is that these behaviors, they interfere with the kid’s daily life. All right, so now we know what we need to see in order to diagnose a kid with Autism Spectrum Disorder. So how do we go about
looking for these signs? Well what we really rely on is asking the parents questions and
talking to and playing with the kid to see if we can pick up on any of these signs here. Now these questions,
they’ll vary quite a bit depending on how old the kid is. So maybe if the child is a toddler, let’s say they’re between the age of six months old to two years old. Well, to look for this deficit in social communication and interaction, we might ask the parents if
their child makes eye contact or smiles and laughs with the parent. Or maybe we’ll ask if the child tries to show or share toys with the parent. If the kid was a bit older, we might ask the parent how the kid is doing with making friends at school. And if we wanted to look
for this restrictive, repetitive behavior, we
might ask how the kid handles change or unexpected situations like a different bed time
routine or going on a trip. Maybe we’ll ask the parents
to see if their child has any particular habits
that they like to repeat like lining up toys in a special way, or if they’ve noticed that
any environmental stimuli like a car honking or a light flashing really tends to bother their kid. Now, while these are
the diagnostic criteria, part of diagnosing
Autism Spectrum Disorder also involves ruling out disorders that can look like
Autism Spectrum Disorder. So for example, intellectual disability, which is when someone
has trouble functioning in many areas of their
life, like communication, taking care of themselves at school with their academics, well,
intellectual disability can actually kind of look the same as Autism Spectrum Disorder, especially when the kid is young. It’s hard to decide if a kid’s trouble with communication and interaction is due to Autism Spectrum Disorder, or due to an intellectual disability. So, part of diagnosing
Autism Spectrum Disorder involves trying to really make sure that the trouble that the kid is having fits this picture here of
Autism Spectrum Disorder rather than the picture of another disorder like intellectual disability. And to make things a little
trickier, it’s actually not uncommon for kids with
Autism Spectrum Disorder to also have an intellectual disability. So this means that they
would meet the criteria for both Autism Spectrum Disorder and intellectual disability. This doesn’t mean that all children with Autism Spectrum Disorder have intellectual disability, not at all. Often, there’s no intellectual
impairment at all, but this just highlights that sometimes, especially when the kid is really young and still growing and developing, it can be a little tricky to figure out exactly what’s behind their struggles with communication and interaction. So it may take a few years
to make a final diagnosis, but diagnosing Autism Spectrum Disorder really comes down to observing the child’s social behaviors and habits for some time.

Comments

(8 Comments)

  • lexa7821

    Hey, autism spectrum disorders are equally found in male and female people. It's just that sins are more obvious in men than women

  • Cesar Filho

    Good lecture, but she repeats Autism Spectrum Disorder like ten thousand times, it's annoying and shows a repetitive behavior. She might have ASD.

  • Phil R

    PLEASE STOP BEGINNING SENTENCES WITH THE WORD SO………..SHEESH COUNT THE WORD SO PER MINUTE !!!!! AAAGH!

  • rigoberto solorzano

    This was helpful thank you

  • Jessica Berry

    Can autism also look like sadness from being stolen from mom and dad?

  • Jen Jeanmard

    Our daughter meets the criteria for ASD and videos like these are so helpful for parents who are trying to identify signs accurately and makes the process to getting an diagnosis less frustrating and confusing. We are very lucky to have such a fantastic pediatrician who was able to see the signs before us. Our daughter is 22 months now.

  • Dotti

    Asd is idiopathic meaning theres no cause. Genetics doesnt make it the cause. At all. That also implies that it needs to be fixed. It doesnt. Please fix THAT. Dsm 5 came out like almost 10 years ago.

  • dAnne Corrigan

    I have pdd nos which is under the autism spectrum umbrella

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