In Topic 3 you explored the possible alterations to ‘executive function’ in people with autism. Desc

In Topic 3 you explored the possible alterations to ‘executive function’ in people with autism. Describe how this aspect of cognition might be altered in a child with autism when, for example, they have been set a task to complete at school.Outline one method that can be used to detect these changes in a child with autism and give one limitation of the method you have described.A study by Harms et al. (2010), a meta-analysis of numerous emotion-recognition tasks, highlighted marked variation in findings, with some researchers finding clear evidence of particular recognition challenges for autistic people, and others not. As with most aspects of autism, the diversity of research findings reflects the heterogeneity of the spectrum. Findings concerning autistic cognition are not universal, and approaches like Baron-Cohen’s have received strong challenges.2.4  Executive function ‘ … children with Asperger’s often end up perseverating, obsessively repeating a particular response even when it is no longer of use … . We are often unable to shift our attention away from the point at which we have become stuck, or generate new strategies to try. Conversely we may pursue a single train of thought that we are interested in, unaware that it is leading us further and further away from the topic we are supposed to be concentrating on’. Sainsbury (2000) This description captures several challenges that autistic children and adults may experience in organising and adapting their behaviour to meet goals. Problems in this domain, known as executive function (EF) are considered in this section.2.4.1  Key components of executive function Box 2.1 uses the activities involved in cooking a dish to illustrate the key domains or components of executive function. initiation  Setting out to cook something. This might be an unfamiliar recipe or even a new one that the cook creates.Planning and organising  Executing the idea involves both of these, e.g. finding or devising a recipe; assembling all the ingredients.Working memory  Carrying out the recipe necessitates retaining and manipulating different items of information, short-term. For instance, to follow an unfamiliar recipe, you need to hold multiple instructions in your mind executing them in the correct sequence (e.g. fry onions, add chopped carrots and stock, season to taste).Behaviour regulation  including:Self-control  For an activity such as cooking, you need to sustain attention long enough to complete the dish and inhibit the impulse to do something different, such as going off to read a book.Mental flexibility  The ability to shift attention as necessary. For instance the ingredients will need stirring, while addressing other aspects of the task, such as adding further ingredients and seasoning. Behaviour may also need adapting (e.g. turn the heat down) if things are not going quite as the recipe suggests. When autistic children complete experimental tests of EF, the pattern of results, as common in the autism field, is not completely consistent. In some studies, a proportion, especially older children and those with good verbal skills, score in the same range as neurotypical control participants (Pellicano, 2011). Moreover, EF problems are not specific to autism. For instance, they are common in ADHD, and where this co-occurs with autism, the precise source of EF problems may be unclear. Research by Charman (2018) suggests that many EF problems seen in autism may reflect an accompanying ADHD condition.Another problem is that experimental EF tests may not adequately reflect real-life behavioural challenges such as those just illustrated concerning cooking and dressing. The following activity highlights this disparity. Child in Video 1.2Child in Video 1.3Mode of playUses the picnic items together with stuffed toys and toy food items for a pretend picnic in which the characters at the picnic are served and fed toy food items. Talks to the toys as if they were alive.Engagement with parentTalks to and makes eye contact with her parent; seeks parent’s help to identify and name food items.  ICD-10DSM-5CommentsThree ‘sub-type’ diagnoses:Childhood autismAsperger syndromePervasive developmental disorder – unspecified (some symptoms in common with autism but insufficient information to diagnose either autism or Asperger syndrome).A single diagnosis:Autism spectrum disorder.DSM-5 has replaced previous unreliable subtype diagnoses (autistic disorder, Asperger syndrome, pervasive developmental disorder and childhood disintegrative disorder) with one spectrum reflecting individually variable profiles. ICD-11 adopts the spectrum but differentiates autism sub-types with/without intellectual disability; with/without language disability.What are the main classes of symptom?Age by which symptoms must have appeared for diagnostic criteria to be met?ICD-10DSM-5CommentsFor childhood autism ‘functional impairment’ in social interaction, or in language use for communication, must have appeared by age 3 years.This early time frame does not apply for Asperger syndrome.Social communication difficulties and RRBIs must have been present in early childhood; however, ‘functional impairment’ need not be apparent till later.Allowing for cases where early childhood symptoms only become functionally impairing after age 3 years means that what was an Asperger type profile can now be included within the continuum.Sensory atypicalities are common in autism: how represented?How are differences in symptoms and severity represented in diagnosis?ICD-10DSM-5CommentsMainly through use of the three sub-diagnoses.Evaluation of severity (level 1, 2 or 3) is an integral part of the diagnosis.The DSM-5 scores specify severity in terms of level of support required.How are additional/comorbid problems represented?         The quote from Luke Jackson, also at the start of this section, suggesting a fascination with chain reactions and springs, could be consistent with systemising. The quote comes from Luke Jackson’s own guide to Asperger syndrome, written when he was a teenager.Baron-Cohen devised questionnaires – the empathy quotient (EQ) and the systemising quotient (SQ) – to measure empathy and systemising traits across the population. Large numbers of autistic and neurotypical respondents evaluated how strongly they agreed or disagreed with statements such as ‘I find it easy to put myself in someone else’s shoes’ or ‘I am fascinated by how machines work’ (Autism Research Centre, 2018). Alternative versions of the tests were devised for completion by parents, so that the EQ and SQ profiles of their children could be scored.On average, autistic respondents tended to score higher on systemising and lower on empathy, than most neurotypical respondents tested (Baron-Cohen et al., 2014; Greenberg et al., 2018). According to this profile, both autistic children and autistic adults should, on average, have particular interests and skills in ‘systematic’ subjects such as engineering, mathematics and IT, and be less interested in or skilled at dealing with people and social relationships.The approach has some merits: it highlights areas of strength in autism, juxtaposes social and non-social characteristics and describes autism in terms of personality traits which are measurable right across the population. In a 2018 collaboration with Channel 4, Baron-Cohen and colleagues collected empathy and systemising scores from around half a million people, including 36 000 on the autism spectrum. The scores for the autistic individuals replicated the pattern reported earlier, being, on average, higher on systemising and lower on empathy (Greenberg et al., 2018).The quote from Luke Jackson, also at the start of this section, suggesting a fascination with chain reactions and springs, could be consistent with systemising. The quote comes from Luke Jackson’s own guide to Asperger syndrome, written when he was a teenager.Baron-Cohen devised questionnaires – the empathy quotient (EQ) and the systemising quotient (SQ) – to measure empathy and systemising traits across the population. Large numbers of autistic and neurotypical respondents evaluated how strongly they agreed or disagreed with statements such as ‘I find it easy to put myself in someone else’s shoes’ or ‘I am fascinated by how machines work’ (Autism Research Centre, 2018). Alternative versions of the tests were devised for completion by parents, so that the EQ and SQ profiles of their children could be scored.On average, autistic respondents tended to score higher on systemising and lower on empathy, than most neurotypical respondents tested (Baron-Cohen et al., 2014; Greenberg et al., 2018). According to this profile, both autistic children and autistic adults should, on average, have particular interests and skills in ‘systematic’ subjects such as engineering, mathematics and IT, and be less interested in or skilled at dealing with people and social relationships.The approach has some merits: it highlights areas of strength in autism, juxtaposes social and non-social characteristics and describes autism in terms of personality traits which are measurable right across the population. In a 2018 collaboration with Channel 4, Baron-Cohen and colleagues collected empathy and systemising scores from around half a million people, including 36 000 on the autism spectrum. The scores for the autistic individuals replicated the pattern reported earlier, being, on average, higher on systemising and lower on empathy (Greenberg et al., 2018).  Health Science Science Nursing HEALTH, SP SK299 Share QuestionEmailCopy link Comments (0)

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