Autism Core Knowledge Flashcards

A child with ASD demonstrates echolalia by repeating phrases from a cartoon immediately after hearing them, but uses those same phrases functionally in relevant contexts later. According to Prizant's framework, this type of echolalia is BEST classified as:

Answer: Functional delayed echolalia

Prizant distinguished functional delayed echolalia — where the child repurposes previously heard scripts to serve genuine communicative purposes in appropriate contexts — from non-functional repetition. The child is using the echoed phrases as a communicative tool, making this functional delayed echolalia rather than mitigated (which involves partial modification) or non-communicative scripting.

During a naturalistic teaching session, a 7-year-old with ASD consistently demonstrates joint attention bids (e.g., pointing to share interest) but fails to respond to the partner's joint attention bids. This asymmetry MOST directly implicates a deficit in which neurocognitive domain?

Answer: Responding to joint attention (RJA)

Joint attention has two separable components: initiating joint attention (IJA) and responding to joint attention (RJA). This child can initiate (bid) but cannot follow or respond to another person's bids — a selective deficit in RJA. RJA relies heavily on gaze-following and social referencing, and its impairment is more strongly associated with later language outcomes in ASD than IJA deficits.

Research on the 'broad autism phenotype' (BAP) is MOST relevant to which aspect of ASD etiology?

Answer: Supporting a dimensional genetic liability model where subclinical traits cluster in relatives of individuals with ASD

The BAP refers to subclinical but measurable social, communication, and rigid/repetitive traits observed in first-degree relatives of individuals with ASD. Its existence supports a quantitative, dimensional genetic liability model — ASD represents the extreme end of a continuously distributed set of traits, and genetic risk can manifest in milder form below diagnostic threshold. This argues against a purely categorical or de novo mutation model for familial ASD.

A practitioner targets 'theory of mind' by teaching a student with ASD to pass first-order false belief tasks (e.g., Sally-Anne). The student masters this but continues to struggle in naturalistic social interactions. This gap is BEST explained by:

Answer: A dissociation between explicit mentalizing (deliberate, effortful ToM reasoning) and implicit social cognition used in real-time interaction

Research distinguishes explicit ToM — deliberate, reflective reasoning about mental states that can be trained via structured tasks — from implicit, automatic social cognition that operates in real-time naturalistic interaction. Individuals with ASD may learn to pass ToM tasks through explicit reasoning strategies but still lack the rapid, automatic mentalizing that underlies natural social exchange. This dissociation, not merely poor generalization, explains persistent social difficulties despite task success.

Sensory processing differences in ASD have been incorporated into DSM-5 under Criterion B. Which of the following patterns represents HYPORESPONSIVITY rather than hyperresponsivity or sensory-seeking?

Answer: Failing to orient to one's own name being called across multiple trials

Hyporesponsivity involves a dampened or absent response to sensory input that would typically elicit a reaction — the child who does not turn to their name despite normal hearing thresholds exemplifies this. Ear-covering and fleeing represent hyperresponsivity (over-reactivity). Seeking spinning and deep pressure is sensory-seeking behavior. Clothing tag discomfort is tactile hyperresponsivity. DSM-5 explicitly lists all three patterns (hypo-, hyper-, and seeking) under the sensory criterion.

When applying the ADOS-2 Module 3 to a verbally fluent adolescent with suspected ASD, an examiner notes the individual produces spontaneous, on-topic narrative but lacks 'quality of social overtures.' Which ADOS-2 algorithm domain does this PRIMARILY contribute to?

Answer: Social Affect (SA) domain score

The ADOS-2 Module 3 algorithm combines items into two domains: Social Affect (SA) and Restricted and Repetitive Behaviors (RRB). Quality of social overtures — the degree to which the individual initiates social interaction with appropriate warmth, reciprocity, and social motivation — is coded within the SA domain. SA encompasses communication and reciprocal social interaction items combined, so the quality of overtures is not isolated to a 'communication only' subdomain in the Module 3 algorithm.