103. Autism Spectrum Disorder

Question 1

What is the hallmark of ASD?

Answer 1

LACK OF EYE CONTACT

deficits in socialization

Question 2

What is the DSM5 Criteria for ASD?

Answer 2

A. Persistent deficits in social interaction across MULTIPLE Contexts: in social-emotional reciprocity, non-verbal communication, AND relationships (ALL 3)
B. Sx of RESTRICTED + REPETITIVE behavior, and/or interests abnormal in intensity/focus: repetitive motor movements, inflexible routine, fixated interests hyperintensely, hypo/hyper-reactivity to sensory input
C. Sx present EARLY in development
D. Sx cause IMPAIRMENT in FX
E. Disturbances not better explained by ID/Global developmental delay

Question 3

What are common co-morbidities of ASD?

Answer 3

1. Hyperactivity/Tics
2. Specific Phobia
3. OCD
4. Self-injury/Aggression
5. Mood Sx (Anxiety/Depression)
6. Intellectual Disability
7. Seizures
8. Sensory Hypersensitivity (ARFID!)

Question 4

What tests should you run to rule out other conditions in evaluating ASD?

Answer 4

Genetic Testing: Fragile X, Rett Syndrome, Down syndrome assoc with ASD
Hearing/Vision Testing
Psychological Testing

Question 5

How does Social Pragmatic Communication Disorder differ from ASD?

Answer 5

SPCD: persistent deficits in social interaction across multiple contexts (DOMAIN A) but NO restricted/repetitive patterns of behavior (DOMAIN B)

Question 6

What is the epidemiology and etiology/RFs of ASD?

Answer 6

M>F 4:1, 1/68 children in US (COMMON)

Genetic: most heritable of all mental disorders (74-93%), POLYGENIC - combo of multiple gene interactions

RF: Maternal age > 40, Paternal Age > 50, Maternal Grandpa age > 50 when had child
Extreme prematurity (<26 weeks)
Closer spacing of pregnancies

Question 7

What are the non-pharm tx of ASD?

Answer 7

1. Behavior Modification: CBT, group therapy
2. Social Skills
3. Speech Therapy
4. OT (sensory sensitivities)
5. School Interventions: 504 plan/IEP - all types of therapy and ADHD accommodations, Vocational/Life skills training

Question 8

What is the pharmacological tx of ASD?

Answer 8

Only target disease sx/comorbidities

• Aggression/temper/self-injury: Atypical Antipsychotics (Risperidone, Aripiprazole), A2 Agonists (Clonidine, Guanfacine)
• inattention/ADHD: Stimulants, Atomoxetine, A2 agonists
• Anxiety/Depression: SSRI