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Special Pops - Peds > ADD, Autism, Aspergers > Flashcards

ADD, Autism, Aspergers Flashcards

1
Q

Major feature of ADD

A

Paying too much attention to too many things (having little focus rather than too little attention)

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2
Q

Types of ADD

A
  • Attentional
  • Hyperactive/impulsive
  • Combined
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3
Q

Diagnostic criteria of ADD/ADHD

A
  1. Onset is NO later than 7 yo
  2. Symptoms present in 2 or more situations (school, home)
  3. Disturbance causes clinically significant distress or impairment in functioning
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4
Q

Diagnostic criteria of inattention/hyperactivity/impulsivity

A
  1. 6 or more symptoms
  2. Symptoms have been present for at least 6 months
  3. Symptoms are inappropriate for developmental level
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5
Q

Treatment of ADD

A
  • Behavioral psychotherapy with effective medication

- Stimulants (methylphenidate) 1st line: side effects MC anorexia w/wt loss, mood effects, tics

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6
Q

What is the 1st line pharm treatment of ADD? MC side effects?

A

Stimulants (meythlphenidate, dextroamphetamine)

  • Anorexia w/wt loss
  • Mood effects
  • Tics
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7
Q

Diet changes to treat ADD/ADHD

A

Ineffective

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8
Q

What is the origin of learning disorders?

A

Neurologic

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9
Q

What is the central clinical feature of a learning disorder?

A

Lack of normal developmental skill, either cognitive or linguistic

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10
Q

What does a learning disorder NOT include?

A

Learning problems caused primarily by:

  • Vision, hearing, motor impairments
  • Mental retardation
  • Emotional disturbance
  • Environmental, cultural, economic disadvantages
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11
Q

What is a reading learning disorder?

A

Dyslexia

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12
Q

What skills are impaired with reading learning disorder?

A

One or more impairments in the 3 skills necessary for reading:

  1. Word decoding
  2. Automaticity of letter and word recognition
  3. Understanding the meaning of words
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13
Q

What is the deficit of dyslexia?

A

Language processing - deficient decoding of phonemes (individual linguistic units, smallest detectable sound in a spoken word)

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14
Q

What are phonemes?

A
  • Smallest detectable sound in a spoken word

- Dyslexia is a deficient decoding of these

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15
Q

Define morpheme

A

Smallest meaningful speech sound

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16
Q

Define grapheme

A

Smallest unit in written language

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17
Q

What is the major phonetic processing consequence of dyslexia?

A

Cannot adequately pair the visually processed graphemes with their associated phonemes (reading problems)

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18
Q

Treatment of reading learning disorder

A
  • Referrals to special ed (SLP)
  • Treatment of comorbidities
  • Consider ophtho
  • Ocular training appears to be INEFFECTIVE
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19
Q

Ocular training for dyslexia?

A

Appears to be ineffective

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20
Q

Describe dysgraphia

A
  • Writing learning disorder

- Uncertain whether this exists as an isolated disorder (usually in combo with reading and other disorders)

21
Q

What does the process of writing connect?

A

Writing connects cognition, language, and motor skills

22
Q

Treatment of math learning disorder

A
  • Address specific subcomponent deficits
  • Exploit a child’s developmental strengths and subject area affinities
  • Bypass techniques (circumvent the deficient math task component)
  • Teach real life math
  • Improve curriculum in US
23
Q

Define autism generally

A

Persistent deficits in social communication and interaction across multiple contexts

24
Q

What is severity of autism based on?

A

Social communication impairments and restricted, repetitive patterns of behavior

25
Q

How must symptoms present in autism to be diagnostic?

A
  • Must be present in the early developmental period
  • BUT may not become fully manifest until social demands exceed limited capacities
  • OR may be masked by learned strategies in later life
26
Q

What may explain some of the increased rates of PDD NOS?

A
  • Screen time has increased
  • May reinforce repetitive behaviors in vulnerable children
  • Decreases amount of interpersonal interactions
27
Q

What may explain hyperacoustic hearing in autistic patients?

A

Central auditory processing deficits that suggest distorted pathways between hearing and cortical processing

28
Q

Diagnosis of PDD requires that features be present by when?

A

3 yo

29
Q

Epidemiology of PDD

A
  • Males 5:1 for PDD/autism
  • Males 10:1 for Aspergers
  • Increase in reported cases probably due to increased identification of cases
30
Q

Clinical presentation of PDD

A
  • Language development issues (especially receptive)
  • Poor social interaction
  • Sensory integration difficulties
  • Stereotypic behaviors
31
Q

What does the AAP recommend for screening of PDD?

A

M-CHAT (Modified Checklist for Autism in Toddlers)

-Given at 18 and 24 months

32
Q

What are critical items of the M-CHAT?

A
  • Does your child imitate you?
  • Does your child respond to his/her name?
  • If you point at a toy, does your child look at it?
  • Does your child take interest in other children?
  • Does your child use index finger to point?
  • Does your child bring objects over to you?
33
Q

What is Retts syndrome?

A
  • X linked d/o in females (lethal in males)

- Leads to developmental reversals especially in expressive language, hand use, breath holding

34
Q

What is Fragile X?

A

MC cause of inherited mental retardation

  • Flat feet, flexible joints, low muscle tone
  • Large body size, forehead, long face
  • Soft skin
  • Macroorchidism
35
Q

What 2 disorders should be ruled out when evaluating for PDD?

A

Retts syndrome

Fragile X

36
Q

Neuropsych testing for PDD

A
  • Distinguish PDD NOS from a mood disorder

- Identify verbal and nonverbal learning disabilities

37
Q

Treatment of PDD

A
  • Antipsychotics

- Treatment of comorbidities (ADHD, OCD, etc.)

38
Q

Pathophys of autism

A

Abnormalities of cellular configurations in several regions of the brain

39
Q

Possible lab findings of autism

A
  • High whole blood serotonin
  • Low serum biotinidase
  • High C-terminally directed beta-endorphin protein immunoreactivity
  • Oxidative stress
  • Hyperlacticacidemia
  • Mitochondrial disorders
40
Q

MRI finding of autism

A

Enlargement of the total brain

41
Q

Treatment goal of autism

A

EARLY identification - well meaning attempts not to “label” children can deprive them of specialized services

42
Q

Pharm treatment of autism

A

No meds are efficacious for the core symptoms of autism

43
Q

Antidepressants in treatment of autism?

A

Help with compulsions/repetitive behaviors

44
Q

Features of Asperger syndrome

A
  • Persistent impairment in social interactions
  • No significant aberrations or delays occur in language (UNLIKE AUTISM)
  • Limited capacity for spontaneous social interactions
45
Q

Major difference between autism and Asperger’s?

A

In Aspergers, there are no significant aberrations or delays in language

46
Q

Life expectancy of Aspergers

A

Normal, except as impacted by comorbidities (especially depression)

47
Q

Clinical presentation of Aspergers

A
  • Peculiar and narrow interests
  • Sensitivity to sound, touch, pain, texture of foods
  • Synesthesia (“loud shirt”)
  • Interprets language literally (sarcasm is difficult)
48
Q

Treatment of Aspergers

A
  • Adaptations to sensory abnormalities (sunglasses, earplugs)
  • Psychotherapy
  • Relaxation training
  • Encouragement of special skills
  • Meds are for comorbidities

Special Pops - Peds (10 decks)

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