ADHD and ASD Flashcards
(25 cards)
What is the triad that characterises ADHD?
inattention
hyperactivity
impulsivity
What is the autistic triad?
communication
social interaction
flexibility of thought/imagination
repetitive behaviours
Describe communication in ASD.
expressive language > receptive language
both are delayed; expressive language is often echoed, at odd donation/pitch and can be chunks of video speak.
Receptive language is delayed and abstract language is difficult.
Which features of social interaction do those with ASD have difficulty with?
joint attention & referencing turn taking unable to share pleasure not motivated by social approval empathy relationships others POV/feelings
What sensory issues do those with ASD have?
fussy eater/medications textures of clothes sleep toilet training hair washing/cutting nail cutting noise
What is the difference between child AdHD and adult ADHD?
adult has less obvious symptoms of hyperactivity/impulsivity and more inattentive symptoms
What is the impact of childhood ADHD?
parenting difficulties
increased levels of home stress & high expressed emotions
difficulties in peer relationships
reckless & dangerous behaviour
developmentally inappropriate decision making
barrier to learning and potentially exclusion from school
higher likelihood of antisocial behaviours
What are some perinatal factors in ADHD?
tobacco and alcohol use
significant prematurity and perinatal hypoxia
unusually short or long labour, foetal distress, low forceps delivery and eclampsia
Exposure to viral infection during 1st trimester?
Which type of parenting might be linked to a higher chance of a child developing ADHD?
inconsistent parenting
Which psychosocial adverse situations are associated with higher rates of ADHD?
severe martial discord low social class large family size paternal criminality maternal mental disorder emotional trauma
What would a typical brain map pattern show in children with ADHD?
underachieve function within frontal lobe
What neurochemistry is seen in ADHD?
excessively efficient dopamine removal system - higher conc of dopamine transporters
Leads to reduction in NA and serotonin
What is the diagnostic criteria for child ADHD?
6 or more symptoms of inattentiveness ±
6 or more symptoms of hyperactivity & impulsiveness
present <5 y/o
reported by parents, school & seen in clinic
symptoms interfere with daily life
What is the diagnostic criteria for adult ADHD?
5 or more symptoms of inattentiveness ±
5 or more of hyperactivity & impulsiveness
Historical concerns since early age.
In adults, it is essential for the diagnosis that symptoms should have a moderate effect on different areas of their life, such as…
underachieving at work / in education
driving dangerously
difficulty making / keeping friends
difficulty in relationships with partners
What is the first line pharmacological treatment for moderate and severe ADHD?
1st = stimulants (methylphenidate, dexamfetamine)
How do the 1st line stimulants work?
methylphenidate increased dopamine by blocking its transporter
dexamphetamine does this too and also increases extracellular NA & possibly serotonin
What is the role of SNRIs in ADHD?
non-stimulants (SNRI, e.g. atomoxetine) increase NA by blocking its transporter or by reducing sympathetic stimulation (alpha-agonists)
What are the specific cases that can cause autistic behaviour?
rubella in pregnant lady tuberous sclerosis fragile X syndrome encephalitis untreated phenylketonuria (PKU)
What is the most common inherited form of intellectual disability?
fragile X syndrome
Which areas of the brain appear pathological in autism?
frontal lobes, amygdala and cerebellum
A large amygdala is associated with what symptoms?
severe anxiety and worse social and communication skills
Which speech & language difficulties can aid diagnosis in children?
Lack of babble / vocal sounds
Can repeat words/phrases spoken by others without formulating their own language, or in parallel to developing their language skills.
Older children have issues with non-verbal behaviours
What are some common co-morbid emotional disorders?
depression and anxiety (40-60%) eating disorders (20%)
