ASD Flashcards
What are the three major areas of qualitative abnormalities in children with autism according to DSM-IV and ICD-10?
- Reciprocal social interaction
- Communication (verbal and non-verbal)
- Restricted and repetitive patterns of behavior
What does “reciprocal social interaction” refer to in the context of autism?
It refers to the ability to engage in social relationships and interactions.The ability to engage in back-and-forth interactions and responding to social cues.
What are “restricted and repetitive patterns of behavior” in children with autism?
repetitive movements, insistence on sameness, or intense focus on unusual interests.
What are the types of Autism Spectrum Disorders recognized in DSM-IV and ICD-10?
- Autism
- Atypical Autism
- Rett Syndrome
- Childhood Disintegrative Disorder
- Asperger Syndrome
- Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)
In DSM IV, what are the three criteria for autism ?
- Social Impairment
- Speech/Communication Deficits and Language Delay
- Restricted/Repetitive Behaviors & Interests
How is Autism represented in the DSM IV classification?
Autism is represented as an overlapping condition among the three categories of developmental issues.
What are the two main criteria included in the DSM 5 for Autism Spectrum Disorders?
- Social Communication and Interaction
- Restricted & Fixated Interests
What are the specifiers used in the DSM-5 for Autism Spectrum Disorders?
- Severity (3 clinical levels)
- Expressive language level
- others :
* ID , language impairment
* Associated with known medical/genetic condition
* Associated with another neurodevelopmental, mental or behavioural disorder
* With catatonia
What associated features are considered in the diagnosis of Autism Spectrum Disorders?
Associated features include intellectual ability and genetic syndromes.
What are some examples of restricted and repetitive patterns of behavior in individuals with Autism Spectrum Disorder?
Examples include :
* stereotyped movements
* insistence on sameness
* highly restricted interests
In which contect must the social communication impairments occur for a diagnosis of Autism Spectrum Disorder?
The impairments must occur across multiple contexts, such as at home, school, and in social settings.
What are the three main areas of social communication deficits in Autism Spectrum Disorder?
- Socio-emotional reciprocity
- Non-verbal communicative behaviors used for social interaction
- Developing, maintaining, and understanding relationships
What is meant by “socio-emotional reciprocity” in the context of ASD?
The ability to engage in back-and-forth interactions, sharing emotions and interests, and responding appropriately to social cues.
Which behaviours fall under the category for restricted and repetitive patterns of behaviour in ASD
- Stereotyped or repetitive
movements, use of
objects, or speech - Insistence on sameness,
inflexible adherence to
routines, or ritualized
patterns of verbal or non-verbal behaviour - Highly restricted, fixated interests
- Sensory hyper/hypo-reactivity
How many of the restricted and repetitive patterns of behavior must one have for the diagnosis of ASD?
two
What does sensory hyper/hypo-reactivity refer to in the context of ASD?
unusual responses to sensory input, such as being overly sensitive to sounds or textures (hyper-reactivity) or showing indifference to pain or temperature (hypo-reactivity)
What are the deficits in social-emotional reciprocity in ASD?
- Abnormal social approach
- Lack of two-and-fro conversation
- Reduced sharing of interests, emotions, affect
- Failure to initiate or respond to social interactions (interest in children, response to children/peers)
What are the deficits in non-verbal communicative behaviors used for social interaction?
- Poorly integrated verbal and non-verbal communication
2.Failure to use eye gaze and body language, facial expressions to regulate social interaction.
3.Difficulties in understanding and use of gestures
Which gestures does an individual with ASD find difficult to understand and use?
- pointing to express interest
- nodding, head shaking * conventional/instrumental gestures, descriptive/emphatic gestures
What are the deficits in developing, maintaining, and understanding relationships in ASD?
- Difficulty adjusting behavior to different contexts
- Difficulty in sharing of imaginative play (spontaneous imitation of action, imaginative play, social play, group play)
- Absence of interest in peers
Give example of how someone with ASD could find it difficult adjusting behavior to different contexts
- Asking inappropriate questions
- making inappropriate facial expressions
What behaviours fall under the the catagory for “Stereotyped or repetitive motor movements, use of objects, or speech”
- Hand and finger mannerisms
- Lining up toys, flipping objects (repetitive use of objects, interest in parts of objects)
- Echolalia, idiosyncratic phrases
What is meant by insistence on sameness in ASD?
- Extreme distress at small changes, difficulty with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food
- (Minor changes in routine, minor changes in environment, concrete thinking, verbal rituals, inflexibility in behavior or play)
What are characteristics of highly restricted, fixated interests in ASD?
- Strong attachment to or preoccupation with unusual objects
- Excessively circumscribed or perseverative interests
What are charectaristics of hyper- or hypo-reactivity to sensory input refer to in ASD?
- indifference to pain/temperature
- dverse response to specific sounds or textures, excessive smelling or touching of objects.
- visual fascination with lights or movement
How is Rett syndrome
classified as a genetic disorder associated with ASD
What are the red flags related to social interaction and communication in ASD?
- Not responding to name by 12 months
- Not pointing at objects to show interest by 14 months
- Avoiding eye contact and wanting to be alone
- Trouble understanding other people’s feelings or talking about their own feelings
- Delayed speech and language skills
- No ‘pretend play’ by 18 months
What are the repetitive behaviors and restricted interests that can be red flags for ASD?
- Repeating words or phrases over and over (echolalia)
- Having obsessional interests
- Hand flapping, body rocking, spinning in circles
What sensory sensitivities and cognitive responses can be red flags for ASD?
- Unusual reaction to sound, smell, taste, look, or feel
- Getting upset by minor changes in routines
- Giving answers unrelated to questions
What is essential for diagnosing ASD?
Clinical judgment and understanding of ASD characteristics as defined in the DSM-5.
How is the assessment for ASD structured ?
- History
- Observations
- Cognition
- Speech and language , OT
- Behaviour and mental health
- Family assessment
- Medical investigations
What types of settings should a child be observed in for ASD assessment?
Home and school, in both structured and unstructured contexts.
What key areas are observed in a child suspected of having ASD?
- Ability to attend,
- Ability to imitate,
- comprehend and use language
- play appropriately,
- engage in social interactions.
What does cognitive assessment for ASD evaluate?
- Attention difficulties,
- working memory problems
- processing speed
- planning, and sensory-motor integration.
What aspects are assessed in speech and language evaluation for ASD?
- Receptive and expressive language skills,
- phonological difficulties
- grammatical abilities
- pragmatic use of language.
What does occupational therapy assessment focus on in ASD?
Motor skills, sensory integration, and overall functioning
What behavioral and mental health conditions should be screened for in individuals with ASD?
Depression, anxiety, OCD, and ADHD
Why is family assessment important in diagnosing ASD?
It helps understand the family profile, other developmental disorders(depression, anxiety), and the family’s needs (support).
What percentage of individuals with ASD may have known medical conditions?
10-20%.
When might genetic testing be justified in ASD assessment?
If there are clinically suspected abnormalities.
What genetic conditions are associated with ASD?
- Fragile X syndrome,
- Tuberous Sclerosis Complex
- Rett syndrome
- Neurofibromatosis type 1
What additional medical investigations may be recommended for ASD?
Imaging and EEG
In what cases is Imaging and EEG recommended in the assessment for ASD?
in cases of epilepsy or intellectual disability.
What is Autism Spectrum Disorder (ASD) classified as?
A behavioral syndrome with no pathognomonic features.
What percentage of individuals with ASD experience regression/decline , and when does this occur ?
Regression is seen in 30% of individuals, typically around 18-21 months.
Is there a greater prevalence of epilepsy in individuals with regression compared to those without?
No
What are the indications for a neurological workup in individuals with ASD?
- Late regression (after 24 months)
- Clinical suspicion of seizures
- Fluctuating clinical course
What specific inborn errors of metabolism are associated with ASD?
- Phenylketonuria (PKU), * mitochondrial disorders
- mucopolysaccharidoses, and Smith-Lemli-Opitz syndrome.
name some of the therapies for ASD that have positive evidence
- Early Intensive Behavioural Interven1on (EIBI)
- Cogni1ve Behavioural Therapy (CBT)
- Treatment and Educa1on of Autistic and related Communication handicapped Children (TEACCH)
- Social Stories
- Applied Behaviour Analysis (ABA)
What is the preferred management approach for ASD?
combined approaches:
behavioural, developmental and educational
strategies (reduce unwanted behaviours,
teach new skills, expand social interaction)
* programmes must be indivisualised
What is a key focus in the effective management of ASD?
A family-centered approach rather than purely child-centered interventions.
Why is early diagnosis and provision of services important in managing ASD?
It helps prevent secondary problems for both the family and the child.
What should be do as ongoing care for individuals with ASD?
- developmental disorders can evolve, requiring continuous support and adaptation.
- Support families for the marathon
- Anticipate and prepare for transition
- Review when there is a change in the child
- Review intervention if there is no progress
What should be done when there is a change in the child’s condition?
Review the situation and adjust interventions as necessary.
What action should be taken if there is no progress ?
Review and modify the intervention strategies being used.
