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Psychiatry3 > ASD > Flashcards

ASD Flashcards

1
Q

What are the three major areas of qualitative abnormalities in children with autism according to DSM-IV and ICD-10?

A
  1. Reciprocal social interaction
  2. Communication (verbal and non-verbal)
  3. Restricted and repetitive patterns of behavior
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2
Q

What does “reciprocal social interaction” refer to in the context of autism?

A

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.

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3
Q

What are “restricted and repetitive patterns of behavior” in children with autism?

A

repetitive movements, insistence on sameness, or intense focus on unusual interests.

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4
Q

What are the types of Autism Spectrum Disorders recognized in DSM-IV and ICD-10?

A
  1. Autism
  2. Atypical Autism
  3. Rett Syndrome
  4. Childhood Disintegrative Disorder
  5. Asperger Syndrome
  6. Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)
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5
Q

In DSM IV, what are the three criteria for autism ?

A
  1. Social Impairment
  2. Speech/Communication Deficits and Language Delay
  3. Restricted/Repetitive Behaviors & Interests
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6
Q

How is Autism represented in the DSM IV classification?

A

Autism is represented as an overlapping condition among the three categories of developmental issues.

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7
Q

What are the two main criteria included in the DSM 5 for Autism Spectrum Disorders?

A
  1. Social Communication and Interaction
  2. Restricted & Fixated Interests
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8
Q

What are the specifiers used in the DSM-5 for Autism Spectrum Disorders?

A
  1. Severity (3 clinical levels)
  2. Expressive language level
  3. others :
    * ID , language impairment
    * Associated with known medical/genetic condition
    * Associated with another neurodevelopmental, mental or behavioural disorder
    * With catatonia
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9
Q

What associated features are considered in the diagnosis of Autism Spectrum Disorders?

A

Associated features include intellectual ability and genetic syndromes.

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10
Q

What are some examples of restricted and repetitive patterns of behavior in individuals with Autism Spectrum Disorder?

A

Examples include :
* stereotyped movements
* insistence on sameness
* highly restricted interests

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11
Q

In which contect must the social communication impairments occur for a diagnosis of Autism Spectrum Disorder?

A

The impairments must occur across multiple contexts, such as at home, school, and in social settings.

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12
Q

What are the three main areas of social communication deficits in Autism Spectrum Disorder?

A
  1. Socio-emotional reciprocity
  2. Non-verbal communicative behaviors used for social interaction
  3. Developing, maintaining, and understanding relationships
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13
Q

What is meant by “socio-emotional reciprocity” in the context of ASD?

A

The ability to engage in back-and-forth interactions, sharing emotions and interests, and responding appropriately to social cues.

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14
Q

Which behaviours fall under the category for restricted and repetitive patterns of behaviour in ASD

A
  1. Stereotyped or repetitive
    movements, use of
    objects, or speech
  2. Insistence on sameness,
    inflexible adherence to
    routines, or ritualized
    patterns of verbal or non-verbal behaviour
  3. Highly restricted, fixated interests
  4. Sensory hyper/hypo-reactivity
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15
Q

How many of the restricted and repetitive patterns of behavior must one have for the diagnosis of ASD?

A

two

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16
Q

What does sensory hyper/hypo-reactivity refer to in the context of ASD?

A

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)

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17
Q

What are the deficits in social-emotional reciprocity in ASD?

A
  1. Abnormal social approach
  2. Lack of two-and-fro conversation
  3. Reduced sharing of interests, emotions, affect
  4. Failure to initiate or respond to social interactions (interest in children, response to children/peers)
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18
Q

What are the deficits in non-verbal communicative behaviors used for social interaction?

A
  1. 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
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19
Q

Which gestures does an individual with ASD find difficult to understand and use?

A
  • pointing to express interest
  • nodding, head shaking * conventional/instrumental gestures, descriptive/emphatic gestures
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20
Q

What are the deficits in developing, maintaining, and understanding relationships in ASD?

A
  • 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
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21
Q

Give example of how someone with ASD could find it difficult adjusting behavior to different contexts

A
  • Asking inappropriate questions
  • making inappropriate facial expressions
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22
Q

What behaviours fall under the the catagory for “Stereotyped or repetitive motor movements, use of objects, or speech”

A
  • Hand and finger mannerisms
  • Lining up toys, flipping objects (repetitive use of objects, interest in parts of objects)
  • Echolalia, idiosyncratic phrases
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23
Q

What is meant by insistence on sameness in ASD?

A
  • 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)
24
Q

What are characteristics of highly restricted, fixated interests in ASD?

A
  • Strong attachment to or preoccupation with unusual objects
  • Excessively circumscribed or perseverative interests
25
Q

What are charectaristics of hyper- or hypo-reactivity to sensory input refer to in ASD?

A
  • indifference to pain/temperature
  • dverse response to specific sounds or textures, excessive smelling or touching of objects.
  • visual fascination with lights or movement
26
Q

How is Rett syndrome

A

classified as a genetic disorder associated with ASD

27
Q

What are the red flags related to social interaction and communication in ASD?

A
  • 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
28
Q

What are the repetitive behaviors and restricted interests that can be red flags for ASD?

A
  • Repeating words or phrases over and over (echolalia)
  • Having obsessional interests
  • Hand flapping, body rocking, spinning in circles
29
Q

What sensory sensitivities and cognitive responses can be red flags for ASD?

A
  • Unusual reaction to sound, smell, taste, look, or feel
  • Getting upset by minor changes in routines
  • Giving answers unrelated to questions
30
Q

What is essential for diagnosing ASD?

A

Clinical judgment and understanding of ASD characteristics as defined in the DSM-5.

31
Q

How is the assessment for ASD structured ?

A
  1. History
  2. Observations
  3. Cognition
  4. Speech and language , OT
  5. Behaviour and mental health
  6. Family assessment
  7. Medical investigations
32
Q

What types of settings should a child be observed in for ASD assessment?

A

Home and school, in both structured and unstructured contexts.

33
Q

What key areas are observed in a child suspected of having ASD?

A
  • Ability to attend,
  • Ability to imitate,
  • comprehend and use language
  • play appropriately,
  • engage in social interactions.
34
Q

What does cognitive assessment for ASD evaluate?

A
  • Attention difficulties,
  • working memory problems
  • processing speed
  • planning, and sensory-motor integration.
35
Q

What aspects are assessed in speech and language evaluation for ASD?

A
  • Receptive and expressive language skills,
  • phonological difficulties
  • grammatical abilities
  • pragmatic use of language.
36
Q

What does occupational therapy assessment focus on in ASD?

A

Motor skills, sensory integration, and overall functioning

37
Q

What behavioral and mental health conditions should be screened for in individuals with ASD?

A

Depression, anxiety, OCD, and ADHD

38
Q

Why is family assessment important in diagnosing ASD?

A

It helps understand the family profile, other developmental disorders(depression, anxiety), and the family’s needs (support).

39
Q

What percentage of individuals with ASD may have known medical conditions?

A

10-20%.

40
Q

When might genetic testing be justified in ASD assessment?

A

If there are clinically suspected abnormalities.

41
Q

What genetic conditions are associated with ASD?

A
  • Fragile X syndrome,
  • Tuberous Sclerosis Complex
  • Rett syndrome
  • Neurofibromatosis type 1
42
Q

What additional medical investigations may be recommended for ASD?

A

Imaging and EEG

43
Q

In what cases is Imaging and EEG recommended in the assessment for ASD?

A

in cases of epilepsy or intellectual disability.

44
Q

What is Autism Spectrum Disorder (ASD) classified as?

A

A behavioral syndrome with no pathognomonic features.

45
Q

What percentage of individuals with ASD experience regression/decline , and when does this occur ?

A

Regression is seen in 30% of individuals, typically around 18-21 months.

46
Q

Is there a greater prevalence of epilepsy in individuals with regression compared to those without?

A

No

47
Q

What are the indications for a neurological workup in individuals with ASD?

A
  1. Late regression (after 24 months)
  2. Clinical suspicion of seizures
  3. Fluctuating clinical course
48
Q

What specific inborn errors of metabolism are associated with ASD?

A
  • Phenylketonuria (PKU), * mitochondrial disorders
  • mucopolysaccharidoses, and Smith-Lemli-Opitz syndrome.
49
Q

name some of the therapies for ASD that have positive evidence

A
  • 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)
50
Q

What is the preferred management approach for ASD?

A

combined approaches:
behavioural, developmental and educational
strategies (reduce unwanted behaviours,
teach new skills, expand social interaction)
* programmes must be indivisualised

51
Q

What is a key focus in the effective management of ASD?

A

A family-centered approach rather than purely child-centered interventions.

52
Q

Why is early diagnosis and provision of services important in managing ASD?

A

It helps prevent secondary problems for both the family and the child.

53
Q

What should be do as ongoing care for individuals with ASD?

A
  • 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
54
Q

What should be done when there is a change in the child’s condition?

A

Review the situation and adjust interventions as necessary.

55
Q

What action should be taken if there is no progress ?

A

Review and modify the intervention strategies being used.

Psychiatry3 (7 decks)

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