ASD Flashcards
What is the incidence of ASD
Males :females ratio
Incidence in Australia 1/60-68 males :females 4:1. Twins mono 60% increase dia 3-10% increased risk 7.6/1000 1/132
If you have fragile X 30% high rate and tuberous sclerosis 40%
ASD is a lifelong neurological condition that effects individuals in 2 main ares communication
And social interaction
They can have repetitive behaviors
Restricted repetitive pattern of behavior interests and activities
Persistent defects in social communication and social interaction
In peceiprocosity
Non verbal communication
Development and maintain and understanding relationships
Symptoms present in early childhood or show up later with the extra social remains but the history needs to show it was present <12 years of age
True
Investigations
History
Need Chromonsomes fragile x and Tubersous sclerosis’s
EEG children 7-14% ASD have epilepsy and 20-35% adults have Epilepsy
Need to test hearing and vision to exclude other causes of poor comminucations
Common presentations for ASD are
Delayed speech
Behavioral problems eg tantrums
You should initate referrals before make a diagnosis
Early intervention makes a difference
Red flags in communications ?? ASD
No words by 16/12. Delayed speech
Appears deaf
Lost words regression
No spontaneous phrases by 24/12 no echolasia
No babbling pointing gestireing by 12/12
In older children
Poor comprehension
Difficulty reading between the lines
Literal pedantic
Difficulties with to and fro communication
Red flags for social
Younger children
Does not smile socially
Restricted eye contact
Isolated / solitary play/ in his own world tunes out
Unaware /no interest in other children ( 2 years)
Prefers own play to social play (3 years )
Older children
Interest in but unable to sustain relationships
Misses social cues
Unusual quality of eye gaze
Unable to understand others feelings
Differences in factual experession/ body postures gestures
DSM 5 definition of ASD
1 persistent deceit is in social communication /interactions across contexts
2 restricted rpt patterns of behavior /interests/and activities
Symptoms limit and impair everyday functioning
+/- intellectual impairment
Social joint attention
Initially share enjoyment in an object looking back and foreword to the person who is with you ( in ASD more attention on the toy)
Later gestures and /or speech can be used to engage and response
Necessary for functional language development
DD of ASD
Sensory impairment eg vision /hearing Developmental delay ID Epilesy ADHD ( may be comorbid in 60%) Neurological/ regressive disorder Social communication disorder
Medical investigations
Bloods FBC/Vit b12 /elfts lead Leadville
TFT lead level urine metabolic screen CGH array
Fragile sr and lead level CK
2 Neuro imaging if head size large or focal neurological signs
3 EEG. If seizures /speech regression /neuro degenerative disorder
4 refer genetics/ neurology dysmorphic family history consanguinity
Development regression
ASD co morbidities
DD/ID Social anxiety ADHD Tic disorders Learning difficulties Language impairment Soldier sleep diet and mental health Medication can be used to target co morbidities eg SSRI for social anxiety Stimulants for ADHD Discussed Complimentary meds as a lot fo people use them Consider support for family and siblings
Interventions
The earlier the better the more the better
Early intervention about 20hours per week
Multidisciplinary approaches
In collaboration with the family
Aiming to produce generalized skills
Develop function communication and spontaneous communication
Reduce the maladaptive behaviors
Teach functional adaptive skills