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PSYCHIATRY > ASD > Flashcards

ASD Flashcards

1
Q

Is Asperger’s syndrome considered a high or low functioning variation of Autism Spectrum Disorder?

A

High functioning

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2
Q

What disorders now all come under the heading of ASD?

A

Asperger’s Syndrome
Rett’s Syndrome (learning disability)
Childhood Autism
Pervasive Developmental Disorder

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3
Q

What is included in the triad of ASD symptoms?

A

Impaired social interaction
Impaired communication
Restricted Interests

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4
Q

What symptom of ASD is common but NOT included in diagnostic criteria?

A

Repetitive behaviours

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5
Q

How do repetitive behaviours in ASD differ from compulsions in OCD?

A

Repetitive behaviours are to provide comfort and safety

Whereas compulsions are distressing to patient, and must be completed to minimise distress

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6
Q

Describe the difficulties that patients with ASD have with social communication?

A
  • Good language skills but find it hard to grasp meaning of conversation
  • Difficulty understanding jokes/sarcasm
  • Voices often monotonous or English/American accent
  • Language = pedantic
  • Narrow interests dominate their conversations
  • Difficulty sharing thoughts/feelings/emotions
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7
Q

Why do patients with ASD struggle with social interaction?

A
  • Difficulty picking up non-verbal cues
  • self-focused/lacking in empathy
  • struggle to make/sustain relationships
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8
Q

What difficulties do ASD patients have with social imagination?

A
  • Difficulties thinking in abstract ways
  • Take things literally
  • Difficulty transferring knowledge across different settings
  • Difficulties projecting themselves into the future
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9
Q

What repetitive behaviours do patients with ASD often display?

A
  • Insistence on sameness, inflexible routine
  • Highly restricted/fixated interests
  • Hyper- or hypo- reactivity to various sensory inputs
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10
Q

How many people are now thought to have autism, and why is it thought to have increased?

A

1 in 60

more people being diagnosed, and spectrum is widening => lower threshold for diagnosis

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11
Q

What is the gender ratio in ASD and why?

A

Boys:Girls
5/4:1

(this may be because girls are usually not diagnosed, as in younger age they possess better social skills than boys)

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12
Q

Why is testosterone thought to play a role in ASD?

A
  • Sex hormones play important role in the organisation of brain circuits during early development
  • higher rates of ASD in gender identity clinics
  • Girls with Congenital Adrenal Hyperplasia have been exposed to high levels of testosterone and showed more traits of ASD than controls
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13
Q

What other physical medical conditions can predispose to the development of ASD?

A
  • Rubella in the pregnant mother
  • Tuberous sclerosis
  • Fragile X syndrome
  • Encephalitis (brain inflammation)
  • Untreated phenylketonuria (PKU)
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14
Q

Does ASD have a genetic component?

A

Yes - it is strongly heritable

BUT genetic testing is not performed routinely as gene mutations do not need to be identified for diagnosis

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15
Q

What environmental factors during pregnancy may predispose to development of ASD?

A
  • Any teratogens the baby is exposed to in first 8 weeks from conception
  • heavy metals toxicity
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16
Q

What biological perinatal causes can predispose to ASD?

A
  • Hypoxia
  • Foetal distress
  • Birth injury/trauma
  • Multiple birth
  • Maternal haemorrhage
  • Low birth weight
  • Congenital malformation
17
Q

What areas of the brain appear pathological in ASD?

A

Frontal lobes
amygdala
cerebellum

18
Q

The amygdala is larger in boys, why is this thought to cause some ASD symptoms?

A
  • associated with more severe anxiety

AND worse social and communication skills

19
Q

What neurotransmitters are involved in ASD?

A

Glutamate receptors, GABA, Serotonin

20
Q

What speech and language difficulties may be noticed in children with suspected ASD?

A
  • Don’t babble or use other vocal sounds
  • Can repeat words or phrases spoken by others
  • Older children have problems using non-verbal behaviours
21
Q

How would patients with ASD be identified in social situations such as school?

A
  • often either gravitate to older or younger children as they struggle to make relationships
  • tend to play alone
  • Difficulties starting conversations
  • Some children don’t demonstrate imaginative or pretend play
  • stick to the same routine
22
Q

What sensory processing difficulties do children with ASD experience?

A 
Taste:
- Finds flavours too strong
- restricted diet
- Certain textures cause discomfort 
Smell:
- some overpowering
=> can cause toileting problems 
Sound:
- Inability to cut out background noise
Touch:
- painful and uncomfortable
- Only tolerates certain types of clothing or textures
Sight:
- problems with throwing and catching/ clumsiness
- problems with bright lights
23
Q

How do adults with ASD display poor communication?

A
  • Difficulty seeing other person’s perspective
  • Difficulty making eye contact during conversations
  • confused by social signals/ body language
  • repeat the same phrase
  • Problems starting a conversation
  • hard time understanding humour/ sarcasm
24
Q

How do adults with ASD appear in social situations?

A
  • shy
  • difficulty fitting in
  • Very few friendships
  • May appear rude or unaware of bluntness
  • Trouble processing certain thoughts
  • Take things very literally
25
Q

What diagnostic tools are often used in ASD?

A

Screening questionnaires and Semi-structured interviews (3di, DISCO - longer questionnaire)

Standardised assessment tools (Autism Diagnostic Observation Schedule - ADOS)

26
Q

What are the essential criteria for and ASD diagnosis?

A
  • Symptoms present in early developmental period
  • Symptoms cause clinically significant functional impairment
  • Disturbances not better explained by other mental health problems
27
Q

Many children with ASD have a comorbid learning disability which impairs their IQ. TRUE/FALSE?

A

TRUE
70% of children have a non-verbal IQ<70
About 35% have a non-verbal IQ<50

28
Q

What physical conditions does ASD often co-exist with?

A

fragile X syndrome
tuberous sclerosis
seizure disorders (epilepsy)
hearing and visual impairment

29
Q

What non-pharmacological management is used in ASD?

A
  • Self and family psychoeducation
  • social skills training may be useful
  • Family and school based supports
30
Q

What pharmacological management can be used in ASD?

A

Treat comorbidities:

  • Antiepileptics if seizure disorder
  • Stimulants/non-stimulants for ADHD symptoms
  • Antipsychotics for tics disorders
  • SSRIs/SNRIs prescribed to decrease social anxiety, treat mood and/or OCD
  • In severe autism with LD mood stabilisers generally used*
  • Melatonin for chronic insomnia

PSYCHIATRY (35 decks)

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