ASD

Question 1

5 disorders that fall under ASD?

Answer 1

Asperger's syndrome
Rett's syndrome
Childhood autism
Pervasive Developmental Disorder
PErvasive Developmental Disorder NOS

Question 2

Triad of ASD?

Answer 2

Impairment in: 
Social communication 
Social interaction 
Social imagination 
(not core criteria but very common to have repetitive behaviours)

Question 3

What difficulties with social communication with children/ adults with ASD have?

Answer 3

Generally good language skills but hard to grasp underlying meaning of conversation
Difficulties understanding jokes, idioms, metaphors and sarcasm
Voices monotonous
Pedantic and idiosyncratic language
Narrow interests that dominate conversation (lack of reciprocity)
Difficulty sharing thoughts and feelings

Question 4

What difficulties with social interaction will children with children/ adults with ASD have?

Answer 4

Difficulties picking up non-verbal cues
Appear self-focused and lacking in empathy
Continually struggle to make and sustain personal and social relationships
Ego-centric; struggle to see other peoples POV

Question 5

What difficulties with social imagination will children/ adults with ASD have?

Answer 5

Difficulties thinking flexibly and in abstract ways
Inability to understand other people’s point of view
Takes things literally
Difficulties applying knowledge and skills across settings with different people
Difficulties projecting themselves into the future or planning goals sensibly

Question 6

What difficulties will children / adults with ASD have?

Answer 6

Stereotyped or repetitive motor movements, use of objects or speech
Insistence on sameness, inflexible adherence to routines, or ritualised patterns of verbal or nonverbal behaviour
Highly restricted, fixated interests that are abnormal in intensity of focus
Hyper-hypo reactivity to sensory input or unusual interest in sensory aspects of the environemtn

Question 7

What impact does gender have on ASD?

Answer 7

Boys: girls
5:1

Question 8

What are the theories surrounding the gender differences in ASD?

Answer 8

Sex hormones play an important role in organisation of brain circuits during early development
Receptors for sex hormones are widely distributed in the brain and influence neural signalling

Question 9

What are the causes of ASD?

Answer 9

Environmental 
Biological 
Genetic 
Rubella in mother
Tuberous Sclerosis 
Fragile X syndrome 
Encephalitis
Untreated PKU

Question 10

Does autism have a genetic link?

Answer 10

Yes; 90% heritability

90% concordance in MZ twins

Question 11

What perinatal complications can lead to ASD?

Answer 11

Umbilical cord complications 
Teratogens within first 8 weeks of conception 
Fetal distress
Birth injury or trauma 
Multiple birth and maternal haemorrhage
Low birth weight 
Congenital malformation 
Meconium aspiration 
Neonatal anaemia, ABO or Rh incompatibility and hyperbilirubinaemia

Question 12

What are the neuroanatomical changes seen in autism?

Answer 12

Frontal lobes, amygdala and cerebellum appear pathological

Question 13

What neurochemical changes are seen in autism?

Answer 13

Glutamate receptors, GABA serotonin are implicated

Question 14

What role does GABA play in the development of the brain?

Answer 14

Regulation of early developmental stages of cell migration, neuronal differentiation and stages of maturation

Question 15

How is ASD diagnosed in children?

Answer 15

Speech and language difficulties
Lack awareness of and interest in other children
Struggle to initiate and sustain friendships
Often gravitate to older or younger children
Play alone
Difficulties understanding peoples emotions and feelings around them
Difficulties starting conversations
Struggle to demonstrate imaginative or pretend play
Prefer to stick to the same routine
Flapping of hands
Engage in repetitive behaviours

Question 16

What sensory difficulties to children with ASD struggle with?

Answer 16

Taste; find strong flavours tricky, textures can cause discomfort
Smell; can be intense and overpowering; can lead to toileting problems
Sound; noise can be magnified and sounds distorted and muddled
Touch; can be painful or need deep pressure to feel anything at all. Can result in issues brushing and washing hair.
Sight; poor depth perception, problems with throwing and catching, clumsiness
Easier to focus on a detail rather than a whole object
Lots of issues surrounding sleep

Question 17

How is ASD diagnosed in adults?

Answer 17

Communication; struggle to see other peoples perspective, difficulties making eye contact, confused easily by social signals and body language 
Often repeat same phrase or expression
Struggle with small talk 
Sarcasm hard 
Social: shy, difficulty fitting in, few friendships, rude, literal
Obsessive
Unusual body movements
Clumsiness, lack of coordination 
Sensory issues

Question 18

Screening questionnaires used in ASD?

Answer 18

3di
DISCO
ADOS

Question 19

Essential criteria for diagnosis of ASD?

Answer 19

Symptoms must be present in early developmental period
Symptoms cause clinically significant impairment in social, occupational or other important areas
Disturbances are not better explained by other mental health problems

Question 20

What are common co-morbid disorders with ASD?

Answer 20

Depression and anxiety 
ED 
Tourettes 
ADHd
Dyspraxia and sensory processing disorder
Dyslexia 
Language impairment

Question 21

Non pharma management of ASD?

Answer 21

Lessen deficits and family distress
Self and family psychoeducation
Applied behavioural analysis, speech and language therapy, social skills training
School support
Diet (food additives, refined sugar, food allergies); controversial

Question 22

Pharma management of ASD?

Answer 22

Risperidone licensed for management of severe aggression and significant self-injury
Antiepileptics if seizure disorder
Stimulants of non-stimulants for ADHD
Antipsychotics for tic disorders
Severe autism with LD; mood stabilisers
SSRI/ SNRI for social anxiety, mood and/or OCD
Melatonin for chronic insomnia