ASD Flashcards
5 disorders that fall under ASD?
Asperger's syndrome Rett's syndrome Childhood autism Pervasive Developmental Disorder PErvasive Developmental Disorder NOS
Triad of ASD?
Impairment in: Social communication Social interaction Social imagination (not core criteria but very common to have repetitive behaviours)
What difficulties with social communication with children/ adults with ASD have?
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
What difficulties with social interaction will children with children/ adults with ASD have?
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
What difficulties with social imagination will children/ adults with ASD have?
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
What difficulties will children / adults with ASD have?
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
What impact does gender have on ASD?
Boys: girls
5:1
What are the theories surrounding the gender differences in ASD?
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
What are the causes of ASD?
Environmental Biological Genetic Rubella in mother Tuberous Sclerosis Fragile X syndrome Encephalitis Untreated PKU
Does autism have a genetic link?
Yes; 90% heritability
90% concordance in MZ twins
What perinatal complications can lead to ASD?
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
What are the neuroanatomical changes seen in autism?
Frontal lobes, amygdala and cerebellum appear pathological
What neurochemical changes are seen in autism?
Glutamate receptors, GABA serotonin are implicated
What role does GABA play in the development of the brain?
Regulation of early developmental stages of cell migration, neuronal differentiation and stages of maturation
How is ASD diagnosed in children?
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
What sensory difficulties to children with ASD struggle with?
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
How is ASD diagnosed in adults?
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
Screening questionnaires used in ASD?
3di
DISCO
ADOS
Essential criteria for diagnosis of ASD?
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
What are common co-morbid disorders with ASD?
Depression and anxiety ED Tourettes ADHd Dyspraxia and sensory processing disorder Dyslexia Language impairment
Non pharma management of ASD?
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
Pharma management of ASD?
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
