ASD

Question 1

what disorders come under Autistic Spectrum Disorders

Answer 1

Asperge's Syndrome 
Rett's Syndrome 
Childhood Autism 
Pervasive Developmental Disorder
Pervasive Developmental Disorder NOS

Question 2

what are the core features of a ASD

Answer 2

Impairments of:

• social communication
• social interaction
• social imagination
• repetitive behaviours

Question 3

what social communications difficulties do those with ASD have

Answer 3

good language skills but can’t grasp underlying meaning of conversation

difficulty understanding jokes, idioms, metaphors and sarcasm

pedantic and idiosyncratic language

narrow interests which dominate conversations (lack of reciprocity)

difficulty sharing thoughts and feelings

Question 4

what social interaction difficulties do those with ASD have

Answer 4

difficulties picking up non-verbal cues

appear self focused and lacking empathy but just trying to figure out social situations

struggle to make and sustain personal and social relationships

Question 5

what social imagination difficulties do those with ASD face

Answer 5

difficulties thinking flexibly and in abstract ways

inability to understand other people’s points of view, takes thinks too literally

difficulty applying knowledge/skills to situations with different people

difficulties projecting themselves into future/planning goals sensibly

Question 6

what are repetitive behaviours seen in those with ASD

Answer 6

stereotypes/repetitive motor movements, use of speech or objects

insistence on sameness, inflexible adherence to routine or ritualised patterns of behaviour

restricted, fixated interests with an abnormal intensity of focus

hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment

Question 7

what is the ratio of boys:girls with ASD

Answer 7

5:1

Question 8

What percentage of the population have a ASD

Answer 8

1-2%

Question 9

what is the link between autism and gender identity dysphoria

Answer 9

8-10% of children and adolescents seen at gender identity dysphoria clinic have an ASD

needs more research

Question 10

what are some causes of ASD

Answer 10

environmental, biological and genetic factors

90% heritability

Question 11

what specific conditions can cause autistic behaviour

Answer 11

Rubella in the pregnant mother 
Tuberous Sclerosis 
Fragile X syndrome
Encephalitis 
Undreated phenylketonuria

Question 12

what environmental factors can contribute to ASD

Answer 12

All known teratogens

Question 13

what biological perinatal factors can contribute to ASD

Answer 13

Umbilical cord complications 
Foetal distress 
Birth injury or trauma 
Multiple birth and maternal haemorrhage 
Low birth weight/small for gestational age 
Congenital malformation 
Meconium aspiration 
Neonatal anaemia, Rh incompatibility and hyperbilirubinaemia

Question 14

what neuroanatomical changes are seen in autism

Answer 14

Amygdala appears larger
Also pathological changes in:
-frontal lobes
-cerebellum

Question 15

what neurochemical changes are seen in autism

Answer 15

Glutamate receptors, GABA and Serotonin seen implicated

Question 16

Signs of ASD in children

Answer 16

Speech and language difficulties

• dont babble or use other vocal sounds
• cant repeat words or phrases spoken by others/ forms own language
• older children struggle using non-verbal behaviours to interact with others (eye contact, facial expression etc)

lack of awareness and interest in other children

struggle to initiate and sustain friendships

often either gravitate to older or younger children

play alone

difficulty understanding others emotions

dont demonstrate imaginative or pretend play - repeat same play

stick to same routine - little changes trigger tantrums

flap hand, twist or flick fingers when excited or upset

repetitive activity - watch same film over and over etc

Sensory processing difficulties

Question 17

what are some sensory processing difficulties seen in ASD

Answer 17

any senses can be over or under sensitive or both at different times

• some flavours too strong
• restricted diet, certain textures cause discomfort

-smells can be intense and overpowering

• noise magnified and sounds become distorted and muddled
• inability to cut out background noise - difficulty concentrating
• touch can be painful and uncomfortable
• difficulties brushing/washing hair
• only tolerates certain clothing textures
• poor depth perception
• easier to focus on detail rather than whole object
• difficulty sleeping as sensitive to light

Question 18

what are signs of autism in adults

Answer 18

same as children but better adjusted to social conventions

Question 19

what tools are used to diagnose autism

Answer 19

HISTORY

• developmental
• collateral

Screening questionnaires and Semi-structured interview

• 3di
• DISCO

Standardised assessment tools
-Autism diagnostic observation schedule

Question 20

what is the essential criteria for ASD diagnosis

Answer 20

Symptoms present in early developmental period

Symptoms cause clinically significant impairment in social, occupational or other important areas of functioning

not better explained by mental health problems, intellectual disability or global developmental delay

Question 21

what are common co-morbidities seen with ASD

Answer 21

Emotional disorders:

• depression and anxiety
• eating disorders

Neurodevelopmental disorders:

• Tourettes and OCD
• ADHD
• Dyspraxia and sensory processing disorder
• Dyslexia
• Language impairment

Learning disability

fragile X
tuberous sclerosis
seizure disorders
hearing and visual impairments

Question 22

what non-pharmacological treatments are used in ASD

Answer 22

Self and family psychoeducation

speech and language therapy
social skills training
behaviour analysis

family and school based supports

diet (management of additives, sugar, allergies)

Question 23

what pharmacological management is used for ASDs

Answer 23

Nothing to treat autism symptoms

Risperidone from management of severe aggression and significant self injury

treat co-morbidities