ASD Flashcards
what disorders come under Autistic Spectrum Disorders
Asperge's Syndrome Rett's Syndrome Childhood Autism Pervasive Developmental Disorder Pervasive Developmental Disorder NOS
what are the core features of a ASD
Impairments of:
- social communication
- social interaction
- social imagination
- repetitive behaviours
what social communications difficulties do those with ASD have
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
what social interaction difficulties do those with ASD have
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
what social imagination difficulties do those with ASD face
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
what are repetitive behaviours seen in those with ASD
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
what is the ratio of boys:girls with ASD
5:1
What percentage of the population have a ASD
1-2%
what is the link between autism and gender identity dysphoria
8-10% of children and adolescents seen at gender identity dysphoria clinic have an ASD
needs more research
what are some causes of ASD
environmental, biological and genetic factors
90% heritability
what specific conditions can cause autistic behaviour
Rubella in the pregnant mother Tuberous Sclerosis Fragile X syndrome Encephalitis Undreated phenylketonuria
what environmental factors can contribute to ASD
All known teratogens
what biological perinatal factors can contribute to ASD
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
what neuroanatomical changes are seen in autism
Amygdala appears larger
Also pathological changes in:
-frontal lobes
-cerebellum
what neurochemical changes are seen in autism
Glutamate receptors, GABA and Serotonin seen implicated
Signs of ASD in children
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
what are some sensory processing difficulties seen in ASD
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
what are signs of autism in adults
same as children but better adjusted to social conventions
what tools are used to diagnose autism
HISTORY
- developmental
- collateral
Screening questionnaires and Semi-structured interview
- 3di
- DISCO
Standardised assessment tools
-Autism diagnostic observation schedule
what is the essential criteria for ASD diagnosis
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
what are common co-morbidities seen with ASD
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
what non-pharmacological treatments are used in ASD
Self and family psychoeducation
speech and language therapy
social skills training
behaviour analysis
family and school based supports
diet (management of additives, sugar, allergies)
what pharmacological management is used for ASDs
Nothing to treat autism symptoms
Risperidone from management of severe aggression and significant self injury
treat co-morbidities
