ASD and ADHD Flashcards

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1
Q

what are the 5 disorders that come under the umbrella of ASD

A
Asperge's 
Rett's 
Childhood autism
Pervasive developmental disorder
Pervasive developmental disorder NOS
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2
Q

what is the most common disorder on the ASD spectrum

A

Asperge’s

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3
Q

what is the triad of impairments people with ASD have

A

social communication
social interaction
social imagination

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4
Q

ASD also has the feature of ______ behaviours

A

repetitive

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5
Q

describe ASD social communication impairment

A

good with language but find it hard to grasp the underlying meaning of conversation - difficulty understanding jokes etc

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6
Q

ASD often has narrow interesting which dominates conversation - this is known as

A

lack of reciprocity

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7
Q

describe ASD social interaction impairment

A

difficulty picking up non-verbal ques - appear self-focused and lacking in empathy but they are just trying to figure out social situations

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8
Q

do people with ASD find it easy to share their thoughts and feelings

A

no

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9
Q

do people with ASD find it easy to make friends

A

no - struggle to make and sustain personal and social relationships

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10
Q

describe people with ASD social imagination impairment

A

difficulty thinking flexibly - inability to understand peoples views and take things literally
difficulty projecting themselves into the future or making goals sensibly

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11
Q

describe the repetitive movements in ASD

A

stereotyped or repetitive motor movements, uses of objects or speech
insistance on sameness

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12
Q

is ASD more common in boys or girls

A

boys

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13
Q

____ levels are reduced in females with asperge’s, pointing to higher levels of free ______

A

SHBG

testosterone

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14
Q

true/false

gender identity problems are higher in people with ASD

A

true

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15
Q

is ASD inheritable

A

yes very

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16
Q

what chromosomal abnormalities are involved in ASD

A

deletion, duplication and inversion

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17
Q

what is the most common form of inherited intellectual disability

A

fragile X syndrome

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18
Q

____ in pregnant mother may cause ASD

A

Rubella

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19
Q

name 3 other things that may cause ASD

A

Tuberous sclerosis
Encephalitis
Untreated PKU

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20
Q

what are some perinatal complications that may cause ASD

A
umbilical cord complications
foetal distress
birth injury or trauma
multiple birth
maternal haemorrhage
LBW/SGA
congenital malformation
meconium aspiration
neonatal anaemia, ABO or Rh incompatibility and hyperbilirubinaemia
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21
Q

what 3 brain areas appear pathological in autism

A

frontal lobes, amygdala and cerebellum

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22
Q

the ______ in boys with autism appears larger leading to more severe ____ and worse _____

A

amygdala
anxiety
worse social and communication skills

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23
Q

what 3 neurotransmitters are implicated in autism

A

Glutamate
GABA
serotonin

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24
Q

what are some signs you would look for in children for a diagnosis of ASD

A
  • speech and language difficulties
  • lack of awareness of and interest in other children - play alone
  • sticking to same routine
  • repetitive activity
  • sensory processing difficulty
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25
Q

what kind of speech and language difficulties are seen in children with ASD

A
  • dont babble or use other vocal sounds
  • repeat words or phrases spoken by others without forming or developing their own language
  • difficulty with non-verbal interactions e.g. eye contact
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26
Q

if a child with ASDs routine is changed slightly what might happen

A

tantrum

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27
Q

what is an example of a repetitive activity seen in ASD

A

watching the same movie over and over again

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28
Q

describe the sensory difficulties seen in children with ASD

A

any of the senses may be over or under sensitive e.g. some foods too strong or noises too loud

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29
Q

how is ASD diagnosed in adults

A

same as children but better adjusted to social conventions

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30
Q

are there any biological markers for diagnosing ASD

A

no

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31
Q

how can ASD be diagnosed

A

subjective clinical assessment - good developmental history and collateral history
+ assessment tools

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32
Q

name 2 screening questionnaires

A

3DI (The Developmental, Dimensional and Diagnostic Interview)
DISCO (Diagnostic Interview for Social and Communication Disorders)

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33
Q

what is the standardised assessment tool for diagnosing ASD

A

Autism Diagnostic Observation Schedule - ADOS

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34
Q

what is the essential criteria for a diagnosis of ASD

A

symptoms must

  • be present in early developmental period
  • cause significant impairment in social, occupational or other important areas of current functioning
  • not be better explained by other mental health problems/intellectual disability/global developmental delay
35
Q

people with ASD commonly have what comorbidities

A
depression and anxiety
ADHD, tourettes, OCD
dyslexia, language impairment
learning disability 
epilepsy 
hearing / visual impairment
36
Q

what are some non-pharmacological managements of ASD

A
  • self and family psychoeducation
  • applied behaviour analysis
  • speech and language therapy
  • social skills training
  • social care
  • dietician
37
Q

what drug is licensed for management of severe aggression and significant self injury in ASD

A

risperidone

38
Q

when is pharmacological intervention appropriate in ASD

A

to treat co-morbidity

39
Q

what can be given to treat chronic insomnia

A

melatonin

40
Q

_____ may be a blood based biomarker for social functioning

A

oxytocin

41
Q

what is the triad of difficulties in ADHD

A

inattention
hyperactivity
impulsivity

42
Q

ADHD is more common in males/females

A

males

43
Q

is ADHD as common in adults as it is in children

A

no but almost

44
Q

the triad of difficulties in ADHD are …. (4)

A
  • developmentally inappropriate
  • impairing function
  • pervasive across settings
  • longstanding from age 5
45
Q

the triad of difficulties in ADHD are frequently co-occurring with what cluster of symptoms

A

impairing symptoms relating to self regulation

46
Q

is ADHD a disorder or a spectrum

A

spectrum

47
Q

how do adult and child ADHD differ

A

adult ADHD has less obvious symptoms of hyperactivity or impulsivity and more obvious inattentive symptoms

48
Q

how does childhood ADHD impact lives

A
  • difficult to parent
  • emotional dysregulation leads to difficulties in friendships and reckless and dangerous behaviour
  • exclusion from education and antisocial behaviours
49
Q

in adults with ADHD there is increased rates of ____ and ______

A

criminality and substance misuse

50
Q

what causes ADHD

A

perinatal precipitants, genetic predisposition and psychosocial adversity lead to neuroanatomical brain changes which lead to the cognitive and behavioural features of ADHD

51
Q

what neurotransmitter genes are mainly involved in ADHD

A

dopamine and serotonin

52
Q

there is ____ clustering in ADHD

A

familial

53
Q

what are some perinatal factors that lead to ADHD

A

tobacco and alcohol
prematurity and perinatal hypoxia
unusually short or long labour/foetal distress/forceps
eclampsia

54
Q

exposure to what in the 1st trimester can lead to ADHD

A

viral infection

55
Q

what kind of parenting is assoc. with ADHD

A

inconsistent parenting (psychosocial adversity)

56
Q

what other psychosocial adversities is ADHD assoc. with

A

severe marital discord, big family, low social class, paternal criminality, maltreatment

57
Q

genetic risk is an important precursor that may be compounded or turned on by ______

A

psychosocial factors / perinatal factors

58
Q

in ADHD there is ______ function in the frontal lobe

A

underactive

59
Q

in ADHD there is a ____ concentration of dopamine uptake transporters

A

higher - excessively efficient dopamine removal system

60
Q

symptoms in ADHD may also be caused by reduction of ____ and _____

A

NA and serotonin

61
Q

assessment of childhood ADHD is mainly driven by

A

parents / school

62
Q

assessment of adult ADHD is mainly driven by

A

patient

63
Q

how is childhood ADHD assessed

A

screening questionnaires and structured diagnostic questionnaires
background info regarding RFs
early history and attachment

64
Q

what is common in adult ADHD

A

comorbidities

65
Q

what is the diagnostic criteria for childhood ADHD

A

6 or more symptoms of inattentiveness and/or 6 or more symptoms of hyperactivity and impulsiveness
present before age 5
reported by parnets/school/seen in clinic
symptoms get in the way of daily life

66
Q

what is the diagnostic criteria for adult ADHD

A

5 or more symptoms of inattentiveness and/or 5 or more of hyperactivity and impulsiveness
historical concerns since early age
symptoms have a moderate effect on different areas of their life such as work/driving/relationships

67
Q

what are the psychosocial interventions for mild moderate and severe ADHD in children

A
parent training (New Forest Parenting programme)
social skills training 
behavioural classroom management strategies
68
Q

what is a good tactic for children with ADHD in the classroom

A

sit at the front

69
Q

what can be given to improve sleep cycle

A

melatonin (controversial)

70
Q

when can pharmacological managements be used in ADHD

A

moderate and severe

71
Q

what is the 1st line pharmacological treatment of ADHD

A

stimulants

72
Q

give 3 examples of stimulants

A

methylphenidate
dexamfetamine
lisdexamfetamine

73
Q

what is 2nd line pharmacological treatment of ADHD

A

SNRI

74
Q

give an example of an SNRI used in ADHD

A

atomoxetine

75
Q

what is 3rd line pharmacological treatment of ADHD

A

alpha agonist

76
Q

name 2 alpha agonists

A

clonidine

guanfacine

77
Q

what is 4th line pharmacological treatment of ADHD

A

antidepressants - imipramine

antipsychotics - risperidone

78
Q

how does methylphenidate work

A

stimulant

- increases dopamine by blocking transporter

79
Q

what are some side effects of methylphenidate

A

head ache
poor appetite
insomnia

80
Q

how does dexamphetamine work

A

stimulant - increase dopamine by blocking transporter

also increases NA and serotonin

81
Q

how do alpha agonists work in ADHD

A

increase NA by reducing sympathetic stimulation

82
Q

what neurotransmitter is responsible for alterness

A

dopamine

83
Q

what neurotransmitter is responsible for concentration

A

norepinephrine

84
Q

what neurotransmitter is responsible for satisfaction

A

serotonin