Autism Flashcards
1
Q
What is the triad of autism?
A
- Social interaction
- Social communication
- Social Imagination
2
Q
How is social interaction seen in autism?
A
- Difficulty recognising emotions, in themselves and others
- Unwilling to make direct eye contact
- Unaware of appropriate social behaviour - failure to share toys or take turns in conversation, indifferent or adverse to physical affection
3
Q
How is social communication seen in autism?
A
- Some children are late to start talking or remain nonverbal - if speaking, often monotone and lack of gestures
- May not respond to own name
- Difficulty understanding non-verbal communication and they themselves may have absent facial expressions
4
Q
How is social imagination seen in autism?
A
- Children often have a limited range of interests
- They may favour one toy greatly or can’t talk about another topic apart from their interest
- Patterns of play can be repetitive
5
Q
What is autism linked to?
A
- Anxiety and poor stress management
- May have problems with loud noises, textures, water etc, consider seeking or avoiding behaviours
- Low mood and depression (may worsen in adolescence)
- OCD
- Sleep disturbance
- Gender dysmorphia
6
Q
What is the management for autism?
A
- No cure, just learning how to manage behaviour, become independent e.g. specialist teaching schools
- Educate family on how to manage
- 40% of autism patients having a learning disability
- Getting help - health visitor and specialist health visitor, parent groups and voluntary organisations, specialist teaching and schools (to help develop social skills)
- Education Health and Care Plan, Disability Living Allowance
7
Q
What is the psychotherapy for autistic patients and their parents?
A
- CBT
- Behaviour management programmes
- Applied Behavioural Analysis program - intense 40hrs/wk for 3yrs based on operant conditioning, imitation and reinforcement
- TEACCH - treatment and education for autistic and related communication handicapped children programme - successful in reducing self-injurious behaviour and enhancing life skills
- Educational psychology
8
Q
What medications can be used as an adjunct to psychological interventions in autism?
A
- SSRIs - main treatment for repetitive behaviours, anxiety, aggression. Require lower doses than needed for antidepressant effects.
- 2nd gen antipsychotics - 1st line pharmacological treatment for aggression, self-injury etc is risperidone
- Melatonin - help reduce sleep latency
9
Q
What are risk factors for autism?
A
- Male 4:1
- Congenital rubella infections - exposure in 1st trimester in early brain development
- Strong link between learning disabilities and seizure disorders
- 90% heritability rate and recurrence rate of 2-8% among siblings
10
Q
What social and emotional interaction questions do you want to ask in the history?
A
- Can they make and keep friends
- Do they understand emotions (their own and others)
- Do they like making eye contact? Abnormal body postures? e.g. walking on tiptoes
- Not clear of social cues (age appropriate
- Special narrowed interests e.g. trains, jigsaw, TV stars, star wars etc, cannot talk details about other topic apart from their interest
11
Q
What flexibility of thought questions do you want to ask in the history?
A
- Imaginative or repetitive play
- Mannerisms (tip toe walking/hand flapping)
- How they cope with change?
- Any obsessions? Routines? Rituals?
12
Q
What language and communication questions do you want to ask in the history?
A
- Can they have a two way conversation?
- Pitch, tone and content of speech
- Gestures while communicating
- Echolalia (understanding < expression)
13
Q
What questions do you ask about sensory features, sleep and diet?
A
- Any problems with loud noises, textures, water - consider sensory seeking or avoiding behaviours
- Consider co-morbidites: ADHD, developmental coordination disorder (dyspraxia), intellectual disability, tics, specific learning difficulties such as dyslexia, dyscalculia
14
Q
What questions do you want to ask in the history about behaviour and development?
A
- Temper problems? Meltdowns?
- Obsessions, fears and phobias
- How do they cope with being left alone/waiting?
- Gross motor or fine motor movement
- Hearing, speech and language - progression of speech, regression is a RED FLAG
- Social interaction and play development
15
Q
What do you want to know about the birth history?
A
- Antenatal hx of alcohol, drugs, smoking or illness
- Perinatal - delivery problems or LBW
- Postnatal problems e.g. infections, epilepsy, delays
- Congenital rubella and phenylketonuria are associated with autism
