Autism

Question 1

intellectual disability

Answer 1

sub avg general intellectual fxing IQ<70

Question 2

intensive intervention for autism

Answer 2

> 20h/wk using ABA or Lovaas (social-communication based therapy); very expensive program

Question 3

a) impaired capacity for social interactions, 2) affects verbal/nonverbal communications, 3) assoc w restricted range of interests or repetitive behaviors

Answer 3

autism

Question 4

sx of autism seen when?
ratio of M:F?
big risk factor of autism

Answer 4

before the age of 3
5:1
advanced paternal age

Question 5

MZT heritability concordance

genetic d/o’s also seen in autistic kids?

Answer 5

88%
fragile X (FMR1 gene)
TS (TSC1/2)
Rett syndrome (MECP2)
Macrocephaly (PTEN)

MAJORITY OF KIDS w/AUTISM do not have genetic abnormalities

Question 6

4 prenatal insults that can be assoc with autism

Answer 6

maternal rubella, CMV, teratogen thalidomide, valproid acid

Question 7

criteria for autism

Answer 7

A. deficits in social comm/interaction currently or by hx: 1) social-emotional receiprocity, sharing of interests; 2) nonverbal deficits, eye contact, gestures; 3) developing/maintaining/understanding relationships
B. Behavior: Two of the following: 1) stereotyped/repetitive motor mvmts, echolalia, lining up objects; 2) insistence on sameness; 3) restricted, fixated interests abnormal in intensity/focus; 4) hyper/po reactivity to sensory input
C. Sx must be present in early dev
D. Sx must cause impairment
E. Not better explained

Question 8

three core areas of autism presenting sx (must be present before when?)

Answer 8

social impairment: eyes, gestures, no give/take
impairment in communication: language, echolalia, you?I, pretend play, high-pitched vocalizations
repetitive/stereotped behaviors: obsession w very few things, hand flapping, finger movements, preocc w/wheels/doors/switches

age 3

Question 9

loss of previously attained language/social/play abilities

Answer 9

regression - 25% of pts

Question 10

autism developmental ddx

etiological ddx

Answer 10

ID/global dev delay
receptive/expressive language d/o
sensory processing d/o
anxiety
ADHD

deafness, fragile X, downs, TS, Rett, CP, psych d/o

Question 11

autism co-morbidities

Answer 11

seizures
pica
constipation/feeding problems
sleep d/o
lower adaptive behaviors

Question 12

psychotherapy intervention for autism?

Answer 12

early intensive behavioral intervention: 20-35h/wk of 1:1

reduce maladaptive beh and reinforce adaptive beh

Question 13

autism sx

Answer 13

anxiety, aggression, self-injury, hyperactivity, impulsivity, sleep

Question 14

pharmacologics for autism

Answer 14

atypical antipsychs: resperidone, aripiprazole for challenging behaviors
melatonin/iron supp can help sleep
restless sleep=low iron stores