Autism

Question 1

Intellectual Disability Dx Criteria

Answer 1

• Deficits in intellectual functioning (reasoning, problem solving, thinking, judging)
• Deficits in adaptive functioning (conceptual, social, practical)
• Onset during developmental period
• Severity based on adaptive functioning NOT IQ (mild, moderate, severe, profound)

Question 2

Autism Dx Criteria (+ specifiers)

Answer 2

• Includes… Autistic disorder, PDD, NOS, Asperger’s, Childhood Disintegrative Disorder (NOT Retts)
• 1- Persistent deficits in social communication and social interaction; need all 3…
  
  • Deficits in social-emotional reciprocity
  • Deficits in non-verbal social communication
  • Deficits in understanding, maintaining and developing relationships
• 2- Restricted, repetitive patterns of behavior, interests, activities; at least 2…
  
  • Stereotyped use of objects, motor movements or speech
  • Inflexible adherence to routine; insist on sameness
  • Highly restricted and intense interests that are abnormal in intensity or focus
  • Hyper-reactive ir lyop=reactive to sensory input (esp texture and sounds)
• Specifiers
  
  • W or W/o intellectual impairment
  • W or W/o language impairment
  • Associated w/ known medical or genetic condition
  • Level 1 2 or 3 supports needed
  • W/ cataonia

Question 3

Autism Epidemiology

Answer 3

• Boys &raquo_space; girls
• 1 in 68
• < 60% in intellectual disability range on IQ test
• No racial, ethnic, SES correlation

Question 4

How to ID Autism

Answer 4

• Red Flags
  
  • No smiles by 6 mo
  • Do not share sounds or facial expressions by 9 mo
  • No babbling by 12 mo
  • No pointing, showing, reaching, waving by 12 mo
  • Unresponsive to own name by 12 mo
  • No single words at 16 mo
  • No 2 word phrases by 24 mo
  • ANY loss of speech or social skills at ANY age
• Screening
  
  • M-CHAT - checklist given to parents w/ 20 y/n questions
    
    • Give at 18 mo, 24 mo and again at 36 mo if concerned

Question 5

Autism Tx Programs (8)

Answer 5

• ABA - applied behavior analysis
• Early intensive behavioral interventions
• Social training skills
• Communication models (ex - iPad)
• Sensory menu
• Life skills training
• Vocational training
• College Ed Accommodations

Question 6

Autism Pharm Tx

Answer 6

mainly treat co-occuring symptoms or disorders

• Stimulants for inattention or impulsivity
  - Less effective & more side effects than in normal children
• Non-stimulatns for inattention or impulsivity
  - Atomoxetine, clonidine, guanfacine
• Atypical antipsychotics for irritability/ tantrums/ aggression
  - Risperidone - monitor for EPS or tardive dyskinesia & monitor metabolic markers
  - Aripiprazole - also monitor metabolic labs
• Anti-depressants for anxiety/rituals/depression)
  - SSRIs
• Mood stabilizers or anti-convulsants (co-occuring bipolar)
  - Lithium
  - Anti-convlsants