Autism Flashcards
How common is it?
which gender is it more common I n?
1/100 people. Affects males 4x as much as females.
When must features of the disorder been present?
Early developmental periods, but may not be apparent until social demands exceed capacity (i.e. school etc)
Give a risk factor and an association.
Genes on Cr11 – 5-10% chance of another sibling being affected if one has it. Epilepsy in 30% of patients.
What are the 3 broad areas of symptoms?
1) poor reciprocal social interaction.
2) poor imagination.
3) Narrow range of activities and interests
Give 4 features of each of the broad areas of sx
Poor reciprocal social interaction: patient unaware of existence of feelings of others, Abnormal response to being hurt, Poor imitation (do it without understanding), bad at making friends, lack empathy.
Poor imagination: few facial expressions, avoid mutual gaze w/ no smiling when socialising, may not treat parents as special. No interest in stories with fantasy, echolalia. Narrow range of activities and interests: Stereotypy. Preoccupation with parts of an object. Unusual attachments. Marked distress over trivial changes, insist on following routines in detail, narrow fixation (knowing loads about one topic).
What can increase IQ by 60%? What else does this help?
Specialist schooling at 3 years old. Also helps social, motor and living skills.
Give 3 other features of management of ADHD
Parental education and training, charities (national autism society), social skills training
Give 3 drugs and specific situations for their use.
Risperidone (agitation)
melatonin (sleep)
SSRIs (repetition)
What causes 80% of ADHD? How common is it?
Genetic inheritance. ADHD is the most common neurobehavioural disorder of childhood. 3-5% in the West.
Give the 3 groups clinical features. When do these appear, and when do they start to get better?
Impulsivity, inattention, hyperactivity. Often first noticed by parents as a toddler but diagnosis then made at school age. By 18, 1/3 have no symptoms, 1/3 have but don’t need medicine, 1/3 do need medicine
Describe each of the 3 groups of clinical features.
Impulsivity: Blurt out answers, interrupt others, not able to take turns, intrude on others. Inattention: Unable to listen or attend closely, careless, cannot sustain attention or follow instructions, often forget or lose things. Hyperactivity: fidgety or squirm a lot, talk incessantly, restless
Give a differential of ADHD
Behaviour normal for age, low or high IQ, hearing loss.
What is recommended in moderate disease of ADHD? What may older children benefit from?
Parent training and education. Older kids ?CBT
Give 2 options if this method for moderate ADHD fails
Meds (NB are 1st line in severe disease). Methylphenidate (IR (Ritalin) or MR, MR lasts a school day and better tolerated. Impairs appetite so don’t use on weekends/hols), or atomoxetine (6 weeks to get full effect but lasts even on withdrawal)
What is the evidence for the medication in ADHD?
Uncertain for long term use but 70% improve on medication
