autism/ADHD

Question 1

hyperactivity

Answer 1

a higher than normal level of activity, excessive fidgetiness & not remain seated

Question 2

impulsivity

Answer 2

the act of reacting to a situation without considering the consequences

Question 3

DMS-5 criteria for ADHD (both types)

Answer 3

an ongoing pattern of inattention and/or hyperactivity & impulsivity that interferes with normal functioning or development

• symptoms present before age 12
• symptoms present in at least 2 settings
• symptoms reduce the quality of educational, social or occupational ability
• symptoms do not occur during another psychotic disorder and are not better explained by another mental disorder

Question 4

DSM criteria for inattention ADHD

Answer 4

at least 6 symptoms for at least 6 months
- not paying attention or making careless mistakes
- ignores instructions
- difficulty maintaining attention
- difficulty organising
- forgetful
- doesn’t listen when spoken to directly

Question 5

DSM criteria for hyperactivity/impulsivity ADHD

Answer 5

at least 6 symptoms for at least 6 months
- high level of fidgeting
- unable to engage in activities quietly
- excessive talking
- blurts out an answer before the question is finished
- has difficulty awaiting their turn
- interrupts or intrudes on others frequently

Question 6

prevalence of ADHD

Answer 6

5% of school-age children & 2.5 % of adults
more common in boys
symptoms are not sex specific – but girls mostly have inattention & boys hyperactivity

Question 7

consequences of ADHD

Answer 7

• prone to temper outbursts, frustration, bossiness, stubbornness, changeable moods, and poor self-esteem.
• academic achievement is impaired = conflict with teachers and family.
• associated with peer rejection and accidental injury.

Question 8

comorbidity of ADHD

Answer 8

• oppositional defiant disorder (ODD) or conduct disorder
• learning disabilities – e.g., dyslexia
• depression & anxiety

Question 9

bio factors of ADHD

Answer 9

• bio causes more important than psychological
• one of the most heritable psychiatric disorders

brains of children with ADHD are smaller and develop more slowly.
- main areas affected = 4 lobes
- deficits in executive functioning & difficulty inhibiting responses - normally controlled by frontal lobes.

problems with dopamine transmission
- struggle with rewards, especially long-term rewards – related to inhibiting behavior

some symptoms can become less visible with adulthood bcuz the brain develops – mostly hyperactivity & impulsivity, inattention stays

Question 10

psychological factors of ADHD

Answer 10

appears to run in families = beyond the fact that there is a genetic component to the disorder

interactions between parent and child – if parent has ADHD they will have trouble dealing with a child who also has it
- parent wouldn’t have patience = makes child’s symptoms worse
- parents accidentally reinforce behavior – child learns that this behavior gets attention from parents (even if its negative) = do it more often

Question 11

prenatal factors for ADHD

Answer 11

pregnant mothers smoking greater than 10 cigarettes per day = more likely to give birth to children with ADHD
- nicotine affects dopamine functioning

Question 12

psychostimulants as treatment for ADHD

Answer 12

= medications that increase CNS activity.
paradoxical effect = psychostimulants lead to restless, even frenetic, behavior when abused – is a MYTH

most commonly prescribed psychostimulants:
Ritalin, Dexedrine, Cylert, and Adderall.

psychostimulant alternatives:
- strattera: NE reuptake inhibitor - the only non stimulant medications approved – severe side effects
- clonidine: can lead to decreases in aggressive behavior,
- antidepressants- may affect ADHD symptoms directly for unknown reasons

Question 13

short-term & long-term effects of psychostimulants on ADHD

Answer 13

Short-term
Hyper/impulsive: dramatic improvements - less active and more focused - fewer social problems
inattention: more work completed, but no change in grades or standardized tests scores

Long-term
no demonstrated benefit for either

Question 14

article - most appropriate intervention for adhd

Answer 14

• preschoolers –> parent training
• school-age w moderate impairments –> group parent training programmes & classroom behavioural interventions
• school-age with severe impairments –> combined with stimulant medication
• middle school/adolescent –> multimodal interventions + social skills training
• adults –> stimulant medication, CBT

Question 15

autism spectrum disorder

Answer 15

a spectrum of developmental impairments and delays that include:
- social & emotional disturbances
- intellectual disabilities
- language and communication deficits
- stereotype or self-injurious behavior patterns

Question 16

triad of impairments (autism)

Answer 16

1. lack of reciprocal social interaction
2. impairments in communication
3. impairments in imagination & flexibility of thought

Question 17

triad of impairments - lack of reciprocal social interaction

Answer 17

• trouble initiating the interaction
• non-verbal communication

Question 18

triad of impairments - impairments in communication

Answer 18

• trouble maintaining eye contact
• echolalia = the immediate imitation of words or sounds that have just been heard
• pronoun reversal = when an individual refers to themself as ‘he’, ‘she’ or ‘you’,

Question 19

triad of impairments - impairments in imagination & flexibility of thought

Answer 19

• need for sameness
• restricted, repetitive and stereotyped patterns of behaviour and interests
• specific and detailed interests
• stereotyped (self-stimulatory) body movements

Question 20

prevalence of ASD

Answer 20

• 1-2% of population
• 80% males
• increased diagnosis in recent years – due to extension of criteria

Question 21

empathizing-systemizing theory

Answer 21

a theory of the social and communication difficulties experienced by individuals w autism

• superior skills in systematizing & finding patters – how they navigate the world

Question 22

consequences of ASD

Answer 22

• trouble socializing & social interaction issues
• difficulty inhibiting complex behaviors
• trouble with planning & organization

Question 23

genetic factors for ASD

Answer 23

• heritable mostly form the fathers gene
• multiple genes
• phenylketonuria (PKU)
• fragile X syndrome

Question 24

prenatal factors for ASD

Answer 24

teratogens - drugs (thalidomide and valproate)
bleeding
immune functioning

Question 25

brain abnormalities for ASD (causes)

Answer 25

• abnormalities in dopamine & serotonin NTs
• brain is generally bigger than average (18m – 5y), except limbic system is smaller
• abnormalities in pre-frontal cortex and amygdala = problems w ToM & exec function

Question 26

treatments for ASD

Answer 26

antipsychotics - reduce:
- repetitive and stereotyped behaviours
- levels of social withdrawal
- aggression and challenging behaviour

parent-implemented early intervention = using parents as effective trainers to teach children with intellectual disabilities basic self-help and communication skills

Question 27

comorbidity of ASD

Answer 27

savant syndrome = extraordinary proficiency in one isolated skill in individuals with multiple cognitive disabilities
closely linked to ASD and Asperger’s syndrome