autism/ADHD Flashcards
hyperactivity
a higher than normal level of activity, excessive fidgetiness & not remain seated
impulsivity
the act of reacting to a situation without considering the consequences
DMS-5 criteria for ADHD (both types)
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
DSM criteria for inattention ADHD
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
DSM criteria for hyperactivity/impulsivity ADHD
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
prevalence of ADHD
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
consequences of ADHD
- 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.
comorbidity of ADHD
- oppositional defiant disorder (ODD) or conduct disorder
- learning disabilities – e.g., dyslexia
- depression & anxiety
bio factors of ADHD
- 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
psychological factors of ADHD
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
prenatal factors for ADHD
pregnant mothers smoking greater than 10 cigarettes per day = more likely to give birth to children with ADHD
- nicotine affects dopamine functioning
psychostimulants as treatment for ADHD
= 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
short-term & long-term effects of psychostimulants on ADHD
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
article - most appropriate intervention for adhd
- 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
autism spectrum disorder
a spectrum of developmental impairments and delays that include:
- social & emotional disturbances
- intellectual disabilities
- language and communication deficits
- stereotype or self-injurious behavior patterns
triad of impairments (autism)
- lack of reciprocal social interaction
- impairments in communication
- impairments in imagination & flexibility of thought
triad of impairments - lack of reciprocal social interaction
- trouble initiating the interaction
- non-verbal communication
triad of impairments - impairments in communication
- 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’,
triad of impairments - impairments in imagination & flexibility of thought
- need for sameness
- restricted, repetitive and stereotyped patterns of behaviour and interests
- specific and detailed interests
- stereotyped (self-stimulatory) body movements
prevalence of ASD
- 1-2% of population
- 80% males
- increased diagnosis in recent years – due to extension of criteria
empathizing-systemizing theory
a theory of the social and communication difficulties experienced by individuals w autism
- superior skills in systematizing & finding patters – how they navigate the world
consequences of ASD
- trouble socializing & social interaction issues
- difficulty inhibiting complex behaviors
- trouble with planning & organization
genetic factors for ASD
- heritable mostly form the fathers gene
- multiple genes
- phenylketonuria (PKU)
- fragile X syndrome
prenatal factors for ASD
teratogens - drugs (thalidomide and valproate)
bleeding
immune functioning
brain abnormalities for ASD (causes)
- 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
treatments for ASD
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
comorbidity of ASD
savant syndrome = extraordinary proficiency in one isolated skill in individuals with multiple cognitive disabilities
closely linked to ASD and Asperger’s syndrome
