Autism and ADHD

Question 1

ASD definition

Answer 1

lifelong neurodevelopmental condition characterised by persistent difficulties in social interaction and communication, stereotypic behaviours, resistance to change or restricted interest

Question 2

ASD prevalence

Answer 2

higher in males

Question 3

ASD causes

Answer 3

genetic
environmental
family - very heritable!

Question 4

ASD co-occuring disorders

Answer 4

intellectual disability
heterogenous mental health condition
epilepsy
sensory problems
GI problems - IBD, coeliac, chronic diarrhoea, constipation

Question 5

ASD diagnosis

Answer 5

persistent deficits in initiating and sustaining social communication, not up to individual’s age or level of development
persistent restricted and inflexible patterns of behaviour, given age and sociocultural context
onset occurs during developmental period typically in early childhood
sx cause significant impairment in all areas, and affects functioning

Question 6

ASD screening

Answer 6

persistent difficulties in social ineraction, communication
resistant to change, restricted interests
problems in obtaining or sustaining employment or education
difficulty in initiating or sustain social relationships
previous or current contact with mental health or learning disability services
hx of neurodevelopmental conditions or mental disorder

Question 7

assessment tools ASD

Answer 7

ADOS
DISCO
ADI-R
3Di

Question 8

ASD principles of management

Answer 8

no pharmacological tx
MDT
supportive/modified intervention environment
educational support
social support
employment opportunities
develop independence
manage comorbidites

Question 9

ADHD definition

Answer 9

persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development

Question 10

ADHD subtypes

Answer 10

inattentive
hyperactive-impuslive
combined (majority)

Question 11

ADHD prevalence adults

Answer 11

in uk - 3/4%

Question 12

ADHD cause

Answer 12

uncertain
genetic and environment
family hx - twin studies

Question 13

risk factors ADHD

Answer 13

family hx
low birth weight
maternal smoking
preterm delivery
epilepsy
brain injury
lead exposure
iron defiency
alcohol exposure during pregnancy
psychosocial adversity
adverse maternal mental health

Question 14

co-occuring disorders ADHD

Answer 14

oppositional defiant disorder
conduct disorder
substance abuse
mood disorders
ASD
dyslexia
dyscalculia
dyspraxia

Question 15

ADHD diagnosis

Answer 15

sx of inattention and/or hyperactivity/impulsivity
- started before 12 yrs od age
- occured in two or more settings
- present for at least 6 months
- interfere with functioning
- sx not accounted by another mental disorder
- not due to substance misuse

Question 16

inattential sx include

Answer 16

difficulty sustaining attention
lack attention to detail
make careless mistakes
not completing tasks
easily distracted
not listening
daydreaming
loses things
forgetful
difficulty remembering to complete future tasks
difficulty planning

Question 17

hyperactivity-impulsivity sx include

Answer 17

excess motor activity
difficulty sitting stikk
physical restlesness
sense of discomfort
difficult engaging in activity
talks too much
difficult waiting turn in convo
impulsive deicisons
reckless driving

Question 18

ADHD tx

Answer 18

supporting people
treat co-exist mental health conditions and substances misuse
declare to DVLA
involving schools, colleges etc
psychological intetvention or CBT
1st line - lisdexamfetamine/dexamfetamine or methylphenidate
2nd line - atomoxetine

Question 19

ADHD monitoring

Answer 19

BMI
CVD - HR, BP, monitor for resting tachycardia, arrythmia or high systolic BP
tics
sexual dysfunction
seizures
sleep
worsening behaviour
stimulant misue

Question 20

s/e and monitoring of methylphenidate

Answer 20

abdominal pain, nausea and dyspepsia. In children, weight and height should be monitored every 6 months
cardiotoxic -ecg

Question 21

non phamacological mx of autism

Answer 21

Applied behavioural analysis (ABA).
ASD preschool program.
Treatment and Education of Autistic and Communication related handicapped CHildren (TEACCH)/Structured Teaching method.
Early Start Denver Model (ESDM).
Joint Attention Symbolic Play Engagement and Regulation (JASPER).