Autism and ADHD Flashcards

1
Q

What are some language disturbances that may accompany autism

A

-deficits in development/use
-may express more than they understand
-echolalia or stereotypy phrases
-odd voice quality/rhythm
-total lack of speech

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2
Q

what are some signs of irritability in children with autism

A

aggression
self-injurious behavior
severe tantrums
may emerge w/o trigger

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3
Q

what are some other common associated features of autism

A

-instability of affect
-hyperactive/inattentive
-precocious skills
-insomnia
-minor infections/GI sx

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4
Q

what are the two medications approved to treat irritability in autism

A

risperidone
aripiprazole

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5
Q

core symptoms of autism

A

-persistent deficits in social communication/interaction
-restrictive/repetitive behaviors/interests

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6
Q

possible manifestations of social communication/interaction deficits in autism

A

-poor eye contact
-disrupting routine can cause extreme anxiety
-atypical attachment behavior
-impaired ability to infer feelings/empathy
-poor social skills

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7
Q

possible manifestations of restricted/repetitive behaviors/interests in autism

A

-Restricted/muted exploratory play
-rigid, repetitive, monotonous play
-ritualistic and compulsive behaviors
-increased self-stimulation and self-injury when intellectual disability is present
-

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8
Q

physical characteristics associated with autism

A

-ear malformations
-ambidextrous
-abnormal fingerprints

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9
Q

Possible disturbances in language usage associated with autism

A

-may express more than they understand
-echolalia or stereotypic phrases out of context
-peculiar voice quality and rhythm

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10
Q

is it common for autism to have deficits in language development

A

No but it can happen
typically lack prosody and inflection

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11
Q

How can irritability be manifested in autism

A

-aggression
-self-injury
-severe temper tantrums
-may emerge unexpectedly w/o trigger

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12
Q

possible responses to sensory stimuli in autism

A

-may over/under respond
-not uncommon to appear deaf
-heightened pain threshold and altered response to pain
-particular enjoyment of vestibular stimulation (spinning, up-and-down, etc.)

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13
Q

hyperactivity and inattention in autism

A

ADHD is often comorbid

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14
Q

minor infections that are more frequent in autism

A

-URIs
-febrile seizures

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15
Q

standardized assessment tool for autism

A

autism diagnostic observation schedule-generic
(ADOS-G)

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16
Q

Targets for autism treatment

A

-core behaviors
-social interaction/communication
-strategies for school integration
-development of peer relationships
-independent living skills -

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17
Q

psychosocial interventions for autism treatment

A

-early intensive behavioral/developmental interventions
-social skills training
-tx comorbid symptoms
-educational interventions

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18
Q

early behavioral/developmental intervention for autism: UCLA/LOVAAS-based model

A

–given one-on-one for several hours weekly in the home
-focuses on social skills, language usage, play skills

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19
Q

early behavioral/developmental interventions for autism: ESDM

A

-parents/educators trained as cotherapists to deliver interventions in natural settings (school, daycare, home)
-focus on play and relationship skills

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20
Q

social skills training in autism

A

-typically in group setting w/ varying ages
-guided practice in initiating conversation, greetings, initiating games, and joint attention
-includes emotional identification and regulation

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21
Q

interventions for insomnia in autism

A

-change parental behavior towards child at bedtime to reduce reinforcement for being awake
-massage

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22
Q

educational interventions for children with autism: TEACCH method

A

-structured teaching based on idea that children have a problem with perception
-uses visual aides to teach academic and social skills

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23
Q

what is the use of medications in autism

A

to treat behavioral symptoms rather than core symptoms

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24
Q

medications approved to treat irritability in autism

A

risperidone
aripiprazole

25
Q

what is risperidone/aripiprazole mainly used for in autism

A

1st line for aggression and self-injurious behavior
0.5-1mg

26
Q

typical dosage of aripiprazole in autism patients

A

5-15mg
weight gain not as bad as risperidone

27
Q

medications used to treat hyperactivity, impulsivity, and inattention in autism

A

methylphenidate (moderate)
atomoxetine (better than placebo)

28
Q

how to treat repetitive/stereotypic behavior in autism

A

risperidone may help by reducing irritability

29
Q

prenatal risk factors for autism

A

-advanced maternal age
-gestational bleeding
-gestational diabetes
-first born baby

30
Q

perinatal risk factors for autism

A

-umbilical complications
-birth trauma/fetal distress
-small for gestational age
-low birth weight
-low 5-minute APGAR
-congenital malformations
-Rh factor incompatibility
-hyperbilirubinemia

31
Q

frequent ADHD comorbidities

A

-learning disorders
-anxiety disorders
-mood disorders
-disruptive behavior disorders

32
Q

what is the age requirement for ADHD dx

A

sx must be present before age 12

33
Q

most common ADHD characteristics

A

-hyperactivity
-attention deficit
-impulsivity
-memory/thinking deficits
-learning disabilities
-speech/hearing deficits

34
Q

medical problems with symptoms that overlap ADHD

A

-petit mal epilepsy
-hearing/vision impairments
-thyroid abnormalities
-hypoglycemia

35
Q

what is considered first line therapy for ADHD

A

stimulants

36
Q

stimulants for the treatment ADHD

A

-methylphenidate
-amphetamine-D
-amphetamine D,L

37
Q

brand names for amphetamine D

A

-dexedrine spansule
-zenzedi
-procentra

38
Q

brand names for amphetamine D.L

A

-adderall
-evekeo
-adzenys
-dyanavel
-mydayis

39
Q

what kind of agonists are methylphenidate and amphetamine

A

dopamine

40
Q

what is the ER formulation of methylphenidate

A

Concerta

41
Q

what is good abount the methylphenidate patch

A

it stops working 1 hour after removal

42
Q

nonstimulant medications for ADHD

A

-atomoxetine
-clonidine
-guanfacine

43
Q

drug class of atomoxetine

A

norepinephrine reuptake inhibitor

44
Q

half-life and dosing of atomoxetine

A

half-life 5 hours and typically given BID

45
Q

drug class of clonidine

A

norepinephrine receptor agonist

46
Q

drug class of guanfacine

A

norepinephrine receptor agonist

47
Q

clonidine dosage range for ADHD

A

0.1-0.2mg typically dosed BID

48
Q

clonidine taper

A

increase by 0.1mg weekly
do not taper any faster than q3-7 days

49
Q

are ER and IR formulations of clonidine interchangeable

A

No

50
Q

dosage of guanfacine in ADHD treatment

A

-start 1mg and titrate up by 1mg at weekly intervals to max dose of 4mg daily

51
Q

dc taper of guanfacine

A

taper by 1mg q3-7 days

52
Q

guanfacine and meals

A

do not take with high fat meal

53
Q

what is best option for depression comorbid with ADHD

A

SSRIs

54
Q

what may work for ADHD in adults

A

modafinil

55
Q

what should be checked quarterly in children taking stimulants

A

height, weight, BP, P

56
Q

psychosocial interventions for ADHD

A

-psychoeducation
-academic organization skills
-parent training
-behavior modification
-CBT
-social skills training

57
Q

which neurotransmitter is the focus of treatment for ADHD

A

dopamine

58
Q

main treatment for ADHD in adults

A

long-acting stimulants