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Psych > Autism and ADHD > Flashcards

Autism and ADHD Flashcards

1
Q

Which questionnaire is used in the assessment of ADHD?

A

CONNERS Questionnaire

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2
Q

What is the ADOS-2?

A

0 ADOS-2: Autism Diagnostic Obversation Schedule, used for diagnosing and assessing autism

  • Structured tasks that involve social interaction with the examiner to observe the patient
  • Examines the patient using play and social interaction
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3
Q

What is the DISCO?

A

DISCO: Diagnostic interview for Social and Communication Disorders
- Clinical and research instrument for ASD in patients of any age

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4
Q

What is the ADI?

A

ADI: Autism Diagnostic Interview-revised (ADI-R)

  • Structured interview conducted with parents of those referred
  • Examined for ASD or related disorders
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5
Q

What characteristics in a developmental history may indicate ASD?

A
  • Delay in speech development
  • Sensory sensitivity
  • Delay in social development
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6
Q

What are school observations useful for?

A

They give a truer impression of the child in their own environment

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7
Q

What signs may be seen at school that can indicate ASD?

A
  • Not obeying commands
  • Not responding to name
  • Poor concentration or disinterest
  • Focusing better in smaller groups
  • Little interest in interacting with other children
  • Poor eye contact
  • Poor engagement in conversations
  • Strong dislike if events are not to their liking/distress
  • Flapping hands when over-stimulated
  • Slower academic progression
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8
Q

What does ASD pertain to?

A

Autism Spectrum Disorder (ASD) pertains to:

  • Autism
  • Asperger’s
  • Childhood Disintegrative Disorder
  • Pervasive Developmental Disorder

This was produced by the DSM-V
- Social communication disorders alone are diagnosed when behaviours/interests are not restricted

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9
Q

What is the epidemiology of Autism?

A

Autism is more frequent in boys than girls in the ratio of 4:1, but this may be due to being under-diagnosed in females

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10
Q

Are there any genetic or congenital associations with autism?

A
  • The risk of developing ASD if a sibling is affected - recurrence sate is 2-8%
  • If a patient has 2 autistic siblings, this increases to 25-30%
  • Phenylkentinuria and congenital rubella are associated with autism
  • Chromosomal disorders: 2, 4, 7, 13, 15 and 19
  • Fragile X syndrome or Tuberous sclerosis
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11
Q

What signs are indicative of a good prognosis in autism?

A
  • Communicative speech 6 years old and above
  • Higher IQ (>50)
  • Skills that can be used to secure employment
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12
Q

What comorbidities are often seen in ASD?

A
  • Depression
  • BPAD
  • Schizophrenia
  • Learning disabilities (80%)
  • Seizure disorders
  • 3/5 patients will be unable to lead independent lives
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13
Q

What is the management for ASD?

A
  • Early intervention at school and with parents
  • Needs-led bases, functional assessment

Psychotherapy for both parents and the patient

  • CBT
  • Behaviour management programmes
  • Applies behavioural analysis program (operant conditioning)
  • TEACCH (Treatment and educations for Autistic and related Communication Handicapped Children programme) enhances life skills and reduces self-harming behaviour
  • Educational psychology

Social - led by functional assessment

  • Carers
  • Respite care
  • Education of peers in school
  • Educational support (learning support, SENCOs, special schools)

Medication, adjuncts to psychological intervention:
- SSRIs, mainstay of treatment
- Second generation antipsychotics - first line pharmacological treatment for children/adolescents with ASD and irritability
(Risperidone is used)
- Melatonin can help reduce sleep latency (time taken to fall asleep)

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14
Q

What areas does the ADI-R assess?

A

Three functional domains:

  • Language and communication
  • Reciprocal Social interactions
  • Restricted, repetitive and stereotyped behaviours and interests
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15
Q

What is the DISCO used for?

A
  • Used in ASD
  • Determines the patient’s individual behaviours and needs
  • Assists clinicians in assessing patient’s development, disabilities and specific needs
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16
Q

What are the modules included in the ADOS-2?

A
  • Toddler module (12-30 months, do not consistently use phrase speech)
  • Module 1 (31mo+, do not consistently use phrase speech)
  • Module 2 (any age, using phrase speech but not verbally fluent
  • Module 3 (verbally fluent children and young adolescents
  • Module 4 (verbally fluent older adolescents and adults)

Scores are then entered into the ADOS-2 algorithm form

The difference between autism and autism spectrum is severity.

17
Q

What initial recommendations can be made following a diagnosis of ASD?

A
  • Access information provided by the National Autistic society
  • Educational psychology for the patient and their family
  • Referral to SALT if needed
18
Q

How should a diagnosis of Autism be explained?

A
  • What it is
    A communication and language disorder which changes the way a patient interacts with other people
    Sensory aspects, learning disabilities etc
  • How autism is likely to affect the patient’s development and function
    They may find it more difficult than their peers to work well in a classroom environment, so additional support or a special school may be advised
    They may have difficulty making friends and communicating their needs with others, so CBT/psychotherapy is provided that can help
19
Q

What should be provided to families and patients following a diagnosis of Autism?

A
  • Written report of diagnostic assessment
  • Share information with GP (with assessment)
  • Share information, with consent, with key professionals involved in the patient’s care, including teachers etc
  • Make the patient profile visible (with consent) to other professionals involved in care and education
  • Follow-up appointment with autism team within 6 weeks of end of autism assessment for further discussion
  • Discuss with parents the risk of autism occurring in siblings and future children
20
Q

What can be seen on an MRI in patients with ASD?

A

MRI scans show brain enlargement:

  • Occipital
  • Parietal
  • Temporal lobes

This could be due to reduced neuronal death, increased neurogenesis, or increased production of glial cells/vasculature

21
Q

What is the theory of mind?

A

A lack of a theory of mind:

  • Deficits in empathy and understanding what others may think
  • Tested using the Sally-Anne test
22
Q

Which medication is licensed to treat challenging aggressive behaviour in autistic children?

A

Risperidone
- NICE suggests that psychosocial interventions are tried and a physical cause for the aggressive behaviour is ruled out/treated first

23
Q

What is Atomoxetine?

A

Atomodetine is an alternative to Methylphendate (Equasym) in the treatment of ADHD

Psych (8 decks)

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