Autism Spectrum Disorder Flashcards
Autism Spectrum Disorder
Neurodevelopmental condition characterised by:
- impairment in social interaction & communication
- repetitive stereotyped behaviour, interests, & activities
DSM5:
“Pervasive developmental disorder”
Aetiology of autism spectrum disorder
- gene & chromosomal anomalies
- family history
- advanced parental age (maternal > 40, paternal > 50)
- environment (toxins, prenatal infections)
Genetic diagnoses associated with autism spectrum disorder
- tuberous sclerosis complex
- fragile x syndrome
- angelman syndrome
- retts syndrome
- down syndrome
Classifying autism spectrum disorder
DSM5 categorises by 3 levels of severity rated separately for social communcation & restricted, repetitive behaviours:
1. Level 1 (requiring support)
2. Level 2 (requiring substantial support)
3. Level 3 (requiring very substantial support)
Clinical features of autism spectrum disorder
- Impaired social communication & interaction
- Repetitive behaviours, interests, & activities
- Intellectual or language impairment
- May also have ADHD or epilepsy
Referral criteria for autism spectrum disorder assessment
NICE 2011, refer if:
- < 3 years if regression in language or social skills
- concerns re possible ASD based on reported or observed signs and/or symptoms
- factors associated with increased prevelance of ASD (e.g. family hx.)
Diagnosing autism spectrum disorder
Based on careful assessment of behaviour, cognitive development & language skills.
DSM5 diagnosis based on presence of:
- persistent deficits in social communication & interaction across social-emotional reciprocacy, non-verbal communication, & developing relationships.
- restrictive, repetitive patterns of behaviour, interests, or activities as shown by stereotyped/repetitive motor movements, inisistence of sameness & inflexible adherence to routines, highly restricted & fixed interests, hyper- or hypo-reactivity to sensory input
- Symptoms must be present in early developmental period
- Symptoms must cause clinically significant impairment in functioning
Differentials for autism spectrum disorder
- ADHD
- social (pragmatic) communication disorder
- global developmental delay/intellectual disability
- developmental language disorder
General management of autism spectrum disorder
Multidisciplinary approach from various professionals including:
- paediatricians
- psychologists
- speech and language therapists
- occupational therapists
- educational professionals
- social care workers
Early interventions in autism spectrum disorder
- applied behaviour analysis (teaching approach that rewards positive behaviour)
- TEACCH (treatment and education of autistic and related communication-handicapped children)
- early intensive behavioural intervention
Communication enhancement in autism spectrum disorder
- Speech and language therapy
- Picture exchange communication system (visual-based system to initiate communication for non-verbal individuals)
Social skills training for autism spectrum disorder
- structured teaching of social norms and behaviours
- help navigate social situations more effectively
Occupational therapy for autism spectrum disorder
- sensory integration therapy (integrate sensosry info, allowing individual to respond appropriately)
- adaptive skills training (develop skills for daily living)
Pharmacological management of autism spectrum disorder
No drug treats symptoms of ASD, but meds may be useful for associated symptoms or comorbidities:
- ADHD = methylphenidate
- OCD & anxiety = SSRIs
Family support in autism spectrum disorder
- parent-managed behavioural interventions (training for parents)
- support groups
- respite care
