Autism Spectrum Disorder Flashcards
DSM-5 Criteria for social communication
==>persistant deficit in social communication need all three categories
lack of social/emotional reciprocity
marked deficits in nonverbal and verbal communication used for social interaction
failure to develop and maintain peer relationships appropriate for developmental level
impairment in two domains
deficits in social communication/social interaction
restricted repetitive patterns of behavior, interests, and activities
DSM5 Behavhior
repetitive, restricted patterns of behavior, interests, and activities as manifested by at least two-
stereotyped motor movements, use of objects or speech
insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behaviors
highly restricted, fixated interests that are abnormal in intensity aor focus
hyper or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment
levels of autism
level 1- requiring support
level 2- requiring substantial support
level 3- requiring very substantial support
social communication disorder
new diagnosis in DSM 5
difficulties with social use of communication or language
NOT a variant of ASD- no restricted or repetitive patterns of behavior
prevalence of autism
occurs 1 out of 68 births
75% of people with autism are
mentally retarted
20% of people with autism
have a seizure disorder
gender ratio
boys: girls
5: 1
increasd risk of autism with
increasing parental age
pre-term babies
1 child with ASD, leaves a what recurrence rate
20%
idential twins vs fratneral twins
70% identical twins
20% fraternal twins
neuro findings of autism
early brain overgrowth in first 2 years
differences in connectivity between frontal and parietal lobes
differences in empathy circuit
increased cerebral volume
diagnostic assesssmnet
no definitive diagnostic test
must first role out
hearing impairment, other psych disorders, eccentric/quirky behavior
different tests to confirm
MRI- focal neurologic signs
metabolic testing
genetic testing (DNA probe for fragile x, microarray, karyotype)
testing for mutations of PTEN gene (ASD and macrocephaly)
EEG
symptoms may
improve with time, but it is a lifelong progression
ASD and head circumference
25% of people have a head circumference in 97th percentile
ASG and _____ have mutations in the _____ gene, placing them at risk for _____
macrocephaly
PTEN
hamartomatous tumors
ADHD and ASD
45-59% of people
ADHD and employment
85% unemployed or under employed
pharmacology and ASD
treat specific symptoms with select medications
psychotropic meds
45% children and 75% adults
SSRIs, atypical antipsychotics, stimulants, clonidine, guanfacine
irritability
10-30%
Aberrant behavior checklist
irritability and agitation lethargy and social withdrawal sterotypic behavior hyperactivity and noncompliance inappropriate speech
first evaluate for
physical pain, dental pain, new stressors
FDA approved for irritability in autism
risperidone (wont eliminate completely)
antipsychotics are
last resort for ASD
kids and relapse on risperidone
yes
another fda approved drug for irritability in autism
aripiprazole
aripripazole vs risperidone
rispiridone- weight gain
aripip- not generic
mood stabilizers/adjunct to risperidone
topiramate
–decrease in sterotypic behavior (hyperactivity/noncompliance)
response rate in ADHD/ASD
less than normal kids
main side effect ADHD meds
irritability
first line adhd
stimulants
second line adhd
alpha 2 adrenergic agonists
atomoxetine
pharm for repetitive behavior
SSRIs- no different than placebo in kids (some work in adults)
aripiprazole and risperidone help but dnt help anxiety
SSRIs and family members
if first degree family member has a good response to SSRI, utilize one
drugs taht show promise for social impairment
oxytocine
d-cycloserine
arbaclofen
