Autism Spectrum Disorder Flashcards
What is Autism Spectrum Disorder (ASD)?
Autism Spectrum Disorders encompass a continuum of developmental disorders
Who gets ASD?
Male/Female Ratio 4:1
Peak Incidence: Before 3 years
Affects up to 1% of the population
What is Asperger’s Syndrome? What’s the deal with that term?
Asperger’s Syndrome is basically ASD without the language or intellectual disorder but now it comes under the classification of ASD alone in DSM5.
What are 3 factors that could be a part of the aetiology of ASD?
Genetic: recurrence rate in families is now estimated to be between 2% and 18%
Syndromal: There is an associated with Tuberous sclerosis, fragile X syndrome and congenital rubella
Structural: Subtle brain abnormalities in some children
What are 3 other disorders associated with ASD?
Intellectual Disability (50%)
Epilepsy (20-30%)
Other: ADHD, aggression and disruptive behaviour, anxiety disorders and depression, OCD, Tourette syndrome
What is the common triad found in the clinical presentation of ASD?
- Marked impairment in social impairment in social interactions (poor social-emotional reciprocity)
- Impaired and atypical verbal and non-verbal communication
- Repetitive and unusual behaviour/play
When will parents notice that something is different with their child?
Parents will notices that something is different by the time the child is 2 years old.
What can the parents note a LACK of in a child that has ASD?
Lack of: Pretend play Pointing out social objects to another person Social interest Joint attention Social Play Response to name when called
Note: Language development is delayed or disordered, and there may be unusual social use of language. Regression of language may be seen.
What are 3 other disorders (DDx) you need to exclude when considering a child for having ASD?
Communication Disorders
Intellectual Disability
Sensory Impairments (especially deafness)
Reactive attachment disorder
Obsessive Compulsive and Related Disorders
Anxiety Disorder
Schizophrenia
Stereotypic Movement disorder
ADHD
Rhett’s Syndrome
Other metabolic or genetic conditions in which kids display autistic like behaviour.
How do you diagnose ASD in a child? What is important in the work-up of a child with ASD?
In terms of the workup of ASD, it is important to rule out and underlying medical condition including any genetic intellectual disability syndromes.
It is important to understand that there is no single test for autism spectrum disorder. It is important to recognise that a multidisciplinary team to diagnose this based of clinical features on Hx and the exclusion of other medical conditions.
What are the 3 broad diagnostic keys for ASD? Within each of the three categories there are a few points in note to make that diagnosis. What are some of them?
- Impairment in social interaction
a. Uses nonverbal behaviours
b. Poor peer relationships
c. Lack of interest in shared behaviours
d. Lack of social or emotional reciprocity - Impairments in communication
a. Delay in language
b. Sterotyped or repetitive language
c. Lack of age appropriate social play - Repetitive behaviours
a. Inflexibility
b. Preoccupation with parts of objects
In terms of categorisation of children with ASD, what are the two components on which children are categorised along ASD? What does it mean?
There are 3 main categories for ASD which are based on the level of social communication and restricted repetitive behaviour. They differ in terms of the amount of support an individual will need with level 1 needing support while level 3 needs “very substantial” support according to DSM-5.
There are 9 points to the management of ASD. It is multidisciplinary. What are they? (Soz for long answer)
Parent support and education.
Appropriate screening of vision/hearing, investigation for associated disorders/syndromes if suspected.
Early intervention programmes, including a well-structured and predictable environment with behavioural modification, speech therapy and special education.
A combination of educational, developmental and behavioural treatments has been shown to improve a child’s rate of progress.
Teaching social skills and friendship skills.
Drug therapy is sometimes used to treat co-morbid psychopathology (e.g. attentional and behavioural problems, anxiety, self-injury). It does not affect the core autistic symptoms.
Advice regarding educational options.
Support groups.
Access to respite care.
When are outcomes the best? In what situation is the prognosis decent?
The best outcomes for children with ASD is that they are recognised early. On top of this it is the children without language problems and intellectual problems when the prognosis is the best. Basically the kids with Aspergers in the old language will be ok.
