Autism Spectrum Disorder

Question 1

What is the difference between autism and asperger’s?

Answer 1

No general delay in cognitive and language development and they are usually of normal intelligence

Question 2

what are the triad of core symptoms in autism?

Answer 2

o Abnormal reciprocal social interaction
o Communication / language impairment
o Restricted and repetitive interests / activities

Question 3

give examples of how cognitive and language impairment in a child with autism may display itself

Answer 3

• Poor development of spoken language;
• Extreme difficulty in initiating or sustaining conversation;
• Repetitive use of idiosyncratic language and lack of imitative or make-believe play.
• Features
  o Speech unusual volume
  o Formal, stilted, pedantic
  o Misinterpretation of literal/implied meanings
  o Advanced vocabulary; poor conversational skills
  o Lack of prosody (monotonous)
  o Talking at rather than to
  o Few nonverbal gestures

Question 4

give examples of how a child’s restricted and repetitive interests may be dis played in autism

Answer 4

• Intense preoccupations with interests such as dates, phone numbers and timetables;
• In- flexible adherence to routines and rituals;
• Repetitive, stereotyped motor movements such as clapping, rocking or twisting and an unusual interest in parts of hard or moving objects.
  o ‘motor mannerisms’
• Compulsive / repetitive behaviours
• Ritualistic daily activities
• Repetitive self injury
• Preference for sameness e.g. food
• Change is unsettling

Question 5

how do you manage autism?

Answer 5

• Structure, routine, predictability
• Information
• Adapting environment e.g. reducing complex social interactions, using routine/timetabling
• Communication aids e.g. use of pictures or objects
• Social skills training
• CBT, OT
• Family support – parenting programmes
• Medication – symptomatic (antipsychotics for stereotyped or aggressive behaviours, SSRI’s for compulsive behaviours, melatonin for insomnia, future research) but NOT to treat the core symptoms

Question 6

What is Rett syndrome

Answer 6

a rare disorder, nearly always seen in girls.
It is a disorder of childhood development.
- Initially there is normal antenatal development, normal head circumference at birth
- Followed by an apparently normal psychomotor development in the first 5 months after birth.
- From 6 months to 2 years of age, a progressive and destructive encephalopathy results in a deceleration of head growth; loss or lack of development of language, and loss of purposeful hand movements and fine motor skills, with subsequent development of stereotyped hand movements (e.g. midline hand-wringing).
- After a decade, most girls are bound to a wheelchair with incontinence, muscle wasting and rigidity and almost no language ability.

Question 7

What is childhood disintegrative syndrome?

Answer 7

• More common in boys,
• Characterised by about 2 years of normal development, followed by a loss of previously acquired skills (language, social and adaptive skills, play, bowel and bladder control and motor skills) before age 10.
• It is also associated with an autism-like impairment of social interaction as well as repetitive, stereotyped interests and mannerisms. Thus, after the deterioration, these children may resemble autistic children.