Autism Spectrum Disorder and ADHD

Question 1

UK prevalence of autism spectrum disorder is around?

Answer 1

1%

Question 2

what are risk factors for autism?

Answer 2

advanced maternal/paternal age
prematurity
perinatal hypoxia

Question 3

what genetic conditions are associated with autism?

Answer 3

fragile X syndrome, tuberous sclerosis and Angelmann syndrome.

Question 4

what % of autism cases are diagnosed by chromosomal analysis and microarray ?

Answer 4

chromosomal analysis = 5%

microarray = 10%

Question 5

what three key areas do autistic people struggle with?

Answer 5

Impaired Social Communication

Restrictive or Repetitive activities

Abnormality of Social Interaction

Question 6

what should be looked at on examination of autism cases?

Answer 6

Skin stigmata of neurofibromatosis or tuberous sclerosis using a Wood’s light.
Signs of injury, for example self-harm or child maltreatment.
Congenital anomalies and dysmorphic features including macrocephaly or microcephaly.

Question 7

what age must symptoms be present for autism ?

Answer 7

3

Question 8

what age must symptoms be present for ADHD?

Answer 8

6

Question 9

what are some DD for autism?

Answer 9

learning difficulties 
attachment disorders
retts syndrome 
schizophrenia 
specific language disorders

Question 10

what is retts syndrome ?

Answer 10

A rare genetic syndrome occurring mostly in girls. It presents in affected girls who develop normally for the first 6 months, but then by 18 months of age begin to regress and lose skills. Marked features include speech delay and repetitive hand movements, in particular hand-wringing and flapping.

Question 11

what are two management techniques of autism?

Answer 11

Behavioural management strategies – visual timetables, preparation and explanation for changes in routine.
Educational measures - special school

Question 12

what does ADHD stand for?

Answer 12

Attention Deficit Hyperactivity Disorder

Question 13

what is the prevalence of ADHD in the UK?

Answer 13

7%

Question 14

what is the heritability of ADHD?

Answer 14

88%

Question 15

what are the two criteria used for ADHD?

Answer 15

ICD-106 or DSM-V7.

Question 16

what age must symptoms be present for ICD-10 criteria ?

Answer 16

before 6

Question 17

what are the three subtypes of ADHD in DSM-V criteria ?

Answer 17

Inattention criteria include – “easily distracted by extraneous stimuli”, “forgetful in daily activities” and “often has difficulty sustaining attention in tasks or play activities”.

Hyperactivity criteria include – “often fidgets with hands or feet or squirms in seat”, “often talks excessively” and “is often on the go or often acts as if driven by a motor”.

Impulsivity criteria include – “often has difficulty waiting turn” and “often bursts out answers before questions have been completed”.

Question 18

how is a diagnosis of ADHD made?

Answer 18

at least six of the criteria from either inattention category or hyperactivity/impulsivity category are met and have been present from before the age of 12 for at least six months. The impairment must be present in more than one setting and there must be evidence of the symptoms impairing the child’s functioning.

Question 19

What are two DD for ADHD?

Answer 19

auditory processing disorder

oppositional defiant disorder

Question 20

what is the questionnaire to give more information for ADHD?

Answer 20

Connors questionnaire

Question 21

what is the management of moderate impairment ADHD?

Answer 21

CBT

parent education

Question 22

what is the management of severe impairment ADHD?

Answer 22

medication is 1st line

Question 23

what are the 5 medications licensed for ADHD?

Answer 23

methyphenidate 
atomoxetine 
lisdexamfetamine 
guanfacine 
antipsychotics (not used children)

Question 24

which of the medication for ADHD is not stimulant?

Answer 24

guanfacine

Question 25

what are SEs of ADHD medication?

Answer 25

raised blood pressure
palpitations (representing potentially dangerous arrhythmias)
disturbed sleep
impaired growth and appetite suppression

Question 26

what are some adverse outcomes ADHD patients are more at risk of?

Answer 26

increased substance abuse, more criminal convictions and lower educational attainment and unemployment.