Autism spectrum disorder (ASD) Flashcards
What is a neurodevelopment disorder?
An impairment in the growth and development of the brain and/or CNS
What is ASD?
Autistic spectrum disorder (ASD) is characterised by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive and inflexible patterns of behaviour, interests or activities that are clearly atypical or excessive for the individual’s age and sociocultural context
What are some comorbidities that are common in ASD?
depression, anxiety, EDs, Tourettes, OCD, ADHD, learning disabilities
Describe the aetiology of ASD
More common in males (4:1)
Suggested link to sex hormones
Possibly due to misdiagnosis of girls
What are some conditions that can increase risk of ASD during pregnancy?
Rubella
Vitamin D deficiency (Neonate)
Valproate use
Tuberous sclerosis
Fragile X syndrome
Encephalitis
Untreated PKU (Neonate)
What processes are controlled by genes which seem to be implicated in ASD?
- Protein synthesis in neuronal cells
- Activity and adhesion of neuronal cells
- Synapse formation and remodeling
- Excitatory to inhibitory neurotransmitter balance
What are some main regions of the brain that seem to be pathological in ASD
Frontal lobes
Amygdala
Cerebellum
What are some specific brain systems that seem to be pathological in ASD?
Fusiform face area on the inferior temporal cortex (Facial recognition)
Limbic system (Emotional and memory processing)
What are some functional changes that occur in the brain in ASD?
Reduced connectivity between specialised regions of the brain, but increased global connectivity of the brain
What is global connectivity of the brain involved in?
Integrating and processing complex sensory and cognitive inputs and comparing them their the brain’s model of the world
What is regional connectivity of the brain involved in?
Detail processing and for adjusting the view of the world to more closely fit the incoming data
What are some neurochemicals that seem to be involved in ASD?
Glutamate
GABA
Serotonin
How does GABA relate to ASD neurochemistry
GABA has a key role in regulation of early developmental stages of cell migration, neuronal differentiation and stages of maturation
How does glutamate relate to ASD neurochemistry
Glutamate is an essential exctitatory neurotransmitter which dysregulation can lead to neuronal damage
How does serotonin relate to ASD neurochemistry
Serotonin neurotransmitter system has a critical role in the regulation of crucial steps of neuronal development
What are some forms of presentation in ASD?
Social communication
Social interaction
Social imagination
Repetitive impairment
What are some symptoms of ASD relating to social communication
- Generally good language skills but find it hard to grasp the underlying meaning of conversation
- Difficulties understanding jokes, idioms, metaphors and sarcasm
- Voices often sound monotonous
- Language can be pedantic and idiosyncratic
- Often have narrow interests which dominate their converations (lack of reciprocity)
What are some symptoms of ASD relating to social interaction
- Difficulties picking up non-verbal cues
- Appear self-focused and lacking in empathy, when in fact they are simply trying to figure out social situations
- Continually struggle to make and sustain personal and social relationships
What are some symptoms of ASD relating to social imagination
- Difficulties thinking flexibly and in abstract ways
- Inability to understand other people’s points of view, taking things literally
- Difficulties applying knowledge and skills across settings with different people
- Difficulties projecting themselves into the future or planning goals sensibly
What are some symptoms of ASD relating to repetitive impairment
- Stereotyped or repetitive motor movements, use of objects or speech
- Insistance on sameness, inflexible adherence to routines, or ritualised patterns of behaviour or nonverbal behaviour
- Highly restricted, fixated interests that are abnormal in intensity of focus
- Hyper- or hypo- reactivity to sensory input or unsual interest in sensory aspects of the environment
What are some screening questionnaires used in ASD?
Autism Quotient - AQ-10
M-CHAT for children
What are the essential criteria for ASD diagnosis
- Symptoms must be present in the early developmental period
- Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning (regardless of age)
- Disturbances are not better explained by other mental health problems, intellectual disability, or global developmental delay
How is ASD usually managed?
Treatment is mainly through education and social interventions
What medication may be used in severe aggressive or self-injurious forms of ASD?
Risperidone
What are some environmental changes that can be made to accomodate those with ASD
- Give personal space
- Use visual supports or easier labels or symbols
- Avoid patterns and high-arousal colours on walls, opting for pastel colours
- Reduce noise levels
- Reduce fluorescent lighting
