Autism Spectrum Disorders Flashcards
What are the 5 ASDs? (not really used just listed in ICD10 still)
Asperge's syndrome, Rett's Syndrome, childhood autism, pervasive developmental disorder, pervasive developmental disorder NOS
What do patients with ASDs have difficulty with?
Social interaction and social communication
What is triad of impairments in ASD? (4)
impaired social communication,
impaired social interaction,
impaired social imagination,
repetitive behaviours
Social communication difficulties in ASD (5)
good language skills but struggle to understand underlying meaning of convo,
difficulties understanding jokes and sarcasm,
voices often sound monotonous,
language can be pedantic and idiosyncratic,
narrow interests that dominate convos
Social interaction difficulties in ASD (3)
difficulties picking up non-verbal cues,
appear self focused but trying to figure out situation,
struggle to make and sustain personal relationships
Social imagination difficulties in ASD (3)
difficulty thinking flexibly,
inability to understand others points of view,
difficulties projecting themselves into the future or planning goals sensibly
Repetitive behaviour examples (4)
stereotyped or repetitive motor movements, use of objects or speech,
insistence on sameness, routine or ritualised behaviour,
intense focused interests,
hyper/hypo reactivity to sensory input
ASD prevalence is %?
1-2%
ASD ratio boys:girls
5:1
Gender difference in ASD theories? (3)
sex hormones,
receptors for sex hormones all over brain so influence neural signalling,
poor specificity in diagnostic tests for females
What hormone is reduced in females with Asperger’s syndrome?
SHBG reduced so increased levels free testosterone
ASD is how many times more likely in patients seen at GID clinics than general population?
3-4 times
Risk factors for ASD? (5)
Multifactorial but: rubella in pregnant mother, tuberous sclerosis, fragile X syndrome, encephalitis, untreated phenylketonuria
What is most commonly inherited form of ID?
Fragile X Syndrome
Of all psychiatric disorders autism has one of highest inhertibalities. T/F?
T
List 3 types of chromosomal abnormalities
deletion,
duplication,
inversion
10 biological perinatal risk factors for autism
umbilical cord complications, foetal distress, birth injury, multiple birth and maternal haemorrhage, LBW/SGA, congenital malformation, meconium aspiration, neonatal anaemia, ABO incompatibility
Neuroanatomical changes in ASD? (not yet clear tho)
larger amygdala,
diff frontal lobe and cerebellum
What neuroreceptors seem to be implicated in autism?
glutamate receptors,
GABA,
serotonin
Speech and language signs of ASD in children? (3)
baby: don’t babble,
toddlers: repeat other peoples words,
older children: can struggle with non-verbal communication behaviours,
Signs of ASD in children? (7)
lack interest in other children, gravitate toward older/younger children, prefer to be alone, difficulties starting convos, some don't do imaginative play, same routine and have tantrums if not, flap hands when excited, repetitive activity e.g. watch movie over and over
Taste sensory problems (child)
flavours too strong or textures cause discomfort so restricted diet
Smell sensory problems (child)
smells too strong/overpowering so can cause problems with cleaning self
Sound sensory problems (child)
noise can be magnified, distorted, muddled,
can struggled to cut out background noise
Touch sensory problems (child)
touch can be painful/uncomfortable,
difficulties brushing/washing hair or wearing certain types of clothing
Sight sensory problems (child)
poor depth perception,
problems throwing/catching,
difficulty getting to sleep because sensitive to light
Adult communication signs
difficulty seeing other persons perspective,
difficulty picking up on body and facial cues,
difficulty eye contact,
show compassion.
repeat same phrase,
struggle with small talk,
struggle with humour/sarcasm
Adult social signs
appear shy, few friendships, can appear rude, take things literally, struggle with social norms e.g. dressing
Diagnostic tools for ASD & gold standard
developmental and collateral history,
standardised assessment tool ADOS - autism diagnostic observation schedule (gold standard),
screening questionnaire e.g. 3di, DISCO
Essential criteria for ASD (3)
symptoms must be present in early development period,
symptoms cause clinically significant in social, occupational or other important areas,
disturbances not explained by other mental health problems, ID or global developmental delay
Comorbidity very high in ASD, List commonest
learning disability, language impairment, dyslexia, depression & anxiety, ADHD, OCD, eating disorder
Non-pharma management?
psychoeducation,
speech and language therapy,
social care supports,
diet
Pharma management?
No Pharma management for ASD symptoms but risperidone licensed for management of severe aggression and self injury
