Autism Spectrum Disorders/Condition

Question 1

Autism refers to auto as in ones self, meaning they are alone and isolated from others due to their lack of social interaction and communication, which is essentially the traits of Autism Spectrum Disorder (ASD).

Answer 1

ASD can range from mild impairments to severe impairments and is not a singular diagnose, but rather a spectrum

Question 2

What is the prevalence (number of people with a condition over a specified time) of Autism Spectrum Disorder in children and adolescents?

1 - 0.9%
2 - 9%
3 - 29%
4 - 59%

Answer 2

1 - 0.9%

Question 3

What % of those with ASD also have a learning disability?

1 - 0.9-9%
2 - 9-19%
3 - 20-30%
4 - 50-70%

Answer 3

4 - 50-70%

• important to rule out other potential causes for symptoms of ASD, such as deafness, poor vision, learning disability

Question 4

Neurodevelopment disorders arise due to abnormalities in growth and development of the CNS. What is the key feature of Autism Spectrum Disorders?

1 - deficits and delays in social and communication development
2 - hyperactivity
3 - inattention
4 - anger

Answer 4

1 - deficits and delays in social and communication development

• also associated with restricted patterns of interest and behaviour

Question 5

Autism Spectrum Disorders (ASD) are characterised by specific impairments. Which 2 of the following are diagnostic of ASD?

1 - deficits in social and communication interactions
2 - learning difficulties
3 - inattention and frustration
4 - restricted, repetitive inflexible interests and behaviours

Answer 5

1 - deficits in social and communication interactions

4 - restricted, repetitive inflexible interests and behaviours

Question 6

Are men or women more likely to be diagnosed with ASD?

Answer 6

• men
• BUT this is though to be because women are able to mask it better and imitate normal behaviours

Question 7

How is ASD diagnosed?

1. -imaging
   2 - clinical
   3 - biomarkers
   4 - psychomotor tests

Answer 7

2 - clinical
- psychomotor tests can be useful

Question 8

Autism Spectrum Disorders (ASD) are characterised by specific impairments. One of these is deficits in social interactions:

• difficult to initiate and maintain interactions
• not interested in affection from parents
• difficult to make and maintain friends
• difficulty sharing with others
• babies that don’t like being held
• lack of social cues

Answer 8

• these deficits must be persistent and affect all aspects of life

Question 9

Autism Spectrum Disorders (ASD) are characterised by specific impairments. One of these is deficits is communication difficulties:

• 25% of patient are speech deficient
• Aspergers syndrome is commonly used to refer to children with ASD who have normal language abilities
• unusual speech form, type
• use a string of questions to maintain conversation

Answer 9

• these deficits must be persistent and affect all aspects of life

Question 10

Autism Spectrum Disorders (ASD) are characterised by specific impairments. One of these deficits is: - restricted, repetitive inflexible interests and behaviours:

• specific, often unusual fixed interests
• lack of interest to play with toys
• repetitive movements and sounds, similar to OCD
• fixed inflexible routines and stressed when changes are introduced
• sensory hyper or hyposensitivitycifc

Answer 10

• these deficits must be persistent and affect all aspects of life

Question 11

In the definition of autism spectrum disorders, does the disorder develop in the development phase (<18 y/o) or in adulthood?

Answer 11

• development phase (<18 y/o)

Question 12

Parents tend to notice subtle symptoms of autism spectrum disorder (ASD) in their children. However, typically what age are children diagnosed with ASD?

1 - <1 y/o
2 - 3-4 y/o
3 - 7-10 y/o
4 - <16 y/o

Answer 12

2 - 3-4 y/o
- can be missed until adulthood though

Question 13

In a young child which of the following are signs that may be present, suggestive of autism spectrum disorder (ASD)?

1 - not looking at faces, even parents
2 - failure to show interest
3 - reduced pretend/imaginative play
4 - all of the above

Answer 13

4 - all of the above

Question 14

Which of the following is NOT a risk factor for developing ASD?

1 - MMR Vaccine
2 - Gestational diabetes
3 - Parents aged >30
4 - Valproate during pregnancy

Answer 14

1 - MMR Vaccine
- no evidence for this

Question 15

Genetics play a key role in ASD. Is this most likely to be polygenic or a single gene?

Answer 15

• polygenic
• evident with range of phenotypes

Question 16

In twin studies, what % of ASD is heritable?

1 - 0-9%
2 - 20-29%
3 - 40-50%
4 - 75-90%

Answer 16

4 - 75-90%

• if a sibling has ASD, then theres a 10-20% chance of another sibling developing ASD

Question 17

Although not the only cause, imaging has identified some changes in the brain in patients with ASD. Changes in which of the following has NOT been linked with autism?

1 - Frontal lobe
2 - Occipital lobe
3 - Limbic system
4 - Temporal lobe
5 - Corpus Callosum
6 - Cerebellum

Answer 17

2 - Occipital lobe

• ASD brains are often described as disorganised
• image shows 2 patients brain activity after being asked to talk about a social event

Question 18

Although genetics plays a key role in the aetiology of ASD, there are other factors as well. One of these is organic brain disorder. What is this?

1 - children’s brains developing faster in childhood
2 - inability to judge what people are thinking and use the knowledge to predict their behaviour (lack of theory of mind)
3 - adverse events in perinatal period (pregnancy and first 12 months of life)

Answer 18

1 - children’s brains developing faster in childhood

Question 19

What is theory of mind?

1 - ability to process emotions and thoughts
2 - ability to judge what people are thinking and use the knowledge to predict their behaviour
3 - ability to process information and think about alternatives

Answer 19

2 - ability to judge what people are thinking and use the knowledge to predict their behaviour

• this is hypothesised to be the main deficit in ASD

Question 20

Patients with ASD are often described as having sensory integration that can be hypo or hypersensitive. Which of the following are examples?

1 - deep pressure blankets
2 - response to pain (often higher threshold for pain)
3 - trampolines and rocking chairs
4 - all of the above

Answer 20

4 - all of the above

• trampolines and rocking chairs are generally because some ASD patients can have a dysfunctional vestibular system

Question 21

Is understanding sensory integration important in patients with ASD?

Answer 21

• yes
• if we know what is hypo and hyper, we can use them to manage patients

Question 22

Patients with ASD can have meltdowns or shutdowns. How are these typically managed?

1 - wait and see
2 - pharmacotherapy
3 - restraint
4 - all of the above

Answer 22

1 - wait and see
- patients with ASD need time to process, so give this to them

Question 23

Do children and adolescents with the features of ASD, such as abnormal behaviour continue into adulthood to the same extent?

Answer 23

• can, but with behavioural intervention they can improve and become less socially impairing

Question 24

What % of children with ASD attend a regular school in the UK?

1 - 7%
2 - 20%
3 - 40%
4 - 70%

Answer 24

4 - 70%

• its 20% in the USA

Question 25

Patients with ASD are often at increased risk of comorbidities. Which of the following is NOT a common comorbidity in ASD?

1 - anxiety
2 - depression
3 - dementia
4 - attention deficit hyperactivity disorders
5 - GI disorders

Answer 25

3 - dementia

Question 26

All of the following are mental disorders that typically occur in ASD. Which is the most common?

1 - ADHD
2 - Anxiety disorders
3 - Depressive disorders
4 - Bipolar disorder
5 - Schizophrenia spectrum disorders (psychosis)

Answer 26

1 - ADHD
- aprox 28% of patients with ASD will have ADHD

Question 27

Alexithymia is common in ASD and is a term to describe problems with feeling emotion, essentially the difficulty recognising their own emotions. Can this affect diagnosis?

Answer 27

• yes
• patients may be anxious or depressed but not be able to recognise and articulate this

Question 28

There are 3 major categories of treatment for patients with ASD. Which of the following is the main treatment?

1 - pharmacotherapy
2 - hospital admission
3 - psychological therapy
4 - electroconvulsive therapy

Answer 28

3 - psychological therapy

Question 29

Psychological therapy is the main treatment for patients with ASD. Which of the following is NOT a type of treatment typically used:

1 - speech and language therapy
2 - social skill training
3 - behavioural modification program
4 - behavioural and attendance monitoring

Answer 29

4 - behavioural and attendance monitoring

• social skill training are generally only useful for high functioning ASD patients

Question 30

Psychological therapy is the main treatment for patients with ASD. Speech and language therapy is important to ensure children at a young age achieve their verbal potential, which defines what they can achieve in later life.

Question 31

Pharmacotherapy are generally only used when what criteria are reached?

1 - children is disruptive at home and in school
2 - child is becoming aggressive
3 - behavioural and psychological interventions have made no change
4 - support system for the child has failed

Answer 31

3 - behavioural and psychological interventions have made no change

Question 32

Pharmacotherapy can be used in patients with ASD, only if behavioural and psychological interventions have made no change. Which of the following are NOT commonly used in the treatment of ASD?

1 - atypical anti-psychotics
2 - Selective serotonin reuptake inhibitors
3 - atomoxetine (stimulant)
4 - melatonin
5 - benzodiazepines

Answer 32

5 - benzodiazepines

• Risperidone is the atypical anti-psychotics of choice, but comes with lots of adverse events

Question 33

Are learning difficulties and learning disability the same thing?

Answer 33

• no
• difficulties = a specific difficult in one aspect of learning, dyslexia or dyscalculia
• disability = impaired development in early childhood affecting both intellectual and adaptive functioning deficits in conceptual, social, and practical domains