Behavioural

Question 1

What does ADHD stand for?

Answer 1

Attention deficit hyperactivity disorder

Question 2

What are the 3 core symptoms of ADHD?

Answer 2

Inattention: difficulty concentrating (not a a defiant thing)
Hyperactivity: always on the move, difficulty in remaining
Impulsivity: interrupts others, struggles to wait

Question 3

How is a diagnosis of ADHD made?

Answer 3

Hx from care givers about behaviour and development from birth
Observation of child

Symptoms must be persistent and prevalent across multiple domains (ie school/home/community)

Typically diagnosis is held off until school age

Question 4

What are some differentials for ADHD?

Answer 4

Age appropriate behaviour
Low (or high) IQ
Hearing problems
Behavioural disorders

Question 5

How is ADHD managed?

Answer 5

Talking therapies
Stimulant medication-methylphenidate (1st line), lisdexamphetamine, dexamphetamine.
Non-stimulant medication- atomoxetine

Question 6

What is important to remember with stimulant medication for ADHD?

Answer 6

It suppresses appetite so can affect growth

Need to have ‘medication holidays’

Question 7

What does ASD stand for?

Answer 7

Autistic spectrum disorder

Question 8

What are the core symptoms of ASD?

Answer 8

1. Persistent deficit in social communication and social interaction in a variety of contexts
2. Restrictive, repetitive patterns of behaviour, interests and activities

Question 9

Explain the 3 clinical symptoms of ASD

Answer 9

1. Impaired imagination: doesn’t engage in adult roles during play, stiffens when held, doesn’t meet eye gaze
2. Impaired social interaction: doesn’t pick up on or acknowledge (existence of)others feelings or emotions, abnormal response to being hurt.
3. Limited range of activities and interests: will stick to rigid pattern and routine, will be fixated on details (ie position of a lamp) and will show marked distress if altered. Stereotyped repetitive movements (head banging/spinning/hand flicking).

Question 10

How is ASD diagnosed?

Answer 10

Collateral history from carers/school/others involved with the child
Autism diagnostic observation schedule (ADOS)
Developmental, dimensional, diagnostic interview (3Di)

Question 11

How is ASD managed?

Answer 11

Early behavioural intervention
Parental education
Drugs: Risperidone (for aggression), melatonin (for sleep), SSRIs (for anxiety)
Diet: some people go gluten free but there is no evidence for this.