CAMHS

Question 1

How common is autism?

Answer 1

1/1000

Question 2

What are some risk factors for autism?

Answer 2

Family history, male, obstetric complications, chromosomal abnormality

Question 3

Define autism

Answer 3

Neurodevelopmental disorder characterised by the triad of difficulties with social interaction, speech and language difficulties, and ritualistic and repetitive behaviours

Question 4

Describe some of the features of autism

Answer 4

• Social interaction difficulties: solitary play, not seeking others for comfort, poor eye contact, poor understanding of social cues
• Speech and language difficulties: concrete thinking, monotone voice, echolalia
• Behaviours: restricted interests, repetitive behaviours/rituals, tantrums when disrupted, stubborn
• Sensory processing differences
• Meltdowns and shutdowns

Question 5

What are some differentials for autism?

Answer 5

Deafness 
Autism spectrum disorder
Learning disability
OCD
Anankastic PD

Question 6

You suspect a 4 year old child has autism after taking a history in GP. What would you do next?

Answer 6

Investigations: hearing test
Refer to autism team for assessment
Provide info for parents, explain that the team will contact them and decide if they want to do a full assessment

Question 7

What is an autism diagnostic assessment?

Answer 7

Specialist assessment including:

• Assessment of signs and symptoms of autism
• Parental concerns
• Medical history, birth history etc
• Needs assessment
• Physical exam + hearing/vision assessment

Question 8

Describe the management of autism

Answer 8

MDT approach with paeds, SALT, OT, psych, school

• Speech and language therapy
• Behavioural therapy, social skills training eg Early Start Denver Model
• Support in school/special eduction
• CBT for comorbid mental health eg anxiety
• Parent support groups and carers needs assessment

Question 9

Which antidepressant is 1st line in children?

Answer 9

Fluoxetine

Question 10

What is school refusal? What are some reasons?

Answer 10

School refusal is when a child openly refuses to attend school, rather than secretively cutting classes.

• Victim of bullying
• Fear of failure
• Unsympathetic teachers

Question 11

What is the management of school refusal?

Answer 11

• Discussion with child about reasons
• Involve the school eg if being bullied
• Early return to school

Question 12

What is the difference between autism and ASD?

Answer 12

ASD (previously Asperger’s) typically have difficulties with social interaction and restricted interests, without language difficulties or low IQ

Question 13

What is conduct disorder? How common is it?

Answer 13

Disorder of antisocial behaviour in young people

10% of 10 year olds

Question 14

What are some risk factors for conduct disorder?

Answer 14

Urban environment, low socioeconomic status, male, disorganised family with incarceration, drug misuse, looked-after children

Question 15

Describe the features of conduct disorder

Answer 15

Basically antisocial PD in teens:
-Bullying
-Stealing
-Truancy 
-Fighting
Can be socialised (in groups) or unsocialised (isolated)

Question 16

What are some differentials for conduct disorder?

Answer 16

Oppositional defiant disorder (young kids)
ADHD
Depression
Schizophrenia (uncommon in young teens)

Question 17

What is the management of conduct disorder?

Answer 17

• Family education and parenting strategies
• Family therapy
• Anger management therapy

Question 18

If a young person has suspected conduct disorder, what should be done next?

Answer 18

• Assessment eg. Strengths and Difficulties Questionnaire, school input
• Refer to CAMHS for full assessment and family therapy