Child health- Autism and ADHD

Question 1

what are the three core symptoms of ADHD in children?

Answer 1

inattention, impulsivity, hyperactivity

Question 2

define ADHD via the DSM V

Answer 2

Present before 12 years

Developmentally inappropriate

Several symptoms in 2 or more settings

Clear evidence symptoms interfere/reduce quality of social/academic/occupational function

Question 3

examples of inattentive symptoms

Answer 3

Is easily distracted

Does not appear to be listening when spoken to directly

Has difficulty sustaining attention during activities

Avoids or dislikes tasks requiring sustained mental effort

Is forgetful in daily activities

Finds it difficult to follow through instructions and fails to complete tasks

Finds it difficult to organise tasks and activities

Fails to give close attention to detail/makes careless mistakes

Loses important items

Question 4

examples of hyperactivity symptoms

Answer 4

Squirms and fidgets

Cannot remain seated

Runs or climbs excessively in inappropriate situations

Often ‘on the go’ or acts as if ‘driven by a motor’

Talks excessively

Cannot perform leisure activities quietly

Question 5

examples of impulsive symptoms

Answer 5

Blurts out answers before questions completed

Has difficulty awaiting turn

Interrupts or intrudes on others

Question 6

what is the incidence of ADHD

Answer 6

4-7% of school children

M:F 4:1

Question 7

which factors are most likely to be involved in ADHD

Answer 7

neurobiologic (neuroanatomical and neurochemical)

genetic influences

environmental/psychosocial factors

CNS insults (such as perinatal factors, CNS infections)

Question 8

which genes / alleles are implicated in ADHD

Answer 8

dopamine D4 receptor (DRD4) gene

DRD4 7-repeat allele
higher rates of DRD$ 7 found in children with ADHD

Question 9

which acquired brain injuries are associated with ADHD

Answer 9

prematurity, Fetal alcohol syndrome, NF

Question 10

what are the principles of treatment for ADHD

Answer 10

education, ADHD parent programme, school support and liason

medications

Question 11

which medications are offered for ADHD

Answer 11

Stimulants
* Methylphenidate (Ritalin,MedikinetXL,EquasymXL,ConcertaXL)
*Lisdexamfetamine(Elvanse)

Non Stimulants
*Atomoxetine
*Intuniv (Prolonged release Guanfacine)

Question 12

what is the incidence of autism spectrum disorder

Answer 12

1:100

Question 13

how many children have ASD in the UK

Answer 13

0.5 million

Question 14

M:F ratio for ASD

Answer 14

4:1

Question 15

is there a known cause for ASD?

Answer 15

no, but genetics are important

Question 16

what does ASD affect

Answer 16

communication

social interaction

behaviour, poor imagination and rigidity of ideas

Question 17

describe communication difficulties experienced by children with ASD

Answer 17

lack of desire to communicate

communicate needs only

disordered or delayed language

repeats speech (echolalia)

poor non verbal communication eg body language

pedantic language use, very literal with poor understanding of idioms and jokes

Question 18

what are social interaction difficulties experienced by children with ASD

Answer 18

no desire to interact with others

being interested in others to have needs met

lack of motivation to please others

affectionate on own terms

friendly but with odd interactions

no understanding of social rules

limited interaction with unfamiliar people in unfamiliar circumstances

Question 19

how can ASD manifest in children of school age

Answer 19

touches inappropriately

plays alone

poor eye contact

finds it hard to turn take

finds it stressful to be with other people

Question 20

describe difficulties with imagination / rigidiity of thought in children with ASD

Answer 20

using toys as objects

inability to play or write imaginatively

resisting change

playing same game over and over

obsessions and rituals

learning by rote and not understanding

inability to see others point of view or wider picture

follows rules exactly

asks same question even when answered

Question 21

why do obsessions occur

Answer 21

helps with anxiety, uncertainty and increases control

way to start conversation

relaxation, enjoyment, happiness

Question 22

what are the principles of management of ASD

Answer 22

education and information

asd parenting workshop

school liason/support

manage any comorbidities