Child health- Autism and ADHD Flashcards
what are the three core symptoms of ADHD in children?
inattention, impulsivity, hyperactivity
define ADHD via the DSM V
Present before 12 years
Developmentally inappropriate
Several symptoms in 2 or more settings
Clear evidence symptoms interfere/reduce quality of social/academic/occupational function
examples of inattentive symptoms
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
examples of hyperactivity symptoms
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
examples of impulsive symptoms
Blurts out answers before questions completed
Has difficulty awaiting turn
Interrupts or intrudes on others
what is the incidence of ADHD
4-7% of school children
M:F 4:1
which factors are most likely to be involved in ADHD
neurobiologic (neuroanatomical and neurochemical)
genetic influences
environmental/psychosocial factors
CNS insults (such as perinatal factors, CNS infections)
which genes / alleles are implicated in ADHD
dopamine D4 receptor (DRD4) gene
DRD4 7-repeat allele
higher rates of DRD$ 7 found in children with ADHD
which acquired brain injuries are associated with ADHD
prematurity, Fetal alcohol syndrome, NF
what are the principles of treatment for ADHD
education, ADHD parent programme, school support and liason
medications
which medications are offered for ADHD
Stimulants
* Methylphenidate (Ritalin,MedikinetXL,EquasymXL,ConcertaXL)
*Lisdexamfetamine(Elvanse)
Non Stimulants
*Atomoxetine
*Intuniv (Prolonged release Guanfacine)
what is the incidence of autism spectrum disorder
1:100
how many children have ASD in the UK
0.5 million
M:F ratio for ASD
4:1
is there a known cause for ASD?
no, but genetics are important
what does ASD affect
communication
social interaction
behaviour, poor imagination and rigidity of ideas
describe communication difficulties experienced by children with ASD
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
what are social interaction difficulties experienced by children with ASD
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
how can ASD manifest in children of school age
touches inappropriately
plays alone
poor eye contact
finds it hard to turn take
finds it stressful to be with other people
describe difficulties with imagination / rigidiity of thought in children with ASD
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
why do obsessions occur
helps with anxiety, uncertainty and increases control
way to start conversation
relaxation, enjoyment, happiness
what are the principles of management of ASD
education and information
asd parenting workshop
school liason/support
manage any comorbidities
