Child Psychiatry II - Disruptive Behavior Disorders, ASD, Intellectual Disability

Question 1

Define Autism Spectrum Disorders in one sentence. When is autism usually diagnosed? Which gender is affected more often? What are the characteristics?

Answer 1

“Neurological disorders characterized by severe and pervasive impairment in several areas of development, especially social interaction and communication.” Usually diagnosed within first 3 years. 4:1 boys:girls. Characteristics: No babble/coo by 12 mo, No gesture by 12 mo, No single words by 16 mo, No 2-word phrases by 24 mo, Any loss of language/social skill, No pretend play, No pointing at objects, No interest in other children, No enjoying social games (peek-a-boo), No bring/show objects to parents, Sameness, Difficulting expressing needs, Repeating words/phrases, Emotions for inapparent reasons, Prefers alone, Tantrums/self-injurious/aggressive, Inappropriate attachments.

Question 2

What is Asperger’s disorder? What are the characteristics?

Answer 2

Now considered an Autism Spectrum Disorder. Characteristics: Impaired social interactions, restricted range of interests, BUT no delay in language, communication, & have above average IQ.

Question 3

What is Childhoood Disintegrative DIsorder? What does the disorder eventually resemble?

Answer 3

“A marked regression (in speech, play, social behavior, etc.) following 2 years of normal development.” At this point, this resembles autism.

Question 4

What is Rett’s disorder? Who does it occur in?

Answer 4

“Development of specific deficits after a period of normal functioning follow birth (first 5 months), with problems in social interaction, locomotion, & language, and characteristic repetitive stereotyped hand movements, such as hand wringing.” Only in girls.

Question 5

How is autism assessed? How is it treated?

Answer 5

Because there are no specific tests for diagnosis, accuracy is based on a “multimodal” assessment: Autism Diagnostic Interview-R, home/school observation, video analysis of behavior, certain genetic studies. Treatment: Discrete Trial Instruction/”Applied Behavior Analysis” (most effective method of acquiring new behavior, and the only EBM), reinforcement-based treatments (most effective for decreasing problematic behavior), certain stimulants (most common)/antipsychotics/SSRIs.

Question 6

What ate the 3 criteria for Intellectual Disability? Which gender is affected most? What is considered “mild,” “moderate,” “severe,” “profound?” What is the course of Intellectual Disability?

Answer 6

1 - Subaverage intellectual functioning (IQ

Question 7

What are causes of Intellectual Disability?

Answer 7

Unknown, chromosomal, hereditary (such as FX), environment, other mental disorders (such as autism), complications of pregnancy, medical conditions (such as lead poisoning).

Question 8

Are repetitive behaviors considered essential for autism? What about “challenging behavior?” What are common types of challenging behavior?

Answer 8

Repetitive behaviors are “essential” for autism. Challenging behavior is an “associated” feature. Examples: Self-Injurious behavior, Pica, Destructive behavior (physical harm to another person or the immediate environment).

Question 9

For ASD, does medication use increase with age? What about CAM (Complementary & Alternative Medical Treatment Use)?

Answer 9

Medication use increases with age. CAM use decreases with age.