Childhood Disorders

Question 1

Explain Autism Spectrum Disorder symptoms

Answer 1

social communication difficulties
*deficits in social-emotional reciprocity, verbal and nonverbal communicative behaviours used for social interaction, and developing and maintaining relationships
repetitive behaviours
*stereotyped or repetitive speech, excessive adherence to routines, highly restrictive and fixated interests, and hyper- or hypo-reactivity to sensory input

Question 2

explain ADHD symptoms

Answer 2

inattention, impulsivity, hyperactivity

Question 3

management considerations for ASD

Answer 3

early, intense, safety, social interaction, toward independence, family support and coordination

Question 4

interventions for ASD - psychological

Answer 4

applied behaviour analysis - intense 1-1 teaching, tasks in small goals, frequent reinforcement

Question 5

interventions for ASD - social

Answer 5

social skills coaching, social thinking skills, perspective taking

Question 6

interventions for ASD - biological

Answer 6

SSRI eg. Prozac, Celexa
target:
anxiety/rigidity/obsessions/ mood instability 
Atypical anti-psychotics eg. risperidone
target: aggression/agitation

Question 7

interventions for ASD - spiritual

Answer 7

consider family conceptions of etiology, social and behavioural symptoms are often perceived differently than other developmental issues, behaviours can limit access to support

Question 8

ASD intervention for anxiety/rigidity/obsessions/ mood instability
SSRIs eg. prozac and celexa

Answer 8

long half life (2 weeks to see any impact)
20% chance of irritability or agitation, suicidal ideation, drowsiness, headache, insomnia, nervousness, sweating, diarrhea, tremor,

Question 9

ASD interventions for aggression/agitation - atypical antipsychotics eg. risperidone

Answer 9

potential effects on liver, heart, bone marrow, risk of significant weight gain, risk of long-lasting neurological effects (dystonias, dyskinesias), requires regular bloodwork for monitoring

Question 10

interventions for ADHD - psychological

Answer 10

educational strats - preferential seating, active breaks, splitting of asns
behaviour therapy - reward systems, frustration management
identify and treat co-morbidities - learning disabilities, depression, anxiety

Question 11

interventions for ADHD - social

Answer 11

find ways for child to experience success - individual sports, theatre
coaching and role-playing to teach consideration of consequences

Question 12

interventions for ADHD - spiritual

Answer 12

hope, comfort, strength, coping means in times of illness

Question 13

interventions for ADHD - biological

Answer 13

• stimulants, immediate release - ritalin/dexedrine or extended release - concerta/vyvanse
• SNRI - atomoxetine (strattera)
• diet - elimiate nutritional contributors (caffeine, food dyes), consider omega-3 supplementation

Question 14

ADHD intervention - stimulants

Answer 14

• increase dopamine and norepinephrine in the pre-frontal cortex
• immediate release lasts a few hours, extended lasts all day
• appetite suppression, sleep disturbances, tics,
• screen for pre-existing cardiac conditions (increase in bp)

Question 15

ADHD interventions - norepinephrine reuptake inhibitor - atomoxetine (strattera)

Answer 15

• less likely than stimulants to aggravate tics and anxiety. effects on appetite, sleep, and cardiovascular system similar to stimulants, but potentially less significant
• long half life: 24 hr coverage, consistent effects
• 1 week to see any benefits, 4-6 weeks until max benefit, dose titration slow