Community Flashcards
What is the autism spectrum?
This from severe autism to high functioning Aspergers
What is the autistic triad?
- Impairment of social relationships
- Impairment of social communication
- Impairment of imagination
What are the key impairments in autism
- Stays in isolation
- doesnt understand social cues or the feelings of others
- doesnt like loud noises or self injures
- Echolalia - repeating words or phrases
- Not pointing - no protodeclaritive pointing
- Doesnt understand body language
- Uses people as tools (hands as tools)
- No eye contact
- Drawn to trivial things eg spinning wheels
- Lack of imaginitive play
- Shows repetitive behaviour
At what age does moderate/sever autism present?
With developmental delay before 30 months
They don’t reach milestones or regress
REGRESSION OF MILESTONES
What is high functioning/aspergers and at what age does it present?
IQ >70
Presents at school age
May have no developmental delay or may show peculiar interests (opera) or particular inteligence
What is atypical autism?
May fit one or two of the triad
How is autism managed?
Education
Behavioural and psychological treatment
Melatonin for sleep disoders
SSRIs for anxiety
Risperidone for aggression
What is a learning disability and what are some causes?
- IQ
- Below 18 (developmental age)
- Impacts on daily function
Genetic - Downs, Fragile X
Infection - Meningitis, encephalitis, rubella
Trauma
Malnutrition
What is cerebral palsy?
It is a group of disorders that affects the development of movement and posture
When does the catalyst for cerebral palsy have to occur?
Before 2
What are the three types of CP?
- Spastic
- Dyskinetic (extra pyramidal - involuntary)
- Ataxic
What is the most common type of CP?
Spastic
What two things characterise spastic CP?
Resistance to passive movement
Increases with velocity
What is the pathology behind spastic CP?
Damage to the motor cortex
What types of spastic CP are there?
Hemiplegia
Quadriplegia
Diplegia
What is extrapyramidal (dyskinetic) CP associated with?
Basal ganglia or pyramidal tract damage
What are the three types of dyskinetic?
- Dystonic - sustained contraction of agonist and antagonists with stronger muscles winning. eg hip flexionsion and knee extension
- Chorea - Slow writhing
- Athetoid - rapid sudden movements
What is ataxic cerebral palsy?
Ataxia which is loss of smooth muscles movement which affects speech and walking.
Associated with cerebellar damage
What are some prenatal causes of CP?
Rubella, chromosome abnormalities
What are some perinatal causes of CP?
Asphyxia, haemorrhage
What are some postnatal causes of CP?
CVA, infection, hyperbilirubinaemia
Which one is hyperbilirubinaemia associated with?
Dyskenetic
Which one is hypoxia associated with?
Dyskinetic
How does it present?
At birth it may be obvious or they may miss developmental milestones such as not sitting aline at 6 months or walking alone at 1 year
What would you see on examination?
Abnormal tone (dyskentic)
Ataxia (ataxic)
Hyperreflexia (spastic)
How is CP coservatively managed?
Physio, education, walking aids
What is the medical management for CP?
How do they work?
Baclofen - Gaba agonist (anti spasmodic)
Botulinum - ACH antagonist (blocks muscle contraction)
What is the surgical management for CP?
Orthopedic correction
Cutting sensory fibres so less motor stimulation - causes very weak muscles
What are the four areas of development?
Gross motor
Fine Motor
Speech and language
Social
What are the gross motor milestones?
What are the fine motor milestones
What are the speech and language milestones?
What are the social milestones
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