Development

Question 1

Which gender is ASD more common?

Answer 1

boys:girls 4:1

Question 2

When does ASD tend to present?

Answer 2

2-4yrs

Question 3

What can be used to help diagnose ASD?

Answer 3

Autism Diagnostic Observation Schedule

Question 4

What are the main features of ASD?

Answer 4

1. Impaired social interaction
2. Speech and language disorder
3. Imposition of routines w ritualistic and repetitive behaviour

Question 5

Give examples of how children w ASD act socially

Answer 5

• lacks empathy
• prefers own company
• avoids gaze
• lack of appreciation of social cues
• socially + emotionally inappropriate behaviour

Question 6

Give examples of how speech and language is different in those with ASD

Answer 6

Delayed development 
Limited use of gestures and expressions
monotonous voice
takes everything literally
echoes q's, refers to self as 'you'

Question 7

give examples of ritualistic and repetitive behaviour of those w ASD

Answer 7

Stereotypical movements such as hand flapping
concrete play
peculiar interests

Question 8

What conditions are associated with ASD?

Answer 8

Fragile X
Rett syndrome
Epilepsy

Question 9

How does Asperger syndrome differ to ASD

Answer 9

Social impairments of ASD but at the milder end w near normal speech development
still have major difficulties w ordinary social encounters
often clumsy
strange interest

Question 10

Give the management of ASD focussed on the child

Answer 10

1. early intensive behavioural intervention + speech therapy + special schooling
2. Drugs: risperidone (aggression), melatonin for sleep and SSRIs for repetitive behaviour

Question 11

What is the management of aSD related to the parents?

Answer 11

parent training to increase ASD knowledge and enhance parent child interaction and reduce parental depression
support e.g. national autism society

Question 12

What benefits are allowed in ASD?

Answer 12

Disability living allowance

Question 13

What is the prevalence of ADHD in the uk

Answer 13

2.4%

Question 14

What gender is ADHD more common in

Answer 14

males 4:1

Question 15

What are the diagnostic features in inattention of ADHD

Answer 15

Doesn’t follow through on instructions
Reluctant to engage in mentally-intense tasks
Easily distracted
Finds it difficult to organise tasks or activities
Often forgetful in daily activities
Often loses things necessary for tasks or activities
Often does not seem to listen when spoken to directly

Question 16

whAT ARE THE diagnostic features relating to hyperactivity/impulsivity

Answer 16

Unable to play quietly
Talks excessively
Doesn’t wait their turn easily
Often interruptive or intrusive to others

Will answer prematurely, before a question has been finished
Will run and climb in situations where inappropriate

Question 17

How many of the diagnostic features of ADHD have to be present in up to 16yrs

Answer 17

6

Question 18

How many diagnostic features of ADHD have to be present in 17 or older to warrant a diagnosis

Answer 18

at least 5

Question 19

What is the management of a child presenting w suspected ADHD

Answer 19

a ten-week ‘watch and wait’ period should follow to observe whether sx change or resolve
If they persist - referral to secondary care: paediatrician w special interest in behavioural disorders or CAMHS

Question 20

When is drug therapyy indicated in ADHD

Answer 20

AS a last resort

Question 21

What age is drug therapy available to children w ADHD

Answer 21

5yrs or older

Question 22

What is 1st line drug rx of ADHD

Answer 22

Methylphenidate - ritalin (6 week trial)

Question 23

What is 2nd line drug rx of ADHD

Answer 23

lisdexamfetamine

Question 24

what is the 3rd line drug rx of ADHD

Answer 24

Dexamfetamine

Question 25

What are important risks of drugs used to treat ADHD, what must be done to monitor this?

Answer 25

cardiotoxic

perform baseline ECG before rx