Developmental Disorders

Question 1

ASD identified through what?

Answer 1

behavioral observation
patient report
review of hx

Question 2

symptoms of ASD characterized by

symptoms evident before what age?

Answer 2

1) reciprocol social-comm
2) repetitive behaviors
3) restricted interest

• before age 3

Question 3

etiology of ASD?

Answer 3

etiology unknown but likely both genetic + environment

highly heritable (identical twins 90% simil symptoms)

Question 4

1) prevalence of ASD in children
2) majority what gender?
3) differences in cultures?

Answer 4

1) 1/110 children
2) male
3) no differences in culture

Question 5

treatment of ASD

best way for substantial gains in functioning

medical treatments for assoc conditions being investigated

Answer 5

1) educ, behavioral, psychological
2) early intervention is best
3) sleeping and eating problems

Question 6

medical definition of ASD

Answer 6

1) persistent deficit in social comm and interaction (not developmental delay)
- deficit in social-emotional recipr
- deficit in nonverbal comm behavior
- deficit in develop/maintain relationship

2) restricted, repetitive behavior
- stereotyped or repetitive speech, motor movement
- XS routines
- fixated interests
- hyper or hyporeactivity to sensory input

3) sx present in ealry childhood
4) sx limit and impair everyday functioning

Question 7

sx for ASD must be present when?

Answer 7

in early childhood

Question 8

sx must __

Answer 8

limit everyday functioning

Question 9

only way to dx ASD

Answer 9

look at gaps or uneven development of social interaction, comm, restricted interests relative to overall development

Question 10

what does “spectrum disorder mean”

Answer 10

ASD affects each person differently

- can share similar sx such as problem with social interaction but diff in when sx start, severity

Question 11

when does ASD usu present and progress?

Answer 11

usu before age 3 –> last thru lifetime though varies

parents concern around 16-24 months b/c worried about lack of language devlopment

Question 12

approx 30% of toddlers with ASD go thru

Answer 12

brief period at 2 y/o when can’t use words once had or not gain new words/com

Question 13

other potential comorbid conditions with ASD

Answer 13

immune disorders
endocrine
neuro (seizures
GI diz

Question 14

3 core areas of development central to ASD

Answer 14

1) impaired social reciprocity
2) lack of communicative competence
3) repetitive activities and restricted interests

Question 15

3 core areas of development central to ASD
impaired social reciprocity

1) define
2) often better at interacting with …
3) may not present unitl

Answer 15

1) children aloof in own world
- persist to avoid social contact with unfamiliar people (not shy or fear)
- or not know how to maintain interactions
- or social style = one sided, awk, intrusive

2) better interact with aduts
3) may not appear until school entry

Question 16

3 core areas of development central to ASD
lack of communicative competence

1) define
2) signs

Answer 16

1) lack of ability to send and receive messages in fluid/integrated manner

2) delayed/disordered speech
poor pragmatic (socially approp) communication
using nonverbals to comm (pairing gestures with sounds, inapprop voice tone or proximity)

child may appear highly verbal but can’t communicate in appropriate manner

Question 17

in DSM 5, which 2 domains are integrated

Answer 17

impairment in reciprocal social comm

and lack of communicative compentence

Question 18

3 core areas of development central to ASD
repetivie activties and restricted interests

1) define
2) signs
3) other terms to describe

Answer 18

1) strong pref for familiarity, routines, insistence

2) repetitive motor behaviros (hand flap or jump)
repetitive play with objects (lining up toys)
- “driven” desire for routines or preoccupation with one interest without “big picture”

3) getting stuck/perseverating

Question 19

resources to hep parents with ASD children

Answer 19

1) develop resources and child care
2) support/ invest in marriage
3) spend 1:1 time with each child
4) do something you love as often
5) mobile comm
6) exercise and encourage child to exercise
7) boundaries on structured/unstructued time
8) teach independent play
9) don’t feel guilty video watching

Question 20

neurodevelopmental disorder means

Answer 20

affects multiple aspects of human functioning (social, emotional, cog, attention, percept)

significantly impacts person’s ability to function/adapt to environment

Question 21

examples of neurodevelopmental disorders

Answer 21

1) ADD
2) ASD
3) fetal alcohol
4) fragile X
5) down
6) Retts
7) schizo

Question 22

What does it mean when repetitive behaviors and restricted interests

Answer 22

1) limited openness to novel ideas/activities
2) ability to adapt to unexpected conditions
3) ability to shift attention
4) ability to modify behaviors based on changes in context

Question 23

assoc conditions in ASD

Answer 23

1) anxiety/depression
2) attention problems
3) language disabilities
4) motor planning difficulties
5) impulsivity
6) sleep/GI problems
7) picky eating
8) seizure disorder

Question 24

risk of having a second child is ___

Answer 24

greater than expected (~18-22%)

Question 25

children at risk for autism

Answer 25

1) siblings
2) children with known genetic conditions (fragile X)
3) childrenw ith known medical conditions (tuberous scleorsis)

Question 26

social and communication symptoms in first 12 months

*rarely or inconsistently happen

Answer 26

1) dysynchrony with caregiver
2) lack of social smile
3) delayed response to name and poor social orienting
4) fewer vocalization
5) poor vocal imitation

Question 27

Red flags for Autism in children under 3

Answer 27

1) Lack of appropriate gaze
2) Lack of warm, joyful expressions with directed gaze
3) Lack of sharing interest or enjoyment
4) Lack of response to name when called
5) Lack of coordination of gaze, facial expression, gestures and sounds

Question 28

symptoms of autism in school aged youth

Answer 28

1) poor social reciprocity
2) impaired social-emotional understanding
3) diff modulating and integrating nonverbals
4) if verbal, language disordered
5) restricted/repetitive play
6) insistence on sameness

Question 29

1) Lack of appropriate gaze
2) Lack of warm, joyful expressions with directed gaze
3) Lack of sharing interest or enjoyment
4) Lack of response to name when called
5) Lack of coordination of gaze, facial expression, gestures and sounds

Answer 29

symptoms of autism before age 3

Question 30

1) poor social reciprocity
2) impaired social-emotional understanding
3) diff modulating and integrating nonverbals
4) if verbal, language disordered
5) restricted/repetitive play
6) insistence on sameness

Answer 30

symptoms of autism in school aged youth

Question 31

Symptoms for older children and adult

Answer 31

1) Limited reciprocity (but usually improved from younger days)
2) impaired gestures

3) Unusual prosody
4) Failure to understand nonverbal behaviors of others
5) Difficulty understanding motivations of other people (can be vulnerable/naïve)
6) For some, there is much improvement in symptom severity
7) For others, there is more functional impairment around puberty
8) Mood and anxiety become increasingly relevant in day-to-day interactions

Question 32

1) Limited reciprocity (but usually improved from younger days)
2) impaired gestures

3) Unusual prosody
4) Failure to understand nonverbal behaviors of others
5) Difficulty understanding motivations of other people (can be vulnerable/naïve)
6) For some, there is much improvement in symptom severity
7) For others, there is more functional impairment around puberty
8) Mood and anxiety become increasingly relevant in day-to-day interactions

Answer 32

Symptoms for older children and adult

Question 33

Where to refer families?

Answer 33

1) child find = part C for