Developmental Disorders and Intellectual Disability Flashcards
What is ASD?
ASD is an umbrella term for 5 disorders:
- aspergers syndrome (high functioning autism)
- rett’s syndrome (mainly in girls, loss of skills)
- childhood autism (classic low functioning)
- pervasive developmental disorder
- pervasive developmental disorder NOS
tend not to use these five terms anymore as just diagnose someone as ASD somewhere on spectrum
What is the triad of impairments in ASD?
Social communication
Social interaction
Social Imagination
Describe what impairments of social communication may be present in ASD?
- good language skills generally but find it hard to grasp the underlying meaning e.g. sarcasm, idioms, metaphors and jokes
- language can be pedantic and idiosyncratic e.g. don’t understand figure of speech
- narrow interests that dominate conversation so there is a lack of reciprocity
- difficulty sharing thoughts and feelings
Describe what impairments of social interaction may be present in ASD?
- difficulties picking up non verbal cues (especially if there is a mismatch between body language and what has been said)
- they don’t lack empathy but just have difficulty figuring out what has been said
- struggle to make and sustain relationships
Describe what impairments of social imagination may be present in ASD?
- difficulties thinking flexibly and in abstract ways
- take things literally
- difficulty applying knowledge and skills across settings with different people
- difficulties projecting themselves into the future
What other impairment not under the ASD triad is often present?
repetitive behaviours
Describe repetitive behaviours in ASD?
- stereotyped or repetitive movements, use of objects or speech
- insistence on sameness, inflexible adherence to routines
- highly restricted, fixated interests that are abnormal in intensity of focus (note: the interest itself is not necessarily abnormal)
- hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment
Describe the neuroanatomy of ASD?
no consistent pathology
frontal lobes, amygdala and cerebellum can appear pathological
glutamate, GABA and serotonin receptors may be implicated
Essential criteria for ASD diagnosis?
Symptoms must be present in the early developmental period
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning (regardless of age)
Disturbances are not better explained by other mental health problems, intellectual disability or global developmental delay
Describe management of ASD?
self and family psychoeducation
applied behaviour analysis, speech and language therapy, social skills training
family and school based supports
no medication for ASD but may be used for co-morbidities
What is ADHD?
attention deficit hyperactivity disorder
involves a triad of difficulties: inattention, hyperactivity and impulsivity
frequently co-occurring with a cluster of impairing symptoms relating to self regulation which are:
developmentally inappropriate, impair functioning, pervasive across settings ie home, work, school, long standing from age 5
Triad in ADHD?
inattention, hyperactivity and impulsivity
Impact of childhood ADHD?
Significant difficulties parenting children with ADHD
Increased level of home stress and high expressed emotions
Emotional dysregulation leads to difficulties in peer relationships and reckless and dangerous behaviour
Poor problem solving ability leading to developmentally inappropriate decision making
Significant barrier to learning and potentially exclusion from education
Higher likelihood of antisocial behaviours
Neuroanatomy of ADHD?
brain mapping shows those with ADHD tend to have underactive function within the frontal lobe, there is an excessively efficient dopamine removal system in ADHD meaning there isn’t enough dopamine which is partly what causes symptoms
Diagnostic criteria for ADHD in children?
6 or more symptoms of inattentiveness; and/or
6 or more symptoms of hyperactivity and impulsiveness
Present before age 5 years (or 3 for some clinicians)
Reported by parents, school and seen in clinic
Symptoms get on the way of daily life
