LEC-15 Autism Spectrum Disorders Flashcards

1
Q

What are the two cardinal deficiencies needed for diagnosis of autism spectrum disorder?

A

I. Impaired social communication

II. Restrictive/repetitive behaviors

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2
Q

What 3 symptoms of impaired social communication must a patient demonstrate before a diagnosis of autism spectrum disorder may be made?

A

I. Deficits in social/emotional reciprocity
II. Deficits in nonverbal communicative behaviors
III. Deficits in developing or maintaining social relationships

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3
Q

A patient must demonstrate 2 of what 4 restrictive/repetitive behaviors before a diagnosis of autism spectrum disorder may be made?

A

I. Stereotyped/repetitive use of speech, motor movements, or objects
II. Excessive adherence to routine, ritualized use of verbal or nonverbal behaviors, excessive resistance to change
III. Highly restricted/fixated interests
IV. Hyper- or hyporeactivity to sensory input or unusual sensory interest

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4
Q

(T/F) Changing the criteria in the diagnosis of autism spectrum disorder regarding restrictive/repetitive behaviors allowed for a significant increase in sensitivity while sacrificing a major portion of the specificity.

A

False. Changing the criteria regarding restrictive/repetitive behaviors allowed for a significant increase in SPECIFICITY while avoiding significant decrease in SENSITIVITY.

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5
Q

Autism spectrum disorder of level (1/2/3) is described as requiring support. Patients demonstrate difficulty initiating social interactions, atypical or unsuccessful reactions to others’ social overtures, and may appear to have a decreased interest in social interactions. Their rituals and repetitive behaviors may demonstrate some interference in one or more contexts. Slight difficulty switching between activities is also a characteristic.

A

Level 1

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6
Q

Autism spectrum disorder of level (1/2/3) is described as requiring substantial support. Patients show marked impairments in social communication, limited social initiation, and reduced or abnormal responses to other’s overtures. Their rituals and repetitive behaviors are obvious to casual observers and interfere in a variety of contexts. They also demonstrate inflexibility of behavior, difficulty coping with change, and moderate stress or difficulty changing focus or actions.

A

Level 2

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7
Q

Autism spectrum disorder of level (1/2/3) is described as requiring very substantial support. It is characterized by severe deficits in social communication, very limited social interactions, and minimal response toward others. The patient’s rituals and repetitive behaviors markedly interfere in all areas of his/her life. They also demonstrate extreme difficulty coping with change and great difficulty or distress with changing their focus or attention from one object or event to the next.

A

Level 3

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8
Q

The male to female ratio in the average number of autism spectrum disorder cases is __:__.

A

4:1 (4 males for every 1 female diagnosed)

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9
Q

(T/F) Children of non-white parents or those with lower parental education are typically diagnosed with autism spectrum disorder at a later date.

A

True.

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10
Q

The genetic heritability of autism spectrum disorder is __%, the highest of all psychological conditions.

A

90%

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11
Q

A(n) _____________ disorder of autistic patients is marked by the inability to connect with others emotionally.

A

Affective

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12
Q

A(n) _____________ disorder of autistic patients materializes in the form of neurological problems with sensory perception and overstimulation.

A

Perceptual

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13
Q

A(n) _____________ disorder of autistic patients may be characterized by the lack of the “theory of mind”, such as how a psychologically healthy individual can recognize and understand how they are different from another living person.

A

Cognitive

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14
Q

Symptoms of autism spectrum disorder are first observed between __-__ months.

A

12-24

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15
Q

(T/F) Most autistic patients improve behaviorally during adolescence.

A

True

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16
Q

70% of autistic patients have __ comorbid psychiatric condition(s) and 40% have __ or more.

A

70% have 1 comorbid condition

40% have 2 or more

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17
Q

________________ refers to any disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains.

A

Intellectual disability

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18
Q

(T/F) Severity of intellectual disability is based on IQ as of DSM V.

A

False. Diagnosis is based upon adaptive functioning, not IQ.

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19
Q

(Mild/Moderate/Severe/Profound) intellectual disability is characterized by difficulty learning academic skills, poor executive function and short-term memory, and immature social interactions. Patients often have difficulty regulating emotions and behaviors along with a limited understanding of risk and increased chance of being manipulated. They may function appropriately with personal care, but still need support with complex daily living tasks, health care, and legal decisions.

A

Mild

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20
Q

(Mild/Moderate/Severe/Profound) intellectual disability is characterized by academic skill deficiencies at all ages. Academic skills usually remain around the elementary level, even for adults. These patients may not perceive or interpret social cues accurately, demonstrate limited social judgment, and need significant social and communicative support in the work setting. They may function appropriately with personal care, but occasionally may still require reminders. They may accomplish household tasks through extensive teaching and any employment does not involve conceptual or communication skills.

A

Moderate

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21
Q

(Mild/Moderate/Severe/Profound) intellectual disability is characterized by little to no conceptual skills or understanding of written language or of concepts involving numbers. Spoken language is in the form of single words or phrases and the patient’s speech is focused on the present. These patients require support in all aspects of daily living along with supervision at all times. They may display maladaptive (self-harming) behavior, though this is only present in a significant minority of patients.

A

Severe

22
Q

(Mild/Moderate/Severe/Profound) intellectual disability is characterized by conceptual skills that only involve the physical world, such as sorting items from one another. These patients display a limited understanding of symbolic communication. They may understand simple directions and commonly express their desires through nonverbal means. They require support in all aspects of daily living along with the need for supervision at all times. These patients may display maladaptive (self-harming) behavior, but only in a significant minority of cases.

A

Profound

23
Q

__% of intellectual disability cases are mild.

A

85%

24
Q

__% of intellectual disability cases are moderate.

A

10%

25
Q

__% of intellectual disability cases are severe and profound.

A

5%

26
Q

What are some of the prenatal etiologies associated with intellectual disability?

A
I. Genetic syndromes
II. Inborn errors of metabolism
III. Brain malformations
IV. Maternal disease
V. Teratogens
27
Q

What are some of the perinatal etiologies associated with intellectual disability?

A

I. Labor complications

II. Delivery complications

28
Q

What are some of the postnatal etiologies associated with intellectual disability?

A
I. TBI
II. Infections
III. Demyelination disorders
IV. Seizures
V. Social Isolation
VI. Toxic metabolic syndrome
29
Q

(T/F) All cases of intellectual disability are caught by two years of age.

A

False. More severe cases of ID are usually observed before two years of age, but mild levels may not be seen until school-going age.

30
Q

(T/F) The severity level of ID may change following intervention.

A

True

31
Q

What are the most common comorbidity disorders of ID?

A
I. ADHD
II. Autism spectrum disorder
III. Depressive and bipolar disorders
IV. Anxiety
V. Stereotypic movement disorders
32
Q

In order to be diagnosed with a language disorder, what three criteria must a patient meet?

A

I. Reduced vocabulary
II. Limited sentence structure
III. Impairments in discourse (conversation or discussion)

33
Q

Language disorders typically onset during the __________________.

A

Early developmental period

34
Q

___________________ are described as difficulty with speech sound production that interferes with intelligible speech. It causes limitations in effective communication that interferes with social participation, academic achievement, or occupational performance. Typically onsets during the early developmental period.

A

Speech sound disorders

35
Q

A disturbance in normal fluency and time patterning of speech in children is referred to as _______________________. This disorder typically causes anxiety about speaking along with limitations in effective communication, social participation, or academic or occupational performance. It typically onsets during the early developmental period.

A

Child-onset fluency disorder (stuttering)

36
Q

In order to be diagnosed with child-onset fluency disorder, patients must satisfy 1 of what seven criteria?

A

I. Sound syllable repetition
II. Sound prolongations of consonants as well as vowels
III. Broken words
IV. Audible or silent blocking
V. Circumlocutions
VI. Words produced with an excess of physical tension
VII. Monosyllabic whole-word repetitions

37
Q

Persistent difficulties in the use of verbal and nonverbal communication that cause limitations in effective communication are referred to as ______________________. This disorder interferes with social participation, academic performance, and occupational performance. It typically onsets during the early developmental period.

A

Social (Pragmatic) Communication Disorder

38
Q

What four criteria are need to obtain a diagnosis of Social (Pragmatic) Communication Disorder?

A

I. Deficits using communication for social purposes
II. Impairment in the ability to change communication to match context or needs of the listener
III. Difficulties following the rules for conversation and storytelling
IV. Difficulty understanding what is not explicitly stated along with nonliteral and ambiguous meanings of language

39
Q

Social (Pragmatic) Communication Disorder has (high/low) heritability.

A

High heritability

40
Q

If a first-degree relative is diagnosed with Speech Sound Disorder or Child-Onset Fluency disorder, your chances of diagnosis are increased by (two/three/four) fold.

A

Three fold

41
Q

A family history of autism spectrum disorder or learning disorders increases the risk for diagnosis of __________________.

A

Social (Pragmatic) Communication Disorder

42
Q

A language disorder diagnosed after the age of ___ is stabled and persists into adulthood.

A

4

43
Q

The age of onset for Child-Onset Fluency disorder is typically ages __-__.

A

2-7

44
Q

What are the most common comorbidities for speech and language disorders?

A

I. Autism spectrum disorder
II. ADHD
III. Specific learning disorder
IV. Development coordination disorder

45
Q

Shana is a 10-year-old girl who has difficulty greeting and sharing information with her peers. She consistently talks in a loud voice, even in the library and movie theater. She also has difficulty knowing when her classmates make jokes or are sarcastic. However, she does not appear to exhibit repetitive or restricted patterns of behavior. What is the most likely diagnosis?

A

Social (Pragmatic) Communication disorder

46
Q

Which of the following is not a symptom of Autism Spectrum Disorder?

a) Monosyllabic whole-word repetitions
b) Deficits in nonverbal communication behaviors
c) Hyper- or hyporeactivity to sensory input or unusual sensory interest
d) Deficits in developing, maintaining, or understanding relationships

A

A. Monosyllabic whole-word repetitions

47
Q

Derek is a 30-year-old man who was diagnosed with Intellectual Disability when he was a child. He is currently working at a job that requires little conceptual skills or interactions with others. He is able to care for his personal needs and participates in household tasks, though it took considerable time and repetition for him to learn these skills. He does not require constant supervision.

Which severity level of Intellectual Disability is being described in the vignette?

a) Mild
b) Moderate
c) Severe
d) Profound

A

A. Moderate

Consistent supervision is descriptive of Severe and Profound levels

Daily living tasks that take considerable time and repetition to learn is characteristic of moderate.

48
Q

Chelsea is a 14-year-old girl who is able to speak in full sentences and engages in communication, though she often has difficulty with to-and-fro conversations with others. She has an odd approach to developing friends and she is typically unsuccessful at establishing or maintaining friendships.
Which severity level of Autism Spectrum Disorder is being described in the vignette?
a) Requiring Support
b) Moderate
c) Requiring Substantial Support
d) Requiring Very Substantial Support

A

A. Requiring Support

Chelsea is able to speak in whole sentences. Sentences break down into 3-4 words at a time beginning with the requirement of substantial support in autism spectrum disorder.

49
Q

Jeff is a 6-year-old boy who began to repeat initial constants. After a few months, he also began to repeat first words of a phrase. Once he became more aware of his difficulties, he began to avoid public speaking and used short and simple phrases or sentences.
Which disorder is being described in this vignette?
a) Language Disorder
b) Speech Sound Disorder
c) Social (Pragmatics) Language Disorder
d) Childhood-Onset Fluency Disorder

A

D. Childhood-Onset Fluency disorder

50
Q

Jason, age 11, has a history of reading difficulties and has a somewhat concrete approach to solving problems. His teacher describes him as socially immature and rather gullible. Like most of his peers, he is very interested in a video game that was just released.
Based on this information, what disorder best describes Jason’s behaviors?
a) Autism Spectrum Disorder
b) Language Disorder
c) Speech Sound Disorder
d) Intellectual Disability

A

D. Intellectual Disability

Jason has a concrete approach and is very gullible. This is characteristic of intellectual disability.

51
Q

Tim is a 3-year-old boy who usually does not look at the person who says his name. He likes to play with his cars, though he usually just spins their wheels. He has a very selective diet and only eats goldfish crackers. He also recently fell off the bed and broke his arm, but he barely cried.
Which diagnosis best describes Tim’s behavior?
a) Intellectual Disability
b) Autism Spectrum Disorder
c) Social (Pragmatics) Language Disorder
d) Language Disorder

A

B. Autism Spectrum Disorder

Preoccupation with parts of objects is one clue, followed by the fact that he is very selective of his diet and only eats one thing. He also demonstrates hypo-reactivity to sensory input, such as breaking his arm but barely crying. These are very characteristic of autism spectrum disorder.