Lec 83 ADHD and Autism Flashcards
What are DSM criteria for ADHD?
persistent pattern of inattention or hyperactivity/impulsivity that interferes with functioning or development
present for at least 6 mo
severe inattentive or hyperactive symptoms were present before age 12, symptoms are present in 2 or more settings, clear evidence that interfere with functioning
What is relationship seizures and autism?
1/3 have seizures
What are the symptoms of inattention associated with ADHD?
inattention: 6 or more of the following for children up to age 16 or 5 if age 17 and older
- fails to give close attention to details
- trouble holding attention on tasks
- does not seem to listen when spoken to directly.
- does not follow through on instructions and fails to finish task = loses focus, side-tracked
- trouble organizing tasks and activities.
- avoids tasks that require mental effort over a long period of time
- loses things necessary for tasks and activities (e.g. school materials)
- easily distracted
- forgetful in daily activities.
What are the symptoms of hyperactivity associated with ADHD?
6 or more up to age 16, 5 or more for > 17
- fidgets with hands/ feet, squirms in seat.
- leaves seat in situations when remaining seated is expected.
- runs about or climbs in situations where it is not appropriate
- unable to play or take part in leisure activities quietly.
- “on the go”
- talks excessively.
- blurts out an answer before a question has been completed.
- trouble waiting his/her turn.
- interrupts or intrudes on others
What are 3 types of ADHD?
- inattentive
- hyperactive-impulsive
- combined
What is epidemiology of ADHD?
- male > female 3:1
- boys more hyperactive, girls more inattentive
- 8% of children
- higher rates of arrest, suicide attempts, drug use, antisocial
What is neurobiology of ADHD?
- highly heritable genetics
- NT imbalance
- structural/functional alterations
What are NT changes in ADHD?
- normally NE enhances relevant signals, regulates DA which suppresses irrelevant signals
- ADHD: NT imbalances = trouble filtering out noise
What structural/functional alterations in ADHD?
- decrease PFC volume
- striatum: decreased caudate nucleus vol [bur normalizes by mid-adolescence], decrease striatal activation
- cerebellum: decreased volume [persists through adolescence]
- decreased corpus callosum area
net effect = less efficient information process, often have to recruit extra regions
What are important structures for ADHD neurobiology?
PFC = organization, planning, working memory
striatum = attention, motor planning
posterior parietal = filters stimuli
cerebellum = attention, anticipation
What is treatment for ADHD?
educational/psychosocial interventions
stimulants = block DA reuptake mech –> increase DA –> decrease noise
atomexetine = increases NE + DA
A2 agonists = increase NE
What are DSM criteria for autism?
persistent deficits in social communication manifest by impairment in all 3 of:
- social-emotional reciprocity
- nonverbal communicative behavior
- developing and maintaining relationships
restricted/repetitive patterns of behavior/activities characterized by 2 of:
- stereotyped or repetitive speech/motor movements
- excessive adherence to routines, ritualized patterns, resistance to change
- restricted fixated interests
- hypo/hyper reactivity to sensory input or unusual interest in sensory aspects of outside environment
symptoms must present early childhood + impair functioning
When is onset of ASD?
< age 3
What is etiology of ASD?
genetic»_space; environmental determine intrauterine/early postnatal brain
very high heritability = multiple genes
What are environmental factors causing ASD?
advanced parental age
intrauterine infection
depakote
toxins
