Lectures 84, 85: Childhood and ADHD/Autism Flashcards
Symptom domains of ASD (2)
Social/communication deficits, restricted/repetitive behaviors
Social/communication deficits includes…
Social/emotional reciprocity; non verbal communication; maintaining/developing relationships
Restricted, repetitive behaviors includes…
Stereotyped speech; routines; fixated interest; sensory input hyper/hyporeactivity
T/F: Seizures can be seen in ASD?
True!
Besides social-communication deficits and restricted/repetitive behaviors, what else is required for an autism diagnosis?
Symptoms must be present in early childhood and limit/impair everyday functioning
Which is more important/necessary for autism diagnosis: social-communication deficits or restricted/repetitive behaviors?
Social-communication deficits (requires 3 out of 3 symptoms)
How early can an autism diagnosis be made? Advantage?
12 - 18 months; early intervention = better outcome
What is the most important “risk alert” for ASD?
Joint attention: child wants to pay attention to the same thing that you’re paying attention to
What are the behaviors included in joint attention? (3)
Pointing (look at this!), bringing and showing, responding to adult point
Are the rates of autism rising? (3 reasons)
Unlikely: there are broadened diagnostic criteria, younger age of diagnosis, improved sensitivity
Genes or environment more important for development of autism? (heritability %)
Genes! 90%, more than really any other psychiatric conidtion
Environmental factors and autism? (2 examples)
Parental age, toxins
Are there any single genes that cause autism?
Yes: very rare variants accounting for
Besides rare genetic mutations, what other genetic model can account for autism?
Large number of common genetic variations (SNPs)
Genes related to ASD tend to impact…
Glutamate synapse (including post synaptic response)
Potential novel target for ASD based on etiology?
IGF
Symptom buckets for ADHD (2). How many symptoms of each? Relation to subtypes (3)?
Inattention, hyperactive/impulsive; 6; predominantly inattentive, predominantly hyperactive, combined
What symptoms of ADHD often persist with age? Which ones improve?
Cognitive/executive problems; hyperactivity
Neurobiology of ADHD (NE and DA)
NE: enhances relevant signals in prefrontal region; DA suppresses irrelevant signal in prefrontal region
Heritability of ADHD (%)
75%
One structural and one functional difference in ADHD
Smaller prefrontal cortex volume; less efficient processing via decreased activity in ACC
Two reasons to treat ADHD
Minimize core symptoms; alter course of other disorders
Are treatments for ADHD effective?
Yes!
Four simple environmental modifications for ADHD
- Structure environment; 2. Simplify communication; 3. Use external aids/reminders; 4. Pyschosocial interventions (social skill training)
How are methylphenidate and amphetamine similar and different?
Methylphenidate and amphetamine block reuptake, amphetamine also blocks uptake into vesicles and DA release
Newborn: motor
Basic reflexes (moro, rooting plamar, Babinksi), some head lifting
Newborn: social
Temperament apparent at birth
Newborn: verbal/cognitive
Crying, limited response to voice
6 months: motor
Primitive reflexes diminish (Moro, rooting and palmar gone); Posture: lifts head, rolls, sits; Picks/passes toys
6 months: social
Smiles, stranger danger
6 moths: verbal/cognitive
Orients to voice, babbles, some memory improvement
1 year: motor
Walking, pointing
1 year: social
Separation anxiety, can follow commands
1 year: verbal/cognitive
Mama, dada; object permanence
2 years: motor
Run, climb stairs, copy a line
2 years: social
Terrible twos: says “no”, ambivalence, parallel play
2 years: verbal/cognitive
200 words, 2 word sentences
3 years: motor
Ride a tricycle, copy a circle, toilet trained
3 years: social
Can be away from caregiver comfortably, gender developed
3 years: verbal/cognitive
1000 words, complete sentences
Latency: motor
Moves and functions as an adult
Latency: social
Sexual preference, learning what they are good at, more empathy
Latency: verbal/cognitive
Learn to write, better at attention and self-regulation, concrete (logical) thought begins
Adolescence: motor
No motor development, but growth during puberty
Adolescence: social
Identity determination; increase in risk taking behavior
Adolescence: verbal/cognitive
Ability to abstract and see a problem from other people’s points of view
Piaget’s Stages (4)
Sensorimotor, pre-operational, concrete operations, formal operations
Sensorimotor stage
0-2; no language/symbols; “intelligence” means sensory exploration of env’t
and learning how to manipulate body
Pre-operational stage
3-6; language without logic, magical thinking; still egocentric
Concrete operations
7-12; logical thought
Formal operations
13+; logic + abstract thought
Erikson: conflict of infancy
Trust vs mistrust
Erikson: conflict of toddlers
Autonomy vs shame and doubt: parents must let kids explore
Erikson: conflict of preschool
Initiative vs guilt: doing more elaborate tings involve planning, guilt if it doesn’t go well
Erikson: conflict of school age
Industry vs inferiority: preoccupied wit what they are good at
Erikson: conflict of adolescence
Identity vs role confusion: who am I?
Erikson: conflict of young adult hood
Intimacy vs isolation: who am I going to be with?
Erikson: conflict of middle age
Generativity vs stagnation: am I being productive?
Erikson: conflict of old age
Integrity vs despair: do I feel good about my accomplishments?
Freud’s psychosexual stages (3) and basic description
Oral, anal, genital; development in terms of which body part provides the most pleasure at each age
Oral stage
0-1; babies suck on everything
Anal stage
1-3; preoccupied with bathroom, aware of
bowel control; focus on controlling things (but can’t accomplish full toilet training until age 3)
Genital stage
3-5; interest in babies, opposite sex, playing with genitals
