Level 2 - Developmental Delay and Emotional/Behaviour Problems COPY Flashcards
What is ASD?
- Lifelong disorder, present from early childhood which significantly limits or impairs activities of daily living
- Continuum of behavioural states
Epidemiology of ASD? When do they usually present?
- >1/200
- Males > Females
- Usually presents between 2-4 years old
Aetiology of ASD?
o Idiopathic
o Genetic
o Family history
o Associated epilepsy in 30 %
Associated conditions with ASD?
o Anxiety
o ADHD
o Challenging behaviour
o Learning difficulties
What is Asperger’s syndrome?
o Child with social impairment of an autistic spectrum disorder but at milder end
What core symptoms of social communication are present in ASD?
Does not seek comfort, form close friendships, prefers own company, no interest in playing with others
Gaze avoidance, socially and emotionally inappropriate
Does not appreciate that others have thoughts and feelings
Delayed language development - delay babbling, less words, regression of speech, refers to self as you/he/she
Formal pedantic language, monotonous voice
Repeats instructions
What core symptoms of restricted, repetitive patterns of behaviour are present in ASD?
Stereotyped or repetitive movements, use of objects or speech
Inflexible adherence to daily routines or ritualised patterns of behaviour
Highly restricted, fixed interests that are abnormal in intensity or focus, such as strong attachment to, or preoccupation with unusual objects
Fascination with sensory aspects of the environment or over/under reactivity to sensations
What functional problems are seen in ASD?
o Sleeping problems
o Feeding problems
o GI disturbances
DDx of ASD?
- Specific language delay
- Global developmental delay
- Stereotypic movement disorder
- ADHD
- Mood disorder
- Anxiety disorder
- Attachment disorder
- Conduct Disorder
Investigations in ASD?
- Autism diagnosed by assessment including detailed history, collateral from school
- Referral to autism team
Parental advice in management of ASD?
- Parent training
o Increase knowledge of ASD
o Enhances parent-child interaction
o Benefits entitled
o Sleep hygiene
Behavioural and drug management of ASD? 3 drugs
- Early Intensive behavioural intervention
o Speech therapy, special schooling starting at 3
o National Autism society
- Drugs
Risperidone (aggression)
Melatonin (sleep)
SSRIs (repetitive behaviour)
Complications of ASD during childhood?
o Impaired social situations
o Challenging behaviours
o Increase vulnerability to mental health problems
o High stress to parents
Complications of ASD during adulthood?
o Unemployment
o Poor general health
o Social isolation
How much of visual impairment is genetic?
- 50% of visual impairment is genetic
When is child registered blind?
- A child is registered blind when best corrected vision is < 3/60
When is a child partially sighted?
- Partial sight= visual acuity >3/60 but <6/60
How common is severe visual impairment?
Severe visual impairment = 1/1000
Inherited aetiologies of blindness?
i) Trisomy 21
ii) CHARGE association
Congenital aetiologies of blindness?
i) Cataract
ii) Albinism
iii) Retinal dystrophy
iv) Retinoblastoma
v) Congenital infection e.g. CMV, rubella
Perinatal aetiologies of blindness?
i) Retinopathy of prematurity
ii) Hypoxic ischaemic encephalopathy
iii) Cerebral damage
iv) Optic n. hypoplasia
Postnatal aetiologies of blindness?
i) Trauma
ii) Infection e.g. ophthalmic herpes simplex
iii) Juvenile idiopathic arthritis: iritis
iv) Vitamin A deficiency
What symptoms do you get in cataracts and retinoblastoma?
- Cataracts, retinoblastoma lose red light reflex
What is CHARGE association?
o Coloboma (hole in part of eye) of the eye, heart defects, atresia of the nasal choanae, retardation of growth and/or development, genital and/or urinary abnormalities, and ear abnormalities and deafness
