Neurodevelopmental disorders

Question 1

What are the 3 core features of ADHD

Answer 1

Inattention
Hyperactivity
Impulsivness

Question 2

DSM-5 criteria for diagnosis of ADHD is?

Answer 2

• Inattention Symptoms - 6 or more symptoms for at least 6 months upto age 16 (5 or more for age 17+)
• Hyperactivity/impulsivity Symptoms - 6 or more symptoms of hyperactivity/impulsivity for at least 6 months upto age 16 (5 or more for age 17+)
• Symptoms begin presenting before age 12
• Symptoms present in two or more settings
• Symptoms interfere with social, school, or work functioning
• Symptoms do not happen only during the course of other mental illness

Question 3

What are the 3 types of presentations of ADHD?

Answer 3

Inattentive
Hyperactive
Combined

Question 4

What can you offer parents pre-diagnosis of ADHD?

Answer 4

Referral to parent education/training programme

Watchful waiting for upto 10 weeks

Question 5

When is medication prescribed for ADHD?

Answer 5

Only in children with SEVERE and PERSISTENT symptoms after being assessed in secondary care by a confirmed specialist (Paediatric psychiatrist)

Question 6

What is the drug treatment for ADHD?

Answer 6

CNS stimulants:

Methylphenidate then Atomoxetine then Dexamphetamine if max dose of both other drugs is unresponsive

Question 7

Side effects of methylphenidate are?

Answer 7

CNS - convulsions, migraine
GI - nausea vomiting, abdo pain
Cardiovascular - tachycardia, palpitations, arrhythmia
Psychiatric - insomnia, emotional instability

Question 8

Psychological treatment for ADHD?

Answer 8

CBT

Question 9

What is a learning disability?

Answer 9

IQ<70
Continued impairment, in adaptive behavioural and social functioning
Age of onset <18 years old

Question 10

How do you measure severity of learning disabilities?

Answer 10

IQ
Mild - IQ 50-70
Moderate - IQ 35-50
Severe - IQ 20-35
Profound - IQ <20

Question 11

What is the ICD-10 criteria for diagnosis of childhood autism?

Answer 11

1. the presence of abnormal or impaired development that is manifest before the age of three years
2. abnormal functioning in all the three areas of psychopathology: social interaction, communication, and restricted, stereotyped, repetitive behaviour

Question 12

What interventions could be recommended for ASD?

Answer 12

• Behaviour and psychological - Early Intensive Behavioural Intervention (EIBI) programmes
• Communication - Speech and Language Therapy
• Occupational Therapy
• Dietary

Question 13

Are ASD screening tools recommended in children?

Answer 13

No - false positives/false negative may delay diagnosis

Question 14

What ASD screening tool is available in adults?

Answer 14

AQ-10

10 question questionnaire - if individual scores more than 6 consider referral