Neurodevelopmental disorders

Question 1

Give 4 risk factors for developing Autism Spectrum Disorder?

Answer 1

Male
Premature
Perinatal hypoxia
Advanced maternal or paternal age

Question 2

Give the 3 distinctive features of Autism Spectrum Disorder

Answer 2

Abnormal social interaction- poor eye contact, failure to use body language or facial expressions, difficulty making friends

Impaired social communication- delay or failure to develop spoken language to communicate with others. Fail to continue conversations. Repeat words, abnormal intonation, pitch, rate and rhythm of speech

Restrictive or repetitive activities- abnormal preoccupations, need for routine, very distressed if routine broken. Repetitive motor movements- hand flapping, compulsive movements

Question 3

Give 4 other features of Autism Spectrum Disorder other than the main 3

Answer 3

Sensory issues 
Restricted diet 
Dislike loud noises 
High pain threshold 
Self harm 
Dislike haircuts/teeth cleaning etc.

Question 4

How is Autism Spectrum Disorder diagnosed?

Answer 4

Need features of each of the 3 main clinical features; Abnormal social interaction, impaired social communication, restrictive/repetitive activities

And either: lack of social attachment, delayed speech or lack of imaginative play before 3 years.

Diagnosis made my an MDT made up of doctors, teachers, parents, educational psychologist and SALT.

Question 5

How is Autism Spectrum Disorder managed?

Answer 5

Behavioural management- visual timetable, preparation for any change

Educational measures- special needs school

Treat comorbid conditions- ADHD, sleep disorders, learning disability, anxiety and depression

Question 6

Give 4 comorbid conditions associated with ADHD

Answer 6

Autism Spectrum Disorder
Learning difficulties 
Communication disorders
Conduct disorder
Depression 
Anxiety 
Tourettes 
Auditory processing disorder

Question 7

Give the 3 main features of ADHD

Answer 7

Inattention- easily distracted, forgetful, difficulty sustaining attention in tasks or play

Hyperactivity- fidgets with hands and feet, talks excessively, excess energy

Impulsivity- difficulty waiting their turn, poor awareness of dangers and consequences

Must present before age 6, be present in 2 or more settings and be out of context for the child’s IQ and age

Question 8

How is ADHD diagnosed?

Answer 8

Diagnostic clinical features present
Conner’s questionnaire
School observation and school report
Full family history

Question 9

How is ADHD managed?

Answer 9

Pre-school- parental education, inform nursery

Mild, school age- parental education, CBT, social skills training, teacher training

Severe, school age- Medications, group parent training/education programme

Question 10

What medication is prescribed first line in ADHD?

Answer 10

> 5 years old

Methylphenidate (1st line)

Question 11

Give 4 side effects of methyphenidate

Answer 11

Hypertension 
Palpitations 
Reduced growth 
Depression 
Aggression 
Anxiety 
Reduced appetite
Disturbed sleep