Neurodivergence in Adults

Question 1

How much of the population are neurodivergent?

Answer 1

15%
79% have cooccurring mental health conditions

Question 2

Describe autism

Answer 2

Neurodevelopmental disorder/ condition
Lifelong diagnosis
2-4 in 100
Neuro-affirming

Question 3

What is the cause of autism?

Answer 3

Difference in the structure of the brain

Question 4

What does neurodiversity mean?

Answer 4

Statistical normal range of a function in a population at a particular age - trait of the whole group

Question 5

What does neurotypical mean?

Answer 5

Individuals where a selective neurocognitive function falls within the prevalent societal norm

Question 6

What does neurodivergent mean?

Answer 6

Individuals where a selective neurocognitive function falls out with the prevalent social norm

Question 7

How is autism assessed and diagnosed?

Answer 7

MDT
DSM-5 and ICD-11
No biological marker or test
Screening tools - Autism quotient AQ-10 or AQ-50

Question 8

What is the diagnostic criteria for autism?

Answer 8

Difficulties in social communication and interaction
Difficulties in routines, repetitive behaviours and rigidity
Must be present from early childhood
Impact/ impairment on functioning

Question 9

Describe masking in autism

Answer 9

Strategies to hide their differences from other people
Self perseveration strategy
Tiring and at a cost to mental health
People with ADHD also mask

Question 10

Describe contemporary assessment of non-verbal communication

Answer 10

Poorly integrated verbal and non-verbal communication
Any difficulty using non-verbal communication - unusual eye gaze, proximity to others and lack facial expressions
Difficulty understanding non-verbal communication

Question 11

Describe the contemporary assessment of repetitive speech, motor movement and use of objects

Answer 11

Evidence of simple motor stereotypes - hand flapping or rocking
Repetitive use of objects
Repetitive use of language

Question 12

Describe building the pathway (AAAT) for autism in NHS Grampian

Answer 12

Referral
Pre-assessment
Waiting list
Assessment - 3 assessment appointments
Diagnostic decision
Discharge

Question 13

What are some key points of autism?

Answer 13

Post-CAMHS
Women aged 45+
Masking and functional range
Adult ND assessment team is preferred
Support to wider system

Question 14

What does SPACE stand for in autism?

Answer 14

S - sensory
P - predictability
A - acceptance
C - communication
E - empathy

Question 15

What are some strategies used in autism?

Answer 15

Autistic lead organisations
Unmasking
Limited resource locally
Stepped care approach
Local and national provision
NAIT guidance

Question 16

What does ADHD stand for?

Answer 16

Attention Deficit Hyperactivity Disorder

Question 17

Describe assessment and diagnosis in ADHD

Answer 17

Highly heritable condition
Physical checks required before treatment - BP, heart rate and BMI
ECG if history of cardiac issues
75% of ADHD patients have 1 other psychiatric condition

Question 18

What are common co-occurring issues seen in ADHD?

Answer 18

ND conditions, mental health esp. anxiety and depression, neurological or genetic presentations and insomnia

Question 19

Describe screening in ADHD

Answer 19

Symptomology, description of displacement, confirmation of symptoms from childhood and ASRS-1
3 appointment process - full MSE, psychometric testing and diagnosis

Question 20

What is the diagnostic criteria for ADHD (DSM5)?

Answer 20

A - 5 or more symptoms of inattention or hyperactivity
B - several symptoms present by age 12
C - several symptoms present in 2 or more settings
D - interfere or reduce quality of social, education or occupation
E - not explained by another condition

Question 21

What is a symptom checklist used in ADHD?

Answer 21

ASRS - adult self report scale 1.1

Question 22

What is the diagnostic interview used for ADHD in adults?

Answer 22

DIVA-5

Question 23

What are the diagnostic overlaps in ADHD?

Answer 23

Anxiety disorders
Depression
Personality disorder
PTSD
Eating disorder

Question 24

What are the strategies used in ADHD?

Answer 24

Environmental and behavioural modification continues to be recommended first line intervention
Medication is not universally chosen or required
Stepped care approach and local provision

Question 25

What are the medications used in ADHD?

Answer 25

Stimulants and Non-stimulants

Question 26

What are some stimulants used in ADHD?

Answer 26

Methylphenidate and Lisdexamphetamine

Question 27

What are some non-stimulants used in ADHD?

Answer 27

Atomoxetine and Guanfacine

Question 28

What are some co-occurring conditions seen in mental health?

Answer 28

Sleep disorders, anxiety, depression, Tourette’s, sensory processing disorder, dyscalculia, bipolar, OCD and intellectual disability

Question 29

What does pathological demand avoidance (PDA) mean ?

Answer 29

Need for autonomy and control
Limited perception of social hierarchy
Can appear sociable
Resists and avoids ordinary demands of life

Question 30

What does rejection sensitivity dysphoria (RSD) mean?

Answer 30

Intense emotional sensitivity to perceived criticism or rejection
Rejection triggers huge feelings of depression, anger and severe anxiety
People pleasers and difficulty starting tasks

Question 31

What are the diagnostic overlaps in autism?

Answer 31

Mental health assessment, trauma, personality disorder, ADHD, anxiety, depression and OCD