Neurodivergence in Adults Flashcards
How much of the population are neurodivergent?
15%
79% have cooccurring mental health conditions
Describe autism
Neurodevelopmental disorder/ condition
Lifelong diagnosis
2-4 in 100
Neuro-affirming
What is the cause of autism?
Difference in the structure of the brain
What does neurodiversity mean?
Statistical normal range of a function in a population at a particular age - trait of the whole group
What does neurotypical mean?
Individuals where a selective neurocognitive function falls within the prevalent societal norm
What does neurodivergent mean?
Individuals where a selective neurocognitive function falls out with the prevalent social norm
How is autism assessed and diagnosed?
MDT
DSM-5 and ICD-11
No biological marker or test
Screening tools - Autism quotient AQ-10 or AQ-50
What is the diagnostic criteria for autism?
Difficulties in social communication and interaction
Difficulties in routines, repetitive behaviours and rigidity
Must be present from early childhood
Impact/ impairment on functioning
Describe masking in autism
Strategies to hide their differences from other people
Self perseveration strategy
Tiring and at a cost to mental health
People with ADHD also mask
Describe contemporary assessment of non-verbal communication
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
Describe the contemporary assessment of repetitive speech, motor movement and use of objects
Evidence of simple motor stereotypes - hand flapping or rocking
Repetitive use of objects
Repetitive use of language
Describe building the pathway (AAAT) for autism in NHS Grampian
Referral
Pre-assessment
Waiting list
Assessment - 3 assessment appointments
Diagnostic decision
Discharge
What are some key points of autism?
Post-CAMHS
Women aged 45+
Masking and functional range
Adult ND assessment team is preferred
Support to wider system
What does SPACE stand for in autism?
S - sensory
P - predictability
A - acceptance
C - communication
E - empathy
What are some strategies used in autism?
Autistic lead organisations
Unmasking
Limited resource locally
Stepped care approach
Local and national provision
NAIT guidance
What does ADHD stand for?
Attention Deficit Hyperactivity Disorder
Describe assessment and diagnosis in ADHD
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
What are common co-occurring issues seen in ADHD?
ND conditions, mental health esp. anxiety and depression, neurological or genetic presentations and insomnia
Describe screening in ADHD
Symptomology, description of displacement, confirmation of symptoms from childhood and ASRS-1
3 appointment process - full MSE, psychometric testing and diagnosis
What is the diagnostic criteria for ADHD (DSM5)?
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
What is a symptom checklist used in ADHD?
ASRS - adult self report scale 1.1
What is the diagnostic interview used for ADHD in adults?
DIVA-5
What are the diagnostic overlaps in ADHD?
Anxiety disorders
Depression
Personality disorder
PTSD
Eating disorder
What are the strategies used in ADHD?
Environmental and behavioural modification continues to be recommended first line intervention
Medication is not universally chosen or required
Stepped care approach and local provision
What are the medications used in ADHD?
Stimulants and Non-stimulants
What are some stimulants used in ADHD?
Methylphenidate and Lisdexamphetamine
What are some non-stimulants used in ADHD?
Atomoxetine and Guanfacine
What are some co-occurring conditions seen in mental health?
Sleep disorders, anxiety, depression, Tourette’s, sensory processing disorder, dyscalculia, bipolar, OCD and intellectual disability
What does pathological demand avoidance (PDA) mean ?
Need for autonomy and control
Limited perception of social hierarchy
Can appear sociable
Resists and avoids ordinary demands of life
What does rejection sensitivity dysphoria (RSD) mean?
Intense emotional sensitivity to perceived criticism or rejection
Rejection triggers huge feelings of depression, anger and severe anxiety
People pleasers and difficulty starting tasks
What are the diagnostic overlaps in autism?
Mental health assessment, trauma, personality disorder, ADHD, anxiety, depression and OCD
