(PM3B) ADHD & Autism Flashcards
What is ADHD?
Attention Deficit Hyperactivity Disorder
Persistent pattern of inattention or hyperactivity
More frequently displayed than other individuals at a similar level of development
When does ADHD tend to start?
Early childhood
<7 years old
Is there a higher incidence of ADHD in boys or girls?
Boys
What is the prevalence of ADHD in children?
2-10%
What tools are used to diagnose ADHD?
(1) DSM-V
(2) ICD-10
How can ADHD be diagnosed?
Assessment of information collected from:
- Parent
- School
- Young person themselves (if old enough)
Using Conner’s Comprehensive Behavior Rating Scalesassessment
Which part of the brain is responsible for ADHD?
Global cognitive effects – (many areas of the brain)
(1) Frontoparietal circuits
(2) Dorsal frontal parietal circuits
(3) Mesocorticolimbic circuits
What are some of the genetic risk factors for ADHD?
(1) Dopamine transporter – D4 receptor
(2) Dopamine beta-hydroxylase
(3) MAOA
(4) Catecholine-methyl transferase
(5) SLC6A4
(6) 5HT2A
(7) 5HT1B
(8) DAT1 gene
(9) DRD4 gene
What are some of the environmental risk factors for ADHD?
(1) Lead exposure
(2) Smoking/ alcohol in pregnancy
Why are animal models used in ADHD?
(1) To model behavioural characteristics
(2) Testing therapeutic compounds
(3) Testing genetic associations
(4) Identification of novel ADHD candidate genes
What is the treatment for ADHD?
(1) Stimulants – ADHD children require more stimulation to maintain attention
- e.g. methylphenidate/ dexamfetamine/ atomoxetine
(2) Antipsychotics are specifically NOT recommended
When is atomoxetine considered first line treatment for ADHD?
When there is risk of drug abuse
What is the mechanism of action of methylphenidate?
Norepinephrine–dopamine reuptake inhibitor
What is normally considered the first line treatment for ADHD in children and young people?
Drug treatment is NOT indicated
Drug treatment reserved for those with severe symptoms
What is normally considered the first line treatment for ADHD in adults?
Drug treatment is first line for moderate or severe ADHD
Methylphenidate is first line
- Atomoxetine or dexamfetamine can be tried if ineffective/ unacceptable
Cognitive Behavioural Therapy (CBT) may be considered
What is Asperger’s syndrome?
Higher intellectual function
Autistic psychopathy in childhood
What is autism spectrum disorder?
Lifelong, developmental disability
Affects how a person communicates with and relates to other people, and how they experience the world around them
Presents from early childhood
What is the prevalence of autism spectrum disorder?
~1.5%
What co-occurring conditions are common with autism spectrum disorder?
(1) Epilepsy
(2) ADHD
(3) Mental health problems
(4) Genetic associations
What is ASD?
Autism Spectrum Disorder
Is autism spectrum disorder more common in males or females?
Males
Ratio of M:F is 4:1
What are some of the common symptoms that present in autism spectrum disorder?
(1) Difficulty with social communication
(2) Patterns of interests/ behaviours
(3) Obsessive interests in hobbies
(4) High dependence of routines and predictability
What are some of the less common symptoms that present in autism spectrum disorder?
(1) Sensory interests
(2) Sensitivity –sometimes experienced as physically painful
(3) Emotional disregulation – strong emotions + difficulty managing responses
(4) Specific motor mannerisms
How does autism spectrum disorder present in adults?
Outcome in adulthood is generally poor
Often a requirement for daily support
Social vulnerability – bullying
Describe the neuroanatomical development of brain size in those with autism spectrum disorder.
At birth – have an increased brain size
Postnatal – very similar size to normal
Adolescence – very similar size to normal
Old age – some possibility of decline/ deterioration
What are some environmental or social risk factors for development of autism spectrum disorder?
(1) Parental age at time of conception
(2) Factors during pregnancy – weight gain/ metabolic conditions
(3) Maternal medication use – e.g. valproate increases his of development of autism spectrum disorder
What are some genetic risk factors for development of autism spectrum disorder?
(1) Individual genetic variants
(2) 74-93% of autism spectrum disorder is inherited
What is the recommended treatment for autism spectrum disorder by NICE?
(1) Non-pharmacological treatments
(2) Psychosocial interventions
(3) Antipsychotics –complex cases ONLY
What are some recommended psychosocial interventions, and their reasons, for individuals with autism spectrum disorder?
(1) Play-based strategies
- Increasing joint attention + engagement
(2) Adjustment of understanding of parents, carers, teachers or peers
(3) Should be delivered by a trained professional
How are animal models used for autism spectrum disorder?
(1) Genetic mutation for ASD inserted into rat host DNA
(2) Growth of ASD rat
(3) Development of therapeutic candidates on ASD rat
What is the ‘Refrigerator Mother’ theory?
The theory that autism spectrum disorder is caused b a lack of maternal warmth of her child
Does the ‘Refrigerator Mother’ theory have any clinical basis?
No
What evidence is there to support dietary interventions in the prevention and management of autism spectrum disorder?
None
What is the curative treatment for autism spectrum disorder?
There is not one
Name two complex neurodevelopmental disorders.
(1) ADHD – attention deficit hyperactivity disorder
(2) ASD – autism spectrum disorder
What do the NICE treatment recommendations focus on in the management of autism spectrum disorder in children?
Non-pharmacological strategies
