Psych Flashcards
Age autism presentation
2-4 years
3 defining features autism
Language/communication difficulty
Impaired social interaction
Repetitive/restricted behaviours/routines
Examples language/comms difficulty in autism
DELAY Monotonous speech Reduced gestures and facial expressions Literal interpretions Question echoing
Examples social interactions in autism
Alone play No imaginative play Concrete play No ToM Gaze avoidance Inability to understand social cues
DDx autism
Asperger's Deafness Specific language deficit Neglect (so reduced socialisation) Learning disability
Ix autism
Full autism interview/ax
Audiology
SLT
Mx autism
Psychosocial - aim to improve attention, engagement, improve reciprocal communication. Educate parents and carers.
SLT - social skills training
Family - family therapy, future plans, carer’s need assessment
Medical - melatonin, antipsychotics (to engage in psychosocial intervention), ritalin (if poor attn)
EHCP - liaison with school - special school
Indicators of better prognosis for autism
Early speech acquisition
IQ>70
Mx chronic tic disorder
CBT - habit reversal technique
alpha2 adrenergic agonists
CLONIDINE, RISPERIDONE
3 defining features of ADHD
Inattention
Impulsivity
Hyperactivity
Risk factors for ADHD
Prem
LBW
FAS
Reduced sensitivity to needs of the child - maternal depression, maltreatment
Genetic component +++
Pathophysiologyof ADHD
Dopamine/noradrenaline dysregulation in the PFC
Diagnostic criteria for ADHD
> 6 months duration
<7 years old
Pervasive across at least 2 different situations (education, social, family, etc.)
Ix/Ax ADHD
EdPsych ax
Mx ADHD
10 weeks watch and wait
Psychosocial - focused group parental-training. Family therapy. Liaison with school.
Psych - CBT
Medication - methylphenidate (Ritalin) 6 weeks trials. Dexamphetamine (Adderall). Both stimulants.
Atomoxetine
(REGULAR MONITORING - height/weight/BP/ECG)
