Psychiatry

Question 1

What is Autism Spectrum Disorder?

Answer 1

neurodevelopmental condition.

characterised by qualitative impairment in social interaction and communication and repetitive stereotyped disorder.

symptoms present in early childhood, could manifest later though.

can occur in association with any level of general intellectual/learning ability.

manifestations range from subtle issues of understanding and impaired social function to severe disability.

no cure
early diagnosis + intensive educational and behavioural management may improve outcomes.

Question 2

epidemiology of ASD

Answer 2

3-4* more common in boys.
505 of children with ASD have intellectual disability

Question 3

clinical features of ASD

Answer 3

social communication impairement and repetitive behaviours in early childhood - before 2-3.

clinical features:

impaired social communication and interaction:
- child plays alone uninterested with being with other kids.
- fail to regulate social interaction with nonverbal cues like eye gaze, facial expression and gestures
- fail to form and maintain appropriate relationship s and become socially isolated

repetitive behaviour, interests and activities - motor mannerisms, inflexible adherance to nonfunctional routines/rituals.

intellectual impairement or language impairement

ADHD 35% and epilepsy 18% commonly seen in kids with ASD

usually associated with higher head circumference to brain volume ratio.

Question 4

how to manage ASD : goals for pt

Answer 4

no cure.

increase functional independence and QoL by

-learning and development, improved social skills and communication
- decreased disability and comorbidity
- aid to families

Question 5

non pharmacological therapy for ASD

Answer 5

applied behavioural analysis - ABA
ASD preschool program
Early Start Denver Model - ESDM
Treatment and Education of Autistic and Communication related handicapped children - TEACCH/structured teaching method.
Joint Attention Symbolic play engagement and regulation - JASPER

family support and counselling:
- parental education on interaction with the child and acceptance of his/her behaviour.

Question 6

pharmacological tx for ASD

Answer 6

no consistent evidence showing med-mediated improvements in social communication

ssri: help reduce anxiety aggression and repetitive stereotyped behaviour

antipsychotic drugs: reduce aggression, self-injury

methylphenidate: ADHD

Question 7

What is attention deficit hyperactivity disorder?

Answer 7

DSM-V : condition incorporating features relating to inattention and/or hyperactivity and/or hyperactivity/impulsivity that