Psychiatry - Autistic Spectrum Disorder

Question 1

Defintion

Answer 1

• Autistic spectrum disorder = full range of people affected by a deficit in social interaction, communication and flexible behaviour.
• The autistic spectrum has a significant range. On one end patients have normal intelligence and ability to function in everyday life but displaying difficulties with reading emotions and responding to others. This was previously known as Asperger syndrome. On the other end, patients can be severely affected and unable to function in normal environments.

Question 2

Classification

Answer 2

Diagnostic and statistical manual of mental disorders fifth edition (DSM-5)

Question 3

Social interaction signs

Answer 3

• Lack of eye contact
• Delay in smiling
• Avoids physical contact
• Unable to read non-verbal cues
• Difficulty establishing friendships
• Not displaying a desire to share attention (i.e. not playing with others)

Question 4

Communication signs

Answer 4

• Delay, absence or regression in language development
• Lack of appropriate non-verbal communication such as smiling, eye contact, responding to others and sharing interest
• Difficulty with imaginative or imitative behaviour
• Repetitive use of words or phrases

Question 5

Behaviour signs

Answer 5

• Greater interest in objects, numbers or patterns than people
• Stereotypical repetitive movements. There may be self-stimulating movements that are used to comfort themselves, such as hand-flapping or rocking.
• Intensive and deep interests that are persistent and rigid
• Repetitive behaviour and fixed routines
• Anxiety and distress with experiences outside their normal routine
• Extremely restricted food preferences

Question 6

Diagnosis

Answer 6

Specialist in autism
Can be made by age of 3
It involves a detailed history and assessment of the child’s behaviour and communication.

Question 7

Treatment

Answer 7

Autism cannot be cured. Management depends on the severity of the child’s condition. Management involves a multidisciplinary team to provide the best environment and support for the child and parent:
- Child psychology and child and adolescent psychiatry (CAMHS)
- Speech and language specialists
- Dietician
- Paediatrician
- Social workers
- Specially trained educators and special school environments
- Charities such as the national autistic society