Week 4- ASD, ADHD Flashcards
What does ADHD stand for?
Attention Deficit Hyperactivity Disorder
What is the diagnostic triad for ADHD?
Inattention
Hyperactivity
Impulsivity
What is the criteria for combined type ADHD, and what else is it known as?
Also known as hyperkinetic disorder The patient must have the normal triad of difficulties but they must be: -developmentally inappropriate -Impairing -Pervasive- occur in multiple settings -Longstanding
Is ADHD a spectrum disorder?
Yes
How can having a family member with ADHD impact on the home?
Complicated to the parents
Raised family stress levels
Increased anger and upset
Increased risk of harm (e.g. impulsive behaviour)
How can having ADHD affect schooling?
Barrier to learning
Frequently in trouble
Disorganisation, forgetting, losing things
What co-morbid difficulties can you have with ADHD?
Social communication difficulties Learning disabilities Attachment difficulties Mood and anxiety problems Behavioural disorders Substance use
What causes ADHD?
Environmental factors
Genes
Brain structure and function
Cognition
How would you go about diagnosing ADHD?
History Screening questionnaires Structural diagnostic questionnaires Background risk factors- family history, male gender, socioeconomic status Careful review of differentials
How would you examine a suspected ADHD case?
School observation
Observation in clinic room
Cognitive assessment
Do symptoms of ADHD ever stop?
Symptoms commonly remain throughout childhood
Core symptoms may symptoms may persist into adulthood
Some will ‘grow out’ of ADHD as part of brain development
How would you treat ADHD psychologically?
1st line- parent training
Behavioural classroom management strategies
2nd line- social skills training
sleep and diet- eliminations and supplements
How would you treat ADHD pharmacologically?
1st line drugs- methylphenidate (ritalin)
dexamfetamine
Lisdexamfetamine
2nd line drugs
Atomoxetine
3rd line- antidepressants, antihypertensives, anti-psychotics.
What are common side effects of stimulant ADHD medications?
Dysphoria (state of unease)
Anxiety
Tics also possible
How do stimulants work in the treatment of ADHD?
What do they affect in ADHD?
Improve dopaminergic neurotransmission in networks involved in executive functioning. They directly improve core symptoms
Name some examples of non stimulant ADHD medication?
Atomoxetine-noradrenergic and dopaminergic agonist
Guanfacine- alpha 2 agonist
What is autism?
Problems with social communication and interaction.
Restricted and repetitive patterns of thinking
How would you diagnose autism (method)?
History generally.
What is the DSM 5 criteria for autism spectrum disorder?
Persistent deficits in social communication and interaction.
Restricted, repetitive patterns of behaviour, interests and activities.
When must symptoms for ASD be present from?
Must be present in the early developmental period.
NOTE
Disturbances in ASD must not be better explained by intellectual disorder or global developmental delay.
How are those with ASD described socially?
Described as being aloof.
Lack of theory of mind
Only interested in people to meet needs
Happy with their own company
What specific things are affected socially in ASD?
Problems reading and transmitting social cues
Metaphor, irony and social rituals are confusing
What is meant by inflexible patterns of thinking and repetitive behaviours in ASD?
Changes/ transitions are often very distressing
Leads to interests in logical things- e.g. IT, maths, engineering, collecting.
Need for routine and repetition
What co-morbidities are common in ASD?
Learning disability Anxiety Depression ADHD Dyspraxia Specific language delay and impairments Sensory differences/sensory defensiveness
What language deficits can be seen in autism spectrum disorder?
No speech- language delay
Confuse pronouns
Odd prosody (patterns of rhythm)
Echolalia (echoing another person)
What sensory differences might be present in someone with ASD?
Temperature and pain sensitivity
Sound and texture difficulties are most common.
Overlaps with social communication and dyspraxia
Which co morbidity is severe autism associated with?
Learning disability
Langauge and other developmental problems
Hyperactivity
Behavioural issues such as repeated self harm.
Which co-morbidity is mild autism associated with?
Inattention/poor organisation
Anxiety and mood disorders
Dyspraxia
What causes ASD?
Strongly heritable- however no single gene found
No clinically helpful findings are found on brain scanning.
What assessment tools can be used to aid diagnosis of ASD?
Social responsiveness scale
Semi-structured interviews
Which allied health professionals are involved in the management of ASD?
Speech
