Week 4- ASD, ADHD

Question 1

What does ADHD stand for?

Answer 1

Attention Deficit Hyperactivity Disorder

Question 2

What is the diagnostic triad for ADHD?

Answer 2

Inattention
Hyperactivity
Impulsivity

Question 3

What is the criteria for combined type ADHD, and what else is it known as?

Answer 3

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

Question 4

Is ADHD a spectrum disorder?

Answer 4

Yes

Question 5

How can having a family member with ADHD impact on the home?

Answer 5

Complicated to the parents
Raised family stress levels
Increased anger and upset
Increased risk of harm (e.g. impulsive behaviour)

Question 6

How can having ADHD affect schooling?

Answer 6

Barrier to learning
Frequently in trouble
Disorganisation, forgetting, losing things

Question 7

What co-morbid difficulties can you have with ADHD?

Answer 7

Social communication difficulties 
Learning disabilities
Attachment difficulties
Mood and anxiety problems
Behavioural disorders 
Substance use

Question 8

What causes ADHD?

Answer 8

Environmental factors
Genes
Brain structure and function
Cognition

Question 9

How would you go about diagnosing ADHD?

Answer 9

History
Screening questionnaires
Structural diagnostic questionnaires
Background risk factors- family history, male gender, socioeconomic status
Careful review of differentials

Question 10

How would you examine a suspected ADHD case?

Answer 10

School observation
Observation in clinic room
Cognitive assessment

Question 11

Do symptoms of ADHD ever stop?

Answer 11

Symptoms commonly remain throughout childhood
Core symptoms may symptoms may persist into adulthood
Some will ‘grow out’ of ADHD as part of brain development

Question 12

How would you treat ADHD psychologically?

Answer 12

1st line- parent training
Behavioural classroom management strategies
2nd line- social skills training
sleep and diet- eliminations and supplements

Question 13

How would you treat ADHD pharmacologically?

Answer 13

1st line drugs- methylphenidate (ritalin)
dexamfetamine
Lisdexamfetamine

2nd line drugs
Atomoxetine

3rd line- antidepressants, antihypertensives, anti-psychotics.

Question 14

What are common side effects of stimulant ADHD medications?

Answer 14

Dysphoria (state of unease)
Anxiety
Tics also possible

Question 15

How do stimulants work in the treatment of ADHD?

What do they affect in ADHD?

Answer 15

Improve dopaminergic neurotransmission in networks involved in executive functioning. They directly improve core symptoms

Question 16

Name some examples of non stimulant ADHD medication?

Answer 16

Atomoxetine-noradrenergic and dopaminergic agonist

Guanfacine- alpha 2 agonist

Question 17

What is autism?

Answer 17

Problems with social communication and interaction.

Restricted and repetitive patterns of thinking

Question 18

How would you diagnose autism (method)?

Answer 18

History generally.

Question 19

What is the DSM 5 criteria for autism spectrum disorder?

Answer 19

Persistent deficits in social communication and interaction.
Restricted, repetitive patterns of behaviour, interests and activities.

Question 20

When must symptoms for ASD be present from?

Answer 20

Must be present in the early developmental period.

Question 21

NOTE

Answer 21

Disturbances in ASD must not be better explained by intellectual disorder or global developmental delay.

Question 22

How are those with ASD described socially?

Answer 22

Described as being aloof.
Lack of theory of mind
Only interested in people to meet needs
Happy with their own company

Question 23

What specific things are affected socially in ASD?

Answer 23

Problems reading and transmitting social cues

Metaphor, irony and social rituals are confusing

Question 24

What is meant by inflexible patterns of thinking and repetitive behaviours in ASD?

Answer 24

Changes/ transitions are often very distressing
Leads to interests in logical things- e.g. IT, maths, engineering, collecting.
Need for routine and repetition

Question 25

What co-morbidities are common in ASD?

Answer 25

``` Learning disability Anxiety Depression ADHD Dyspraxia Specific language delay and impairments Sensory differences/sensory defensiveness ```

Question 26

What language deficits can be seen in autism spectrum disorder?

Answer 26

No speech- language delay Confuse pronouns Odd prosody (patterns of rhythm) Echolalia (echoing another person)

Question 27

What sensory differences might be present in someone with ASD?

Answer 27

Temperature and pain sensitivity Sound and texture difficulties are most common. Overlaps with social communication and dyspraxia

Question 28

Which co morbidity is severe autism associated with?

Answer 28

Learning disability Langauge and other developmental problems Hyperactivity Behavioural issues such as repeated self harm.

Question 29

Which co-morbidity is mild autism associated with?

Answer 29

Inattention/poor organisation Anxiety and mood disorders Dyspraxia

Question 30

What causes ASD?

Answer 30

Strongly heritable- however no single gene found | No clinically helpful findings are found on brain scanning.

Question 31

What assessment tools can be used to aid diagnosis of ASD?

Answer 31

Social responsiveness scale | Semi-structured interviews

Question 32

Which allied health professionals are involved in the management of ASD?

Answer 32

Speech