Autism

Question 1

Define autism

Answer 1

A triad of impaired communication, impaired social interaction, and restricted, repetitive, stereotypic patterns of behaviour

Question 2

What is the male to female ratio of autism?

Answer 2

4:1

Question 3

Define autistic savant

Answer 3

An individual with autism and an above average IQ, typically with skills in a very isolated area

Question 4

Describe the verbal impairments in autism

Answer 4

Speech delay, stereotyped and repetitive speech, lack of social usage of language (slang, colloquialisms)

Question 5

Describe the non-verbal communication impairments in autism

Answer 5

Poor gesture, lack of creative play

Question 6

Describe the impairments in social interaction in autism

Answer 6

Lack of reciprocity, missing of social-emotional cues, lack of theory of mind, literal and concrete understanding, failure to develop peer relationships, lack of shared enjoyment

Question 7

Describe the behavioural abnormalities in autism

Answer 7

Unusual sensory interests, little imaginative play, stereotyped motor mannerisms (e.g. hand flapping, spinning), adherence to non-functional routines or rituals, unusual preoccupations or interests

Question 8

Before what age must abnormalities be apparent for a diagnosis of childhood autism?

Answer 8

3

Question 9

Describe some typical symptoms of childhood autism

Answer 9

Irrational fears or phobias, sleeping disturbances, eating disturbances, temper tantrums, aggression, self-injury

Question 10

How is Asperger’s syndrome differentiated from childhood autism?

Answer 10

No general delay or retardation in language or cognition

Question 11

What percentage of individuals with autism have an identifiable medical cause?

Answer 11

6-10%

Question 12

What is the concordance rate of autism in monozygotic twins?

Answer 12

36-60% severe, 90% mild

Question 13

State an implicated genetic site in autism

Answer 13

2q, 7q32, 6q21, 15q11-13, 16p

Question 14

In which population groups are rates of autism higher?

Answer 14

Children of engineers and children of South-East Asian immigrant mothers

Question 15

Name at least 5 medical conditions which can cause autism

Answer 15

Tuberous sclerosis, fragile X, maternal rubella, neurofibromatosis, Herpes simplex encephalitis, Turner’s syndrome, blindness, deafness, Down’s syndrome, untreated phenylketonuria

Question 16

Name at least 3 speculative causative environmental factors

Answer 16

Diet, pollutants, antibiotics, allergies, severe deprivation

Question 17

Name 2 mental health disorders associated with autism

Answer 17

Anorexia nervosa and ADHD

Question 18

In which sub-group of autistic patients is schizo-affective disorder more common than in the general population?

Answer 18

Fragile X autism

Question 19

What percentage of autistic individuals have epileptic seizures before age 3?

Answer 19

20%

Question 20

What percentage of autistic individuals develop epileptic seizures in adolescence?

Answer 20

15-20%

Question 21

Why can deafness confound an autism diagnosis?

Answer 21

Hearing impaired children talk later and are less socially skilled, symptoms shared with autism - but autism is also more common in the deaf population, hypothesised due to an underlying neurological disorder causing both

Question 22

State at least 5 autism-suggestive behaviours in infants

Answer 22

Feeding problems, dislike of physical contact, content to be alone (angel baby), not lifting arms to be lifted, not snuggling down when held, not gripping when being carried piggy-back, fascinating with lights or spinning, lack of curiosity, lack of social pointing and eye contact, delayed motor milestones, limited babbling

Question 23

How do the 2011 NICE guidelines suggest autism is identified early?

Answer 23

Regular health visitor checks, hearing and vision tests, training professionals to recognise signs and symptoms

Question 24

What is the prevalence of autism spectrum disorder? (Chakbarti & Frombonne, 2006)

Answer 24

116 per 100,000

Question 25

What is the prevalence of childhood autism?

Answer 25

25 per 100,000

Question 26

What percentage of the adult population has autism?

Answer 26

1.1%

Question 27

Give 3 reasons why autism appears to be on the increase

Answer 27

Changes in diagnostic criteria, increasing awareness, recognition of associations (e.g. with hearing impairment and Down’s syndrome), increased willingness to receive diagnosis (reduction in institutionalisation), increased benefits of diagnosis (development of specialist services)

Question 28

Give some differentials for autism

Answer 28

Receptive language disorder, expressive language disorder, elective mutism, schizophrenia, disintegrative disorder

Question 29

How can receptive-expressive language disorder patients be distinguished from autistic patients?

Answer 29

They exhibit reciprocal social behaviour and good eye contact

Question 30

How can severe neglect mimic autism (as seen in the Romanian orphans?)

Answer 30

It produces language delay, abnormal social behaviour, and unusual habits and stereotypies - however once relationships are re-established, children start to show language comprehension and normal social reciprocity

Question 31

Why are height, weight, and head circumference measurement important in suspected autism?

Answer 31

To exclude Rett’s syndrome

Question 32

What percentage of children with autism have an IQ below 70?

Answer 32

75%

Question 33

Which is higher in most autistic children - performance or verbal IQ?

Answer 33

Performance IQ

Question 34

What is the most important intervention in childhood autism?

Answer 34

Appropriate educational placement (often the hardest thing to achieve)

Question 35

State some negative prognostic factors in autism

Answer 35

Regression, low IQ, no speech by 7

Question 36

What are the aims of behaviour management in autism?

Answer 36

Reinforcing desired behaviours and reducing unwanted behaviours, the impact of obsessional behaviours, and destructive and aggressive behaviours