Autistic Spectrum Disorder

Question 1

What is autism?

Answer 1

A pervasive developmental disorder characterised by a triad of features.

Question 2

What is the triad of features seen in autism?

Answer 2

• Impaired social interaction
• Impaired communication
• Restricted, stereotyped interests and behaviours

Question 3

What is the role of genetics in autism development?

Answer 3

• Polygenetic relationship
• Number of chromosomes implicated
• Increased risk in genetic syndromes such as fragile X syndrome and tuberous sclerosis

Question 4

What are the pre-natal risk factors for developing autism?

Answer 4

• Family history
• Older parental age
• Exposure to certain medications in womb
• Prenatal viral infections

Question 5

Exposure to what drug in womb can increase the risk of autism?

Answer 5

Sodium valproate

Question 6

What prenatal viral infection can increase the risk of developing autism?

Answer 6

Rubella

Question 7

What are the antenatal risk factors for developing autism?

Answer 7

• Hypoxia during birth
• Prematurity
• Very low birth weight

Question 8

What are the post-natal risk factors for developing autism?

Answer 8

• Toxins such as lead and mercury

- Pesticide exposure

Question 9

How can the symptoms of autism be divided?

Answer 9

• Asocial features
• Restricted behaviour
• Impaired communication

Question 10

What are the asocial features of autism?

Answer 10

• Few social gestures e.g. waving, nodding

- Lack of eye contact, social smile, response to name and interest in others etc.

Question 11

How do people with autism restrict their behaviour?

Answer 11

• Restricted, repetitive and stereotyped behaviour e.g. rocking
• Obsessively pursued interests
• Fascination with sensory aspects of the environement
• Upset at change to daily routine
• May prefer same foods, clothes and games etc.

Question 12

How can autism lead to impaired communication?

Answer 12

• Distorted and delayed speech

- Echolalia

Question 13

What is echolalia?

Answer 13

Repetition of words

Question 14

When do most parents have concerns about their children when presenting with autism?

Answer 14

By 12-18 months of age

Question 15

When must the onset of autism be?

Answer 15

Before 3 years of age

Question 16

What are the other features of autism?

Answer 16

• Intellectual disability*
• Temper tantrums
• Impulsivity
• Cognitive impairment

Question 17

Why is intellectual disability not necessarily a feature of autism?

Answer 17

If you include all of the autistic spectrum, the majority will not have intellectual disability

Question 18

What aspects should be fully investigated when assessing for autism?

Answer 18

• Family history
• Pregnancy
• Birth
• Medical history
• Developmental milestones
• Daily living skills
• Communication
• Social interaction
• Stereotyped behaviours

Question 19

What additional test may be needed if indicated by presentation/history?

Answer 19

Hearing test

Question 20

What are the differential’s for autism?

Answer 20

• Asperger’s Syndrome
• Rett’s syndrome
• Childhood disintegrative disorder
• Learning disability
• Deafness
• Schizophrenia

Question 21

What model can be used to breakdown the management of autism?

Answer 21

Biopsychosocial model

Question 22

How can autism be managed biologically?

Answer 22

• Treatment of any co-existing disorders
• Anti-psychotics for challenging behaviour as a last line
• Melatonin for sleep disorders that persist despite behavioural interventions

Question 23

What psychological interventions can be used in managing autism?

Answer 23

• Psychoeducation for family and carers
• Full assessments of functions and behaviours
• CBT

Question 24

When is CBT usually a good treatment option?

Answer 24

If the child has verbal and cognitive ability to engage

Question 25

What social interventions can be used in the management of autism?

Answer 25

• Modification of environmental factors
• Social-communication interventions
• Self-help groups
• Special schooling may be considered

Question 26

How can environmental factors be modified?

Answer 26

• Manage lighting, noise etc.

- Avoiding inadvertent reinforcing of challenging behaviour

Question 27

What is an example of a self-help group for people with autism?

Answer 27

National Autism Society