- Attentional - Hyperactive/impulsive - Combined

- Behavioral psychotherapy with effective medication - Stimulants (methylphenidate) 1st line: side effects MC anorexia w/wt loss, mood effects, tics

- Smallest detectable sound in a spoken word - Dyslexia is a deficient decoding of these

ADD, Autism, Aspergers Flashcards by Megan MacNabb

Major feature of ADD

Paying too much attention to too many things (having little focus rather than too little attention)

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Types of ADD

Attentional
Hyperactive/impulsive
Combined

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Diagnostic criteria of ADD/ADHD

Onset is NO later than 7 yo
Symptoms present in 2 or more situations (school, home)
Disturbance causes clinically significant distress or impairment in functioning

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Diagnostic criteria of inattention/hyperactivity/impulsivity

6 or more symptoms
Symptoms have been present for at least 6 months
Symptoms are inappropriate for developmental level

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Treatment of ADD

Behavioral psychotherapy with effective medication

- Stimulants (methylphenidate) 1st line: side effects MC anorexia w/wt loss, mood effects, tics

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What is the 1st line pharm treatment of ADD? MC side effects?

Stimulants (meythlphenidate, dextroamphetamine)

Anorexia w/wt loss
Mood effects
Tics

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Diet changes to treat ADD/ADHD

Ineffective

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What is the origin of learning disorders?

Neurologic

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What is the central clinical feature of a learning disorder?

Lack of normal developmental skill, either cognitive or linguistic

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What does a learning disorder NOT include?

Learning problems caused primarily by:

Vision, hearing, motor impairments
Mental retardation
Emotional disturbance
Environmental, cultural, economic disadvantages

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What is a reading learning disorder?

Dyslexia

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What skills are impaired with reading learning disorder?

One or more impairments in the 3 skills necessary for reading:

Word decoding
Automaticity of letter and word recognition
Understanding the meaning of words

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What is the deficit of dyslexia?

Language processing - deficient decoding of phonemes (individual linguistic units, smallest detectable sound in a spoken word)

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What are phonemes?

Smallest detectable sound in a spoken word

- Dyslexia is a deficient decoding of these

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Define morpheme

Smallest meaningful speech sound

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Define grapheme

Smallest unit in written language

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What is the major phonetic processing consequence of dyslexia?

Cannot adequately pair the visually processed graphemes with their associated phonemes (reading problems)

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Treatment of reading learning disorder

Referrals to special ed (SLP)
Treatment of comorbidities
Consider ophtho
Ocular training appears to be INEFFECTIVE

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Ocular training for dyslexia?

Appears to be ineffective

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Describe dysgraphia

Writing learning disorder

- Uncertain whether this exists as an isolated disorder (usually in combo with reading and other disorders)

What does the process of writing connect?

Writing connects cognition, language, and motor skills

Treatment of math learning disorder

Address specific subcomponent deficits
Exploit a child’s developmental strengths and subject area affinities
Bypass techniques (circumvent the deficient math task component)
Teach real life math
Improve curriculum in US

Define autism generally

Persistent deficits in social communication and interaction across multiple contexts

What is severity of autism based on?

Social communication impairments and restricted, repetitive patterns of behavior

How must symptoms present in autism to be diagnostic?

- Must be present in the early developmental period - BUT may not become fully manifest until social demands exceed limited capacities - OR may be masked by learned strategies in later life

What may explain some of the increased rates of PDD NOS?

- Screen time has increased - May reinforce repetitive behaviors in vulnerable children - Decreases amount of interpersonal interactions

What may explain hyperacoustic hearing in autistic patients?

Central auditory processing deficits that suggest distorted pathways between hearing and cortical processing

Diagnosis of PDD requires that features be present by when?

3 yo

Epidemiology of PDD

- Males 5:1 for PDD/autism - Males 10:1 for Aspergers - Increase in reported cases probably due to increased identification of cases

Clinical presentation of PDD

- Language development issues (especially receptive) - Poor social interaction - Sensory integration difficulties - Stereotypic behaviors

What does the AAP recommend for screening of PDD?

M-CHAT (Modified Checklist for Autism in Toddlers) | -Given at 18 and 24 months

What are critical items of the M-CHAT?

- Does your child imitate you? - Does your child respond to his/her name? - If you point at a toy, does your child look at it? - Does your child take interest in other children? - Does your child use index finger to point? - Does your child bring objects over to you?

What is Retts syndrome?

- X linked d/o in females (lethal in males) | - Leads to developmental reversals especially in expressive language, hand use, breath holding

What is Fragile X?

MC cause of inherited mental retardation - Flat feet, flexible joints, low muscle tone - Large body size, forehead, long face - Soft skin - Macroorchidism

What 2 disorders should be ruled out when evaluating for PDD?

Retts syndrome | Fragile X

Neuropsych testing for PDD

- Distinguish PDD NOS from a mood disorder | - Identify verbal and nonverbal learning disabilities

Treatment of PDD

- Antipsychotics | - Treatment of comorbidities (ADHD, OCD, etc.)

Pathophys of autism

Abnormalities of cellular configurations in several regions of the brain

Possible lab findings of autism

- High whole blood serotonin - Low serum biotinidase - High C-terminally directed beta-endorphin protein immunoreactivity - Oxidative stress - Hyperlacticacidemia - Mitochondrial disorders

MRI finding of autism

Enlargement of the total brain

Treatment goal of autism

EARLY identification - well meaning attempts not to "label" children can deprive them of specialized services

Pharm treatment of autism

No meds are efficacious for the core symptoms of autism

Antidepressants in treatment of autism?

Help with compulsions/repetitive behaviors

Features of Asperger syndrome

- Persistent impairment in social interactions - No significant aberrations or delays occur in language (UNLIKE AUTISM) - Limited capacity for spontaneous social interactions

Major difference between autism and Asperger's?

In Aspergers, there are no significant aberrations or delays in language

Life expectancy of Aspergers

Normal, except as impacted by comorbidities (especially depression)

Clinical presentation of Aspergers

- Peculiar and narrow interests - Sensitivity to sound, touch, pain, texture of foods - Synesthesia ("loud shirt") - Interprets language literally (sarcasm is difficult)

Treatment of Aspergers

- Adaptations to sensory abnormalities (sunglasses, earplugs) - Psychotherapy - Relaxation training - Encouragement of special skills - Meds are for comorbidities