ASD Flashcards
(22 cards)
What is ASD?
Autism Spectrum Disorder
Problems with:
• Social communication and interaction
• Restricted / repetitive patterns of thinking
What type of disorder is ASD?
A spectrium disorder, which implies that their are a range of type and severities of PCs, unified by overlying symptoms themes
Older nomenclature for ASD?
High functioning autism - IQ in the normal, or above average, range
Kanners autism - low functioning end of the spectrum and can be almost completely detached from the world; these patients almost always have a degree of LD
Aspergers - higher functioning end of the spectrum, with average/ above average intelligence, but with difficulty in their social interactions
Pervasive developmental disorders - patients who have difficulties in >1 developmental area but do not fulfill the diagnostic criteria for Autism or Asperger Syndrome
Difference between HFA and Aspergers?
Debate as to whether these should be combined into 1 category
Presentation is largely the same
Primary difference is that a diagnosis of HFA requires that, early in development, the child had delayed language; in Aspergers, the child did not show a significant delay in language development
Occurrence of ASD?
More common in boys (may be that it is less obvious in girls)
DSM-V criteria for ASD?
2 core areas of difficulties
- Persistent deficits in social communication and social interaction
- Restricted, repetitive patterns of behaviour, interests or activities
NOTE - language impairment used to be a third area but this is no longer required
Symptoms must be present in the early developmental period
Symptoms can cause clinically significant impairment in social, occupational or other important areas of current functioning
Disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay
Symptoms and signs of the deficits in social communication in those with ASD?
Social motivation - often, these patients are described as ‘aloof’ and are happy with their own company; they often are interested in people to meet their own needs
Social ability - they have problems reading and transmitting social cues, e.g: they do not see a leading “we’re going to lunch” as an invitation; these patients find metaphors, irony and social rituals confusing
Symptoms and signs of the restricted, repetitive patterns of behaviour, interests or activities?
Inflexible or systematic thinking - problems with social fit; often find change/transition very distressing. This leads to interests in systematic/logical themes, e.g: IT, maths, etc
Restricted/repetitive behaviours - need for routine and repetition; they shows stereotypies and stimming
What are stereotypies?
Repetitive or ritualistic movement, posture, or utterance, e.g: body rocking, marching, self-caressing
What is stimming?
Self-stimulatory behaviour
It is the repetition of physical movements, sounds, or repetitive movement of objects common in individuals with developmental disabilities, mainly in those with ASD (it is a VERY COMMON FEATURE)
Co-morbidities present with ASD?
Almost always has a comorbid condition assoc. with it:
• LD
• Anxiety, esp. social anxiety
• Depression
• ADHD
• Dyspraxia
• Specific language delay and impairments
• Sensory differences / sensory defensiveness
Language deficits that may be present in a patient with ASD?
May have no speech (LD)
Can confuse pronouns
Can have odd prosody (pitch, duration and intensity)
Echolalia (a type of stimming)
Sensory differences commonly present in ASD?
Sound and texture differences are most common (they are very sensitive to this); others are taste, smell, temp, pain sensitivity
Overlaps with social communication and dyspraxia
Conditions that are often co-morbid with severe autism?
LD
Language and other developmental problems
Hyperactivity
Behavioural issues, such as repeated self-harm
Conditions that are often co-morbid with mild autism?
Inattention / poor organisation
Anxiety and mood disorders
Dyspraxia
FH of ASD?
Strongly heritable - relatives are commonly affected and 20% of siblings meet the diagnostic criteria
Cause of ASD?
No clear unifying pathology mechanism and there are no clinically helpful findings on brain imaging
Why is early diagnosis of ASD so important?
Reduces impact on life, due to better educational planning, decreased family stress and more appropriate treatment for the child
Examination and Ix for ASD?
Screening test - social responsiveness scale
Semi-structured interviews
Standardised assessment tools, e.g: Autism Diagnostic Observation Schedule (ADOS
Diagnosis based on clinical judgement
Different healthcare professionals inv. with assessment and diagnosis of ASD?
SLT – language disorders/impairment
Psychology (educational/clinical) – IQ level cognitive strengths
Psychiatry – ADHD, complex or late presentations etc
OT - dyspraxia; sensory defensiveness
Paediatrics – developmental delay
Social Work – looking after; abusive or struggling families
Non-pharmacological Mx of ASD?
Aim to lessen assoc. deficits and family distress, increase QoL and functional independence
Family and school-based support
Applied behaviour analysis, speech and language therapy, social skills training
Play to strengths of patient
NOTE - no non-pharmacological intervention treats the core symptoms of ASD
Pharmacological Mx of ASD?
Risperidone / aripiprazole can be used short-term for significant aggression, tantrums or self-injury
Methylphenidate for ADHD symptoms
Anxiolytics, anti-depressants and melatonin may also be used
NOTE - there is no medication that treats the core symptoms of ASD
