What are the Anti-Autism Medicatoins?
2 Antipsychotic Meds used for "irritability due to autism"
SSRIs used for compulsive/anxiety behaviors in autism can WORSEN symptoms
Co-occuring ADHD is commone so give either Methylphenidate (ridolin) or non-stimulant Atomexitine (alpha agonist)
What are some key milestones to look for in early social development of a child?
Relating to others with warmth and pleasure
Continuous Flow and Reciprocity in engaging people
back and forth gesturing and vocalization
What is Autism Spectrum disoder?
Kids who either regress to have or never develop deficits in social communication or ineraction such as:
- using communcication as a functional goal in a relationship
- social reciprocity (differential includes hearing/vision problems or neglect/abuse can cause as well)
- Nonverbal communcations
Kids also often exhibit:
-restricted repetitive behaviors or patterns - stereotype movmenments or rigid adherence to patterns and fixed interests
-symptoms of functional impairment
THAT can not solely be explained by intellectual capacity
Describe the gender differences in autism?
Prevalence is 4:1 M>F
but females tend to have more severe intellectual disability
What are some neurobiological considerations/clues in brain development?
Co-occuring seizures are common - do neuro testing!!!
Can see elevated peripheral serotonin levels
Stereotypic movements suggest a role for Da
Increase in Brain Size
fMRI shows difficulties with tasks involving facial expression
can see alterations in WM
Risk Factors for Autism
Advanced maternal or paternal age
Extreme Prematurity (
Closer spacing of pregnancies
MORE OCCURENCE IN SIBLINGS
Family recurrence among siblings is 2-10% and up to 18% if broad spectrum autism is considered
Essential vs syndromic Autism - main points
Essential Autism see no clear link with genetic findings or abnormalities (no dysmorphic features) and higher 6:1 Male to Female recurrence rate; higher sibling recurrence and family history
Syndromic Autism is more align with recognizable patterns of dysmorphic features, lower male:female 3:1 ratio, lower sibling recurrence and familty history -- Genetic Testing can help see like Karyotypes etc
When does screening for autism occur?
Universal screening at 18 and 24 months with a questionaire so you can know by age 2 and interject
How can you test for intellectual disability?
test for deficits in intellectual functions by both clinical evaluation and standardized testing....IQ test
usually >2 SD below population mean
meaning IQ approximately
What is Adaptive Functioning?
How well you deal with day to day functioning - often autism kids have deficits hear that onset during development
Severity of Autism now more based on Adaptive functioning vs IQ
What are the 3 domains for judging severity of autism?
Conceptual: reading, math, writing, knowledge and memory
Social: empathy, social judgment, interersonal communication and skills, ability to make and maintain friends
Practical: personal care, job responsibility, money management, recreation, organizing tasks
What other conditions might be on the differential and why is it important to consider those?
infectious - like encephalitis causes
Endocrine (Hypothyroid) and Metabolic (homocystinyurea) are important to consider bc you CAN TREAT THESE!!!!!
Trauma or Neglect
Genetic syndromes - with other worrisome health predisposisitons
What do you consider in the Psychiatric workup for Autism/Intellectual Disabiliyt?
MEdical considerations - sometimes kids act out when have tooth pain, GERD etc
Developmental considerations - Identifiy when these are occuring and and put behavior in developmental context - are these behaviors learned?
Environmental Considerations - increased sensitiivty to changes in environment/transitions
What is Self-Injurious behavior sometimes indicative of? How can you prevent it?
Self-Injurious behavior oftem serves a function for child (especially a non-verbal child) and can indicate ways of esaping from demand or getting social attention so it's best to seek the function of the behavior and the underlying medical condition
Better to use fixed time schedule reinforment with positive social attention