Developmental Disorders Flashcards

Question

Prognosis of ASD

Answer 1

-ASDs are lifelong conditions with no cure -Functional impact fluctuates with stressors, change and physical illness -Prognosis is very dependent on severity of symptoms =Good prognostic factors are IQ >70, communicative language by age 5 years and absence of epilepsy =Those with comorbid intellectual disability are unlikely to be able to live independently in adulthood -Some individuals with ASD learn strategies to overcome their limitations and play to their strengths allowing them to take up employment and live with minimal if any support

Answer 2

group of disorders where abnormal development of the central nervous system leads to impairment in brain function (e.g. movement, cognition)

Answer 3

global intellectual impairment (IQ < 70) associated with adaptive functioning difficulties, manifesting during development

Answer 4

any condition that impairs learning, most often not associated with a global reduction in IQ; a specific learning difficulty is one that impairs only a particular type of learning (e.g. dyslexia, dyscalculia)

Answer 5

-Developmental delay -Difficulties with learning, memory and attention -Abnormal communication and socialising -Behavioural problems e.g. aggression, self-injury, poor impulse control

Answer 6

-85% cases, 50-69 IQ range -Difficulties may be subtle and difficult to identify -Often only identified at later age -Difficulties in academic work (reading and writing) but greatly helped by educational programmes -Usually capable of unskilled or semi-skilled manual labour -May be able to live independently or with minimal support

Answer 7

-10% cases, 35-49 IQ -Language and comprehension limited -Self-care and motor skills impaired, may need supervision -May be able to do simple practical work with supervision -Rarely able to live completely independently

Answer 8

-3-4% cases, 20-34 IQ -Marked degree of motor impairment -Little or no speech during early childhood, may learn to talk in school-age period -Capable of only elementary self-care skills -May be able to perform simple tasks under close supervision

Answer 9

-1-2% cases, <20IQ -Severely limited in ability to communicate their needs -Often severe motor impairment with restricted mobility and incontinence -Little or no self-care -Often require residential care

Answer 10

-Prevalence of intellectual disability is 1% -1.5 times more common in males than females -Normally presents in childhood -Up to 1/3 of patients have a comorbid psychiatric illness =ASD and ADHD common =Schizophrenia present in ~4% of those with intellectual disability -Epilepsy is another common comorbidity

Answer 11

-Some common causes of intellectual disability are: =Genetic (trisomies, structural variants, point mutations) =Prenatal (TORCH infections, substance use, other complications) =Perinatal (birth trauma, prematurity) =Environmental (neglect, malnutrition) =Childhood illness (infection, head injury, toxins) -However, in a third of mild cases of intellectual disability no aetiology is ever determined -Severe intellectual disability is more likely to have a specific cause identified

Answer 12

-Neurodevelopmental disorder =Intellectual disability =Autism spectrum disorder =Attention deficiency hyperactivity disorder =Tourette syndrome -Specific learning difficulty -Sensory impairment (e.g. hearing) -Mental health disorder (e.g. reactive attachment disorder) -Psychosocial adversity (e.g. abuse)

Answer 13

-Physical problem (e.g. constipation) -Sensory impairment (e.g. vision) -Mental health problem (e.g. depression) -Environmental change (e.g. change of carer, change of location) -Psychosocial adversity (e.g. abuse ,divorce) -Medication change (stop/start/OTC) -Substance use

Answer 14

-History =Thorough developmental, psychiatric and medical history ==Global or specific intellectual difficulty? ==Associated problems with adaptive or social functioning? -Collateral histories are very important (parents, carers, teachers) -Examination =Assess IQ score using a suitable method (done by psychology) =Assess for syndromic causes of intellectual disability e.g. single palmar crease =Exclude physical causes and sensory impairments =Perform MSE (look for difficulty understanding questions, short answers, dysarthria speech; also any evidence of comorbid psychiatric disorders) -Investigations =Nothing specific required for diagnosis however can be useful for excluding differentials and identifying comorbidities such as epilepsy

Answer 15

-History =Psychiatric =Physical health =Social circumstances =Any medication changes =Substance use =Collateral histories are very important (parents, carers, teachers) -Examination =Screen for sensory impairments =Full physical exam =MSE (focussing on any evidence of comorbid psychiatric disorders) -Investigations =Consider bloods as guided by findings above e.g. FBC, U&E, TFT, glucose, CRP

Answer 16

-Bio =Prevention and early detection – amniocentesis, rhesus status, genetic testing =Treatment of specific cause of ID, where possible =Treatment of psychiatric comorbidities by intellectual disability psychiatrist =Treatment of physical comorbidities by specialist -Psycho =Early support for patients and their families – ongoing for as long as needed =Psychological therapies (e.g. CBT) as appropriate for psychiatric conditions -Social =The person should attend mainstream education if possible, but not for everyone =Vocational and housing support should also be offered later in life

Answer 17

-Intellectual disability is a lifelong condition with no cure – prognosis varies with severity -Appropriate multidisciplinary care can improve symptoms/functional ability -Functional impact fluctuates with stressors -Some with intellectual disability will live independently with minimal support and adaptations -Those with comorbid ASD and intellectual disability are less likely to be able to live independently