Lecture 26, 27 - ADHD, Autism Flashcards Preview

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Flashcards in Lecture 26, 27 - ADHD, Autism Deck (21):

ADHD -- what are the two categories of symptoms for ADHD ?

Describe some of the characterisitc features

which category decreases with age

Inattentive symptoms -- careless errors, can't sustain attention, don't seem to listen when spoken to directly, doesn't follow through on tasks, difficulty organizing tasks, loses things, easily distracted, forgetful in daily activity

Hyperactive-impulsive - fidgets, squirms, leaves seat, runs or climbs inappropriately, can't play quietly, on the go, talks excessively, blurts out, difficulty awaiting turn, interrupts symptoms
(decreases with age)


when do symptoms have to present by?

where does the impairment have to be observed?

age 12

in greater than 1 setting


challenges of the dx?

all kids have some of these characaterisitcs
have to identify what is outlier behavior

need multiple sources of data (teachers, parents)


ADHD Co-occurring conditions

Disruptive Behavior Disorders
Anxiety Disorders
Mood Disorders
Substance Abuse in Teens --- Impulsivity control


ADHD -- course in adulthood --what % of kids have the DSM criteria into adulthood?

what are some predictors of this

combined hyperactive and inattentive symptoms
severity of symptoms
Comorbid depression
Parental Anxiety mood disorders


ADHD -- environmental risk factors?

Maternal smoking, alcohol, substance
Maternal stress
Low birth weight
Nutritional deficiencies
Nutritional excess --- sugar


ADHD Neuro imaging --

Functional Imaging -- hypo activity during reward anticipation; hyper-responsiveness to reward; Prefer immediate rewards over delayed

not able to suppress activity as well in the frontal cortex

Poor time perception: -- affected ability to wait/delay response and make predictions about their environment


Rates of cortical thickening in adhd, adhd sx vs non adhd dx?

• Rate of cortical thinning:
(slowest) ADHD < ADHD symptoms < no sx


ADHD Treatment

• Psychoeducation
• Parenting skills training/behavior management
• Stimulants are first line medication
○ Methylphenadate based --
○ Amphetamine based


DMS Criteria for Autism Spectrum D/o

• Deficits in social communication/interaction -- Social reciprocity, nonverbal communications, developing/maintaining and understand relationship

Restricted, repetitive patterns of behavior, interests or activities -- Stereotypic repetitive movements, rigid adherence to routine; hyper or hypoactive to sensory input

must cause functional impairment


ASD -- when do these symptoms present in order to make the dx?

early development


Gender differences in ASD

Males > Females 4:1

But females will have more severe intellectual disability


Risk factors for ASD

• Familial recurrence among siblings -- 2-10%; up to 18%
• Advanced maternal or paternal age
• Extreme prematurity

Closer spacing of pregnancies


What method is used for screening of ASD?

Gold standard for dx ?

MCHAT Questionnaire @ 18 and 24 mo

ADOS -- autism diagnostic observation schedule (assessment of communication, social interaction, play)


What is inclusive in the interdisciplinary assesment of ASD?

• Audiology, speech, occupational, physical exam (screen for sz)
• Genetic testing is now standard of care (G Band karyotyping, fragile X, chromosomal microarrays)


Common co-morbidities in ASD?

Co-occurring seizures

intellectual disability -


Criteria for Intellectual disability

Deficits in intellectual functions (by clinical eval and standardized testing)

• Deficits in adaptive functioning

• Onset during development


Domains of severity of Intellecual disability?

Conceptual (academic)

Social -- empathy, social judgement, interpersonal

Practical -- personal care, job, money,



Possible etiologies (general)

Co-occurring lllness (general)

Inborn errors of metabolism, Genetics

Psychiatric Illness - 10 to 39% of individuals with ID


what behaviors is observed in 50% of kids with ASD or ID?

Self-Injurious Behaviors --


what 2 antipsychotics are approved for irritability due to autism ?

what drugs may worsen symptoms?

ariprprazole and risperidone