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?
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
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
Parental Anxiety mood disorders
ADHD -- environmental risk factors?
Maternal smoking, alcohol, substance
Low birth weight
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
• 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?
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?
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?
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 --