PSY2004 SEMESTER 2 - WEEK 9

Question 1

what is life expectancy for williams syndrome

Answer 1

lacking research but expectation similar to neurotypicals

• shortened due to comorbid health conditions (heart problem, MHI)

Question 2

what has life expectancy in DS rise from

Answer 2

from 12 in 1949, to 60 2018

Question 3

why has DS life expectancy improved

Answer 3

• improvements in living conditions
• more than half of babies with DS have congenital heart conditions - improvement in treatment

Question 4

what was original viewpoint on life expectancy of autistic individual

Answer 4

16yrs shorter than a neurotyp, 30yr shorter if also intellec dis
however, didn’t account for most people with diagnosis being young= skew age estimate of life expectancies

Question 5

what is recent view of autism life expectancy

Answer 5

smaller differences in life-expectancy

Question 6

why are autistic more shorter life expectancy?

Answer 6

• more likely co-occuring issue: epilepsy, hearing/vis impairment, cerebral palsy, MHI, immune condition, sleep disorder, obesity, heart disease
• communication barrier to healthcare:
  
  • difficulty booking or talking to doctor, voicemail, anxiety, needing more time, expressing emotions differently
• sensory barriers: waiting room (noise, lighting, touching)

Question 7

what are communicative recommendations to increase accessibility in autism healthcare

Answer 7

clear language
e-consult
instruction and written advice
signpost to directive resource

Question 8

what are sensory processing recommendations to increase accessibility in autism healthcare

Answer 8

conduct sensory audit of premises
offer times facilitating attendences
allow time to process info

Question 9

what are predictability recommendations to increase accessibility in autism healthcare

Answer 9

regular doctors
provide info on whats expect
advise on timings for procedure

Question 10

compare adults/children who has williams syndrome

Answer 10

almost identical cog profile to children, sometimes increase visuospat ability

Question 11

(Howlin & Udwin, 2006) parents quesionnar, mean age of child 36 - Williams syndrome, what % had health issue

Answer 11

79% heart problems
51% dep/anx

Question 12

(Howlin & Udwin, 2006) parents quesionnar, mean age of child 36 - Williams syndrome, what % were independent

Answer 12

62% lived with families
16% lived independently
2% residential communities

Question 13

(Howlin & Udwin, 2006) parents quesionnar, mean age of child 36 - Williams syndrome, what % education

Answer 13

71% attended college
33% attained formal qualification

Question 14

(Howlin & Udwin, 2006) parents quesionnar, mean age of child 36 - Williams syndrome, what % works

Answer 14

20% full time educat
30% day centre
1.6% full-time employed
18% part-time
9% voluntary
6% stays at home

Question 16

(Howlin & Udwin, 2006) parents quesionnar, mean age of child 36 - Williams syndrome, what % parents dissatisf with support

Answer 16

23% parents dissatisfied with ment/phys medical help
33% unhappy with educational provision
20% unhappy with workplace assistance

Question 17

outline cognitive changes in adulthood DS

Answer 17

reach stage later, stays longer = developmental gap widens with age
hard to investigate cog -comorbid w/ early onset alzheim
memory and cog decline in-line with expectation for neurotyp indiv

Question 18

outline physical changes in adulthood DS

Answer 18

accelerated ageing, skin/hair change, early-onset menopause, hearing impairments, diabetes, musculoskeletal problem

Question 19

name key features of alzhiemer

Answer 19

excessive amounts of amyloid (form plaque) and tau (form tangle)

Question 20

how does genetics mean more likely to have alzheimers DS

Answer 20

gene coding for amyloid precursor protein located on chromosome 21 - duplicated in DS, causing increased amyloid plaques and AD

Question 21

how many DS individual have plaques assoc with alzheimer

Answer 21

up to 100% individuals 40+ years of age show plaques associated with AD (although don’t necessarily have AD)

Question 22

how many DS age 30-39 show signs DS

Answer 22

33%

Question 23

how many DS age 40-49 show signs DS

Answer 23

55%

Question 24

how many DS age 60+ show signs DS

Answer 24

75%

Question 25

what is usual age of onset of alzheimer for neurotyp

Answer 25

65+

Question 26

summarise cognitive adult profile for autism

Answer 26

some areas of difficulty (ToM) improving w/ age however most model suggest no diff in age trajectory btw/ autistic/neurotyp or steeper declines

Question 27

why is autism prevalence much lower for adult than childhood

Answer 27

diagnostic criteria changed over time, awareness of autism increased (seen in screening and medical record studies, community based case identification studies)

Question 28

Grosvenor (2024) used electronic health records, insurance claim data, found what regarding ASD diagnosis

Answer 28

substant less adult diagnosed

Question 29

O'Nions (2023) used population based retrospective cohort study of med record, found what regarding autism diagnosis

Answer 29

- substantially fewer adults diagnosed

Question 30

why are there fewer autistic adults than children

Answer 30

- “grow-out of autism” - environmental factor - diagnostic criteria evolved, so autistic adults weren’t meeting criteria as a child - increased awareness

Question 31

how can actual number autism be studied in community

Answer 31

use community based case identification study, via autisim screening, ie like Bruga (2011) using stratified sampling

Question 32

what did Bruga (2011) find via Adult Psychiatric Morbidity Survey- overall prevalence

Answer 32

estimated autism prevalence 0.98%, none of identified cases had existing diagnosis of autism

Question 33

what did Bruga (2011) find via Adult Psychiatric Morbidity Survey- gender splits

Answer 33

men= 1.82% women= 0.2%

Question 34

what did Bruga (2011) find via Adult Psychiatric Morbidity Survey- time split

Answer 34

adult prev sim to children prevalence of 2007, suggesting that rate ASD not signif assoc with age, so cause of autism were "temporally constant"

Question 35

what did Bruga (2011) find via Adult Psychiatric Morbidity Survey- whats autism associated with

Answer 35

reduced verbal IQ, lower educational attainment, male gender

Question 36

what did Bruga (2011) find via Adult Psychiatric Morbidity Survey- who were excluded

Answer 36

care setting, moderate-severe intellctual disabil

Question 37

what did Bruga (2011) find via Adult Psychiatric Morbidity Survey- follow up study focusing on intellc dis, what was prevalence

Answer 37

- autism prevalence higher in intellectual disabilities but gender differences reduced - prevalence of autism in combined reweighted sample was 1.1% - as moderate-profound intellectual disability makes up 0.3% population means overall association of autism with age and gender for population as whole unchanged by inclusion of rates for people with intellectual disability

Question 38

what is AMPS

Answer 38

- given over several yrs, establish prevalence of psychiatric conditions in population - autism not psychiatric condition but q are included to study autism prevalence, designed as represent of households in England - data then is available for researcher secondary data analysis

Question 39

what are challenges of autism diagnostics for adulthoods

Answer 39

not recog experience and dev coping strategy diagnosing usually require dev info, experiences, childhood milestone lack of dev norm to see diffic, harder to compare adult than child

Question 40

when should assessment of autism be considered in adults

Answer 40

if show possible features (diffic obtaining/keeping job, education, init soc rel, contact with mental/LD serv, history of neurodev disab)

Question 41

what mental health conditions can be difficult to identify for ASD adults

Answer 41

identifying depression in ASD is challenging: issues recognising and articulating feelings and emotions - rigid thought style and dichotmous thinking means more suicidal thoughts are actually done