Overview
What is the significance of the DSM-5 criteria change from DSM-IV in diagnosing ASD?
The DSM-5 criteria consolidated previous subcategories of autism-related disorders into a single diagnosis of ASD, which aims to improve diagnostic consistency and better reflect the spectrum nature of the disorder
What is the Autism Diagnostic Observation Schedule 2nd edition?
Overall: SN 96% || SP 50-85%
What are some common side effects of antipsychotics in children with ASD?
Common side effects of risperidone include weight gain, drowsiness, increased appetite, and potential metabolic changes
What is the new diagnosis in DSMV provided to be the "catch" for those who are equivocal to make the diagnosis of ASD with primary dysfunction related to social interactions?
Social pragmatic communication disorder
What is the hospital number for a code grey at Walter Reed?
777
~3-4x males > females
What are some environmental factors that have been proposed as potential risk factors for ASD?
Environmental factors include prenatal exposure to certain medications, maternal infections during pregnancy, and exposure to environmental toxins.
What are some non-pharmacological interventions commonly used in ASD treatment?
Non-pharmacological interventions include applied behavior analysis (ABA), speech and language therapy, occupational therapy, and social skills training
What is the etymology of the word autism?
From German “Autismus”
The word “autism” is composed of two parts, “aut” and “ism.” The prefix of the word is “aut,” which comes from the Greek word “autós,” meaning “self.” The suffix “ism,” also from Greek, implies a state of being or condition. When I looked at the prefix and suffix of the word combined, I found that the word “autism,” in its purest form, means “a state of being oneself.”
A program by the military to help families accommodate for services required by family medical and mental health needs.
Exceptional family member program (EFMP)
Fill in the blank for Criterion B:
Restricted, repetitive, and _____ patterns of behavior, ______, or activities
Restricted, repetitive, and inflexible patterns of behavior, interests, or activities
What is the sensitivity and specificity overall of the ADOS-2
~80 and 40
What are the two medications approved by the FDA for treating irritability in children with ASD?
The two medications approved by the FDA for treating irritability in children with ASD are risperidone and aripiprazole.
What is the prevalence of autism spectrum disorder in the tech industry compared to the general population?
2-3% rather than 1% of the population.
List the entities associated with covering ABA therapy for families and patients.
Tricare
In-utero exposure to which one of the following medications has been associated with the development of autism spectrum disorder?
A. Carbamazepine
B. Valproic acid
C. Phenobarbital
D. Lithium
E. Oxcarbazepine
B. Valproic acid
Explanation:
Valproic acid is a known teratogen for the development of intellectual disability and autism spectrum disorder among persons with in-utero exposure. Lithium exposure in utero is associated with Ebstein's cardiac anomaly.
At what ages does the American Academy of Pediatrics recommend screening for autism?
18 and 24 month Well Child Check
What is the significance of the severity levels in the DSM-5 criteria for ASD?
The severity levels (Level 1: Requiring Support, Level 2: Requiring Substantial Support, Level 3: Requiring Very Substantial Support) help clinicians determine the amount of support an individual with ASD needs based on social communication impairments and restricted, repetitive patterns of behavior
A 5-year-old is diagnosed with autism spectrum disorder after a complete workup and evaluation. Which of the following is the most likely neurotransmitter abnormality found in similar children in research studies?
A. Elevated urinary dopamine metabolites
B. Elevated urinary metanephrines
C. Elevated CSF 5-HIAAD. Low platelet MAO levels
E. Raised serotonin blood levels
E. Raised serotonin blood levels
Explanation:Elevated whole blood serotonin is the correct answer because it is the first biomarker identified in autism spectrum disorder (ASD) and is present in more than 25% of affected children. The serotonin system is a logical candidate for involvement in ASD due to its pleiotropic role across multiple brain systems both dynamically and across development. Clues connect this peripheral biomarker with changes in brain and behavior in ASD, but the contribution of the serotonin system to ASD pathophysiology is not fully delineated at this time. Emerging data from both neuroimaging and postmortem samples also indicate changes in the brain serotonin system in ASD.
My patient in clinic thinks they have autism spectrum disorder, what do I do?
Build a relationship and explore it with them, especially with probes on being about their philosophy on relationships ~2 sessions.
- Story telling, description,
What is the prevalence of autism spectrum disorder estimated in the US? (But also Europe and Asia).
Estimates in estimate in 1:10 or 1:100 or etc...
2 to 25 per 1000
What is the neuropathology behind the social communication impairments found in autism spectrum disorder?
A. Decreased frontal lobe and anterior temporal volume
B. Decreased gray matter in amygdala-hippocampus complex
C. Decreased local connectivity in parietal-occipital regions
D. Increased integration across frontal and posterior cortical regions
E. Decreased volume in middle-inferior frontal gyrus
B. Decreased gray matter in amygdala-hippocampus complex 45%
Decreased gray matter in bilateral amygdala-hippocampus complex and bilateral percuneus and slight increase in volume in middle-inferior frontal gyrus have been implicated in defective social communication found in autistic children. There is an increase in the volume of the frontal lobe and anterior temporal region in autistic children. There is actually an increase in local connectivity in the parietal-occipital regions. There is an overall lack of integration between different brain regions, particularly across the frontal, and posterior cortical regions. There is a slight increase in the volume in middle-inferior frontal gyrus.
Parents whose firstborn child has been diagnosed with an autism spectrum disorder (ASD) consult on the risk of subsequent offspring also having ASD. Which one of the following statements will accurately guide them in their understanding?
A. ASD is sporadic in occurrence and likely to afflict a second child with a risk no higher than that of the general population
B. ASD is mostly genetically determined with dizygotic twin studies showing a concordance of 3% to 15%, which would be the risk of ASD in a second child
C. Monozygotic twin studies show ASD concordance of 60% for the full syndrome and up to 90% for the broad syndrome, suggesting that they should probably adopt a second child
D. ASD is one of the least strongly genetic of all neuropsychiatric conditions and they will almost certainly not have a second child with the condition
E. ASD is an autosomal recessive disorder and conducting a careful family history is required to provide the parents accurate guidance
What is the cost for the kit to administer the gold standard evaluation for ASD?
$2,700.00
I have a child in the ED with ASD brought in by parents for an outburst of irritability that led to a chair being thrown out the window, what do I do?
Ensure they’re comfortable (hungry? Tired? Pain? Pervasive distressing belief?).