Clinical Presentation
Can symptoms present before two years when a child is usually diagnosed with autism?
Yes
Which gender is more likely to have autism spectrum disorder?
Males, 4 to 1 ratio
Who are some of the individuals in a child's life that may provide a history to help with the diagnosis of ASD?
The history is usually obtained from the parents. Teachers, childcare professionals, and therapists also can provide useful information
What are some early treatments for ASD?
Behavioral management
Occupational Therapy
Speech therapy
What is something tested for early on to ensure a physical deficit may not be causing communication problems?
Hearing impairment, can be tested by an audiologist
What is the PTEN gene?
The PTEN enzyme is part of a chemical pathway that signals cells to stop dividing and triggers cells to self-destruct through a process called apoptosis.
Has the prevalence of ASD increased over time?
Yes
Can intellectual impairment be seen with autism spectrum disorder?
Yes, the child may not hit developmental milestones. However, some patients are savants (special skills in one area)
What is the benefit of a multidisciplinary team?
A team autism evaluation occurs when different professionals come together to provide a multidisciplinary approach to ASD assessment. This is ideal in order to gather information from multiple sources and make use of expertise from different disciplines.
What are some clinical features of ADHD?
frequent symptoms of hyperactivity/impulsivity
normal intelligence on school testing
limited attention
most cases diagnosed between 6 to 12 years old
What is one physical characteristic that might be present in 25% of children with autism?
95th percentile head circumference
What is the prevalence of ASD
2 to 25 per 1000
What M-CHAT-R
M-CHAT-R is a screener that will ask a series of 20 questions about your child’s behavior. It's intended for toddlers between 16 and 30 months of age. The results will let you know if a further evaluation may be needed.
What symptoms may require pharmacological intervention?
Hyperactivity, impulsivity, and inattention
Maladaptive behaviors/problem
Anxiety
Mood lability
Depression
What are some clinical features of Fragile X syndrome?
Fragile X syndrome is an X-linked disorder
a long, narrow face, prominent forehead and chin, large ears, testicular enlargement in adolescence
In a systematic review, 30 percent of males with fragile X syndrome had features of ASD
What are some deficits that might be seen in social interactions for a child with autism?
Failure to hold a conversation
Lack of friends or difficulty making friends
Abnormal eye contact or body language
What are some neurological findings in a child with ASD?
Neuroimaging, electrophysiology, and autopsy studies in patients with ASD suggest that brain abnormalities, particularly atypical neural connectivity, play an important role in the development of ASD
What is ADOS-2
What are some of the outcomes of a child growing up to an adult with ASD?
It ranges from low-functioning patients may never live independently to high-functioning patients may live independently, hold jobs successfully, and even marry and have children
What's a general condition that may be confused with autism?
Global developmental delay or intellectual disability (formerly referred to as mental retardation) may be difficult to distinguish from ASD
What are some behavioral patterns that might be seen in a child with autism? Name 5
Repetitive movements
Wanting to stick to the same movements
Attachment to the same objects
Atypical language
Difficulty with communication
Temperament issues
What are some linked factors for causing ASD?
Some medications during pregnancy (like valproate
Environmental factors such as prenatal infections, toxic exposures
How many levels are there of severity for social communication and for repetitive/restrictive behavior in the DSM-5?
Three for each
Level 1: Requiring support
Level 2: Requiring substantial support
Level 3: Requiring very substantial support
What is the mechanism of action of risperidone and aripiprazole?
Aripiprazole: exerts its effects through agonism of dopaminic and 5-HT1A receptors and antagonism of alpha adrenergic and 5-HT2A receptors
Risperidone: thought to reduce this overactivity through inhibition of D2 receptors and serotonergic 5-HT2A receptors
What are some clinical features of Down's syndrome? Name 7
Flat facial profile, Flat nasal bridge, Low-set small years, Short neck, Prominent epicanthal folds ,Palpebral fissures, Congenital malformations such as heart, transverse palmar crease, short stature