Screens and Work ups
Ongoing developmental and behavioral surveillance in addition to screening for ASD at these ages continues to be recommended in primary care.
What is 18 and 24 months?
(MCHAT)
A teen in your practice restricts her calorie intake to 900 calories per day and has an intense fear of gaining weight. She describes herself as obese even though her BMI is in the 75th%tile. You diagnose her with this. Be specific.
What is atypical anorexia nervosa?
As pediatricians, we do not support nutritional interventions for ASD because the interventions we do must always be this.
What is Evidence Based?
A dental exam on eating disorder patients may reveal these 2 specific findings, whether the patient purges or not.
What are dental caries and erosion?
This is the reported prevalence of ASD in the US.
What is 1 in 59 children?
At certain ages, a general developmental screening is recommended at well checks using a validated screening tool, the ASQ. These are the ages.
What is 9, 18, and 30 months of age?
A diagnosis of Bulimia Nervosa or Binge-eating disorder is qualified as "of low frequency or limited duration" if the eating disorder meets all criteria except this.
What is less than once per week and/or less than 3 months?
This is the timing that children with developmental delays, including those suspected of having ASD, should be referred for necessary services.
What is at the time of diagnosis?
(or immediately)
There are many cardiovascular effects of eating disorders. The most common seen/heard in an office exam includes these three.
What is bradycardia (decreased HR), orthostasis, and poor peripheral perfusion (decreased pulses, acrocyanosis)?
Findings may resemble POTS.
Abrasions or callouses on the knuckles of an eating disorder patient are known as this.
What is Russell's sign?
After performing a HEADS exam on an adolescent female with an eating disorder, a medical student asks you about what misuse of drugs and alcohol can lead to in this patient. You tell him this.
What is: misuse of drugs and alcohol among patients with eating disorders is associated with a poorer outcome or death?
Notable changes in DSM-5 since the previous edition include the elimination of these 2 factors in the diagnosis of anorexia nervosa.
What are amenorrhea and specific weight percentiles?
Toddlers and children identified through screening as having ASD should have an evaluations with psychology and these 3 services, which, if age-appropriate, can be provided through an early intervention referral.
What is speech therapy, physical therapy, and occupational therapy?
This syndrome is associated with the abuse of stimulant cathartics such as senna, cascara, bisacodyl, phenopthalein, and anthraquinones. This is why osmotic or bulk-forming laxatives are preferred for constipation.
What is cathartic colon syndrome?
These 2 domains identify the core deficits in ASD.
What are: deficit in social communication and interaction and restrictive, repetitive patterns of behavior?
Families of children diagnosed with ASD should be offered genetic evaluation including these 2 specific tests that the PCP can order.
What are chromosomal microarray and fragile X testing?
A child in your practice experiences significant weight loss, marked nutritional deficiencies, and needs to be supplemented with vitamin D, B12, and folate, and pediasure shakes daily. He is otherwise healthy but says he isn't interested in eating and nothing tastes good anyway. You diagnose him with this.
What is ARFID?
(Avoidant Restrictive Food Intake Disorder)
This is known to be the fundamental early step in treating eating disorders.
What is re-establishing regular eating patterns?
The euthyroid sick syndrome is the most common thyroid abnormality seen in restrictive eating disorders and will have these markers on testing.
What is: low T3, elevated rT3, normal to low T4, normal to low TSH?
Clinicians need to recognize that children who have or have experienced these 3 things are at increased risk of autism.
What are a sibling with ASD, preterm birth, and exposure to teratogens? (exposure to antiseizure meds or a specific one named is acceptable)
Your work-up for a cachexic patient with an eating disorder should include at minimum: these tests for blood, this test for urine, and this one other common office or hospital test. Additionally, vitamins D, B12, iron, and zinc may be tested.
What is: CBC, CMP, phosphorus, magnesium, and TSH; UA; ECG?
In the restricting subtype of anorexia nervosa, weight loss is achieved primarily through these 3 behaviors.
What is dieting, fasting, and excessive exercise?
This treatment for eating disorders consists of three phases and contends that parents are not to blame for their child's illness, eating disorders are not caused by dysfunctional families, and parents play an essential role in recovery.
What is FBT?
(Family-Based Treatment, Family-Based Therapy)
Common co-occurring conditions in children with ASD include GI symptoms, obesity, seizures, and these 5 others. Some of these, along with disruptive behaviors, may require behavioral health interventions.
What are: sleep disorder, feeding disorder, ADHD, anxiety, and wandering or elopement?
As clinicians, we need to be aware that increased rates of eating disorders occur in this special group of patients.
What is sexual minority youth or transgender youth?