conditions that are seperately on DSM IV now under ASD on DSM V
autistic d/o
Asperger
childhood disintegrative d/o
pervasicve d/o NOS
seperate na and RETT
how to dx with ASD
severity : depends on the social domain and RRB
marked social impairement but normal cognition, adaptive and language
Asperger
T / F
head circumf growth deckine at 6mos among px with RETT
True .
mutation at MECP 2 gene
at 6mos - changes
head circum, decline in language witrh MR
preschool yrs- apraxia and ataxia
documented neurobiologic/ physiologic cganges in pxs with autism
Inc total brain vol grand mal sezi inc ventricular size EEG abnormalities- non sp elevated serotinin levels
On DSM V no age is specificied for dx of autism.. but in DSM V .. abn fxn should begin at least at … age
at 3 yrs .
most common comorbid of autism ?
MR
autistic d/o is 4-5x more common among boys vs girls
most common complain of parents of pxs with autism ? ano una nila napapanisn?
Delays in acquisition of language
diff bet autism and asperger ? dsm IV to a
asperger later onset, les simopairment less severe social and commu deficits less prominent agreesion/ self injurious more freq motor clumsiness struggle socially but not withdrawn
no significant delay in language, cognitive and self help skills
Possible pharmaco mgts in pxs with autism
for decraesing stereotypic behaviors
diminish aggression, irritability seld injurious behavior
obsessive-compulsive behaviors
for decraesing stereotypic behaviors - opiate antagonist
diminish aggression, irritability seld injurious behavior - D2 blockers, or D2 + serotonin blocking
obsessive-compulsive behaviors - SSRI
unintentional muscle movement , a.k.a. motor overflow
Synkinesia
vs.
Dyspraxia- diff exhibiting sequentail, coordinated motor movements .
Dyskinesia - diff performing movements
Hypotonus/ hypertonus- abn in muscle tone
Impersistence- ianvility to sustain body posture
risk factors for dev of dev coordination d/o ?
prematurity perinatal hypoxia malnutrition' low birth weight exposure to nicotine, alcohol and cocaine
Reading d/o - May, June, july
what are the 4 domains of languange competence
Phonology - ability to prod sounds
semantics - organiztaion of concepts
grammar- organization of words, rules about placing words
Pragmatics- skill in actual use of language
How to DX I.D. ?
3 criteria must be met
1. deficits in intellectual ability - prob solving, reasoning, planning - proven by clinical AND std test
Diff of I.D vs GDD
I.D.
3 criteria must be met
1. deficits in intellectual ability - prob solving, reasoning, planning - proven by clinical AND std test
GDD- < 5yrs old, when px cannot has diff undergoing std test
Unspecified I.D. > 5yrs
diff in assessment due to sensory / physical impairements ( blind/ deaf)
when is someone considered as a late talker ?
children with normal cognitive fxn, fewer than 50 words, no word combinations at age 2 yrs.
usually improve at preschool years
Intervention if with persistence at age 4-5 yrs
selective mutism is associated with … by 95%
social phobia
selective mutism- consistent failure to speak in specific social situations where speaking is expected. lack of speech must interfere with acheivements/ communications, must last at least 1month.
disturbance in programming of speech ,movements assoc with ormary insukt to the left cerebral hemishopere
organic cause include endocrine dysf and laryhngeal papilloma
sentences are short, incomplete , ungrammatical
speech sounds [prob
cleft lip and palate
disturbance in programming of speech ,movements assoc with ormary insukt to the left cerebral hemishopere- verbal apraxia
organic cause include endocrine dysf and laryhngeal papilloma - voice disorder
sentences are short, incomplete , ungrammatical - Expressive language disorder
speech sounds [prob- phonological
cleft lip and palate - phonological
communicative d/o are more common among females
T/F
false
expressive language disorder
mixed recetive-expressive d/o
phonological
stuttering
cluttering, dysrythmic spurt of words is cahrac of :
expressive lamnguage d/o
peak of stuttering : 2-3.5yrs , 5 and 7 yrs