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Paeds SAQsgrowth-development-and-behaviour

Paeds SAQs · growth-development-and-behaviour

Autism spectrum disorder — formative SAQs

Formative SAQs on autism spectrum disorder assessment and management.

20 marks30 min2 min readVerification in progress

Target exams

RACP General PaediatricsMRCPCH Clinical
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Study tools

Target exams

RACP General PaediatricsMRCPCH Clinical
Prompt
Autism spectrum disorder: assessment and management

SAQ 1 (10)

A 3-year-old boy is referred because childcare staff say he does not respond to his name, lines up toys, and has no pretend play. Language is limited to single words. Hearing has not been tested. Parents want “the autism blood test” and ask whether vaccines caused this. [1]

  1. State the DSM-5-TR domain structure required for ASD and one key specifier you will document. (3) [1]
  2. List your immediate assessment and support actions this week, including what you will not delay for a final diagnostic appointment. (4) [1] [6]
  3. How do you answer the vaccine question and the request for a blood test for autism? (3) [1]

Model answer

Criteria. All three social-communication domains plus at least two of four restricted/repetitive domains, with early developmental onset and impairment. Specifiers include intellectual impairment, language impairment, known genetic/medical condition, or catatonia. [1]

This week. Multi-setting history; paediatric observation; audiology; developmental assessment pathway; start early intervention / speech-language supports while diagnosis proceeds; safety and sleep/feeding screen; written safety-net. Do not wait for paperwork before supports when concern is high. [1] [6]

Communication. Vaccines do not cause autism — state that clearly and without false balance. There is no blood test that diagnoses ASD; diagnosis is clinical. Genetic tests after diagnosis look for aetiologic contributors in some children and guide counselling, not the ASD label itself. [1]

Paediatrics Fellowship Pro

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You have read the opening of this SAQ. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship library.

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References6ShowHide
  1. [1]Hyman SL Identification, Evaluation, and Management of Children With Autism Spectrum Disorder Pediatrics, 2020.PMID 31843864
  2. [2]McCracken JT Risperidone in children with autism and serious behavioral problems N Engl J Med, 2002.PMID 12151468
  3. [3]Owen R Aripiprazole in the treatment of irritability in children and adolescents with autistic disorder Pediatrics, 2009.PMID 19948625
  4. [4]Bearss K Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: a randomized clinical trial JAMA, 2015.PMID 25898050
  5. [5]King BH Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: citalopram ineffective in children with autism Arch Gen Psychiatry, 2009.PMID 19487623
  6. [6]Dawson G Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model Pediatrics, 2010.PMID 19948568
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