Review Question - QID 106890

The most likely diagnosis in this 3-year-old is an autism spectrum disorder.

According to the DSM-5, autism spectrum disorder can be diagnosed based on the following criteria:
1) Persistent deficits in social interaction or communication – in history or currently. This includes deficits in social-emotional reciprocity, non-verbal communication behaviors used for social interaction, and in developing, maintaining, and understanding relationships.
2) Restricted and repetitive patterns of behavior interests, or activities shown as two of the following: stereotyped/repetitive motor movements, speech, or use of objects; being inflexible with routines, patterns, and sameness; highly fixated, restricted focus on objects or interests; hyperactive response to sensory input or heightened interest in sensory aspect of the environment.
3) Symptoms must present in early developmental years.
4) Symptoms must affect normal function, social, or occupational aspects of life.
5) Symptoms are not a result of intellectual disability or developmental delay.

Fogleman writes that up to 75% of patients with autism spectrum disorder also display intellectual disability. He writes that autism spectrum disorders have a variety of symptoms associated with them that seem to respond to intervention. Treatment to relieve cognitive, behavioral, and social deficits should be offered to the patient as early as possible.

Newschaffer et al. suggest that genetics and environment play a role in autism, possibly through complex gene-environment interactions. No specific population effects are known, but key biomarkers have been identified and will hopefully lead to specific biologic pathways that will reveal the role of genes and environmental exposures.

Incorrect Answers:
Answer 1: Attention deficit hyperactivity is characterized by symptoms of impulsivity and hyperactivity, including failure to pay close attention to details, difficulty organizing activities, excessive talking, fidgeting, and an inability to stay seated.
Answer 2: Generalized anxiety disorder is characterized by persistent, unrealistic, and excessive worrying and tension about every day matters.
Answer 3: Bipolar disorder is typically diagnosed in older children and teens. It can occur in children of any age, however, and is associated with moods low as depression and high as mania.
Answer 4: Obsessive-compulsive disorder is a condition in which people have obsessions (recurrent, intrusive thoughts), compulsions (repetitive behaviors or mental acts aimed at reducing anxiety), or both obsessions and compulsions.