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Continuing Medical Education - Quiz 1

1. Identification of autism prior to age 3…




The correct answer is D. Autism can be identified as early as 18 months of age. Early identification and intervention can make a significant difference in the development of children with autism. Delays in referral can negatively impact their development.

2. What is the most common pediatric condition?




The correct answer is A. Of the disorders listed, autism is the most common. The prevalence of autism has been reported between to be as much as 1 in 166 children (6/1,000) to 1 in 294 children (3.4/1,000). Down syndrome occurs in 1 out of 800 births, hearing loss (1.1 per 1,000), and childhood cancer 1.5 per 10,000 children.

3. Myths about children with autism include…




The correct answer is D. With early intervention, children with autism do show growth and improvement. Children with autism can make eye contact, but they often lack a social purpose behind their look. They can also show affection but it may be in their own way.

4. The prevalence of autism may be as much as…




The correct answer is A. The prevalence of autism has been reported between to be as much as 1 in 166 children (6/1,000) and 1 in 500 (2/1000). A study conducted by the CDC found the rate of autism in a metropolitan city to be 3.4 per 1,000 children.

5. Autism spectrum disorders include…




The correct answer is D. The autism spectrum disorders include a range of diagnoses. These disorders include Autism, Rett syndrome, Asperger’s syndrome, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (NOS).

6. The MMR vaccine…




The correct answer is C. There have been fears that a link existed between the use of thimerosal, a mercury-based preservative used in the measles-mumps-rubella (MMR) vaccine, and autism. Although mercury is no longer found in childhood vaccines in the United States, some parents still have concerns about vaccinations. Many well done, large-scale studies have now been done that have failed to show a link between thimerosal and autism.

7. Recommendations from the American Academy of Pediatrics on autism include everything, EXCEPT…




The correct answer is B. There have been fears that a link existed between the use of thimerosal, a mercury-based preservative used in the measles-mumps-rubella (MMR) vaccine, and autism. Many well-done, large-scale studies have now been done that have failed to show a link between thimerosal and autism.

8. Developmental signs for autism could include...




The correct answer is D. By six months, a child should be smiling or expressing happiness. By nine months, a child should be reciprocating smiles, sounds, and facial expressions. By 12 months, a child should be babbling, pointing, or gesturing. By 16 months, a child should be speaking in single words. By 24 months, a child should be using two-word phrases.

9. Intensive early intervention…




The correct answer is C. Well-implemented programs can brighten a child’s future and the impact a developmental disorder has on the family. It can lead a child to greater independence, enable that child to be included in his/her community, and offer him/her a more productive and fulfilling life.

10. Identify the myth about social problems that children with autism might have.




The correct answer is B. Children with autism can look at or through you, but eye contact has no social purpose.

11. Language delays may not be as severe in children with…




The correct answer is C. As in the other autism spectrum disorders, children with Asperger’s syndrome show qualitative impairment in social interaction, restricted repetitive and stereotyped patterns of behavior, and significant impairment in important areas of functioning. However, these patients do not have a significant general delay in language.

12. Examples of repetitive behaviors among children with autism include…




The correct answer is D. By six months, a child should be smiling or expressing happiness. Some children and older individuals spend a lot of time repeatedly flapping their arms or walking on their toes. Some suddenly freeze in position. They might spend hours lining up their cars and trains in a certain way, rather than using them for pretend play. Repetitive behavior sometimes takes the form of a persistent, intense preoccupation.

13. All of the following are examples of joint attention interactions EXCEPT…




The correct answer is A. Joint attention is defined as the ability to coordinate one’s own attention between an object and another person to indicate a need or to share interest. Problems with joint attention can be a sign for autism. Dividing attention between two books is not an example of joint attention.

14. Some conditions that might be associated with autism include...




The correct answer is A. One in four children with ASD develop seizures, often starting either in early childhood or adolescence. Fragile X syndrome affects about two to five percent of people with ASD. One to 4 percent of people with ASD also have tuberous sclerosis. There does not seem to be an association of neurofibromatosis or lupus with autism.

15. About their child’s development and behavior…




The correct answer is B. Parents are usually the first to notice unusual behaviors in their child. While parents may not know what is afflicting their child, they know that something is wrong. The key is to listen to their concerns and explore their situation with appropriate questions.

16. Cultural differences in children with autism…




The correct answer is D. While parental concerns are often highly predictive of developmental delay, clinicians cannot wait for parents to bring up concerns. Some parents do not provide any information specific to their child’s social interactions unless probed by their clinician.

17. The areas of difficulty in autism include…




The correct answer is D. All children with ASD demonstrate deficits in 1) social interaction, 2) verbal and nonverbal communication, and 3) repetitive behaviors or interests. In addition, they will often have unusual responses to sensory experiences, such as certain sounds or the way objects look. Each of these symptoms runs the gamut from mild to severe. They will present in each individual child differently.

18. Developmental screening…




The correct answer is B. The American Academy of Pediatrics has recommended that in the context of the medical home, pediatricians should monitor all areas of development at each well-child visit. They should be especially vigilant when there are deficits in language and social skill development.

19. Screening instruments for autism…




The correct answer is B. The Checklist of Autism in Toddlers (CHAT), the modified Checklist for Autism in Toddlers (M-CHAT), and the Screening Tool for Autism in Two-Year-Olds (STAT) are instruments that might not identify children with high-functioning autism. The Autism Spectrum Screening Questionnaire (ASSQ) and the most recent, the Childhood Asperger Syndrome Test (CAST), are some of the instruments that are reliable for identification of Asperger syndrome or higher functioning autism.

20. The acronym A.L.A.R.M. stands for…




The correct answer is A. A.L.A.R.M is an acronym that stands for Autism is prevalent, Listen to parents, Act early, Refer, and Monitor. The American Academy of Pediatrics Autism Task Force developed this approach.

21. Intensive early intervention has…




The correct answer is C. Early diagnosis of autism spectrum disorders (ASD) is critical for a number of reasons, perhaps most importantly because interventions to improve the functioning of children with ASD may be more effective with younger children. Evidence suggests that early treatment optimizes long-term prognosis and that treatment yields diminishing returns, as children get older.

22. The Individuals with Disabilities Education Act (IDEA) is…




The correct answer is C. The Individuals with Disabilities Education Act (IDEA) is a Federally mandated program that assures a free and appropriate public education for children with diagnosed learning deficits. For every child eligible for special programs, each state guarantees special education and related services.

23. Treatment options for autism…




The correct answer is A. Evidence suggests that early treatment optimizes long-term prognosis and that treatment yields diminishing returns, as children get older. Beyond early intervention, there is no single best treatment package for all children with ASD. Most individuals with ASD respond well to highly structured, specialized programs.

24. Medicaid waivers…




The correct answer is B. Medicaid Waivers are state-run programs that use federal and state funds to pay for health care for people with certain health conditions. The Waiver program began in 1982, when the first Katie Beckett Waivers became part of a state’s Medicaid optional benefits allowed by the Secretary of Health and Human Services.

25. For primary care physicians…




The correct answer is D. A definitive diagnosis is not required and referrals to early intervention should be made immediately when a delay in development is suspected. The referral process to specialists can be prolonged and complicated for families. Continued guidance from their primary care provider can be of enormous benefit to patients.

 
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