Child abuse and autism

[Dr. USMLE]

I know the textbook answers on this...but in your expert opinions, what are the major behavioral issues exhibited by (1) children in abusive households and (2) autistic children? Please help

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[Fastball32]

I know the textbook answers on this...but in your expert opinions, what are the major behavioral issues exhibited by (1) children in abusive households and (2) autistic children? Please help

Pretty hard to give you a generalized answer that applies to these patients.

1) Abuse
Kids who have been physically or sexually abused often have a form of PTSD. Rather than intrusive thoughts or nightmares, they will re-enact their abuse (i.e. being physically aggressive to family or peers, or sexually act out).
There's also a thing called the "MacDonald's Triad". It was based on Conduct/Antisocial patients who had homicidal ideations. They were found to have higher rates of Fire-setting, Animal curelty, and Bed-wetting. The idea was that the humiliation related to abuse often led to a displacement/externalization of their anger towards those with less power than them.

One clinical pearl are children who have suffered emotional abuse/neglect. Often these kids/adults will have pathological lying. Lying about irrelevant things. You can imagine how a child who is often promised things (Dad - "I'll take you out for ice cream next week". Then this doesn't happen. Child subconsciously accepts that lies are acceptable and re-creates this in other relationships).

2) Autism
Unless you specialize in a PDD or Child Psych clinic, Psychiatrists will see Autistic children when they become difficult to manage or extremely emotional.
Risperdal and Abilify are approved for Aggression in children with autism. There's evidence that low-dose SSRI's help with the ritualized/repetitive behaviors in Autism. Ruling out ADHD/concentration difficulties due to poor school performance. Children with delays are at higher risk for abuse from the care-giver due to frustration.

Not sure if I helped you with your question but responding with some thoughts.

 

[Dr. USMLE]

Pretty hard to give you a generalized answer that applies to these patients.

1) Abuse
Kids who have been physically or sexually abused often have a form of PTSD. Rather than intrusive thoughts or nightmares, they will re-enact their abuse (i.e. being physically aggressive to family or peers, or sexually act out).
There's also a thing called the "MacDonald's Triad". It was based on Conduct/Antisocial patients who had homicidal ideations. They were found to have higher rates of Fire-setting, Animal curelty, and Bed-wetting. The idea was that the humiliation related to abuse often led to a displacement/externalization of their anger towards those with less power than them.

One clinical pearl are children who have suffered emotional abuse/neglect. Often these kids/adults will have pathological lying. Lying about irrelevant things. You can imagine how a child who is often promised things (Dad - "I'll take you out for ice cream next week". Then this doesn't happen. Child subconsciously accepts that lies are acceptable and re-creates this in other relationships).

2) Autism
Unless you specialize in a PDD or Child Psych clinic, Psychiatrists will see Autistic children when they become difficult to manage or extremely emotional.
Risperdal and Abilify are approved for Aggression in children with autism. There's evidence that low-dose SSRI's help with the ritualized/repetitive behaviors in Autism. Ruling out ADHD/concentration difficulties due to poor school performance. Children with delays are at higher risk for abuse from the care-giver due to frustration.

Not sure if I helped you with your question but responding with some thoughts.

Thanks...that was very helpful. Definitely some stuff I never learned in med school, like the term MacDonald's triad and the pathological lying.