Unit 1 Clinical PresentationAsperger’s Syndrome
Presenter: Dr. Susana mwanza & Dr. Jonathan NcheengamwaModerator: Dr. Mpabalwani
24/11/2011
• L.F.• Female/6 yr old• Of Chilanga• Referred to UTH for Neurological Assessment• Presented to UTH on 13/10/2011 at• 09.00hrs
c/o
• Regression of speech• Inappropriate behaviour 4 6/12• Inappropriate communication • Difficulties in concentration• Hyperactivity 12/12• Not able to construct sentences
However able to read and write single words
Hx P/C
• Well till age 2• First noted change was loss of speech
developmental mile stone previously appropriately developed
PMHx
• RVT-NR• No other illneses
Birth Hx
• 1st born• Term• SVD• 3.6kg• Cried spontaneously• Pregnancy and labour uncomplicated
Feeding and <5 hx
• Breast fed in under 2hrs after birth• Weaning at 4 months• Received all vaccinations according to MOH
protocol
FHx
• Negative• No TB contact• No hx of Psychiatric disease
Socio-economic Hx
• Mother-House wife• Father-planner
examination
• Temp 35.3 deg. Celsius• Wt-22kg• Ht 123cm• Fully conscious• Afebile• Exhibiting inappropriate behaviour with• Occasional screeming
Examination
• RS• CVS Normal• P/A
Problem
• Delayed neuro-psycho-social development
Plan
• Consult neurologist and Child psychiatrist• Follow up in clinic 2 under Unit 1
Clinic 2 review (26/10/11)
• Delayed speech• Hyperactivity• Neonatal period-No jaundice• Sat by 6/12• Stood at 9/12• Able to feed self• Able to toilet self
Social Hx
• Moody• Plays alone 9even when in a group of children)• Hardly ever hugs with mum-hits her
sometimes• Sometimes hits self• Can use computer on his own and captures
new words easily• Says a word at a time
examination
• Alert• Hyperactive• Inappropriate behaviour-moving all over
examination room• No dysmorphism• Systemic exam normal• Normal testis
Problems
• Hyperactivity• Speech delay• Autistic behaviour
Review (same day0
• Noted hx of using computer beyond neurologic age
• Tends to learn things on his own• Mum says unable to sustain conversations• But, able to read
O/E
• Alert• In his own world• Not hyperactive
Diagnosis
• Asperger’s syndrome
Plan
• To UNZA School of Education for psycosocial assessment
• Review in 3/52 in clinic 2
Highlights of UNZA assessment
• Hyperactive tendencies• Not able to sit in one place• Always making sounds and statements• Did not make eye contact when being talked
to• Unable to take formal assessment• Instead, Special Needs Assessment profile
(SNAP) was administered
Diagnosis
• Autistic spectrum Disorders-Asperger’s Syndrome
Review (9/11/2011)
• Based on recommendations made at UNZA, mum was counselled
• To have child enrolled to special school (Baobab or UTH)