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Neurodevelopmental Disorders

Terms in this set (47)

Overview
- often manifest early in development
- deficits that are associated with impairments of personal, social, academic, or occupational functioning
- range from learning difficulties, executive function deficits, poor social skills, or limited intellectual abilities
- frequently co-occur
Neurodevelopmental Disorders
- Intellectual Disability
- Communication Disorders
- ASD
- ADHD
- Specific Learning Disorder
- Motor Disorders
- Other specified and unspecified
Intellectual Developmental Disorder
Characterized by deficits in intellectual and adaptive functioning
- deemphasis of IQ scores and promotes a focus on daily living skills and adaptive functioning
Intellectual Developmental Disorder Diagnostic Criteria
A. Deficits in intellectual functioning (reasoning, problem solving, planning, abstract thinking, judgement, academic learning, and learning from experience) confirmed by both clinical assessment and IQ testing
B. Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility
- without ongoing support, adaptive deficits limit functioning in 1+ ADL (communication, social participation, and independent living) across multiple environments (home, school, work, and community)
C. Onset of intellectual and adaptive deficits during the developmental period
Intellectual Developmental Disorder Specifiers
based on adaptive functioning, not IQ, because adaptive functioning determines level of support
IQ scores of intellectual disability
65-70 or 70 +/- 5
Intellectual Developmental Disorder vs. Neurocognitive Disorders
IDD is a neuroDEVELOPMENTAL disorder, whereas neurocognitive disorders represent a LOSS of cognitive functions (TBI)
Intellectual Developmental Disorder vs. Communication Disorder and Specific Learning Disorder
specific to communication and learning domains and do not show deficits in intellectual and adaptive functioning
Intellectual Developmental Disorder vs. ASD
IDD is common among individuals with ASD and assessment of IDD may be complicated due to communication and behavior deficits of ASD
Intellectual Developmental Disorder Common Comorbid Disorders
- ADHD
- Depressive and bipolar
- Anxiety
- ASD
- Stereotypic Movement Disorder
- Impulse Control Disorders
- Neurocognitive Disorders
Communication Disorders Overview
characterized by deficits in language, speech, and communication
- take into consideration cultural and language context, especially bilingual individuals
Language
system of symbols to convey the form and function of language
Speech
expressive sounds and articulation
Communication
verbal or nonverbal that influences the behavior or ideas of another individual
Communication Disorders
- language disorder
- speech sound disorder
- childhood onset fluency disorder
- social (pragmatic) communication disorder
- Unspecified
Language Disorder
difficulties in both the acquisition (comprehension) and use of language due to deficits in language abilities across modalities (spoken, written) which results in deficits in the areas of both receptive and expressive language
Language Disorder Differential Diagnosis
- normal variations in language development
- hearing or other sensory impairment
- intellectual disability
- neurological disorders
- language regression
Speech Sound Disorder
production of speech sounds that interferes with intelligible speech and prevents effective verbal communication
Speech Sound Disorder Differential Diagnoses
- normal variations in speech
- hearing or other sensory impairment
- structural deficits
- dysathria
- selective mutism
Childhood-Onset Fluency Disorder
disturbances in normal fluency and timing of speech (syllable repetitions, prolongations, blocks)
Childhood-Onset Fluency Disorder Differential Diagnoses
- sensory deficits
- normal speech dysfluencies
- medication side effects
- adult-onset dysfluencies
- Tourette's
Social (Pragmatic) Communication Disorder
persistent difficulties in following social rules in terms of the use of verbal and nonverbal communication resulting in functional limitations in effective communication, poorly developed social relationships, difficulties with academic achievement, or poor occupational performance
- impaired social communication, inability to adapt communicate style to situational demands
- difficulty understanding abstract communications
- lack of awareness for standards of storytelling and conversation
Social (Pragmatic) Communication Disorder Differential Diagnoses
- ASD
- ADHD
- Social Anxiety Disorder
- Intellectual Disability
Autism Spectrum Disorder Overview
deficits in social communication and social interaction and a pattern of restricted, repetitive behaviors, interests or activities that are not consistent with the individuals expected level of development
- most adequately described using severity specifiers and specifiers regarding associated features
ASD Diagnostic Criteria
A. Persistent deficits in social communication and social interactions across multiple contexts as manifested by symptoms currently or by history
B. Restricted, repetitive patterns of behavior, interests or activities, as manifested by 2+ symptoms, currently or by history
C. Symptoms must be present in early developmental period (but may not manifest until social demands exceed capacity or masked by learned strategies later in life)
D. Cause clinically significant impairment in social, occupational, or other are of functioning
E. Not better explained by intellectual disability or global developmental delay
ASD Social Communication Symptoms
1. deficits in social-emotional reciprocity (failure of normal back-and-forth conversation, reduced sharing of interests, emotions, or failure to initiate or respond to social interactions)
2. Deficits in nonverbal communicative behaviors used for social interaction (eye contact, gestures, lack of facial expressions)
3. Deficits in developing, maintaing, and understanding relationships (adjusting behavior to suit difference contexts, imaginative play, absence of interest in peers)
ASD severity based on
social communication impairments and restricted, repetitive patterns of behavior
ASD Patterns of Behavior Symptoms
1. Stereotyped or repetitive motor movements, use of objects, or speech
2. Insistence on sameness, inflexibility to routines, or ritualized patterns of verbal or nonverbal behavior
3. Highly restricted, fixated interests that are abnormal in intensity or focus
4. Hyper or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment
ASD vs. Selective Mutism
early development is not typically disturbed and the child usually exhibits appropriate communication skills in certain contexts
- social reciprocity is not impaired even when mute
- restricted patterns of behavior are not observed
ASD specifiers
- with or without accompanying intellectual impairment
- with to without accompanying language impairment
- associate with a known medical or genetic condition or environmental factor
- associated with another neurodevelopmental, mental, or behavioral disorder
- with catatonia
Attention-Deficit Hyperactivity Disorder Overview
persistent patterns of inattention and/or hyperactive or impulsive behaviors that interfere with functioning, learning, and development in general
Inattention
lack of focus, lack of persistence, distractibility, and disorganization
Hyperactivity
excessive motor activity, fidgeting, tapping, or talkativeness
Impulsivity
hasty actions without forethought that have potential harm or consequences, social intrusiveness, or making important decisions without consideration of long-term consequences
Attention-Deficit Hyperactivity Disorder Diagnostic Criteria
A. Persistent patterns of inattention and/or hyperactivity that interferes with functioning or development as characterized by inattention symptoms and/or hyperactivity and impulsivity symptoms
B. Several symptoms present before 12
C. Symptoms are present in 2+ settings
D. Evidence that the symptoms interfere with social, academic, or occupational functioning
E. Do not occur during schizophrenia or another psychotic disorder or are not better explained by another mental disorder
ADHD Inattention Criteria
6+ symptoms for 6+ months to a degree that is inconsistent with developmental level and that negatively impacts directly on social/academic/occupational activities (age 17+, only 5+):
- inattention to detail or careless mistakes
- difficulty sustaining attention in tasks or play
- does not seem to listen when spoken directly to
- does not follow thru on instructions and fails to finish schoolwork, chores, etc.
- difficulty organizing tasks and activities
- avoids or dislikes tasks that require sustained mental effort
- losing things necessary for tasks or activities
- easily distracted by external stimuli
- often forgetful in daily activities
ADHD Hyperactivity and Impulsivity Criteria
6+ symptoms for 6+ months to a degree that is inconsistent with developmental level and that negatively impacts directly on social/academic/occupational activities (age 17+, only 5+):
- fidgets with or taps hands or feet/squirms
- leaves seat insinuations when it is expected
- runs about or climbs in inappropriate situations
- unable to play quietly
- "on the go"
- talkative
- blurts out an answer before question has been completed
- difficulty waiting their turn
- interrupts
ADHD vs. ODD
resist confirming to others' demands
- negativity, hostility, and defiance
ADHD vs. Intermittent Explosive Disorder
aggression not attention problems
ADHD subtypes
- combined presentation
- predominately inattentive
- predominately hyperactive/impulsive
- in partial remission
ADHD vs. Bipolar
chronicity
Specific Learning Disorder
difficulties learning and using academic skills in the areas of reading, writing, and math
- substantially below those expected for age and cause interference with academic, occupational, or other ADL
- begin during school-age years, but may not manifest until demands are exceeded
- individual's history, school reports, and educational assessment
- DO NOT require IQ
- specify both type of learning disorder and severity
- should not be diagnosed if there is an indication that another diagnosis could account for the difficulties
- Response to intervention
Developmental Coordination Disorder
impairments in the acquisition and execution of coordinated motor skills in tasks that require fine and gross motor coordination
- interferes with performance or participation in daily activities at home, school, community, or relationships
- buttoning shirt, clumsiness
Stereotypic Movement Disorder
repetitive, seemingly driven, purposeless motor behavior
Stereotypic Movement Disorder Specifiers
- with self-injurious behavior
- without self-inujurious behavior
- associated with a known medical or genetic condition, neurodevelopment disorder, or environmental factor
- severity
Tic Disorders
sudden, rapid, recurrent, and non-rhythmic motor movements or vocalizations
- Tourette's
- Persistent motor or vocal tic disorder
- Provisional Tic Disorder
ASD v. Social (Pragmatic) Communication Disorder
both disorders are characterized by deficits in social communication, however SCD do not demonstrate repetitive patterns of behavior or catatonia
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