13. CIS Clinical Approach to Neurodevelopmental and Attention Disorders

Question 1

What disability is characterized by deficits in mental abilities such as reasoning, problem solving, abstract thinking, judgment, academic learning- which result in impairment of adaptive functioning in communication, social participation, academic/occupational functioning and personal indepedence at home or in community settings?

Answer 1

Intellectual Disability/ Intellectual Developmental Disorder

Question 2

What diagnosis is used for individuals who are unable to undergo systematic assessments of intellectual functioning: children who are too young for standardized testing, acquired insult during developmental period or severe head injury?

Answer 2

Global Development delay

Question 3

Intellectual disability is disorder w onset during developmental period that includes intellectual and adaptive functioning deficits in conceptual, social and practical domains**, diagnosis involves having the following 3: deficit in intellectual and adaptive function with an onset of?

Answer 3

deficits during developmental period

Question 4

Adaptive functioning has 3 domains, which domain involves conceptual skills, language/preacademic skills lacking, reading/writing/math lags behind others, adults: skill is typically at elementary level and support is required for work and personal life?

Answer 4

Conceptual Domain

Question 5

Adaptive functioning has 3 domains, which domain involves difficulty developing same age friends, immature in social interactions, doesnt perceive social cues, communication/conversation are less mature, etc?

Answer 5

Social Domain

Question 6

Adaptive functioning has 3 domains, which domain involves difficulty with personal care, complex daily living tasks compared to others (grocery shopping/transportation), difficulty making good decisions, need more support making health care decisions and legal ones?

Answer 6

Practical domain

Question 7

Communication disorders include language DO, speech sound DO, social (pragmatic) communication DO and childhood onset fluency DO (stuttering)- first 3 are characterized by deficits in development and use of language, speech and social communication respectively, communication disorders begin early in life and may produce lifelong?

Answer 7

functional impairments

Question 8

Assesment of speach language and communication abilities must take into account the individual’s cultural and language?

Answer 8

context

Question 9

What disorder is difficulties in acquisition and use of language across modalities (spoken, written, sign, other) due to deficits that include reduced vocab, limited sentence structure, and impairment in discourse (ability to use vocab and connect sentences)?

Answer 9

Language disorder

Question 10

What disorder is difficulty with speech sound production (mechanics such as tongue/vocal cord), preventing verbal communication, causes limitations in effective communication, onset of sx during developmental period, difficulties not attributable to congenital/acquired abnoramlities?

Answer 10

Speech sound disoder

Question 11

childhood onset fluency disorder is aka as what, which causes speech issues along with anxiety about speaking, onset during developmental?

Answer 11

Stuttering

Question 12

What communication disorder is difficulties in social use of verbal and nonverbal communication manifested by deficits in using communication for social, impairment of ability to change communication to match contex of situation, difficulties following rules for conversation/storytelling, and understanding what is not explicity stated- deficits result in functional limitation in effective communication*****?

Answer 12

Social-Pragmatic Communication Disorder

Question 13

Social-Pragmatic Communication Disorder has a primary difficulty with social use of language and communication, MC assoc feature is *delay in reaching language milestones, milder forms of disorder may not be apparent until adolescence when language/social interactions become?

Answer 13

More complex

Question 14

What disorder is characterized by the following: deficits in social communication and interaction across multiple contexts including deficits in social emotional reciprocity, nonverbal communication, developing/maintaining and understanding relationships, have restricted repetitive pattersn of behavior/interests/activites maniffested by highly restricted fixated interests that are abnormal in intesnity or focus, and *HYPERreactivity to sensory input?

Answer 14

Autism Spectrum Disorder

Question 15

Severity of autism is based on social communication impairments and restricted, repetitive patterns of behavior: level 3-requiring very substantial support, Level 2- requiring substantial support, level 1=?

Answer 15

Requiring support

Question 16

The most consistently useful behavioral intervention for austism is education and support for parents, siblings, teachers and caregivers, learning about what and learning how to use it is helpful too- which involves joining the pts process and doing it with them? (ex: theyre steering the wheel, grab wheel and do it with them)

Answer 16

Parallel process

Question 17

Medications for autism include risperidone (causes prolactin issues) and aripiprazole for irritability and agitation, gabapentin and other meds can help.

Answer 17

MEOW

Question 18

ADHD in children from 8-15- 8.7% met criteria for ADHD, but only 37% had medication treatment during the year, females with ADHA present more commonly with the inattentive subtype than boys do, less disruptive behavior in females with ADHD may contribute to referral bias causing under identification and lack of?

Answer 18

treatment for females with ADHD

Question 19

Adult ADHD is 4% of the US which is 4/100. Comorbidity is common with mood disorders, anxiety disorders, substance disorders and intermittent explosive disorder… More females than males with ADHD received treatment for mental/substance abuse. What is a comorbidity syndrome triad which includes Tics (lasting longer than 1 year), OCD, and ADHD?

Answer 19

Tourette’s Syndrome Triad (conceptual-not diagnosis)

Question 20

What is a childhood onset characterized by motor and vocal tics that are longer than 1 year, a neuropsychiatric spectrum disorder associated with OCD, ADHD, with boys being more likely to have tics and ADHD while girls are more likely to have OCD?

Answer 20

Tourette’s Syndrome Triad

Note: tics are exacerbated by stimulant meds for ADHD

Question 21

Executive functioning is the ability to assess a situation, prioitizing what is relevant vs not, filtering out extraneuous information, make a plan how to act, execute the plant, and assess effect of action in a fluid manner, so if someone had problems with these tasks it would be due to a dysfunction within which cortex, primarily due to deficiency of what two NTs?

Answer 21

Prefrontal cortex due to deficiency in dopamine and norepinephrine

Question 22

The most consistent cross study and cross modality data identifying a region as dysfunctional in ADHD has been identified as the dosal anterior? (daMCC)

Answer 22

Midcingulate Cortex (daMCC)

Question 23

In diagnosing ADHD, children should have 6 or more and adults over 17 should have 5 or more symptoms including: fails to pay attention to close details, cant sustain attention, does not listen, struggles to follow instructions, difficult with organization, loses things, easily distracted, forgetful… all of these are involved in what type of ADHD?

Answer 23

Inattentive Type

Question 24

In diagnosing ADHD, children should have 6 or more and adults over 17 should have 5 or more symptoms including: fidgeting, cant remain seated, runs about or climbs excessivly/ restlessness, cant engage in activites quietly, driven by a motor, talks excessively, blurts out answers before questions completed, difficultly waiting turns… all of these are involved in what type of ADHD?

Answer 24

Hyperactive Type

Question 25

TOVA = tests of variables of attention is used to diagnose ADHD- hardware on computer that takes 14 mins, shorter test for young children. What is task oriented computerized assessment of attention related problems in individuals 8+- 15 mins to complete on laptop?

Answer 25

Conners Continuous Performance Test

Question 26

What age group is the following american academy of pediatrics guidelines for?… prescribe evidence based parent and or teacher administered behavior therapy as the first line treatment (no drugs), and prescribe what if the behavior therapy does not provide significant improvement and child continues to have mod/sev symptoms

Answer 26

Preschool aged 4-5

Question 27

What age group is the following american academy of pediatrics guidelines for?… Prescribe FDA approved medications for ADHD and or evidence based parent/teacher administered behavior therapy as treatment for ADHD although preferably both the med and therapy

Answer 27

Elementary school aged 6-11

Question 28

What age group is the following american academy of pediatrics guidelines for?… prescribe FDA approved meds for ADHD with the assent of the adolescent, and may prescribe behavior therapy as treatment for ADHD although preferably both should be used

Answer 28

Adolescents 12-18

Question 29

Guanfacine and clonidine are alternatives to stimulants based on their ability to modulate noradrenergic tone in the PFC, what drug is an antidepressant that may increase the risk of seizures*?

Answer 29

Bupropion

Question 30

What motor disorder is the acquisition and execution of coordinated motor skills substantially below average (clumsiness/ slowness/inaccurate/cant catch things), which significantly and persistently interferes with activities of daily living , onset during early development- motor skills deficits not explained by intellectual disability?

Answer 30

Developmental Coordination Disorder

Question 31

What motor disorder is characterized by repetitive, seemingly driven, and purposeless motor behavior (body rocking/hand shaking) which interferes with social academic and other activites, and can injure the patient, specifcied as mild/mod/severe, associated with a known medical or genetic condition, neurodevelopmental DO, or environmental factor (lesch nyhan synd, intellectual disability)?

Answer 31

Stereotypic Movement Disorder

Question 32

A tic is a sudden rapid recurrent nonrhythmic motor movement or vocalization. What syndrome is classified by the following… multiple motor tics and one+ more phonic tics at some time during illness, tics must occur many times a day, every day, location and frequency of tics must change over time, onset before 21?

Answer 32

The Tourette Syndrome (tourette’s disorder)

Question 33

Tourette’s disorder/syndrome has many comorbidities which include ADHD, OCD, mood disorders/suicide risk, and anxiety disorders, disruptive behaviors, learning diabilities/poor school performance and what disorder?

Answer 33

Sleep disorders

Question 34

Haloperidol/Pimozide and what are tx for tourettes disorder and the only approved drugs in the US but may cause TD, dopamine depleters, antipsychotics are not approved but can help?

Answer 34

Aripiprazole