4-12 Developmentally Diasabled Flashcards
What are the DSM-V Disorders usually first diagnosed in infancy, childhood or adolescence?
- Intellectual Disability
- Communication Disorders
- Autistic Spectrum Disorders
- Specific Learning Disorders
- Feeding and eating disorders of infancy or early childhood
- Tic disorders
- Separation Anxiety Disorder
- Attention-deficit and disruptive behavior disorders
What is intellectual disability?
- Deficits in intellectual functions such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, learning from experience confirmed by intellectual testing and clinical evaluation
- Failure to meet developmental and sociocultural standards for independence and responsiblility
- Onset in the developmental period and not due to a trauma or other organic cause
What are the levels of intellectual disability?
- Mild IQ of 50 to 55-70
- Moderate IQ of 35 to 40-50 to 55
- Severe IQ of 20 to 25-35 to 40
Profound - Level below 20 to 25
What are some major birth defects that cause intellectual disabiltiy?
- Down’s Syndrome - Mainly trisomy 21 single palmar transverse crease, protruding tongue, flat facies, small ears, thick neck
- Tay Sach, error on inborn metabolism
- Untreated PKU
- Fragile X Syndrome - FXS- Xq27 the fragile site Affects males more severely delayed cognitive abilities, behavior problems, hand flapping, large ears, elongated faces and enlarged testicles.
What are some aspects of clinical management of intellectual disability?
- Placement issues (mainstreaming)
- Supportive counseling and training in behavioral techniques for the family
- Medication management (if indicated)
What is a learning disorder? What does it include?
- Inability to achieve in a specific area of learning at a level consistent with the person’s overall IQ
- Includes:
▫Reading
▫Mathematics
▫Written expression
What are learning disorders of comorbid with?
•Often comorbid with other disorders such as conduct disorder, oppositional defiant disorder, mood disorder, substance abuse, ADHD, and truancy.
What does Tx of learning disorders include?
•Treatment includes:
▫Remedial instruction
▫Supportive counseling for child and family
What are the main problems with autistic spectrum disorder?
- Impaired social interactions
- Impaired ability to communicate
- AND, a restricted range of activities and interests
What are some epidemiological factors with autism?
- Onset in the first 3 years of life
- Prevalence of 10-15 cases per 10,000 individuals
- Boys are 4X as likely to have autistic disorder than girls
- No empirical evidence to link autism with environmental toxins, vaccines, etc.
- Good prognostic indicators are higher IQ and better language and social skills
What are some characteristics of Asperger Syndrome?
- Relatively good verbal language
- Milder nonverbal language problems
- Restricted range of interests and relationships
- Often engage in repetitive routines
What is the etiology of autism spectrum disorders?
- Theory is that it is a brain dysfunction with abnormalities in brain structure (including the cerebellum and cerebral cortex – frontal and temporal lobes),
- And, abnormalities in neurotransmitters such as serotonin and dopamine
- It is likely that genetic factors play a role
Children with autistic spectrum disorders are helped by…?
▫Well-structured classroom and home routines
▫Individualized instruction
▫Behavior modification techniques
What happens with Rett’s syndrome?
- Rett’s Syndrome - mainly in girls
- Normal development to age 4 then:
▫decreased social, verbal and cognitive skills
▫Hand wringing
▫Ataxia
▫Decreased IQ
What happens in childhood disintegrative disorder?
•Childhood Disintegrative Disorder
▫rare condition
▫Normal development to age 2 to 10, then they lose those skills
▫More common in boys
What are some criteria for feeding and eating disorders of infancy or early childhood?
- Failure to eat adequately with failure to gain weight or loss of weight over at least one month
- Not due to associated GI or other general medical condition
- Not better accounted for by another mental disorder or lack of available food
- Onset before age 6
How do some children appear with feeding and eating disorders of infancy or early childhood? Epidemiology?
may appear apathetic
- Equally common in girls and boys
- Research indicates about a 3% rate
- Children with this disorder may develop to be smaller than their peers
What factors affect feeding and eating disorders of infancy or early childhood?
- Parent-child interaction problems my contribute to or exacerbate the feeding problem
- Factors may include:
▫Temperament
▫Intrauterine growth retardation
▫Preexisting developmental impairments
What do Tic disorders include?
▫Tourette’s Disorder
▫Chronic motor or vocal tic disorder
▫Transient tic disorder
What is the epdiemiolgy of Tourette’s disorder? How long does it last?
- 5-30 per 10,000 children have this disorder
- Median age of onset is 6-7 years, but can be seen as early as 2 years
- Seen more often in boys (3-5 X) than girls
- Duration may be lifelong or may resolve with adulthood
What are the symptoms of Tourette’s disorder? How is it treated?
- Involuntary Motor Movements & Vocal Tics (Dopamine in Caudate Nucleus)
- More frequently in boys: starts age 8
- Vocal tics - barking, profanity, grunting
- Motor tics - facial grimacing or blinking
- Rule out pure Motor Tic Disorders or pure Vocal Tic Disorders
- Treat with antipsychotics
What is chronic motor or vocal tic disorder?
- Either motor or vocal tics, but not both
- Probably Tourette’s and chronic motor or vocal are related genetically
What are the characteristics of transient tic disorder?
- Presence of single or multiple motor or vocal tics, for no longer than 12 months
- Essential features are the same as Tourette’s, except the duration must not surpass 12 months
What are the characteristics of separation anxiety disorder? How common is it?
- Also known as School Phobia or School Refusal
- Fear of loss of a major attachment figure
- They complain of physical symptoms so they do not have to leave their mom.
- Treated with Selective Seratonin Reuptake Inhibitors, (antidepressants) & therapy with good results. Anxiety disorders are often in the family.
4% of School Age Children
