50: Neurodevelopmental Disorders

Question 1

developmental window

Answer 1

specific time in early life when brain is activey shaped by environmental input

Question 2

critical period vs sensitive period

Answer 2

1. critical period: environmental input is required for proper development of a particular brain circuit
2. sensitive period: environmental input has the greatest inpact on brain circuitry (looser than critical period)

Question 3

for all neurodevel disorders but motor, what is a big dx criteria

Answer 3

must be present before child enters grade school

Question 4

intellectual disability**

Answer 4

have to have functioning deficits in 3 domains: conceptual, social, practical

Question 5

conceptual domain of an intellectual disability

Answer 5

reasoning, problem solving, planning, abstract thinking, judgement

Question 6

social domain of an intellecual disability

Answer 6

making same-aged friends, reading social cues, conversation and language, difficulty regulating emotion in social situations, gullible

Question 7

practical domain of intellecual disability

Answer 7

difficulty with personal care, making good decisions about health and well being

Question 8

global developmental delay

Answer 8

meet observable dx criteria for intellectual disability disorder but cannot participate in standardized testing (too young, TBI, etc.)

Question 9

four communication disorders

Answer 9

1. language disorder
2. speech sound and fluency disorder
3. social communication disorder
4. Childhood-onset fluency disorder (Stuttering)

Question 10

language disorder

Answer 10

difficulty with spoken, written, and sign language; reduced vocab and sentences are incomplete, negatively impact functioning

Question 11

speech sound disorder

Answer 11

difficulty making speech sounds -> limits verbal communication, social participation, etc. not due to other condition or limited opportunity for language acquisition

Question 12

childhood onset fluency disorder (stuttering)

Answer 12

difficulty with fluency and patterns of speech sound - prolongations, pauses, word substitutions to avoid problematic words

Question 13

social communication disorder

Answer 13

difficulty with social use of verbal and non-vrbal communication - issues with: sharing info appropriately, speaking differently in different settings/to different people, taking turns in conversation, difficulty understanding references/humor/metaphors

Question 14

when does social communication disorder typically become apparent

Answer 14

early adolescence

Question 15

seven features of autism

Answer 15

1. deficits in social-emotional reciprocity
2. deficits in nonverbal communication
3. deficits in developing, maintaining, and understanding relationships
4. repetitive motor movements or speech
5. insist on sameness, routines, rituals
6. highly restricted range of interests
7. abnormal reaction to sensory input (hyper or hypo-reactivity)

Question 16

core neurophysiologic feature in autism***

Answer 16

sensory integration deficits

Question 17

salience network vs default mode network in autism

Answer 17

1. salience network: evaluating salient socio-emotional stimuli + mediates interactions with environment
2. default mode network: mediates internally-directed processes, involved in directing attention to internal mental events (Develops faster + larger than salience network in autism)**

Question 18

stimming

Answer 18

use of highly repetitive behavior such as: finger flapping/ finger rubbing, rolling hems of clothes, walking on toes, spinning, twirling

Question 19

two things that best differentiate autism from intellectual disability**

Answer 19

restricted interests, repetitive behaviors

Question 20

two drugs FDA approved to tx irritability/agitation in autism**

Answer 20

risperidone, aripiprazole

Question 21

ADHD

Answer 21

deficit in the ability to gain, sustain, or shift focus

Question 22

girls and ADHD

Answer 22

less likely to have the disorder recognized bc less disruptive behavior means less referral for help + more commonly have the inattentive subtype

Question 23

comorbidities with ADHD, esp one big one

Answer 23

1. Big one: Tic disorders

2. others: mood DOs, anxiety, SUD, intermittent explosive disorder

Question 24

what can bring out tics in pt with ADHD?

Answer 24

stimulant medications

Question 25

Tourette’s syndrome Triad

Answer 25

Tourettes + ADHD + OCD

Question 26

executive function deficit

Answer 26

problems with: assessing situations, prioritizing, filtering extraneous info, developing a plan of action, executing a plan to completion

Question 27

where in the brain is executive function deficit targeted?**

Answer 27

prefrontal cortex

Question 28

what causes executive function deficit in ADHD**

Answer 28

deficiency in dopamine and norep

Question 29

how many dx criteria does one need to make the dx of ADHD

Answer 29

6+ Sx (5+ in adults 17+)

Question 30

three tests for ADHD

Answer 30

1. TOVA
2. Conners continuous performance test
3. vanderbilt

Question 31

Kids 4-5 with ADHD Tx plan

Answer 31

1. behavior management

2. methylphenidate if therapy doesnt work

Question 32

Kids 6-11 with ADHD Tx plan

Answer 32

1. ADHD med + behavior management together

Question 33

Kids 12-18 with ADHD Tx plan

Answer 33

1. ADHD med +/- behavior management

2. get consent from the teen

Question 34

three types of motor disorders

Answer 34

1. developmental coordination disorder
2. stereotypic movement disorder
3. tic disorders

Question 35

developmental coordination disorder

Answer 35

problems with motor skills - clumsy, hard to catch objects and use scissors, difficult with writing, riding bike, sports

Question 36

stereotypic movement disorder

Answer 36

repetitive, compulsive, purposeless motor behavior - hand shaking, body rocking, head banging, self-biting, self-hitting

Question 37

tic

Answer 37

sudden, rapid, recurrent motor movement or vocalization

Question 38

Tourette’s vs persistent motor or vocal tic disorder

Answer 38

1. Tourettes: both vocal and motor tics

2. Motor or Vocal tic disorder: only motor or only vocal tics

Question 39

Tourette’s onset must be before which age

Answer 39

18

Question 40

comorbidities with tourette’s disorder

Answer 40

ADHD, OCD, anxiety, mood disorders, risk of suicide, sleep disorders

Question 41

how long do tics have to occur to be dxed with motor/vocal tic disorder

Answer 41

1+ year