Approach to Neurodeveopmental & Attention DOs Flashcards
What are the domains of intellectual disability? (3)
- Conceptual
- Social
- Practical
Neurodevelopmental DO’s must develop before ______ and produce impairments in _______, _______, _______ or _______.
Must manifest early in development, before grade school & produce impairments of personal, social, academic or occupational functioning.
What are tow diagnostic tools for identifying intellectual disabilities?
- Denver Developmental Screening Tool (DDST)
2. Wechsler Intelligence Scale for Children 5th Ed. (WISC-V)
What is global developmental delay?
A child too young to undergo standardized testing for Intellectual Disability DO but meet the observed criteria. They may have acquired an insult during development (i.e. severe head injury)
Subcategories for communication DO? (4)
- Language DO
- Speech sound DO
- Social (pragmatic) communication DO
- Childhood-onset fluency DO - stuttering
What communication DO?: Pt. who has difficulty with interpreting spoken or written words, sign language &/or pictures.
Language DO
*not due to hearing/sensory impairment, motor dysfunction, neurologic condition, or language barrier
What communication DO?: Pt. who has difficulty articulating words, vocal tones, connecting words fluently.
Speech Sound DO
*not due to limited language acquisition
What communication DO?: Pt. who is not able to convey thoughts and feelings verbally or nonverbally primarily with the social use of language.
Social (Pragmatic) Communication DO
*not due to a dx of autism spectrum DO
What communication DO?: Pt. who has difficulty with word fluency and patterns of speech SOUND causing pauses with a word, monosyllabic whole-word repetitions (“I-I-I-I see him”)
Childhood-onset fluency DO (stuttering)
*not due to defect or motor sensor deficit.
A 6 yo male presents with his parents because they say he is more difficult in raising than his brother. They explain he is hard to communicate with, seems distant, & it is hard to get him to corporate. Upon talking to the boy, he is fixated on toy in his hands, he refuses to make eye contact and he overreacts to a loud phone alarm. Dx?
Autism Spectrum DO
**difficulty with sensory integration (including emotion)
In diagnosing ADHD, do girls or boys more commonly present with an inattentive subtype?
Girls
Usually also less disruptive -> referral bias and difficulty in identifying and treating females with ADHD
What clinical triad of comorbidities of ADHD can present in children?
Tourette’s syndrome triad
- symptoms of ADHD + OCD + Tourette syn.
**tics can be exacerbated by ADHD meds (stimulants)
In ADHD, what biochemically is dysfunctional within the brain?
Executive function deficit from processing dysfunction within the dorsal anterior midcingulate cortex (daMCC) of the prefrontal cortex.
Primarily due to deficiency of DA and NE
What are the two subtypes of ADHD?
- Inattentive type
2. Hyperactive type
Diagnostic tools for ADHD? (2)
- Computerized tests (TOVA & Conners Continuous Performance Test)
- Standardized Checklists (Vanderbilt & Conners)
What are the American Academy of Pediatrics (AAP) clinical practice guidelines for preschool-aged children (4-5 years of age)?
- Behavior therapy as first line tx
2. methylphenidate if BT does not provide sig. improvement
What are the American Academy of Pediatrics (AAP) clinical practice guidelines for elementary school-aged children (6-11 years of age)?
- Prescribe FDA approved meds for ADHD &/or behavior therapy
What are the American Academy of Pediatrics (AAP) clinical practice guidelines for adolescents (12-18 years of age)?
- Prescribe FDA approved meds
What are the three types of motor disorders?
- Developmental coordination DO
- Stereotypic movement DO
- Tic DO
What motor DO?: Pt who is clumsy, has problems with motor skills, like riding a bike and handwriting, to a point that it interferes in self-care, self-maintenance and interferes in school, leisure and activities.
Developmental coordination DO
** Not attributable to a neurological condition or degenerative DO
What motor DO?: Pt who has a compulsive or repetitive urge to move without purpose. Sometimes they shake or wave their hand, rock their body or head bang without reason. It interferes in their social and academic life.
Stereotypic movement DO
What motor DO?: Pt who has these sudden, rapid, recurrent, nonrhythmic motor movements or vocalizations.
Tic DO
What are the dx criteria for Tourette’s Syn
Multiple motor and phonic tics present either
- many times a day nearly every day
- intermittently throughout a period of more than 1 year
before person is 18
What are some comorbidities of Tourette’s Syn.? (7)
- ADHD
- OCD
- Anxiety DO
- Mood DOs and risk of suicide
- Disruptive behaviors
- Learning DOs and poor academic performance
- Sleep DOs
Meds for Tourette’s Syn.?
- Antidopaminergic
- Dopamine depleters
- Antipsychotics
- Alpha adrenergic agonists
- Botulinum toxin injections
- Anticonvulsant agents
