B7-047 Childhood Developmental Disorders Flashcards
childhood developmental disorder causing cognitive impairment
intellectual disability
childhood developmental disorder causing social/communication impairement
autism
childhood developmental disorder causing motor impairment
cerebral palsy
intelligence is substantially below average
important limitations in adaptive function
intellectual disability
cut off for IQ < 70
intellectual disability
(also must have limitations in function to be classified as this though)
intellectual disability must onset before age
18
(if after 18, it is called dementia)
for IQ, the average is set to […] and the standard deviation is set to […]
100
15
(<70 is two SDs below normal)
IQs between […] and […] are considered borderline for intellectual disability
70 and 84
mild intellectual disability IQ is between […] and […]
50-69
often not noticed until school age
reading and writing typical of a child 9-12
often become independent
mild intellectual disability
moderate intellectual disability IQ is between […] and […]
35-49
delayed speech development
usually require life-long partial support
moderate intellectual disability
severe intellectual disability IQ is between […] and […]
20-34
profound is below 20, requires complete life-long support
most common identified cause of intellectual disability in males
Fragile X syndrome
most common toxin exposure causing intellectual disability
lead
impaired socialization detected before age 3
autism
restricted interests with stereotyped behavior
autism
about what percentage of individuals with autism have intellectual disability?
more than half
why is early identification of autism important?
SPED can lead to improvements with age
preferences for routine and restricted behavior patterns
autism
theories about increasing prevalence of autism [3]
changing definition
improved recognition
true epidemic
[males/females] are more commonly affected by autism
males
4:1 ratio
humans understand the mental state of others and are able to explain and predict the behaviors of others
theory of mind
(autism)
generally, humans prefer faces over objects
however, people with autism can have an abnormal gaze in social situations due to lack of
mutual attention
what species of animal has evolved to share mutual attention?
(i.e. looking when pointing?)
dogs
(idk this might’ve been a “fun fact” who knows”
by definition, autism present before age
3
baby does not turn when called by name
does not attend to person/object of other people’s attention
early signs of autism (12-18 months)
around what age is Asperger syndrome diagnosed?
school age
functional imaging defects commonly noted in autism [3]
orbitofrontal cortex
anterior cingulate cortex
amygdyla
(impaired decision making, socialization, ect)
is there a genetic component to autism?
yes, strong concordance in monozygotic twins
but probably polygenetic
many forms are likely X-linked
autism
encephalopathy acquired before age 3
cerebral palsy
manifested by disorder of movement or posture
cerebral palsy
spasticity
hyperreflexia
upgoing toes
spastic cerebral palsy
(can be further subtyped by pattern: diplegia, hemiplegia, quadriplegia)
cerebellar symptoms
ataxic cerebral palsy
rigidity
abnormal involuntary movements
dyskinetic CP (affecting the basal ganglia)
most common pattern of CP
spastic
least common pattern of CP
ataxic
what percentage of CP patients have intellectual disability?
30-50%
15-60% of patients associated with epilepsy
CP
major risk factor for CP
preterm birth
why is it difficult to determine where the lesion is in babies?
will just have generalized hypotonia
involution of the germinal matrix is complete by […] weeks gestation
32 weeks
produces neurons and glial cells which populate the cerebral cortex
germinal matrix
most cases of GMH/IVH occur within […] of life
the first week
approximately 50% in the first day
who is at high risk of GMH/IVH?
neonates < 32 weeks gestation
birth weights under 1500 g
highly vascularized layer within the subventricular zone
germinal matrix
bleeding into ventricles due to reduced glial fiber support and impaired autoregulation of BP in premature infants
neonatal intraventricular hemorrhage
second most common CNS complication in preterm infants
periventricular leukomalacia
caused by ischemia in the watershed territory of the preterm infant
periventricular leukomalacia
ischemia in watershed zone affects
oligodendroglia
myelination is impaired
fibers to the […] are selectively impaired by periventricular pathology
legs
(causes spastic diplegia CP)
what causes the spastic diplegia pattern of CP?
fibers to the legs are selectively impaired by periventricular pathology in preterm infants
where are the watershed zones in the term babies/adult brain? [2]
area between ACA-MCA zones
area between PCA-MCA zones
what causes spastic quadriplegic CP?
term brain hypoperfusion of watershed areas
what causes spastic hemiplegic CP?
vascular injury in MCA distribution
areas of the brain that are selectively vulnerable to hypoperfusion
watershed zones
(differ in preterm vs term brain)
what layer of the cerebral cortex is selectively vulnerable to pure hypoxia?
layer 3
areas of the brain that are selectively vulnerable pure hypoxia
cerebral cortex
basal ganglia
purkinje cells of cerebellum
pure hypoxia of the cerebral cortex causes
intellectual disability
pure hypoxia of the basal ganglia causes
dyskinetic CP
pure hypoxia of the purkinje cells causes
ataxic CP
bilirubin induced neurologic dysfunction
kernicterus
what area of the brain is selectively vulnerable to kernicterus?
basal ganglic
(causes of dyskinetic CP)
most common form of CP
spastic
spastic CP is caused by damage to the […] tract
corticospinal
ataxic CP arises from damage to the […] system
cerebellar
dyskinetic CP arises from damage to the […] system
basal ganglia
what is theory of mind?
the ability to infer what someone else is thinking
theory of mind is missing in […]
autism
specific learning issue within a specific domain
learning disability
