Behavioural + neurodevelopmental disorders in childhood Flashcards
What is a neurodevelopmental deisorder?
abnormality in brain function that affect:
- behaviour
- memory
- ability to learn
onset in the developmental period (before age 7)
Name some neurodevelopmental disorders
intellectual disability
specific learning disability - dyslexia, dyscalculia
communication disorders - speech and sound disorder, fluency disorder
motor disorders - tics, developmental coordination disorder (dyspraxia)
autism spectrum disorder
attention deficit hyperactive disorder
Triad of impairment in ASD
social interaction
communication
activities + interests
Features of social interaction in ASD
appears unresponsive
absent/unusual eye contact
does not make friends with peers
does not spontaneously share interest or enjoyment
Features of communication in ASD
unusual or repetitive language
delayed or impoverished language development
does not play ‘make-believe’ or ‘pretend’
cannot initiate or sustain conversation
Features of activities and interests in ASD
unusual or repetitive gestures or actions
pre-occupation with narrow interests
rigid routines
fascination with object parts
ASD presenting features in preschool age
poor eye contact
no interest in peers
speech delay or absent
no pretend play
repetitive play
ASD presenting features in school age
no friends, wanders around at playtime
abnormal speech development
can’t cope with routine change
repetitive topics of interest
repetitive behaviours eg. flap hands
ASD presenting features in adolescents
difficulty with peer relationships
monotonous voice
literal interpretation of language, difficulty understanding jokes
narrow range of interests
strengths eg. technology
Describe sensory processing differences in people with ASD
can experience hypersensitivity or hyposensitivity to stimuli
altered sensitivity to:
- sights
- sounds
- smells
- tastes
- touch/textures
- balance (vestibular sense)
- body position + movement (proprioception)
- internal body cues + sensations (interoception)
Which syndromes are associated with ASD?
Fragile X
Retts
Trisomy 21
Williams syndrome
Tuberous sclerosis
Neuromuscular disorders
Environmental factors associated with ASD
increasing parental age
prematurity (<35w)
maternal alcohol, valproate
Common comorbidities of ASD
sleep disorders
ADHD
epilepsy/tic disorders
learning disabilities
aggression/self harm
mental health problems - anxiety, depression
constipation
ADHD triad
inattention
hyperactivity
impulsivity
ADHD subtypes
hyperactive-predominant
inattentive-predominant
Biological risk factors for ADHD
preterm
epilepsy comorbidity
strong FH
maternal substance misuse in pregnancy
acquired brain injury
other neurodevelopmental disorders
Adverse outcomes associated with undiagnosed ADHD
impact on self-esteem
impact on learning
disruptive behaviour
poor social skills
impact on siblings + family
school exclusions
challenging behaviour
substance abuse
youth offending
complex learning difficulty
ADHD common comorbidities
anxiety
depression
other neurodevelopmental disorder
sensory problems
bipolar disorder
conduct disorder
eating disorders
speech + communication difficulties
ADHD management
1st line = non-pharmacological:
- parent training
- school intervention, behavioural techniques
- sleep hygiene advice
pharmacological:
- stimulants
- non-stimulants
- melatonin for sleep
Name some stimulant ADHD medications
methylphenidate
lisdexamfetamine
(probably work by blocking reuptake of dopamine and noradrenaline)
Name some non-stimulant ADHD medications
atomoxetine
guanfacine
(selective noradrenaline reuptake inhibitors)
