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psycopathology > Block 3- Neurodevelopmental Disorders part 1 > Flashcards

Block 3- Neurodevelopmental Disorders part 1 Flashcards

1
Q

What are the 2 categories of brain dysfunction?

A
  1. Neurodevelopmental disorders- onset in the developmental period
  2. Neurocognitive disorders- onset in later life
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2
Q

Why are patients not a checklist of symptoms ?

A
  • Clinical summary of social, psychosocial, biological factors
  • Importance of patient’s distress or impairment in social, occupational, important areas of daily living
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3
Q

When are neurodevelopmental disorders onset?

A

Onset in the developmental period

Present during early childhood, typically before child enters grade school

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4
Q

What may result from developmental deficits ?

A
  • Developmental deficits producing impairment of personal, social, academic or occupational functioning
  • not due to visual/ audition/ neurological problems, lack of/inadequate academic instruction
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5
Q

Describe the range of Neurodevelopmental Disorders

A
  • Range of disorders frommspecifuc limitations to global impairments
  • in some disorders, the clinical presentation includes symptoms of excess as well as deficits and delays in achieving expected milestones
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6
Q

Give the epidemiology of Intellectual disability

A
  • about 1% in high income countries
  • 2 to 4% in low to middle income countries
  • More prevalent in males than females
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7
Q

What are the diagnostic Criteria of intellectual disability?

A
  1. Deficits in intellectual functioning
  2. Deficits in adaptive functioning that lead to limitations in communication, social participation, independent living across multiple environments (home, school, work, community)
  3. Begins before 18 years
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8
Q

How are deficiencies in intellectual functioning confirmed?

A
  1. Clinical assessment

2. Standardized intelligence testing

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9
Q

Give an example of standardized intellectual assessment

A

Wechsler intelligence test (versions for adult and children)

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10
Q

What is the normal range for results from a standardized intelligence assessment?

A

100 SD= +/- 15

Neurotypical IQ= 85-115

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11
Q

At what point of results is standardized intellectual disability diagnosed?

A

An IQ score at least 2 SD below the mean

-Score 70 or below +/- 5

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12
Q

Explain the Deficits in adaptive functioning in intellectual disability

A
  • Failure to achieve developmentally appropriate daily living skills in atleast one of the following domains:
    • Conceptual (e.g. academic skills)
    • Social (e.g. relational skills)
    • practical (e.g. self management skills)
  • Assessed using a standardized rating scale:
    • Vineland Adaptive Behavior Scales
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13
Q

What are the classifications of intellectual disability?

A

Mild

Moderate

Severe

Profound

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14
Q

Describe the “Mild” classification of intellectual disability and it’s conceptual

A

About 85%

IQ=. 50-69

Mental age= 9-12

Conceptual- functional ay 6th grade level

  • Detected in middle school
  • Difficulty doing abstract and egocentric thinking
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15
Q

Describe the socialization and dailies living skills of a “ MILD” intellectual disability

A

Socialization: immature social interactions and judgement

Daily living skills: appropriate personal care

-Needs support with complex tasks

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16
Q

Describe the “Moderate” classification of intellectual disability including the conceptual

A

Moderate

About 10%

IQ= 35-49

Mental age = 6-9 y/old

Conceptual:

  • detected at a younger age
  • Developmental delays
  • Marked lag in cognitive skills
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17
Q

Describe the socialization and Daily living skills of “Moderate” intellectual disability

A

Socialization:

  • Limitation in communication and socialization
  • Aware of their limitations —> feel alienated, frustrated

Daily living skills:

  • Varying degrees of support to live and work in the community
  • maladaptive behavior —> self injury
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18
Q

Describe the classification of intellectual disability(based on adaptive function) “Profound” including conceptual

A

Profound

-about 1-2%

IQ= less than 20

Mental age is less than 3

Conceptual:

-Motor or sensory impairments limit functioning

19
Q

Describe the classification of intellectual disability including socialization and daily living skills in profound

A

Socialization :
-Nonverbal —> gestures, emotional cues

Daily living skills:

-Severe limitation in self care, continence,communication and mobility

20
Q

Explain the etiology and management of Intellectual Disability

A

Cause of intellectual disability is usually known

Examples:

  1. Genetic disorders (fragile X, Down’s Syndrome)
  2. Prenatal complications(fetal alcohol syndrome)
  3. Perinatal injury (anoxia)
  4. Acquired medical conditions (head injury)

Management:

  1. Family education
  2. Behavioral therapy
21
Q

What are the diagnostic criteria for Specific learning disorders ?

A
  1. Difficulty learning and using academic skills

AND

  1. Academic skills less than expected for age
22
Q

Explain the diagnostic criteria “difficulty learning and using academic criteria” for specific learning disorders

A

At least one symptom for atleast 6 months

  • Slow/inaccurate/effortfulbword reading
  • Difficulty understanding meaning of what is read
  • difficulty spelling
  • Difficulty with written expression
  • Difficulty with numbers/calculation
  • Difficulty with mathematical reasoning
23
Q

Explain the diagnostic criteria “Academic skills less than expected for age “ for specific learning disorders

A

Academic skills less than expected for age
-Causes significant interference with academics/ occupation/ daily living

  • Confirmed with standardized tests and clinical assessment
  • Present during school age when demands > capacity
24
Q

What are the specifier of Specific learning disorders?

A
  1. Impairment in reading (dyslexia )
  2. Impairment in written expression
  3. Impairment in mathematics (dyscalculia )
25
Q

What is the severity of Specific learning disorders based on?

A

Based on how many academic sub levels (e,g, spelling, reading, comprehension) are affected and how much support is needed

26
Q

What is the epidemiology of Specific learning disorders?

A

Epidemiology:

  • 3% to 9% school age population
  • 4% adults
  • Males more prevelant than females
27
Q

What are the risk factors of specific learning disorders?

A
  • Genetics (60% heritability)
  • Very low birthweight weight/prematurity
  • Prenatal exposure to nicotine
28
Q

How are specific learning disorders managed?

A
  • early intervention to lessen effects

- Learning strategies to compensate

29
Q

What are the requirements of communication disorders before diagnosis? (not diagnostic criteria)

A

Children must have a mastery of multiple aspects of language:

- Understand and express ideas using speech 
- Express themselves in vernacular language

Domains of language competence:
Phonology- produce sounds, discriminate various sounds
Grammar - organization of words, placing words in sensible order
Semantics- organization of concepts, acquisition of words
Pragmatic- use of language, rules of conversation

30
Q

What are the domains 9f languange competence?

A

Domains of language competence:
Phonology- produce sounds, discriminate various sounds
Grammar - organization of words, placing words in sensible order
Semantics- organization of concepts, acquisition of words
Pragmatic- use of language, rules of conversation

31
Q

What are communication disorder types?

A
  1. Language disorder
  2. Speech disorder
    • Speech sounds disorder
    • Childhood-onset fluency disorder
  3. Social(pragmatic) communication disorder
32
Q

What are the diagnostic criteria of Language Disorder?

A
  1. Persistent difficulty in acquisition and use of language across modalities(speaking, reading, writing, singing, etc.,)

There is:

  • decreased vocabulary
  • limited sentence structure
  • impairments in conversing (limited vocabulary, cannot connect sentences)

AND

  1. Language ability below expectations for age (typically present before 4 years)
33
Q

What is Speech Sound Disorder?

A

-Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication

Blue —> bu
Rabbit —> wabbit

  • speech should be intelligible by 3-4 years old
  • Milder cases spontaneously recover by age 8
  • With speech therapy, almost all cases completely recover
34
Q

What are the diagnostic criteria for Childhood-onset fluency disorder?

A
  1. Persistent disturbances in the normal fluency and time patterning of speech that are inappropriate for age and level of language skill
    -Sound and syllable repetitions
    • Sound prolongation of consonants and vowels
    • Broken words
    • Blocking- pauses in speech
    • Words produced with excessive tension.
    • Monosyllabic whole -word repetitions (e.g., “I-I-I- see him”)
      AND
  2. The disturbance causes anxiety about speaking or limits effective communication
35
Q

When is Communication disorder-childhood fluency-onset usually diagnosed?

A

Usually diagnosed by 6 years old

-May not be present during oral reading, singing or talking to inanimate objects

36
Q

How many recover from Communication disorder childhood-onset fluency?

A

80% recover without intervention before 16 ye@rs old

37
Q

What are the diagnostic criteria of Social (pragmatic) communication disorder?

A
  1. Persistent in the social use of verbal and non verbal communication (all 0f the following)
    • Deficits in using communication for social purposes (greeting, sharing info)
    • Impairment in ability to change communicati9n to match context
    • Difficulty following the rules for communication
    • Difficulty understanding implicit meanings

AND

  1. The deficits result in functional limitations in effect8ve communication that interferes with soc8al, academic, occupational performance

Diagnosis rarely made before 4-5 years old

38
Q

What are Tic Disorders?

A

Tics are motor movements of vocalizations that are sudden, rapid, recurrent, non-rhythmic and involuntary

Examples:
Motor
A) sample - eye blink
B) complex- gestures, sequence of movements

Vocal:
A). Sample -throat clearing
B) complex- linguistically-meaningful utterances

39
Q

What are the diagnostic criteria for Tourette’s disorders?

A
  1. Multiple motor tics AND at least one vocal tic sometime during the illness
  2. Symptoms last over a year
  3. Onset is before 18 years and not due to another cause
40
Q

What is the etiology of Tourette’s disorder?

A

A genetic disorder with over-activity of dopamine

41
Q

How can Tourette’s disorder be treated?

A

Psychotherapy:

  • stress reduction (to decrease tic frequency)
  • coping strategies (e.g., “masking”/disgusting tics)

Pharmological: if required —> dopamine receptors blockers (antipsychotics)

42
Q

What is “Tourette’s triad”?

A

Tourette’s disirder can be associated with OCD and ADHD

43
Q

Give 2 other Tic disorders aside from Tourette?

A
  1. Persistent motor or Vocal Tic a Disirder
    - Mood OR vocal tics present during illness, not both motor and vocal

-Tics May wax and wane in frequency but persist for over 1 year since onset

  1. Provisional tic disorder
    • Motor and/or vocal tics
    • Tics are present for under 1 year since first tic onset

psycopathology (23 decks)

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