Chapter 13- Neurodevelopmental and Neurocognitive Disorders Flashcards by Tyler Pollock

Neurodevelopmental Disorders

Neurologically based disorders that clinically present during the developmental period that persist through adulthood

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Childhood Communication and Motor Disorders

Childhood-onset fluency disorder
Language Disorder
Social (Pragmatic) Communication Disorder
Tourette’s Disorder

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Childhood-Onset Fluency Disorder

Stuttering
Disturbance in speech fluency that includes repetition, prolonging sounds, pauses, and substituting words
Boys > Girls 2:1
Caused by genetics and impacts many brain pathways
Treated by parent counseling, self-monitoring, and regulated breathing to prevent stuttering

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Language Disorder

Limited speech in all situations, spoken language is much less than what is understood
10-15% fo all children less than 3, 5x more likely in boys
Caused by lack of speech modelling or ear infection
Many self-correct without treatment

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Social (Pragmatic) Communication Disorder

Difficulties with social aspects of verbal and non-verbal communication
“Autism without restrictive, repetitive behaviors”
Includes impaired verbosity and prosody; excessive switching of topics and dominating conversations
Treated with social skills training

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Tourette’s Disorder

Involuntary tics- Motor movements or vocalizations that occur in rapid succession
High comorbidity with ADHD and OCD
Treated psychologically with self-monitoring, relaxation, and habit reversal

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ADHD Description

Problems of Inattention- Difficulty sustaining attention on task or activity
Motor hyperactivity
Impulsivity
Must have inattention or hyperactivity&impulsivity for diagnosis
Leads to low academic performance and social rejection

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ADHD statistics

5.2% of the child population
Boys 2-3x more likely than girls
Presents young, hinders performance starting in school
Over half are chronic to adulthood

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ADHD causes

Genetics- Copy number variants of many genes
Dopamine, norepinephrine, serotonin, and GABA systems
Poor inhibition control
Prenatal smoking, stress, and complicated pregnancy
Smaller brain volume
Negate childhood experiences

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ADHD Treatments

Psychosocial-
Academic goal setting and reinforcement
CBT and social skills training to reduce distractibility and improve organization
Biological-
Stimulants (methylphenidate)
Non-stimulants
Reinforce attention and problem solving abilities in low doses

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Specific Learning Disorder Description

The discrepancy between IQ and performance based on age, IQ, and education
Subtypes in reading, writing, and math
Diagnose by comparing test scores or by the response to intervention strategies
Impacts 5-15% of population

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Communication Disorders

Closely related to specific learning disorder
Child-onset fluency disorder and language disorders

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Specific learning disorder causes

Genetics
Neurobiological- decreased brain areas associated with tasks
Environmental- Home reading and school habits and cultural expectations
Motivation and psychological reinforcement

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Specific learning disorder treatment

Educational intervention
Specific skill instruction
Strategy instruction
Direct instruction with strict lesson plans and teaching for mastery

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Autism Spectrum Disorder (ASD) Description

Impairments in social communication and interaction
-Issues with reciprocity and joint attention
-Problems with non-verbal communication
-Lack of initiation and maintenance of social interactions
Restricted, repetitive patterns of behavior, interests, or activities
-Maintenance of sameness
-Stereotyped and ritualistic behaviors
Presents in childhood and limits functioning

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ASD Statistics

Changed based on criteria from DSM 4 to 5
1/68 eight-year-olds (2014)
Male > Female 4-5:1
31% have intellectual disabilities

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ASD Causes

Psychosocial- Lack of self-awareness
Genetics- Moderate heritability, low oxytocin
Reduced amygdala function

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ASD Treatments

Focus on enhancing communication and daily skills
Reinforce imitation of speech
Naturalistic teaching, home-focused or with peers
Early intervention

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Intellectual Disability

Significantly below-average intellectual and adaptive functioning in conceptual, social, and practical domains
Difficulty learning and with real-world functioning
IQ less than 70

Causes

30%- no apparent cause
Environmental, prenatal, perinatal, postnatal, and biological factors

Down’s Syndrome

Extra 21st chromosome
Presents with characteristic facial features, congenital heart malformations, ID
Increased risk with higher maternal age

Fragile X Syndrome

Abnormal X chromosome structure
Primarily impacts males
Present with hyperactivity, preservative speech, and ID

Phenylketonuria (PKU)

Inability to breakdown phenylalanine
Can cause ID

Intellectual Disability Treatments

Skills training- gain independence
Task analysis- Break tasks into component parts
Communication therapy
Support within communities

Prevention of Neurodevelopmental Disorders

Early intervention Reduce maternal stress, drug and alcohol use Genetic screening

Neurocognitive Disorders

Develop Later in Life Delirium Dementia

Delerium

Impaired consciousness and cognition during the course of several hours or days Appear confused, disoriented, and out of touch, unable to sustain attention Gradual impairments in memory and language

Delerium Statistics and Causes

20% of older adults Linked with intoxication, withdrawal, infections, head injury and trauma Caused by substances, dementia, age, sleep deprivation, immobility, and stress

Delerium Treatment

Address underlying cause (if present) Substance abuse- Give antipsychotics Psychosocial intervention to cope with agitation, anxiety, and halluciantions

Delerium Prevention

Proper care for mental illnesses and drug monitoring

Mild Neurocognitive Disorder

Early stages of cognitive decline Modest impairments in cognitive abilities

Major Neurocognitive Disorder (dementia)

Gradual deterioration of brain functioning that impacts memory, judgement, language, and advanced cognitive processes Agnosia- Inability to recognize and name objects Causes emotional and behavioral changes

Dementia Statistics

More frequent in older adults Increase with age, especially over 75

Alzheimer's

Multiple cognitive defects that develop gradually and steadily Impair memory, orientation, judgment, and reasoning, ability to integrate new information Cause by plaques and tangles More prevalent in women

Vascular Disease

Progressive brain disorder following stroke in which blood vessels no longer carry oxygen to brain Marked decline in processing speed and executive function

Frontotemporal degeneration

Impact personality, language, and behavior

Pick's Disease

5% of neurocognitive disorders with similar symptoms to alzheimer's Caused by genetics with onset in 40s-50s

Traumatic brain injury

Symptoms persisting over 1 week following trauma Include executive dysfunction, learning, and memory

Lewy body disease

2nd most common dementia cause Microscopic deposits of protein damage brain cells over time Cause gradual impairments of alertness and attention, hallucinations, and motor impairments similar to Parkinson's

Parkinson's Disease

Degenerative disorder impacting basal ganglia, reducing dopamine production Characteristic motor impairments like bradykinesia, tremors, jerking, and monotone voice

HIV-1 Infections

Cause cognitive slowness, impaired attention, and forgetfulness impacting sub-cortical areas independent from other infection Can cause depression and anxiety

Prolonged Substance Abuse

Prolonged use, poor diet, and brain damage can combine to form neurocognitive deficits and memory impairments

Huntington's Disease

Subcortical deficits causing chorea (involuntary limb movements) and small cognitive defects

Prion Disease

Self-replicating proteins that damage brain cells No current treatments Creutzeldt-Jakob disease and mad cow disease

Other medical conditions that cause dementia

Hydrocephalus Hypothyroidism Brain tumors Vitamin B12 deficiency Chronic trauma encephalopathy

Dementia Treatments

Goal- Prevent conditions, delay onset, help impacted and caregivers Biological treatments- -Treat conditions with reversible etiology -Medication to improve cognition (acetylcholine breakdown inhibitors) -Antidepressants and antipsychotics Psychosocial treatments: -coping mechanisms -cognitive stimulation -Communication skills

Dementia prevention

Control blood pressure Don't smoke Active physical and social life