Chapter 13- Neurodevelopmental And Neurocognitive Disorders

Question 1

What is the difference between Axis 1 & 2?

Answer 1

Axis 2 – lifelong disorders- born with and will work on for your whole life
Axis 1 – time-limited- acquired

Question 2

What is Developmental psychopathology?

Answer 2

Study of how disorders arise and change with time

Disruption of early skills can affect later development

Question 3

What are Neurodevelopmental Disorders?

Answer 3

Diagnosed first in infancy, childhood, or adolescence

Question 4

Examples of Neurodevelopmental Disorders

Answer 4

Attention deficit hyperactivity disorder (ADHD)
Specific learning disorder
Autism spectrum disorder
Intellectual Disability
Communication and Motor Disorders

Question 5

What is Childhood Onset Fluency Disorder?

Answer 5

Speech difficulty that may include repeated syllabus (stuttering), pauses or substituting words that are easier to pronounce “Studdering”

Question 6

What is Language Disorder?

Answer 6

Limited speech in all situations; understanding of speech is normal and problem may self-correct “delayed language”

Question 7

What is Social (Pragmatic) Communication Disorder?

Answer 7

Difficulty with social aspects of communication (e.g., dominating conversations, switching topics excessively), but lacks other features of autism spectrum disorder (e.g., restrictive behaviors and interests) “don’t have the other parts of Autism”

Question 8

What is Tourette’s Disorder?

Answer 8

Involuntary motor movements and/or vocalizations, which may include obscenities

Question 9

Nature of ADHD

Answer 9

Central features – inattention, overactivity, and impulsivity

Question 10

What is the criteria in the DSM-5 for ADHD?

Answer 10

1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
   Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.
   (a) Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities; (b) often has difficulty sustaining attention in tasks or play activities; (c) often does not seem to listen when spoken to directly; (d) often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace; (e) often has difficulty organizing tasks and activities; (f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort; (g) often loses things necessary for tasks or activities; (h) is often easily distracted by extraneous stimuli (for older adolescents and adults, may include
   unrelated thoughts); (i) is often forgetful in daily activities.

Question 11

What is the criteria in the DSM-5 for ADHD Con’t?

Answer 11

2. Hyperactivity and impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
   Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.
   (a) Often fidgets with or taps hands or feet or squirms in seat; (b) often leaves seat in situations when remaining seated is expected;
   (c) often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless.)
   (d) Often unable to play or engage in leisure activities quietly. (e) Is often “on the go,” acting as if “driven by a motor.” (f) Often talks excessively. (g) Often blurts out an answer before a question has been completed. (h) Often has difficulty waiting his or her turn. (i) Often interrupts or intrudes on others.
   B. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years.
   C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings.
   D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.
   E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder, substance intoxication, or withdrawal.

Question 12

The Causes of ADHD: Biological Contributions

Answer 12

Genetic contributions:
ADHD seems to run in families
DAT1 – dopamine transporter gene has been implicated
Some ADHD drugs work by inhibiting DAT1

Neurobiological correlates of ADHD:
Smaller brain volume
Inactivity of the frontal cortex and basal ganglia
Abnormal frontal lobe development and functioning

The role of toxins:
Food additives (e.g., dyes, pesticides) may play very small role in hyperactive/impulsive behavior among children
Maternal smoking increases risk

Question 13

The Causes of ADHD: Psychosocial Contributions

Answer 13

Psychosocial factors:
ADHD children are often viewed negatively by others > Frequent negative feedback from peers and adults
Peer rejection and resulting social isolation
Such factors foster low self-esteem

Question 14

What is the goal of Biological Treatment of ADHD

Answer 14

To reduce impulsivity and hyperactivity and to improve attention

Question 15

Biological Treatment of ADHD

Answer 15

Stimulant medications:
Currently prescribed for approximately 4 million American children
Low doses of stimulants improve focusing abilities
Examples include Ritalin, Dexedrine, Adderall
Problem: May increase risk for later substance abuse

Stimulants: results in better preformance outcomes than behavioral therapy (School)
At home psycho-social intervention is better

Question 16

Biological Treatment of ADHD

Answer 16

Other medications with more limited efficacy:
Imipramine and clonidine (antihypertensive)
Genes affect individuals’ response to meds:
Some trial and error is necessary
Effects of medications:
Improve compliance, decrease negative behaviors
Do not affect learning/academics directly
Benefits are not lasting following discontinuation

Question 17

Behavioral and Combined Treatment of ADHD

Answer 17

Behavioral treatment:
Reinforcement programs 
To increase appropriate behaviors
Decrease inappropriate behaviors
May also involve parent training

Combined bio-psycho-social treatments:
Often recommended
May be superior to medication or behavioral treatments alone, but more research is needed

Question 18

Specific Learning Disorders:

Answer 18

Scope of learning disorders:
Academic problems in reading, mathematics, and/or writing
Performance substantially below expected levels based on age and/or demonstrated capacity
Problems persist for 6+ months despite targeted intervention

Question 19

Specific Learning Disorder: Types

Answer 19

With impairment in reading, may include:
Word reading accuracy
Reading rate or fluency
Reading comprehension

Question 20

Specific Learning Disorder: Types Con’t

Answer 20

With impairment in written expression, may include:
Spelling accuracy
Grammar punctuation and accuracy
Clarity/organization of written expression

Question 21

Specific Learning Disorder: Types Con’t 2

Answer 21

With impairment in mathematics, may include:
Number sense
Memorization of arithmetic facts
Accurate or fluent calculation
Accurate math reasoning