Childhood Disorders Flashcards
When do neurodevelopmental disorders occur?
Manifest in early childhood
What impairments do the developmental deficits produce?
Personal, social, academic
Generally lifelong, but can be subject to maturational changes
What are the developmental disorders we study?
Intellectual disability (ID)
Specific Learning Disorder (SLD)
Autism Spectrum Disorder (ASD)
Attention deficit/Hyperactivity Disorder (ADHD)
What are the DSM V criteria for intellectual disability?
A- Deficits in intellectual functioning (reasoning, problem solving, planning, learning, judgement)
B - Deficits in adaptive functioning that result in failure to meet developmental & social standards for personal independence and social responsibility (communication, social participation, independent living, across multiple environments)
C - onset of intellectual and adaptive deficits during the developmental period (early childhood)
What is the definition of intellectual disability?
Intellectual and adaptive functioning deficits in conceptual, social and practical domains.
How do you test for deficits in intellectual functioning for ID?
Use standardized intelligence tests to estimate intelligence (IQ)
What is the cutoff for an IQ test?
IQ of 70
Who conducts IQ tests?
Psychologist or trained professional
How do you test for deficits in adaptive functioning for ID?
Rating scales - what a child can do independently or with assistance (conceptual skills, social skills, practical skills)
Parent, teacher, caregiver, family members complete the form.
What are the different types of ID you can get?
Mild, Moderate, Severe, Profound
What are the symptoms of ID?
Fails to meet developmental level of independence in daily life
Communication, social, independence
Deficit in intellectual functioning
Usually agrees with everything that is said
What is mild ID?
IQ range of 50-55 to 70
Often cannot distinguish from non-ID until they attend school
Learn more slowly, but develop academic skills
What is moderate ID?
IQ range 35-40 to 50-55 Progress minimally in academic skills Develop good self-care skills Perform simple tasks Unskilled/semiskilled jobs with supervision
What is severe ID?
IQ range from 20-25 to 35-40
Learn to talk & develop basic self-care skills
Often live in group homes/with families
What is profound ID?
IQ below 20-25
Require constant care
Understand some language, little ability to talk
Neurological conditions accounting for disability
What causes ID? (etiology)
Genetic disorders
Acquired brain injury
What is Autism Spectrum Disorder?
Affects communication (verbal/non-verbal), social skills and hevhaviour. There is a spectrum --> wide range of differences Signs and symptoms vary with age & over time
What are the different levels of ASD?
Mild, moderate, severe
What are the DSM V criteria for ASD?
A - persistent deficits in social communication & social interaction across multiple contexts, as manifested by the following:
1 - Deficits in social emotional reciprocity e.g. abnormal social approach & failure of normal back-and-forth conversation, reduced sharing of interests, emotions, affect. Failure to initiate or respond to social interactions.
2 - Deficits in non-verbal communicative behaviours used for social interaction e.g. poorly integrated verbal/non-verbal communication, abnormalities in eye contact & body language, deficits in understanding the use of gestures, lack of facial expressions & non-verbal communication.
3 - Deficits in developing, maintaining and understanding relationships. E.g. difficulties adjusting behaviour to suit various social contexts, difficulties sharing imaginative play or making friends, absence of interest in peers.
B - Restricted, repetitive patterns of behaviour, interests or activities; as manifested by at least two of the following, currently or in history:
1 - Stereotyped or repetitive motor movements, use of objects or speech (e.g. simple motor stereotypes, lining up toys, echolalia)
2 - insistence on sameness, inflexible adherence to routines or ritualized patterns of verbal or non-verbal behaviour (e.g. extreme distress at small changes, difficulties with transitions, rigid thinking patterns, need to eat the same food everyday)
3 - highly restricted, fixated interests that are abnormal in intensity or focus (e.g. strong attachment to/preoccupation with unusual objects, excessively circumscribed or preservative interests)
4 - hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling/touching objects, fascination with lights or movement.)
C - symptoms must be present in early developmental period
D - symptoms cause clinically significant impairment in social, occupational or other important areas of current functioning
E - symptoms are not better explained by intellectual disability
What disorder frequently occurs with ASD?
ID
Describe the cognitive functioning of ASD.
Intellectual is extremely varied
50-70% have ID
Ranges from ID to genius
Non-autistic ID = typically even intellectual profile
Autistic = uneven profile with lower verbal than performance scores
25% = special talents
5% = autistic savants (geniuses)
What is the etiology of ASD?
Maternal age, genetic, teratogen, unknown
How do you assess ASD?
Clinical/developmental interview Assessment for comorbid medical conditions/mental health issues Standardized cognitive testing Behavioural observations Rating scales
Describe specific learning disorder.
A specific difficulty in an academic skill which is significantly below overall cognitive ability.
When is the onset of specific learning disorder?
Onset during formal schooling (may be seen earlier)
List the DSM criteria for specific learning disorder.
A - difficulties learning & using academic skills, as indicated by the presence of at least one of the following symptoms have persisted for at least 6 months, despite provision of interventions that target those difficulties:
1 - inaccurate/slow/effortful word reading
2 - difficulty understanding the meaning of what is read
3 - difficulties with spelling
4 - difficulties with written expression
5 - difficulties with mastering number sense, number facts of calculation
6 - difficulties with mathematical reasoning
B - the affected academic skills are substantially & quantifiably below those expected for the individual’s chronological age, and cause significant interference with academic/occupational performance or activities of daily living (confirmed by individualized standardized achievement measures & clinical assessment)
C - The learning difficulties begin during school-age years but may not become full manifest until the demands for those affected academic skills exceed the individual’s capacity (e.g. timed tests, complex reports)
The learning difficulties are not better accounted for by intellectual difficulties, uncorrected visual or auditory acuity, other mental or neurological disorder, psychosocial adversity, lack of adequate academic instruction.
What are the academic domains that are impaired?
Reading - word reading accuracy, reading rate/fluency, reading comprehension
Written expression - spelling accuracy, grammar/punctuation accuracy, clarity or organization of written expression
Mathematics - number sense, memorizing arithmetic facts, accurate or fluent calculation or math reasoning
List the severities of specific learning disorder.
Mild, moderate, severe
Name essential features of ADHD
Inattention/hyperactivity - impulsivity that interferes with functioning/development
Inattention - wander off task, lack persistence, can’t sustain focus, being disorganized
Hyperactivity - excessive motor activity (running about, fidgeting, tapping, talkativeness)
Impulsivity - social intrusiveness, decision making without considering long term consequences
List the DSM criteria for ADHD.
A persistent pattern of inattention and or hyperactivity-impulsivity that interferes with functioning or development, as characterized by 1 or 2.
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/occupational activities
- careless or not pay attention to detail
- difficulty sustaining attention in tasks/play activities
- seems not to listen when spoken to directly
- difficulty organizing tasks or activities
- often avoids/dislikes or reluctant to engage in tasks that require sustained mental effort
- often loses things necessary for task/activities
- easily distracted by extraneous stimuli
- often forgetful in daily activities
List the DSM criteria for ADHD.
A persistent pattern of inattention and or hyperactivity-impulsivity that interferes with functioning or development, as characterized by 1 or 2.
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/occupational activities
- careless or not pay attention to detail
- difficulty sustaining attention in tasks/play activities
- seems not to listen when spoken to directly
- difficulty organizing tasks or activities
- often avoids/dislikes or reluctant to engage in tasks that require sustained mental effort
- often loses things necessary for task/activities
- easily distracted by extraneous stimuli
- often forgetful in daily activities
2 - hyperactivity or impulsivity: six or more of the following symptoms, persisting for at least 6 months to a degree that is inconsistent with developmental level & negatively impacts on social and academic/occupational activities:
- often fidgets, taps hands/feet, squirms in seat
- often leaves seated situations when remaining seated is expected
- often runs or climbs when inappropriate
- often unable to play or engage in leisure activities quietly
- often on the go/driven by a motor
- often talks excessively
- often blurts out answers before question complete
- often has difficulty waiting his/her turn
- often interrupts/intrudes on others
Inattentive or hyperactive impulsive symptoms prior to 12 years
Present in two or more settings
Clear evidence the symptoms interfere with, or reduce the quality of social, academic or occupational functioning
Not better explained by another mental disorder
What do you need to specify for ADHD?
Combined presentation
Predominantly inattentive presentation
Predominantly hyperactive/impulsive presentation
List the severity of ADHD types
Mild, moderate, severe
List some inattention symptoms of ADHD.
Careless Doesn't listen Doesn't follow through Forgetful Can't organize Avoids/dislikes tasks requiring sustained effort Loses important items Difficulty sustaining attention in activity Easily distractible
List the symptoms of hyperactivity in ADHD.
Squirms & fidgets Can't stay seated Runs/climbs excessively Can't play/work quietly On the go Talks excessively
List the symptoms of impulsivity of ADHD.
Blurts out answers
Can’t wait turn
Intrudes/interrupts others
What co-occurs with ADHD?
Autism, ID
