Childhood Learning And Neuropsychiatric Disorders Flashcards

1
Q

What are primary determinants of dyslexia?

A

Disruptions to posterior regions

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2
Q

What are the two models of dyslexia?

A
*Visual processing model
Surface: 
-word reading impaired/sounding out unimpaired 
-impairment if orthographic skills
-visual and visuo-perceptual problems

Deep:

  • sounding out words impaired
  • impaired auditory/language skills
  • phonological skills impaired

*Phonological loop

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3
Q

PM: what is impaired and what is intact with dyslexia?

A
Difficulty with:
Word-decoding
Slow & non-automatic reading
Identifying and comprehending words
Phonological processing (+ naming speed deficit)

Preserved:
Syntax, intelligence, reasoning, vocab
Listening comprehension

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4
Q

PM: what are the 3 aspects and the model’s hypothesis?

A
  • Phonological processing
  • Word-decoding
  • Naming speed

Double deficit hypothesis: reading disabilities are deficits in either phonological or naming speed

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5
Q

What two working memory systems are thought to be involved with dyslexia?

A

Articulatory phonological loop: temp buffer for maintaining + manipulating verbal + auditory behavior

Visuospatial sketchpad: temp buffer for visuo and visuo-spatial info

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6
Q

What are the 3 proposed reading-related systems?

A

Left dorsal P-T areas
Left ventral O-T region
Left Broca’s area

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7
Q

What are the differences between a reading-spelling disability and nonverbal learning disability?

A
  • Psycholinguistic skills: RS=weak, NVLD=strong
  • Visual and tactile perception, psychomotor and non-verbal/novel problem solving: RS=preserved; NVLD=poor
  • Academics: RS=poor reading/spelling, mechanical arithmetic competent but below avg; NVLD=poor basic arithmetic, sight word reading intact
  • Arithmetic performance: RS=poor because of verbal deficits; NVLD=poor due to visual-perceptual and non-verbal
  • Dysfx: RS=LH; NVLD=RH
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8
Q

What neurological areas are involved in Dyslexia?

A

Genetics (‘chromes’ 6 and 15)
Planum temporale of L post. temp. lobe (phonological processing)
Regional abnormality (less activation in LPT and T-P cortices)
CBF to region surrounding planum temporale (Wernicke’s & angular gyrus) = reading performance
Abnormal development of L planum temporale (neuronal ectopias & cytoarchitectonic dysplasia)

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9
Q

NVLD: Neuropsychological pathogenesis

A

RH (posterior, possibly anterior - mental flexibility, white matter tracts connecting F and RH)

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10
Q

RH organization

A

diffuse
more association regions
greater inter-regional integration of info
more adept at processing complex, novel or ambiguous info

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11
Q

Pervasive developmental disorders (4 criteria)

A

Must show impairment in 1 or more:

  1. Social interactions
  2. flexibility in behaviour
  3. verbal and non-verbal language
  4. range of interests and activities
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12
Q

Autism: are males more affected than females?

A

Male 2:1 - 6:1

  • *Males naturally have more vasopressin and low oxytocin (females have more oxytocin - more likely to bond with others/make eye-contact)
  • *Males externalize symptoms (commonly co-morbid with ADHD); females internalize (more comorbid with anxiety/depression)
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13
Q

Autism: 3 core deficits

A
  1. Ability to relate to others
  2. Deficits in communication
  3. Unusual behaviour patterns
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14
Q

Autism: Ability to relate to others

A
"autistic aloneness"
Often exhibit: joint attention deficits (inability to see from someone else's PoV)
poor conversational skills
lack of eye contact 
inappropriate facial expressions
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15
Q

Autism: Deficits in communication

A

Minimal development in symbolic play
Delayed-onset of language
Restricted
Issues understanding/utilizing non-verbal
could see: echolalia, pronoun reversal, neologisms

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16
Q

Autism: Unusual behaviour patterns

A

Preoccupation
Specificity
Routine NB
Stereotypic body movements (rocking, hand-flipping etc)

17
Q

Autism: pathogenesis

A
  • Environ: perinatal complications, NOT vaccine
  • Genetic: 20 possible genes (15q11-13) sib. study
  • Bigger head circumference
  • Growth profile = warning sign (small brain, accelerated 1-2 & 6-14, declines)
  • Neural substrates (Social mind network; atypical white-to-grey; hyperserotonaemia)
18
Q

Autism: What neural substrates are implicated?

A
  • Hyperseratonemia (25-50%) increased seratonin
  • Cortical and subcortical regions
  • Social brain network (theory)
  • Atypical white-to-grey matter ratio
19
Q

Autism: Social brain network

A
O and medial PF cortices
Anterior cingulate
Amygdala
Superior temporal sulcus
Fusiform face area
20
Q

What are explanatory theories of autism?

A

Theory of Mind

Executive Dysfunction theory (‘stuck in set’ perseveration)

21
Q

Controversy regarding Disruptive Behavioural disorders

A

Overprescription of ritalin (kinds are naturally very energetic, should not be used in place of parenting/discipline)
- difference between not understanding and not WANTING to understand

22
Q

ADHD: clinical presentations

A

Chronic, age-inappropriate inattention, impulsivity & hyperactivity

  • across situations
  • developmental origin (before school and typically persists)
23
Q

ADHD: What happens when conduct disorder persists into adulthood?

A

Now fits into category of antisocial personality disorder

24
Q

Theory for why more boys diagnosed with ADHD?

A

(3:1-9:1)
Boys more likely to externalize; might be because socially regarded as more acceptable for boys to play ‘rough’ (remember by word boisterous)

25
Q

ADHD: ODD?

A

Oppositional defiant disorder: chronic age-inapprop angry mood and resistant, stubborn behaviours

26
Q

ADHD: CD?

A

Conduct disorder: repeated violations of rights of others + societal norms

27
Q

ADHD: pathogenesis

A

frontal lobes not symmetrical (R>L)
disruption in frontal-BG circutry
Smaller cerebellum
Major cortical/subcortical regions (4 foci in research/disruptions of transmission)

28
Q

ADHD: tx

A

Behavioural intervention
Pharmacology

Multimodal (tailored, targets impulsivity, inattention, hyperactivity, more difficult when comorbid, continuity across contexts of intervention is NB for its success - teachers, parents etc)

29
Q

Tic disorders and its 2 classifications

A

Repetitive, stereotypic, non-rhythmic, recurring motor movements or vocal responses in brief duration (<1sec)

  • Simple: more reflexive (blinking, face twitch)
  • Complex: appears more coordinated/purposeful (repeating others’ speech, obscene words)
30
Q

Tic: 3 classifications of clinical presentation

A

Transient: motor OR vocal tics (1-12m)
Chronic: m OR v (>1y)
Tourette’s (GTS): 1 m AND v AND clinically significant impairment

31
Q

GTS: clinical presentation

A

Copropraxia: obscene gestures
Echopraxia: repeat other’s movements
Coprolalia: inappropriate/obscene speech
Echolalia: repeat other’s words

32
Q

GTS: pathogenesis

A

Genetics
Changes in NT intrinsic to frontostriatal pathways (Da) frontal=disinhibition issues (dopamine, specifically in substantia nigra)
Environment has been found as etiological factor (toxic exposure in mining areas)
Alterations to brain structure/metabolic activity

33
Q

GTS: tx

A

-Behav mod: trigger identification (CBT)
habit reversal training (smile/frown)
-Pharmacology: dopamine agonists prescribed (but side effects)
contraindicated meds for GTS and adhd (antipsychotics, anti-epileptic, ADHD meds)

34
Q

GTS: prevalence and co-morbidity

A

Boys (4:1), no ethnic preference, school 1/1000

ADHD and OCD, behavioural problems, anxiety, mood disorders (depression), learning and sleeping difficulties

35
Q

ADHD: developmental course

A

Infancy: active, overly responsive, low adaptability, anger
Toddler-preschool: constantly busy/shifting activities, failure to follow/listen, disregard for consequences, diff to handle (esp. defiant)
High school: interferes with learning, frustration, peer & family judgement
Adult: greater regulatory control = reduction of symptoms of inattention, impulsivity, hyperactivity: but could persist