Clinical Approach to Neurodevelopment + Attention Disorders Flashcards
When do neurodevelopment disorders typically manifest? how are they characterized?
early in development, often before child enters grade school
characterized by developmental deficits that produce impairments of personal, social, academic or occupational functioning
What are the neurodevelopmental disorders?
Intellectual disability (intellectual development disorder)
Communication disorders (language, speech sound, childhood-onset fluency, social (pragmatic) communication)
Autism Spectrum Disorder
ADHD
Specific Learning Disorder
Motor disorders (developmental coordination, sterotypic movement, tic)
Intellectual disability (intellectual developmental disorder) is characterized by deficits in:
general mental abilities:
- reasoning
- problem solving
- planning
- abstract thinking
- judgement
- academic learning
- learning from experience
The deficits in general mental abilities of intellectual disability result in what?
impairment of adaptive functioning (communication, social participation, academic or occupational functioning, personal independence at home or in community settings)
Global development delay dx is used for who?
individuals who are unable to undergo systematic assessments of intellectual functioning
aka too young to participate in standardized tests, acquired insult during developmental period, severe head injury
What are the two main deficits seen in intellecutal disabillity?
intellectual and adaptive functioning deficits in conceptual, social, and practical domains
What are the criteria that must be met for Intellectual disability?
A. deficits in intellectual functioning - reasoning, problem solving, planning, abstract thinking, etc.
B. deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility
C. onset of A + B deficits during the developmental period
What are the three domains of adaptive functioning deficits?
conceptual, social, and practical
What is the conceptual domain of adaptive fxning?
where conceptual skills lag markedly behind those of peers
preschoolers–> slow language/pre-academic skill develpt
school-age kids–> lagging progressing in reading, writing, math, time and money understanding
adults–> academic skill developt @ elementary level; support is required for all use of academic skills in work + personal life
TLTR- conceptual stuff is hard
What is the social domain of adaptive fxning?
- difficulty developing age-mates, is immature in social interactions
- difficulty accurately perceiving peers’ social cues
- communication, conversation, and language are more concrete, less mature
- difficulties regulating emotion + behavior are noticed by peers in social situations
- social judgment is immature for age, person is at risk of being manipulated by others (gullible)
TLTR- social activity struggling, unawareness
What is the practical domain of adaptive fxning?
- difficulty w/ age-approp personal care + complex daily living tasks in comparison to peers (ex. adults need help shopping)
- difficulty making good decisions about personal well-being and recreational activities
- competitive employment is restricted to jobs not emphasizing conceptual skills
- individual usually needs support with health care decision + legal decisions + to learn to perform a skilled vocation competently
- support typically needed to raise family
TLTR- NEED HELP W/ DAILY LIVING activities
language disorder, speech sound disorder, and social (pragmatic) communication disorder are characterized by what?
deficits in development and use of language, speech, and social communication, respectively
childhood-onset fluency disorder is characterized by what?
disturbances of normal fluency and motor production of speech (repetitive sounds or syllables, prolongation of consonants or vowel sounds, broken words, etc.)
assessments of speech, language, and communication abilities must take into account what?
the individual’s cultural and language context
Describe language disorder.
A. Persistent difficulties in the acquisition and use of language across modalities (i.e., spoken, written,
sign language, or other) due to deficits in comprehension or production
-include: reduced vocabulary, limited sentence structure, impairments in discourse (using vocab to connect sentences)
B. language abilities are substantially and quantifiably below those expected for age
Describe speech sound disorder.
Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages.
Describe childhood-onset fluency disorder (stuttering):
Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual’s age and
language skills, persist over time, and are characterized by frequent and marked occurrences of one (or more) of the
following: sound syllable repetition, sound prolongation of consonants + vowels, broken words, audible or silent blocking, circumloculations, words produced w/ excess of physical tension, monosyllabic whole-word repetitions
Describe Social (pragmatic) communication disorder.
Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following: deficits in using communication for social purposes (appropriately), impairment of ability to change communication to meet needs of listener, difficulties following rules for convo and storytelling (ex. taking turns in convo), difficulties understanding whats not explicitly state (ex. making inferences) and nonliteral/ambiguous meanings of language
*similar to what people with ASD have (so have to rule that out)
What do all the communication disorders have in common?
the disturbances result in functional limitation of some sort, including social participation, academic achievement or occupational performance
onset of syx is in the early developmental period
symptoms are not attributable to another medical/neuro condition
What is the mc associated feature of social (pragmatic) communication disorder?
delay in reaching language milestones
more board question he said
Describe Autism Spectrum Disorder. (2 major criteria)
A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested
by all of the following, currently or by history : 1)deficits in social-emotional reciprocity, 2) deficits in nonverbal communicative behaviors used for social interactions, 3) deficits in developing, maintaining, and understanding relationships
B. restricted, repetitive patterns of behavior, interests, or activities; 2 of the following: 1) stereotyped/repetitive motor movements, use of objects, and speech, 2) insistence of sameness, inflexibility, 3) highly restricted, fixated interests (abnormal in intensity), 4) hyper- or hyporeactivity to sensory input ** (cooley emphasized*) or unusual interest in sensory aspects of environment
What are some other criteria associated w/ ASD?
- syx must be present in early devleopment period
- syx cause clinically signif impairment in social, occupational, or other impt areas of functioning
- disturbances aren’t better explained by intellectual disability or global developmental delay
*note: intellectual disability and ASD frequently co-occur
What is the severity of ASD based on?
social communication impairments + restricted, repetitive patterns of behavior
Level 1: “requiring support”
Level2: “requiring substantial support”
Level 3: “requiring very substantial support”
What is the most consistently useful behavioral intervention for ASD?
education + support for patients, siblings, teachers, and caregivers
-learn about “parallel process” (aka join w/ them, adopt), and learning how to use it for behavioral management
