Clinical Approach to Neurodevelopmental and attention disorders Flashcards

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1
Q

What are the (7) Comorbidities associated with Tourette’s disorder?

A
  1. ADHD
  2. OCD
  3. Anxiety disorders
  4. mood disorders
  5. disruptive behavior
  6. learning disabilities and poor school performance
  7. sleep disorders
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2
Q

What are the main classification criteria for Tourette’s disorder?

A
  • Both multiple motor tics and one or more phonic tic
  • These tics change overtime with anatomical location, number, frequency, tone, etc…
  • onset before age 21
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3
Q

What is a developmental coordination disorder?

A
  • The acquisition and execution of coordinated motor skills is substantially below that expected for age.
  • This interferes with daily living (significantly)
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4
Q

What is a stereotypic movement disorder?

A
  • One that is purposeless motor movement and is most of the time characterized by self injury
  • example: head banging
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5
Q

How do we specify stereotypic movement disorder?

A
  • either with or without injurious behavior
  • associated with a known medical or genetic condition
  • mild (distractable, suppressed by sensory stimulus), moderate (need explicit protective measures), severe (continual monitoring with protective measures).
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6
Q

Which medication used as an antidepressant has seizures as a risk factor?

A

Bupropion

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7
Q

What are the American Academy of Pediatrics clinical guidlines for treatment of ADHD? Hint: there are three different age ranges

A
  1. 4-5 year olds, behavioral therapy is first line
    - methylphenidate is second line
  2. 6-11 y/o can use FDA approved medication but want to do this with behavioral thereapy
  3. 12-18 y/o FDA approved meds with behavioral therapy
    - note 12-18 was when you want consent from the patient even if they are 12 because they will adhere more closely to treatement.
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8
Q

What are the two diagnostic tests we can use to measure (objectively) for ADHD?

What is a pro of this test?

A
  • TOVA and Conner’s Continous performace test
  • Easy to read, and only takes 14 minutes
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9
Q

What is the DSM-V diagnotic criteria for diagnosing ADHD in adults vs. kids?

A

Adults need 5 symptoms

Kids need 6 symptoms

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10
Q

What are the symptoms of inattentive type of ADHD?

A
  • does not listen, difficulty sustaining attention, makes careless mistakes, unorganized, dislikes tasks that require complex thinking, loses things, easily distracted, is forgetful
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11
Q

What are the symptoms of Hyperactive type ADHD?

A

Figdets, cant sit still, runs or climbs excessively, difficulty engaging in quiet activities, excessive talking, blurts out answers, difficulty waiting or taking turns.

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12
Q

Where does executive functioning take place?

If executive functioning is deficient what neurotransmitters are deficient?

A
  • prefrontal cortex
  • dopamine and norepinephrine
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13
Q

What is the region of the brain that is most effected by ADHD?

A

Dorsal Anterior Midcingulate cortex

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14
Q

What is executive functioning?

A
  • ability to assess a situation
  • prioritizing relevant vs irrelevant info
  • filtering out extraneous information
  • make a plan on how to act
  • execute a plan
  • assess effect of action in a fluid manner
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15
Q

What were the three disorders that essentially all had comorbidities with each other?

A

Tics + OCD + ADHD

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16
Q

Why are females diagnosed less with ADHD? What subtype are they more likely to present with in comparison to boys?

A
  • They have less disruptive behavior
  • inattentive subtype
17
Q

What are the two meds approved by the FDA for Autism Spectrum Disorder treatment?

A

Risperidone and Aripiprazole

18
Q

What is the most consistently useful behavioral intervention for children with autism spectrum disorder?

A

Education and support for parents, siblings, teachers, and caregivers

19
Q

What are some of the main deficits in Autism spectrum disorder?

A
  • social communication and interaction
  • social emotional reciprocity
  • nonverbal communication
  • relationships
20
Q

(EXAM) What is the best differentiating factors for Autism Spectrum Disorder?

A

Restricted interest & repetitive behavior

  • note this is highly restricted, fixed interests
21
Q

How do we specify autism spectrum disorder and what is it based on?

A
  • Levels 1 - 3 (best to worst)
  • Severity is based on social communication impairments and restricted, repetitive patterns of behavior
22
Q

What is a social (pragmatic) communication disorder?

A

This is difficulty in communication, but does not have the fixed interest or repetitive behavior like autism spectrum disorder.

23
Q

What is the associated features supporting diagnosis of Social (pragmatic) communication disorder?

A

The most common associated feature of social (pragmatic) communication disorder is the delay in reaching language milestones.

24
Q

What is childhood-onset fluency disorder?

A
  • Stuttering
  • Disturbance in normal fluency, sound and syllable repititions, broken words, Cicumlocutions (substituting words to avoid difficult ones), audible or silent blocking etc…
  • note this causes anxiety about speaking for the patient
25
Q

What is speech sound disorder?

A
  • deals more with mechanics and forming/hearing correct sounds.
  • difficulty with speach sound production
26
Q

What are the three classes of adaptive functioning disorder under the umbrella of intellectual disability?

A
  • conceptual domain
  • social domain
  • practical domain
27
Q

What are some of the hallmarks of conceptual domain deficits?

A
  • preschoolers, language and preacademic skills develop slowly.
  • school age have trouble with math, reading, writing, and understanding time and money
  • adults function at an elementary level and have few life skills.
28
Q

What are some examples of social domain deficits?

A
  • difficulty developing friends of similar age
  • difficulty perceiving social ques
  • social judgement is immature for age, the person is at risk of being manipulated by others (gullibility)
29
Q

What are deficits within the practical domain of adaptive functioning deficits?

A
  • difficulty with age appropriate personal care.
  • difficulty with complex daily living tasks i.e. grocery shopping, transportation, home care, child care etc…