Clinical Approach to Neurodevelopmental and attention disorders Flashcards
What are the (7) Comorbidities associated with Tourette’s disorder?
- ADHD
- OCD
- Anxiety disorders
- mood disorders
- disruptive behavior
- learning disabilities and poor school performance
- sleep disorders
What are the main classification criteria for Tourette’s disorder?
- 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
What is a developmental coordination disorder?
- The acquisition and execution of coordinated motor skills is substantially below that expected for age.
- This interferes with daily living (significantly)
What is a stereotypic movement disorder?
- One that is purposeless motor movement and is most of the time characterized by self injury
- example: head banging
How do we specify stereotypic movement disorder?
- 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).
Which medication used as an antidepressant has seizures as a risk factor?
Bupropion
What are the American Academy of Pediatrics clinical guidlines for treatment of ADHD? Hint: there are three different age ranges
- 4-5 year olds, behavioral therapy is first line
- methylphenidate is second line - 6-11 y/o can use FDA approved medication but want to do this with behavioral thereapy
- 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.
What are the two diagnostic tests we can use to measure (objectively) for ADHD?
What is a pro of this test?
- TOVA and Conner’s Continous performace test
- Easy to read, and only takes 14 minutes
What is the DSM-V diagnotic criteria for diagnosing ADHD in adults vs. kids?
Adults need 5 symptoms
Kids need 6 symptoms
What are the symptoms of inattentive type of ADHD?
- does not listen, difficulty sustaining attention, makes careless mistakes, unorganized, dislikes tasks that require complex thinking, loses things, easily distracted, is forgetful
What are the symptoms of Hyperactive type ADHD?
Figdets, cant sit still, runs or climbs excessively, difficulty engaging in quiet activities, excessive talking, blurts out answers, difficulty waiting or taking turns.
Where does executive functioning take place?
If executive functioning is deficient what neurotransmitters are deficient?
- prefrontal cortex
- dopamine and norepinephrine
What is the region of the brain that is most effected by ADHD?
Dorsal Anterior Midcingulate cortex
What is executive functioning?
- 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
What were the three disorders that essentially all had comorbidities with each other?
Tics + OCD + ADHD
Why are females diagnosed less with ADHD? What subtype are they more likely to present with in comparison to boys?
- They have less disruptive behavior
- inattentive subtype
What are the two meds approved by the FDA for Autism Spectrum Disorder treatment?
Risperidone and Aripiprazole
What is the most consistently useful behavioral intervention for children with autism spectrum disorder?
Education and support for parents, siblings, teachers, and caregivers
What are some of the main deficits in Autism spectrum disorder?
- social communication and interaction
- social emotional reciprocity
- nonverbal communication
- relationships
(EXAM) What is the best differentiating factors for Autism Spectrum Disorder?
Restricted interest & repetitive behavior
- note this is highly restricted, fixed interests
How do we specify autism spectrum disorder and what is it based on?
- Levels 1 - 3 (best to worst)
- Severity is based on social communication impairments and restricted, repetitive patterns of behavior
What is a social (pragmatic) communication disorder?
This is difficulty in communication, but does not have the fixed interest or repetitive behavior like autism spectrum disorder.
What is the associated features supporting diagnosis of Social (pragmatic) communication disorder?
The most common associated feature of social (pragmatic) communication disorder is the delay in reaching language milestones.
What is childhood-onset fluency disorder?
- 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
What is speech sound disorder?
- deals more with mechanics and forming/hearing correct sounds.
- difficulty with speach sound production
What are the three classes of adaptive functioning disorder under the umbrella of intellectual disability?
- conceptual domain
- social domain
- practical domain
What are some of the hallmarks of conceptual domain deficits?
- 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.
What are some examples of social domain deficits?
- 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)
What are deficits within the practical domain of adaptive functioning deficits?
- difficulty with age appropriate personal care.
- difficulty with complex daily living tasks i.e. grocery shopping, transportation, home care, child care etc…
