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Block 8 Week 3 > Developmental Disorders-Ryst > Flashcards

Developmental Disorders-Ryst Flashcards

1
Q

What is this:

Impairment in ability to receive, send, process and comprehend concepts or symbol systems.

A

communication disorder

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2
Q

What is this:

problems with articulation, fluency, and voice. More of a motor probelm with speech.

A

speech disorder

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3
Q

What is this:

impaired comprehension and/or use of spoken, wirtten or other symbol systems

A

Language disorder

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4
Q 
What is this:
Persistent difficulties in the acquisition and use of language across modalities due to deficits in comprehension or production that include the following:
-Reduced vocabulary
-Limited sentence structure
-Impairments in discourse
A

Language disorder according to DSM- 5

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5
Q

What is this:
Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages.

A

Speech sound disorder according to DSM-5

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6
Q

What is this:
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 or marked occurrences of one or more of the following

A

Child-Onset fluency disorder (stuttering)

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7
Q

What are these components of:
Sound and syllable repetitions
Sound prolongations of consonants as well as vowels
Broken words (pauses within words)
Audible or silent blockers (filled or unfilled pauses in speech)
Circumlocutions
Words produced with an excess of physical tension
Monosyllabic whole-word repetitions

A

Child onset fluency disorder (stuttering)

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8
Q

There is expresive language delay in (Blank) percent of children under 3 years, by school age, only (blank) percent

A

10-15%

3-7%

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9
Q

Mixed receptive-expressive delays in approx (blank) percent of preschoolers and (blank) percent of school-age children

A

5%

3%

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10
Q

There are phonological disorders (moderate to severe) in (blank) percent of early school-age children; up to (blank) percent with mild form

A

2%

20%

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11
Q

There is stuttering in (blank) percent of young children

A

1%

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12
Q

About 1/2 of children with communication disordes also have (Blank). What are the most common?

A

axis I psychiatric disorders

-ADHD, ODD, Conduct Disorder, anxiety disorder

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13
Q

What should be on your differential diagnosis when you see a kid that has seems to have a psych communication disorder?

A

Hearing impairment
Intellectual Disability
Autism
Selective Mutism

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14
Q

What is the treatment for communication disorders?

A
  • Teach specific strategies to change the deficit and increase skills (speech and language therapy)
  • Teach compensatory coping strategies
  • Change the child’s environment
  • Parents are the biggest assets in helping to improve their child’s development (Hanen)*
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15
Q

What is this:
Acquisition and execution of coordinated motor skills is substantially below expected; Difficulties are manifested as clumsiness, as well as slowness and inaccuracy of permformance of motor skills.
Significantly interferes with academic achievement or ADL’s.
Not due to a medical condition and not part of PDD.
If intellectual disability is present, the motor difficulties can’t be better explained by it.

A

Developmental Coordination Disorder

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16
Q

What is this:

sudden, repatitive muscular contraction and vocalization

A

a Tic

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17
Q

How long does a tic last and is it voluntary?

A

less than 1 second and are voluntary

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18
Q 
How do tics occur?
How do they progress?
What are simple tics?
What are complex tics?
What is the typical age of onset?
What is the peak onset?
When do you typically get tic reduction?
A 
in bout and wax and wane
rostral to caudal
-limited to a few muscle groups
-mutiple organized contractions which mimic contextual speech or movement (copropraxia coprolalia, echolalia, echopraxia)
-5-6
-10-12
-15-17
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19
Q

If the tics have been present for less than one year, it is a (blank) tic disorder

A

provisional

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20
Q

(blank) includes multiple motor and one or more vocal tics present at some time during the illness; the tics may wax and wane in frequency but have persisted for >1 year since onset.

A

Tourette’s disorder

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21
Q

If only motor or only vocal tics for >1 year, then it is a (blank) or (blank)

A

Persistent (Chronic) Motor or Vocal Tic Disorder

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22
Q

How common is tourettes?
How common are chronic tic disorder during school years?
What is the overall prevalence of tics?

A

0.1%
2-15%
11% girls; 18% boys
*MORE common in boys

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23
Q

50% of TD patients meet criteria for (blank) and (blank) percent of children diagosed with ADHD have tics or TD.

A

ADHD

30-40%

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24
Q

For patients with tic disorders, they often have what diseases in their family histories?

A

ADHD, OCD, tics in first and second degree relatives

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25
Q

How do you treat tic disorders?

A

First line = Alpha-2 Agonists
Second line = Atypical antipsychotics
Third line = Typical antipsychotics
Habit Reversal Training = behavioral technique to reduce tics.
Refer to a specialist if moderate to severe TD or substantial comorbidity.

26
Q

What is this:
Repetative, seemingly driven, and apparently purposeless motor behavior (hand shaking or waving, body rocking, head banging, self-biting, hitting own body.)

A

Sterotypic movement disorder

27
Q

What is this:
1) Persistent difficulties in the social use of verbal and nonverbal communication
as manifest by deficits in all of the following:
– Deficits in using communication for social purposes, in a manner that is appropriate for the social context
– Impairment in the ability to change communication to match context or the
needs of the listener
– Difficulties following rules for conversation and storytelling
– Difficulties understanding what is not explicitly stated

A

Social (pragmatic) communication disorder

28
Q

In social (pragmatic) communication disorder, deficits result in (blank) limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance.

A

functional limitations

29
Q

In social (pragmatic) communication disorder, deficits must be present in the (blank) period, but may not become fully manifest until social communication demands exceed limited capacities.

A

early developmental period

30
Q

In (blank), deficits are not better explained by autism spectrum disorder, intellectual
disability (intellectual development disorder), global developmental delay, or
another mental disorder or medical condition.

A

social (pragmatic) communication disorder

31
Q

What is this:
A brand new diagnosis—therefore no information yet about epidemiology.
Meant to capture children who have significant pragmatic difficulties, relatively intact vocabulary, grammar and speech-sound production abilities, and no history of restricted/repetitive behaviors or interests.

A

social (pragmatic) communication disorder

32
Q

What are the risk factors for social communication disorders?

A

Family history of Autism Spectrum Disorder, Specific Learning Disabilities or Communication Disorder

33
Q

What is the differential diagnosis for patients with symptoms of social communication disorder?

A

ASD
ADHD
Social Phobia
Intellectual Disaiblity

34
Q

How do you treat social communication disorder?

A

Social Skills Training

Speech/Language Therapy

35
Q

(blank) replaces DSM-IV’s autistic disorder, Asperger’s disorder, childhood disintegration disorder, and pervasive developmental disorder not otherwise specified

A

Autism spectrum disorder

36
Q

What is the criteria for ASD?

Which area is very specific for autism?

A

A. persistent deficits in social communcation and social interaction across multiple contexts
B. restricted, reptetitive patterns of behavior, interests, or activities
C. Symptoms must be present in the early developmental period
D. Symptoms cause clinically significant impairment in social, occupational, or other
important areas of current functioning.
E. These disturbances are not better explained by intellectual disability or global
developmental delay.

Area B

37
Q

(blank) and autism spectrum disorder frequently co‐occur; to make comorbid diagnoses of autism spectrum disorder
and intellectual disability, social communication should be below that expected for general developmental level.

A

Intellectual disability

38
Q

In ASD, there are persistent deficits in social communication and social interaction across multiple contexts, as manifested by …..?

A
  1. Deficits in social‐emotional reciprocity
  2. Deficits in nonverbal communicative behaviors used for social interaction
  3. Deficits in developing, maintaining, and understanding relationships
39
Q

In ASD, there is restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of what?

A
  1. Stereotyped or repetitive motor movements, use of objects, or speech
  2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of
    verbal or nonverbal behavior
  3. Highly restricted, fixated interests that are abnormal in intensity or focus
  4. Hyper‐or hyporeactivity to sensory input or unusual interest in sensory aspects of the
    environment.
40
Q

What are the concerns about ASD in DSM-5?

What did the data show?

A

Sensitivity has been “sacrificed” in order to improve specificity
Merging all pervasive developmental disorders into one may result in loss of uniqueness/identity of Asperger’s Disorder

That the DSM-5 made the right decision

41
Q

If you want to make ASD more specific, how do you do this?

A
  • give level of severity
  • say whether has intellectual impairment
  • say whether there is a language impairment
  • say if its assoc. w/ medical, genetic, or environmental factor
  • associated w/ neurodevelopment, mental or behavioral disorder
  • w/ catatonia
42
Q

What is the epidemiology of ASD?

A

t recent CDC prevalence in US is 1/88
Prevalence varies worldwide
-rate has been increasing (made be due to increased awarness and better diagnosing)
-4:1 male to female ratio

43
Q

What is the etiology of ASD?

A
  • bio based and multi-factorial
  • genetic (80% or higher)
  • exhibits recurrence in families
  • no single genetic anomaly found
  • environmental factors
  • risk factors
44
Q

What are the environmental factors associated with ASD?

A

prenatal rubella, thalidomide and valproic acid.

45
Q

What are the potential risk factors associated with ASD?

A

prematurity, low birth weight, parental age.

46
Q

How do you diagnose autism?

A

level 1 screening

level 2 eval

47
Q

What is the level 2 eval?

A

Review of developmental history/presenting problems with parents
Review of available records
Direct interaction with/observation of the child.
Assessment of intellectual, language and adaptive functioning.

48
Q

What is the most important screeening tool for ASD and should be administered by a primay care physician?

A

The M-CHAT

49
Q

What is the gold standard measure for ASD?
REsearch gold standard?
other measures?

A

ADOS (gold standard)
ADI-R (research gold standard)

Social Communication Questionnaire
M-CHAT (Screening)

50
Q

What are comorbidities associated with ASD?

A 
Genetic Syndromes (eg Tuberous Sclerosis)
Seizure Disorder
Intellectual Disability
Language Impairment
Self-injury
Catatonia
51
Q

What is the rate of psychiatric comorbidity in autism?

A

-65-70% of children

52
Q

What are the 3 most common comorbidites assoc. with autism?

A

Social anxiety disorder (29.2%)
ADHD (28.1%)
Oppositional Defiant Disorder (28.1%)

53
Q 
What are these:
Social anxiety disorder (29.2%)
ADHD (28.1%)
Oppositional Defiant Disorder (28.1%)
Generalized Anxiety Disorder (13.4%)
Panic Disorder (10.1%)
Enuresis (11%)
Sub-threshold depression or irritability (10.9%)
Major Depression (0.9%)
Dysthymic Disorder (0.5%)
Conduct Disorder (3.2%)
A

Rates of psych comorbidity in autism

54
Q

What are some psychiatric symptoms that may show up with ASD and cause signif impairment?

A 
Hyperactivity/agitation
Impulsivity
Inattention
Restlessness
Aggression (Tantrums, self-injury, irritability, emotional lability)
Repetitive, obsessive-compulsive type behaviors
Tics
Sleep problems
55
Q

One study found 84.1% of children with autism met criteria for at least one (blank).
What are frequent types?

A

anxiety disorder

separation anxiety and obsessive compulsive behavior

56
Q

Kids with autism may have specific phobias regarding …..?

A

thunderstorms, dark places, large crowds, dark rooms or closets, going to bed in the dark and closed places.

57
Q

In ASD patients, anxiety may increase (blank) behaviors such as ….? Why do they do these behaviors?

A

repetitive behaviors

echolalia, hand flapping and repetitive questioning, and these behaviors may be calming.

58
Q

How do you treat ASD?

What is most effective and widely used?

A
  • multi-modal approach
  • behavioral interventions (most effective and widely used)
  • developmental intervention
  • medical interventions
  • school interventions
  • family support
59
Q

What are some behavioral interventions for ASD?

A

Lovaas (EIBI) and Early Start Denver Model

60
Q

What are the medical interventions for ASD (to treat associated or comorbid symptoms rather than core symptoms)?
What exactly do they treat?

A

Risperidone and aripiprazole

Irritability and agitation

61
Q

What is this:
reserved for kids under the age of 5, when the clinical severity level cannot be assessed during early childhood. The individual fails to meet expected developmental milestones in several areas of intellectual functionign and aplies to individuals who are too young to participate in standardized testing. This category requires reassessment after a period of time.

A

Global developmental delay

62
Q

Learning, communication, motor skills disorders, intellectual disability and autism spectrum disorders are (blank) disorders with significant morbidity.

A

developmental

Block 8 Week 3 (11 decks)

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