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Block 8; Week 3 > Developmental Disorders-Ryst > Flashcards

Developmental Disorders-Ryst Flashcards

1
Q

What are some important developmental disorders to consider when diagnosing a child?

A 
Learning Disorders
Intellectual Disability
Communication Disorders
Social (Pragmatic) Communication Disorder
Autism Spectrum Disorders
Motor Disorders
Global Developmental Delay
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2
Q

What are some important communications disorders to consider?

A

Language Disorder
Speech Sound Disorder
Childhood onset Fluency Disorder (stutter)
Social (pragmatic communication disorder)
unspecified communication disorder

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3
Q

What is a communication disorder?

A

Impairment in ability to receive, send, process and comprehend concepts or symbol systems.
Speech & Language disorders are subsets…

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4
Q

What is a language disorder?

A

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

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5
Q

What is a speech sound disorder?

A

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

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6
Q

A type of communication disorder, what is child onset fluency disorder?

A

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 or marked occurrences of one or more of the following:

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7
Q

What percentage of children have expressive language delay when under 3 yo? When at school age?

A

Under 3 years: 10-15%

School Age: 3-7%

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8
Q

What is the percentage of children with a mixed receptive-expressive disorder who are preschool age? School age?

A

Preschool age: 5%

School Age: 3%

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9
Q

What is the percentage of children with phonological disorders who are early school age? HOw many of these have only a mild form?

A

Early School age: 2%

OF those–20% mild form

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10
Q

What percentage of young children have stuttering?

A

1%

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11
Q

What are common comorbidities with communication disorders?

A

1/2 children also have a psychiatric disorder, commonly ADHD, ODD, Conduct Disorder, Anxiety

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12
Q

What are some other important diagnoses to consider when you suspect a communication disorder?

A

Hearing impairment
Intellectual Disability
Autism
Selective Mutism

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13
Q

What is the treatment for a communication disorder?

A

Teach specific strategies to change the deficit and increase skills (speech and language therapy)
Teach compensatory coping strategies
Change the child’s environment

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14
Q

What is social pragmatic communication disorder?

A

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
**functional limitations
**present in early developmental period

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15
Q

Describe which conditions must be ruled out before making a diagnosis of social communication disorder?

A

autism spectrum disorder
intellectual disability
global developmental delay

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16
Q

What is the characterization of children diagnosed w/ social communication disorder?

A

significant pragmatic difficulties, relatively intact vocabulary, grammar and speech-sound production abilities, and no history of restricted/repetitive behaviors or interests.

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17
Q

What are the risk factors of social communication disorder?

A

family hx of autism, learning disorder, communication disorder

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18
Q

What is the on the differential diagnosis for a child with a social communication disorder?

A

ASD
ADHD
Social Phobia
Intellectual Disability

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19
Q

What is the treatment for social communication disorder?

A

social skills training

speech/language therapy

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20
Q

What is a developmental coordination disorder?

A

difficulty w/ acquisition & execution of coordinated motor skills
clumsy, slow, inaccuracy of motor skills
interferes w/ activities of daily living

21
Q

What are 2 important types of motor disorders?

A

Tic disorders

Stereotypic Movement Disorders

22
Q

What is a tic disorder?

A

Sudden, repetitive muscular contractions and vocalizations.
Last < 1 second and are voluntary
Tend to occur in bouts and wax and wane.
rostral-caudal progression

23
Q

What is the typical age of onset of tics? Peak intensity? Reduction?

A

Onset: 5-6 yo
Peak Intensity: 10-12 yo
Tic Reduction: 15-17 yo

24
Q

If a tic is present for less than one year…what is it?

A

provisional tic disorder

25
Q

What does it take to make a diagnosis of tourette’s disorder?

A

multiple motor & 1 or more vocal tics

persist for more than 1 year

26
Q

What is the diagnosis if you have only motor tics? or only vocal tics or more than 1 year?

A

Persistent (Chronic) Motor or Vocal Tic Disorder

27
Q

What percentage of the population suffers from Tourette’s?

A

0.1%

28
Q

What is the prevalence of chronic tic disorders during school years?

A

2-15%

29
Q

WHat is the overall prevalence of tics in girls & boys?

A

girls: 11%
boys: 18%

30
Q

There is a strong tie b/w a diagnosis of tic disorders & ____

A

ADHD

31
Q

Those with tic disorders often have family history of what?

A

tic disorders
ADHD
OCD

32
Q

How do you treat tic disorders?

A 
First line: alpha-2 agonists
Second Line: atypical antipsychotics
Third Line: Typical Antipsychotics
Habit Reversal Training
Specialist
33
Q

What is a stereotypic movement disorder?

A

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

34
Q

Which disorders were formerly separated in the DSM IV & are now lumped together in the DSMV related to autism?

A

Formerly: autistic disorder, Asperger’s disorder, childhood disintegration disorder, and pervasive developmental disorder not otherwise specified
Now: Autism Spectrum Disorder
**sacrifice sensitivity for specificity

35
Q

What is autism spectrum disorder?

A

deficits in social communication & social interaction
restricted, repetitive patterns of behavior, interests, activities
present in early developmental period

36
Q

How do you differentiate between the different conditions now that everything is called autism spectrum disorder?

A

use specifiers
w/ intellectual impairment
w/o language impairment etc

37
Q

What is the prevalence of autism in the US? What is the gender difference?

A

1/88 in the US

4:1 male to female ratio

38
Q

Is there a genetic component to autism?

A

yes 80% or more of the risk is attributable to autism

39
Q

WHat are the environmental factors that could potentially contribute to autism? Other risk factors?

A

Environmental factors: prenatal rubella, thalidomide and valproic acid.
Potential risk factors: prematurity, low birth weight, parental age.

40
Q

After a child has been level 1 screened for autism…what is the next step?

A 
Level 2:
look at developmental hx w/ parents
review records
interact w/ & observe the child
assess intellectual, language & adaptive functioning
41
Q

What are some different measure for autism spectrum disorder?

A

ADOS (gold standard)
ADI-R (research gold standard)
Social Communication Questionnaire
M-CHAT (Screening)

42
Q

What are some possible comorbidities for children with autism spectrum disorder?

A 
Genetic Syndromes (eg Tuberous Sclerosis)
Seizure Disorder
Intellectual Disability
Language Impairment
Self-injury
Catatonia
43
Q

What is catatonia?

A

Catatonia is a state of neurogenic motor immobility and behavioral abnormality manifested by stupor.

44
Q

Do children with autism often have a psychiatric comorbidity?

A

yes, 65-70% of them.

45
Q

What are some of the common psychiatry comorbidities with autism?

A 
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%)
46
Q

What are some other psychiatric symptoms that could warrant attention in a child with autism?

A 
Hyperactivity/agitation
Impulsivity
Inattention
Restlessness
Aggression (Tantrums, self-injury, irritability, emotional lability)
Repetitive, obsessive-compulsive type behaviors
Tics
Sleep problems
47
Q

What is the relationship b/w anxiety and autism spectrum disorder?

A

84% of ASD kids have anxiety.

frequent types: OCD & separation anxiety

48
Q

What is the treatment for ASD?

A

behavioral interventions
developmental intervention
medical intervention-can treat irritability & agitation w/ risperidone & aripiprazole

49
Q

What is global developmental delay?

A

applies to kids under 5 yo who aren’t meeting multiple intellectual milestones but are too young for standardized testing…
basically you say–we need to reevaluate later.

Block 8; Week 3 (11 decks)

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