Developmental Disorders - Ryst Flashcards
What is a communication disorder?
Impairment in ability to receive, send, process and comprehend concepts or symbol systems.
What is a speech disorder from the ASL assoc?
Problems with articulation, fluency and voice.
What is a language disorder from the ASL assoc?
Impaired comprehension and/or use of spoken, written or other symbol systems.
What is a language disorder from the DSM5?
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
What is a speech sound disorder according to the DSM5?
Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages.
WHat is a child-onset fluency disorder according to the dSM5?
- disturbances in normal fluency and time pattern
2. persist over time
What are these things characteristic 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
Stuttering, aka child-onset fluency disorder
Expressive language delay occurs in (blank) percent of children under three years and drops to 3-7% by school age
10-15%
MIxed receptive-expressive issues in approximately (blank) percent of preschoolers and 3% of school aged kids
5%
Moderate to severe phonological disorders are seen in only 2% of early school aged kids but mild forms can be up to (blank) percent
20%!
What percent of young kids stutter?
1%
About 1/2 of kids with comm disorders also have an axis (blank) disorder
Axis I psych disorder
What are the most common comorbid psych disorders seen with comm issues?
ADHD
OCD
Conduct disorder
anxiety disorders
What’s on your DDx for a comm disorder?
Hearing impairment
Intellectual Disability
Autism
Selective Mutism
What is the Tx for a comm disorder?
- teach specific strategies to change the deficit and increase skills, aka speech and language therapy
- compensatory coping skills
- change kid’s environment
What is the biggest asset in improving a kid’s dev?
the parents!
What are the criteria for a development coordination (motor) disorder?
- clumsiness or slowness and inaccuracy of motor skills.
- sig. interferes with ADLs
- not due to a a med condition and not due to PDD
- If ID is present, motor difficulties cannot be better explained by it
What are the two major categories of motor disorders?
tics
Stereotypic movement disorder
Tics are (voluntary/involuntary)
voluntary
Over time, tics show a (blank to blank) progression
rostral to caudal; start with eye blinking and move down the body
What are simple tics?
few muscle groups; eye blinking, jaw thrusting, throat clearing
What are complex tics?
multiple organized contractions which mimmic contextual speech or movement (copropraxia, corprolalia, echolalia, echopraxia)
when do tics onset?
5-6 years
when do tics reach their peak intensity?
10-12
when do tics begin to reduce?
15-17 years
If a tic has been present for less than (blank) amount of time, then it is a provisional disorder
less than one year
Tourette’s includes what?
multiple motor and one or more vocal tics at some time during the illness; present for more than one year
If only motor OR vocal tics present for more than one year , then the disorder is….
Persistent (Chronic) Motor or Vocal Tic disorder
Overall presence of all tics, including transient tics, is….
11% girls
18% boys
FHx is often positive for what issues in first in pts with tics?
ADHD, OCD, and tics in first and second degree relatives
50% of TD pts meet criteria for (ADHD/OCD) and 30-40% of kids with (ADHD/OCD) have tics or TD
ADHD
What is the Tx for tics?
rare to achieve >50% reduction in moderate to severe tics firstline: A-2 agonists Second line: Aytpical antipsychotics Third line: typical antipsychotics Habit reversal training Refer to specialist
What is stereotypic movement disorder?
Repetetive, seemingly driven, and apparently purposeless motor behavior (hand shaking or waving, body rocking, head banging, self-biting, hitting own body.)
Social Pragmatic Communication disoder are difficulties in….
social use of verbal and nonverbal communication
SPCD results in (blank) limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance
functional
SPCD deficits must be present during what period of time?
early development, but may not fully manifest until social communcation demands exceed their capacities
SPCD deficits are not better explained by what other disorders?
Autism
ID
global dev delay
Describe the overall profile of a kid with SPCD?
significant pragmatic difficulties, relatively intact vocabulary, grammar and speech-sound production abilities, and no history of restricted/repetitive behaviors or interests.
What are the risk factors for SPCD?
FHx of ASD, SLD, or Comm disorder
What’s on your DDx for Social comm disorder?
ASD
ADHD
Social Phobia
Intellectual Disaiblity
What is the Tx for SPCD?
Social skills training
Speech and language therapy
Autism spectrum disorder in the DSM 5 replaces which diagnoses?
Autism
Asperger’s
childhood disintegration
pervasive dev disorder NOS
How do you Dx Asperger’s now?
ASD without intellectual impairment and without structural language impairment
What are the three major components do Dx ASD?
- Deficits in social communication
- Restricted, repetitive behaviors and/or interests
- Present in early dev period
- causes functional impairment
- not better explained by anything else
What are the ways that autistics show issues in social comm?
- Deficits in social‐emotional reciprocity
- Deficits in nonverbal communicative behaviors used for social interaction
- Deficits in developing, maintaining, and understanding relationships
What are some examples of restricted behavior?
- Stereotyped or repetitive motor movements, use of objects, or speech
- Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior
- Highly restricted, fixated interests that are abnormal in intensity or focus
- Hyper‐or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment.
(Sensitivity/Specificity) has been sacrificed in the Dx of ASD in the DSM 5
sensitivity to increase specificity
T/F: Distribution of autism Dx varies by geography
true; based on which states where services were only given for ASD has lower rates of Asperger’s
What are some of the modifiers when describing an ASD Dx?
Severity (level of support needed)
W/w/o intellectual impairment
W/w/o language impairment
Associated with known medical, genetic condition or environmental factor
Associated with another neurodevelopmental, mental, or behavioral disorder
With catatonia
What is the current prevalence of ASD in the US?
1/88
What is the male:female ratio of Autism?
4:1
What are some of the reasons that ASD has been increasing?
better detection, increased awareness and use of broader diagnostic criteria; however, does not fully explain.
ASD is believed to be a (blank) condition with multi-factorial eitology
biologically
What is the risk attributable to genetics in ASD?
greater than 80%
what is the recurrence rate of ASD in a younger sibling?
18.7%
T/F: ASD is potentially caused by a single genetic anomaly
false
What are the environmental factors associated with ASD?
prenatal rubella
thalidomide and valproic acid
What are the other risk factors associated with ASD?
preme babies
low birth weight
parental age
What are the measurement tools for ASD?
ADOS (gold standard)
ADI-R (research gold standard)
Social Communication Questionnaire
M-CHAT (Screening)
What are some of the comorbidities in ASD?
Genetic Syndromes (eg Tuberous Sclerosis) Seizure Disorder Intellectual Disability Language Impairment Self-injury Catatonia
What is the rate of psychiatric comorbidity in kids with ASD?
65-70%
What are the most common comorbid issues in ASD?
SAD ADHD Oppositional defiant disorder GAD Panic disorder Enuresis
What are some of the symptoms of autism that cause sig. impairment?
Hyperactivity/agitation Impulsivity Inattention Restlessness Aggression (Tantrums, self-injury, irritability, emotional lability) Repetitive, obsessive-compulsive type behaviors Tics Sleep problems
84% of kids with Autism met criteria for at least one (blank) disorder
anxiety
The high rates of anxiety and autism show the conterversy regarding….
what is and is not part of the disorder
What are the most frequent types of anxiety seen in autism?
separation anxiety and OCD
What are the common phobias of kids with autism?
thunderstorms, dark places, large crowds, dark rooms or closets, going to bed in the dark and closed places.
Anxiety in autistics will increase what?
repetitive behavior
What is the most effective Tx for ASSD?
behavioral intervention
What Tx models are used in autism?
Lovaas and Early Start Denver model
Besides behavior intervention, what other specific types of therapy are needed for autistics?
developmental intervention for speech/language, OT, PT
Risperidone and aripiprazole are used to treat what in ASD?
associated or comorbid symptoms rather than the ASD itself, such as irritablity or agitation
T/F: school intervention is critical in ASD
treu
What age do you have to be to meet the criteria for global developmental delay?
younger than five
Describe Global developmental delay?
This category is diagnosed when an individual fails to meet expected developmental milestones in several areas of intellectual functioning, and applies to individuals who are too young to participate in standardized testing. This category requires reassessment after a period of time.
