ID, ASD, GD Flashcards by caleb markusic

3 neuro developmental disorders

global developmental delay

intellectual disability

autism spectrum disorder

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Diagnosed in individuals below the age of 5 years who fail to meet expected developmental milestones in several areas of functioning

developmental delay

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t/f developmental delay Requires reassessment over time

True

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t/f Global developmental delay and ID are interchangeable terms

false nope don’t you do it

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most of the ID population fall into what severity group?

mild 85 % the percentage decreases with severity

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describe mildID

prior to school entry appears normal to peers

can achieve up to a grade 6 level

vocational success with minimal support and supervision

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describe moderate ID

grade 2 expectations (school)

vocational success in sheltered workshops

highly structured

needs support and behavioral methods

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describe severe ID

increased medical, motor, and neuro problems

pre academic skills with limited vocab

success in group homes need monitored

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describe profound ID

multiple motor and neuro problems

augmentative communication (picture boards)

long term placement in sheltered settings to allow monitoring

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describe profound ID

multiple motor and neuro problems

augmentative communication (picture boards)

long term placement in sheltered settings to allow monitoring

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where is mild ID most prevelent

developing countries or areas with low socioeconomic classes

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most common cause of ID

50-70% prenatal (e.g., genetic syndromes, maternal disease/virus, teratogen exposure)

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chromosomal causes of ID

Trisomy 21 (Down syndrome) 
Most common chromosomal etiology

Fragile X
Most common heritable etiology

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Early Signs of ID

Lack of appropriate play skills

Signs of cognitive delay/difficulties with preacademics

Adaptive delay )Significant difficulties with toileting, self-feeding, dressing activities)

Delayed receptive/expressive language development

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Intervention for ID

Systematic instruction within the school system

Peer tutors

Use of technology

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Considered a neurodevelopmental disorder/developmental disability characterized by pervasive deficits in social communication functioning in addition to restricted and repetitive behavior patterns

Autism Spectrum Disorder (ASD)

types of autism spectrum disorders

Pervasive Developmental Disorders (PDDs)

High-Functioning Autism (HFA)

Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS)

Asperger Syndrome (AS)

t/f Compared to the general population, individuals with ASD tend to have higher rates of other conditions

true!!!!!
such as:
Intellectual disability
Attention-deficit/hyperactivity disorder
Anxiety
Depression

Clinical Diagnostic Criteria for ASD

Persistent deficits related to social communication and social interactions across multiple contexts to include deficits in (must have evidence in all 3 areas)

AND

Restricted or repetitive patterns of behaviors, interests, or activities to include (must have evidence of at least 2 behavioral symptoms)

what are the 3 Persistent deficits related to social communication and social interactions across multiple contexts to include deficits in (must have evidence in all 3 areas)

Social-emotional reciprocity (e.g., social approach/response, reciprocal conversation, sharing of affect)

Nonverbal communicative behaviors (e.g., integration of eye contact, gestures, and facial expressions, understanding nonverbal cues from others)

Relationship functioning (e.g., ability to make/maintain friendships, adjust behavior to context)

the 4 Restricted or repetitive patterns of behaviors, interests, or activities to include (must have evidence of at least 2 behavioral symptoms)

Repetitive motor movements, actions, or speech patterns (e.g., repetitive play, echolalia, stereotypies)

Inflexible behavior/insistence on sameness (e.g., rigid adherence to routines, difficulty with transitions, difficulty adapting to changes changes)

Restricted, unusual, or preoccupying interests (e.g., fixated interest unusual in intensity or focus)

Unusual sensory interests or responses (e.g., interest or sensitivity to certain sounds or textures)

the 4 Restricted or repetitive patterns of behaviors, interests, or activities to include (must have evidence of at least 2 behavioral symptoms)

Repetitive motor movements, actions, or speech patterns (e.g., repetitive play, echolalia, stereotypies)

Inflexible behavior/insistence on sameness (e.g., rigid adherence to routines, difficulty with transitions, difficulty adapting to changes changes)

Restricted, unusual, or preoccupying interests (e.g., fixated interest unusual in intensity or focus)

Unusual sensory interests or responses (e.g., interest or sensitivity to certain sounds or textures)

Social Communication/ Interaction Impairment in toddlers

Less responsiveness to people/limited interest in social games

Joint attention deficits

Lack of response to name

Atypical eye contact

Limited shared enjoyment/may not want parents to do things together (e.g. read books)

Delayed speech/language

Loss of acquired words

Echolalia/stereotyped speech

Social Communication/ Interaction Impairment in children

Preference for playing alone

Limited interest in other same-age children

Poor or limited imitation of others

Lack of/difficulty with pretend play

Unusual rhythm, intonation of speech

Limited facial expressions

Limited social insight

Inappropriate social overtures

Restricted/Repetitive Behaviors, Interests, or Activities in children and toddlers

Extreme distress at small changes/difficulties with transitions Need to take same route or eat food every day Unusual or repetitive play Interest in parts of objects Attachment to unusual objects Repetitive, stereotyped movements Insistence on sameness Excessively perseverative interest Unusual sensory interests/excessive smelling, touching objects Extremely adverse reactions to certain textures or sounds

Clinical Diagnostic Criteria for ASD

Evidence of symptoms must be present early on in development, but may not become fully apparent until social demands increase Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning Disturbances are not better explained by global developmental delay (DD) or intellectual disability (ID)

t/f Although ASD and DD/ID frequently co-occur, social communication functioning must be below expectations for an individual’s general developmental level to provide a diagnosis of ASD if a person has DD or ID

true

what screening tools do you use to dx ASD

Screening tools are NOT to be used to diagnose individuals, but may be helpful in guiding decisions to refer individuals for full developmental/diagnostic evaluations

what age can ASD be dx

ASD can be diagnosed reliably as young as 18 months We can no longer honestly tell a family that autism diagnosis must wait until a child is 3 or older.

interventions for ASD

Applied Behavior Analytic (ABA) intervention/therapy Structured TEACCHing supports and other visual supports/positive behavior interventions Social skills training (individual and group interventions) Counseling/psychotherapy services to address co-occurring psychiatric concerns Medication management and other medical care for behavioral symptoms or other co-occurring psychiatric/medical concerns Parent training, coaching, and support resources Adaptive skill-building and community supports Supported employment programming

Four risk factors for surveillance of ASD

Sibling with ASD Parent concern, inconsistent hearing, unusual responsiveness Other caregiver concern Pediatrician concern

when to screen for ASD

Surveillance at every visit, with specific screening for potential autism spectrum disorder (ASD) symptoms conducted at 18-month and 24-month (or 30-month) well-child visits.

when to follow up with Borderline screens –

Discuss monitoring with parent; timely follow-up before next routine visit

follow up for Positive screens -

Refer for a comprehensive evaluation to assess cognitive levels, speech-language skills, and possible ASD Consider other relevant referrals: Genetics, Neurology, Gastrointestinal specialists, developmental behavioral pediatrics

follow up for positive screen in kids under 3

Children under age 3 (Part C): Refer for evaluation/services through the NC Infant-Toddler Program/Child Find (http://www.beearly.nc.gov/)

follow up for positive screen in kids over 3

Children age 3 & over (Part B): Refer for evaluation/services through NC Public Schools Office of Early Learning (http://www.ncpublicschools.org/earlylearning/)

follow up for positive screen in kids over 3

Children age 3 & over (Part B): Refer for evaluation/services through NC Public Schools Office of Early Learning (http://www.ncpublicschools.org/earlylearning/)

long term asd plan

``` Guardianship Education planning Vocation planning Living planning Family Care Plan ```

Medication Management for ASD

``` No medication specific to ASD Treat the symptoms: Comorbid ADHD: psychostimulants Comorbid anxiety/depression: SSRI Comorbid aggression/irritability: atypical antipsychotics ```