Intellectual Disability and Tic Disorders

Question 1

Intellectual Disability

Answer 1

Onset during developmental period that includes both intellecutal and adaptive functionign deficits in conceptual, social and practical domains

3 cirteria must be met

Question 2

Crtieria A of intellectual disability

Answer 2

Defined by IQ
Intellectual
70 or below

Question 3

Crtierai B of intellectual disability

Answer 3

Adaptive functioning
Failure ot meet standards for indepence and social responsbility
Adaptive deficits limit functioning in daily life

Question 4

Adaptive functioning

Answer 4

Skills needed to live in an independent and responsible manner

Question 5

Skills for daily liiving

Answer 5

Communication
Social skills
Personal independce
School/work functioning

Question 6

Criteria C of intellectual disability and levels

Answer 6

Onset during the developmental period (childhood/adolescne)

If problems are after, then neurocognitive disorder

Mild/mod/severe/profound

Question 7

Heredity
Early alterations of embryonic development
Environtmental influence
Mental disorders
Pregnancy/perntala probs

Answer 7

Fragile X, metab
Trisomy, damage due to toxins 
Nurutrance derpvity 
Autistic
Fetal malnutrition, prematurity, hypoxia

Question 8

3 most common causes of ID

Answer 8

Down’s syndrome - most common genetic course (chromosome 21)

Fragile X - most common inherited (x-linked FMR-1)

Fetal alcohol syndrome - grwoth retardation, developmental delay, and faical features)

Question 9

Cornerstones of ID evaluation

Answer 9

Hisotyr of functiongi nfrom other sources

Neuropscyhitric and adaptive behavior testing

Question 10

Most commmon co-morbid with ID

Answer 10

ADHD
Depression
Autism (7–80% pf autistic have intellecutal impairment)

Question 11

Aggesssion and ID and tx

Answer 11

Behaviorla tx is 1st followed by meds

Main reason for consultation

Question 12

Slef-jury and tx

Answer 12

Reptitive acts that occur in an identical form

Behavior therapy is main

Meds can also address compulsive acts

Question 13

Stereotypy and tx

Answer 13

Invariant behaviors or action sequences without an obvious reinforcement pattern

Seen in circumstances of extreme stimulation or deprivation

Bahvior therapy and SSRIs

Question 14

Tx of ID

Answer 14

Treat underlying disorders, QOL, etc

Question 15

Pharmacotherapy

Answer 15

Stimulants - for hyperactivity, inattention, and impulsivity
Non-stimulants (strattera) - hyperacitive, inattnetion, impulsiity
SSRIs - depression and anxiety
Antipsychotics - aggression, slef-injurious behaviors

Question 16

Tic disorders

Answer 16

One second or less and are voluntary that can be anticipated

Sudden, rapid, recurrent, non-rhythmic movement

Question 17

tic demo

Answer 17

Boys much higher

Question 18

Tourette’s and environment

Answer 18

Maternal nausea, low brith weight, forceps delivery

Stimulant therapy induces earlier onset

Group A B-hemolytic strep infection leading to AI disorders

Question 19

Tic onest, peak, and reduction and course

Answer 19

5-6 onset
10-12 peak
15-17 reduction

Occur in bouts and wax and wane

Suppressinble to a degree

Question 20

Tic encouragers

Answer 20

Stress and anxiety

Decrease during sleep and absorbing activities

Question 21

Simple vs complex tics

Answer 21

Simple - one muscle group

Complex - multiple

Question 22

Complex vocal tics

Answer 22

Single words or phrases
SPeech blokcing
Changes in prosidy

Echolalia or coprolalia (rare)

Question 23

Tourette’s

Answer 23

Both multiple motor and one or more vocal have been present

Tics may wax and wane in frequency but have persisted for 1 years

Onset befroe 18

Question 24

Course of tourettes

Answer 24

Starts young with motor, then vocal

Strts in head and face then body

Starts simple then mre ocmplex

Question 25

Persistnet (chronic) motor or vocal tic disorder

Answer 25

Exact same BUT cannot have both motor and vocal

Question 26

Tx of tic disorders

Answer 26

Supportive, educationla, and psychotherapuetic interventions for patients and families

Pharm

Tourette’s often seen as triad with ADHD and OCD

Question 27

Meds for tics

Answer 27

Alpha-2A agonists - clonidine and guanfacine - diminish dopamine levels and stimulate inhibitory cortical functions

Antipsychotics - typical and atypical - blcok dopamine receptors