Module 4 - Cognition Flashcards
6 domains of cognition
perceptual motor function (psychomotor)
language
learning and memory
social cognition
complex attention
executive function
Physiologic factors impairing cognition
hypoglycemia
impaired perfusion
impaired gas exchange
acid-base imbalance
3 main NDD
FASD
ASD
ADHD
Types of FASD
fetal alcohol syndrome –> facial dysmorphia + developmental delay
alcohol related neurodevelopmental disorder –> developmental delay
Types of ADHD
Inattentive
Hyperactive/impulsive
combined
Types of ASD
Asperger’s
Pervasive developmental disorder not otherwise specified
Autistic disorder
Childhood disintegrative disorder
Embryonic periods
week 1-2 = implantation
week 2-7 = organogenesis
High-risk period for embryonic brain development
week 3-4
**most women unaware they are pregnant at this time
What happens on day 29 of embryonic development?
primitive lobes of brain & spinal cord in place
Facial features of FASD
Patho of FASD
decreased grey/white matter –> lower cerebral volume
impaired communication b/w brain lobes
Frontal lobe function
decision making
executive function
planning
Corpus callosum function
connects left/right hemispheres
allows for coordination of both sides of body –> gross/fine motor control
inhibition of nerve impulses
Hippocampus function
learning
memory
transfer info from short-term –> long-term memory
PCerebellum function
motor control –> balance, gait
motor coordination
planning/execution of movement
Basal ganglia function
motor control
motor learning
routine habits, behaviors, emotions
initiation/control of movement
reward center –> motivation
Patho of ADHD
changes to maturation of white matter bundles & grey matter density
ADHD behaviors
difficulty w/ change
easily distracted
difficulty planning, initiating, realizing actions or correcting errors
ASD Patho
atypical cortical growth/folding
grey matter outpaces white matter –> abnormal interconnections
Amygdala function
emotional/social cognition
fight/flight response –> fear response/aggession
recognizing facial expression
Proposed patho mechanisms of ASD
chronic neuroinflammation w/ microglia activation
mitochondrial dysregulation
dysregulation of cell signaling pathway
immune dysregulation
GABA imbalance
Glutamine dysregulation
Genetics
Core sx of ASD
1) communication & social interactions
2) repetitive behaviors & limited interests in activity/play
When is ASD usually diagnosed
~2 years old
12 months if symptoms severe
ASD treatmnet
behavior management/education
specialized therapy –> speech, OT
medicine (adjunct)
ASD communication & social interactions
lack of eye contact, awkward facial expressions/body posture
difficulty socializing
lack of empathy or emotional intelligence
lack of shared interests
delayed speech, mute, may appear deaf
difficulty conversing
trouble understanding other’s POV –> very literal interpretation
ASD repetitive behaviors & limited interests
fixation on objects/topics (pieces of things)
need for sameness/routine –> difficulty with change
body rocking/hand flapping
echolalia
sensory under/overstimulation
Other ASD S/S
food aversion, dietary restrictions
GI problems –> diarrhea, constipation, abdominal pain
trouble sleeping
lack of coordination
pica (eating non-edible items)
elopement
savant
seizures
ADHD symptoms
trouble paying attention (inattentive)
trouble sitting still even for a short time (hyperactive)
acting before thinking (impulsive)
When is ADHD diagnosed
6-12 years old
ADHD treatment
psychostimulatants
nonstimulant norepinephrine reuptake inhibitor
adrenergic agonist anti-hypertensives
antidepressants
behavior therapy
Which NDD can be treated with medicine
ADHD
Which NDD can be diagnosed at birth
FASD
Definition of binge drinking
3+ drinks at a time
FASD RF
alcohol consumption during pregnancy
binge drinking or drinking throughout pregnancy
age of birth parents
concurrent substance abuse
genetics
Piaget stages of development
1) sensorimotor 0-2
2) pre-operational 2-7
3) concrete operational 7-11
4) formal operational 12+
Sensorimotor (0-2)
infants think through 5 senses
object permanence
begin to develop language
Preoperational (2-7)
egocentric (cannot see others POV)
concrete thought –> directly observable
can use language/symbols
imaginative play
transductive logic
Concrete operations (7-11)
logical, coherent thought
conservation
concrete, systematic problem-solving
inductive reasoning
can see others POV
inductive logic
Formal operations (12+)
adaptible & flexible thought
abstract thought
scientific problem-solving
deductive logic
What are NDD
group of disorders w/ disturbed CNS development –> developmental brain dysfunction
Affects of NDD
intellect
language/speech
FASD impairments
language processing
vision
hearing difficulties
heart, kidney, liver, organ damage
poor memory
poor impulse control
trouble with judgment
delayed growth
verbal learning
visual-spatial
attention
reaction time
executive function
Facial features of FASD
small eyes
flat philtrum
thin upper lip
short nose
flat midface
smaller head
FASD dx
facial malformation
maternal record of alcohol use
psychosocial testing
diagnostic imaging
FASD treatment
multifaceted
education/behavior mgmt for parents
impulse control therapy
special education
no specific drug treatment –> adjunct therapy
Severity levels of ASD
requiring support
requiring substantial support
requiring very substantial support
Causes of ASD
chromosomal abnormalities
functional brain abnormalities
structural brain abnormalities
Which neurotransmitter is LOW in ADHD?
dopamine/norepinephrine
Domains of cognition
“every leming can see lost pies”
executive function
learning/memory
complex attention
social cognition
language
psychomotor
Stimulant side effects
Appetite suppression (give at night or after meals)
Weight loss
Nervousness
Tics
Insomnia
Increased BP
