Motor disorders Flashcards
what is comorbid with developmental coordination disorder about 50% of the time
ADHD
specific learning disorder
language disorder
what are the 3 areas of deficit that contribute to developmental coordination disorder
-poor predictive control of motor movements
-deficit in rhythmic coordination and timing
-deficits in executive function
what areas of executive function are deficient in developmental coordination disorder
working memory
inhibition
attention
what might you find in the developmental history of a child with developmental coordination disorder
delays in achieving milestones like crawling, walking, sitting, etc
what is dx of developmental coordination disorder based on
hx of delay in achieving milestones and observation of deficits in coordination
what are 3 specialized tests of motor coordination
-bender visual motor gestalt test
-frosting movement skills test battery
-Bruininks-Oseretsky test of motor evelopment
3 broad categories of interventions to treat developmental coordination disorder
-deficit oriented approaches
-task specific interventions
-motor imagery
what are 3 deficit-oriented approaches to the treatment of developmental coordination disorder
-sensory integration therapy
-sensorimotor-oriented tx
-process-oriented tx
what are 2 task specific intervention for the treatment of developmental coordination disorder
-neuromotor task training
-cognitive orientation to daily occupational performance
what is the purpose of parental counseling in the treatment of developmental coordination disorder
-reduce anxiety/guilt
-increase awareness
-facilitate coping skills
risk factors for developmental coordination disorder
-prematurity
-hypoxia
-low birth weight
-perinatal malnutrition
-prenatal exposure to drugs/alcohol
what part of the brain plays a vital role in motor coordination
cerebellum
what are stereotypic movements
repetitive motor behaviors emerging in early childhood that appear to lack a clear function and may disrupt daily life
characteristics of stereotypic movements in relation to behavior
-may be self-soothing, self-stimulating, or self-mutilating
-appear involuntary
are stereotypic movements involuntary
no. they can be suppressed with concetrated mental effort
what is the difference between stereotypic movements and tics
-stereotypic movements manifest sooner and lack a premonitory urge
-tics tend to be shorter duration and less rhythmic
-stereotypies are soothing while tics are disruptive
what are 2 typical types of stereotypic movements seen in stereotypic movement disorder
head banging
nail biting
what are the most effective treatments for stereotypic movement disorder in the absence of comorbidities
behavioral treatments such as habit reversal training and differential reinforcement of other behaviors
what is included in medication management of stereotypic movement disorder if needed
-some effect with antipsychotics
-SSRIs may help self-injurious stereotypies
what region of the brain and neurotransmitters are hypothesized to be associated with stereotypic movement disorder
origin in the basal ganglia and involving dopamine and serotonin
manifestation of tics
usually between 5-6 with highest severity between 10-12
what part of the brain is though to be dysfunctioning in tics
basal ganglia (particularly involving dopaminergic transmission in the CSTC)
definition of tic
repetitive muscle contraction that leads to involuntary movement or vocalization
what are the 2 types of tics
motor
vocal
examples of simple motor tics
eye blinking
head jerking
grimacing
examples of complicated motor tics
grooming
smelling objects
jumping
touching
echopraxia
copropraxia
What differentiates a tic from a stereotypy
stereotypies are voluntary and often provide comfort while tics are involuntary and associated with distress
what is copropraxia
obscene gestures
what are common simple vocal tics
throat clearing
grunting
snorting
coughing
barking
examples of complex vocal tics
-repeating words/phrases out of context
-coprolalia
-palilalia
-echolalia
coprolalia
obscenities
palilalia
repeating your own words
echolalia
repeating others words
how long must tics persist for dx of Tourettes disorder
at least 1 year with onset prior to 18
2 disorders highly associated with Tourette’s
ADHD
OCD
diagnostic tools for tics/Tourette’s
-tic symptom self-report
-yale global tic severity scale
-premonitory urge for tics scale
what age range is the premonitory urge for tics scale (PUTS) appropriate for
children older than 10
what type of tics are required for dx of Tourette’s
both vocal and motor tics
what are some topics for psychoeducation with Tourette’s
variability of tics
history of disorder
stress reduction interventions
what are some EBP behavioral interventions for Tourette’s
habit reversal
exposure and response prevention
components of habit reversal
awareness training
competing response training
how does exposure and response prevention work with Tourette’s
patient voluntarily suppresses tics for longer and longer to break the association between urge and tic
main drug class options for the tx of Tourette’s when meds are needed
-antipsychotics
-noradrenergic agents
what is the most well studying atypical antipsychotic for the treatment of tics
risperidone
what are the most well studied typical antipsychotics for treating tics
haldol
pimozide
what noradrenergic agents are used to treat tics
clonidine
guanfacine
atomoxetine
alternative medications that are sometimes used for the treatment of tics
tetrabenazine
topiramate
tetrahydrocannabinol
main difference between Tourette’s and persistent motor/vocal tic disorder
Tourette’s requires both types of tics while persistent motor/vocal tic disorder only requires one or the other
how long must tics persist to qualify for dx of persistent motor/vocal tic disorder
at least 1 year
treatment for persistent motor/vocal tic disorder
behavioral interventions
in severe cases medication may be necessary