NB14-2 - Neurodevelopmental Disorders Flashcards
List the neurodevelopmental disorders we need to know and what all of these disorders have in common.
- Intellectual Disability
- Global Developmental Delay
- Autism Spectrum Disorder
- Communication Disorders
- Language Disorder
- Speech-Sound Disorder
- Social (pragmatic) Communication Disorder
- Childhood-onset Fluency Disorder
- Specific Learning Disorder
- ADD/ADHD
All of these disorders have their onset in the developmental period, often before the child enters grade school. These disorders are characterized by defecits that produce impairments of personal, social, academic, or occupational functioning.
What are the diagnostic criteria for intellectual disability?
All of the following must be true:
- There are deficit in intellectual functions confirmed by clinical assessment and individualized, standardized intelligence testing
- There are deficits in adaptive functioning in conceptual, social, and practical domains that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility
- The onset is during the developmental period
What are the intelligence tests typically used to aid in the diagnosis of intelligence disabilities? How are the results interpreted?
Wechsler Adult Intelligence Scale (WAIS) or Wechsler Intelligence Scale for Children (WISC). Both tests have a mean score of 100 with a standard deviation of 15.
To be considered intellectually deficient, the score must be at least two standard deviations below the mean (so a 70 or lower)
Describe how the severity of an intellectual disability is determined. What percentage of those with ID fall within each severity category and what are generally the IQs of those in each category?
It is based upon adaptive functioning in conceptual (ability to learn/IQ), social (maturity in social interactions), and practical (ability to care for personal needs) domains.
- Mild - IQ 50 to 70 - ~85% of ID patients
- Moderate - IQ 40 to 55 - ~10% of ID patients
- Severe - IQ 40 - ~4% of ID patients
- Profound - IQ 40 -~1% of ID patients
What are the diagnostic criteria for global developmental delay (GDD)?
Only for children under the age of 5. Child must fail to meet expected developmental milestones in several areas of intellectual functioning
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What are the diagnostic criteria for Autism Spectrum Disorder?
All of the following must be present:
- Persistent deficits in social communication/interaction across multiple contexts, including social-emotional reciprocity, nonverbal communicative behaviors, and developing/maintaining/understanding relationships
- Restricted, repetitive patterns of behaviors, interests, or activities as manifested in at least two of the following:
- Repetitive motor movements, use of objects, or speech
- Insistence on sameness or strict adherence to routine
- Highly restricted and hyperintense focus on interests
- Hyper- or hypo-reactivity to sensory input
- Sympoms must be present in early development
- Symptoms cause clinically significant impairment i social, occupational, or other important areas of functioning
- Symptoms can’t be accounted for by ID.
What are the specifiers for Autism Spectrum Disorder?
- With or without accompanying ID
- With or without accompanying language impairment
- Associated with a known medical, genetic, or environmental factor
- Associated with another neurodevelopmental, mental, or behavioral disorder
- With catatonia
How is autism spectrum disorder severity determined? List the severity classes.
By the amount of support required
Level 1 - some support needed (without support they can still function but will have trouble forming relationships)
Level 2 - substantial support needed (even with support they still have deficits)
Level 3 - very substantial support needed
What are the diagnostic criteria for language disorder?
All of the following must be present:
- Persistent difficulties in the acquisition and use of language across modalities
- Language abilities substantially below age expectations
- Onset in early developmental period
- Cannot be attributable to sensory impairment, motor dysfunction, or other disorders/injuries
Diagnoses made before the age of 4 may be unreliable
What are the diagnostic criteria for speech-sound disorder?
All of the following must be present:
- Persistent difficulty with speech sound production that interferes with speech intelligibility
- The disturbance limits effective communication to the point that it interferes with social, academic, and/or occupational performance
- Onset of symptoms in the early developmental period
- Not attributable to hearing loss or other disorders/injuries
Cannot diagnose before 3-4 because speech normally isn’t intelligible until then.
What are the diagnostic criteria for Social (pragmatic) Communication Disorder?
All of the following must be present:
- Persistent difficulties in the social use of verbal and nonverbal communication (all of the following):
- Deficits in communicating for social purposes
- Deficit in ability to change communication to match context
- Difficulty following the rules of communication
- Difficulty understanding implicit meanings
- Deficits interfere with social, academic, or occupational performance
- Onset in early development
- Not attributable to low abilities in word structure and grammar or other disorders/injuries
Diagnosis rarely made before the age of 4-5
What are the diagnostic criteria for childhood-onset fluency disorder (stuttering)?
All of the following must be present:
- Persistent disturbances in the normal fluency and time pattering of speech that are inappropriate for age and level of language skill
- The disturbance causes anxiety about speaking or limits effective communication
- Onset of symptoms in the early developmental period
- Not attributable to other disorders/injuries
Usually diagnosed by age 6 with 65-85% of children recovering from the dysfluency. The dysfluency is often absent during oral reading, singing, or talking to pets or objects
What are the diagnostic criteria for specific learning disorder?
All of the following must be present:
- Difficulty learning and using academic skills, as indicated by the presence of at least one of the following syptoms persisting for at least 6 month despite targeted interventions:
- Inaccurate or slow/effortful word reading
- Difficulty understanding the meaning of what is read
- Difficulties with spelling
- Difficulties with written expression
- Difficulties mastering number sense, facts, or calculation
- Difficulties with mathematical reasoning
- The affected academic skills are substantially below those expected for age (as confirmed by comprehensive clinical assessment) and cause significant interference with daily living,
- The learning difficulties began during school-age years
- Not better accounted for by ID, impaired sensory abilities, lack of proficiency in the language of instruction, inadequate instruction, or other disorders/injuries.
Requires Psychoeducational assessment
What are the specifiers for specific learning disorder and how is the severity of the disorder classified?
- Specifiers
- With impairment in reading
- With impairment in written expression
- With impairment in mathematics
- Severity
- Mild - mild difficulties in 1 or 2 academic domains; may learn to function well with initial support services
- Moderate - marked difficulties in 1 or 2 academic domains; needs support to complete tasks
- Severe - severed difficulties across several academic domains; needs intensive and individualized teaching
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