Neurodevelopment: ADHD, learning disability and intellectual disability (week 10) Flashcards
Week 10
What are neurodevelopmental disorders?
- Disorders first diagnosed in infancy, childhood, or adolescence
- Attention-deficit/hyperactivity disorder (ADHD)
- Specific learning disorder
- Intellectual disability
- Autism spectrum disorder-
What is ADHD?
- Unable to sustain attention on tasks, activities
- Inattentive, motor hyperactivity, impulsive behaviour
- Disrupted schooling and relationships
- DSM-5TR differentiates two categories of symptoms:
Inattention
Hyperactivity and
impulsivity
ADHD DSM diagnosis: A
A) Need either or both of 1) Inattention 2) Hyperactivity/ Impulsivity
* Need 6 or more symptoms for at least 6 months at a level inconsistent
with developmental level
* ADHD –IA
- 6 or more Inattentive
symptoms
* ADHD- HY
- 6 or more Hyperactive/ Impulsive symptoms
* ADHD- C
- Met both Inattention
and Hyperactive criteria
ADHD inattention symptoms (need 6+):
- Often fails to give close attention to details or makes careless mistakes in schoolwork,
at work, or with other activities. - Often has trouble holding attention on tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often does not follow through on instructions and fails to finish schoolwork, chores, or
duties in the workplace (e.g., loses focus, side-tracked). - Often has trouble organizing tasks and activities.
- Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long
period of time (such as schoolwork or homework). - Often loses things necessary for tasks and activities (e.g. school materials, pencils,
books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones). - Is often easily distracted
- Is often forgetful in daily activities.
ADHD: hyperactivity and impulsivity symptoms (need 6+):
- Often fidgets with or taps hands or feet, or squirms in seat.
- Often leaves seat in situations when remaining seated is expected.
- Often runs about or climbs in situations where it is not appropriate
(adolescents or adults may be limited to feeling restless). - Often unable to play or take part in leisure activities quietly.
- Is often “on the go” acting as if “driven by a motor”.
- Often talks excessively.
- Often blurts out an answer before a question has been completed.
- Often has trouble waiting their turn.
- Often interrupts or intrudes on others (e.g., butts into conversations or
games)
What is the ADHD DSM - 5TR diagnosis?
B) Symptoms present prior to the age of 12
C) Symptoms present in two or more settings
D) Clear evidence of functional impairment
E) Not better accounted for by medical or other psychological disorder
What is ADHD comorbid with?
Disruptive behaviour disorders
What are the causes of ADHD?
Highly genetic
inhibition of dopamine gene
prenatal smoking, stress, alcohol use
Associations with ADHD are:
subtle brain differences: reduced with medications
The volume size of the brain is slightly smaller
Sleep problems
Negative responses by others create low self esteem
Biological treatment for ADHD (meds):
stimulant medication:
Improves motor planning, response inhibition, decreases negative behaviour
*effects are NOT longterm
Psychological treatment for ADHD (behavioural):
Goal setting and reinforcement
Is psychological or biological treatment better for ADHD?
A combination of meds and psychosocial is actually best!
What is a specific Learning Disorder?
- Performance substantially below what would be expected given
age, IQ, and education - Deficits in reading, math, and written expression
- Problems persist despite intervention
DSM - 5 criteria of learning disorders:
A. History of academic functioning below the expected level
B. Below average academic achievement in at least one area
C. Evidence that difficulties are related to a psychology process (e.g.,
phonological, memory, receptive language, visual-spatial etc)
D. At least average IQ
Who do learning disorders affect?
boys and girls are equally affected
What is Learning disorders related to?
later development of other mental health problems (less education, underemployment, unemployment)
Genetic causes of Learning Disorders:
found in identical twins and relatives
Neurobiological causes of learning disorders:
Subtle brain damage
- phonological processing problems and reading disabilities (linked in children and adults)
Environmental causes of learning disorders:
SES, cultural expectations, parental
interactions and expectations, child management practices,
support (lack of) provided in school
Treatment of Learning Disorders:
Education intervention
- remediate directly the
underlying basis
process of problems
- improve cognitive skills
- improve behavioural
skills
Combination of programs is effective
What is an Intellectual Disability?
- Intellectual functioning significantly below average
* Language and
communication
impairments - Wide range of impairment in daily activities
* Mild to profound - Individuals with ID have difficulty learning
What is the clinical description of intellectual disability?
Criteria:
* Person must have
significantly subaverage
intellectual functioning
(IQ ~ 70)
* Concurrent deficits or
impairments in
adaptive
functioning
* Age of onset (deficits
evident before age 18)
* Degree of disability varies among ID individuals
Is intellectual disability chronic?
YES: people do not recover
Causes of intellectual disability
Abuse and neglect
prenatal exposure to substance use
Perinatal: issues with labour and delivery
post natal: head injury, infections
Biological dimensions of intellectual disability:
30% have no identified etiology
Down syndrome
Fragile X syndrome: ID with chromosomal cause
Treatment for intellectual disability:
- Behavioural focus similar to that for ASD
* Focus on building
adaptive functioning
skills - Additional support to live in the community
- Communication training; supported employment
* Augmentative
strategies
ADHD-C
Met both Inattention and Hyperactive criteria
ADHD-IA
6 or more Inattentive
symptoms
ADHD-HY
6 or more Hyperactive/ Impulsive symptoms
