Neurodevelopmental Disorders Flashcards

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1
Q

Neurodevelopmental Disorders

A
  • children experience some of the same mental health problems as adults (mood, anxiety disorder, eating disorder - anorexia in teen years)
  • consistent failure to meet developmental milestones should prompt a medical workup
  • ex) intellectual disability, autism, ADHD
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2
Q

Intellectual Disability

A

intellectual and adaptive functioning deficit

  • conceptual/language
  • social/interpersonal
  • practical skills/ADL’s

have an effect on all areas of life

essential feature of IQ < 70

several causes of intellectual disabilities exist
-you may see specifiers of mild to profound

ex) Down syndrome, fragile X, fetal alcohol syndrome = causes of genetic intellectual disability

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3
Q

Autism Spectrum Disorder

A

persistent deficits in social communication AND interaction (restricted interest) across environments

spectrum = wide range of symptom severity and functional abilities

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4
Q

ASD

A

onset = infancy, in 20% of cases there is regular development until 2-3 YO then there is regression or loss of abilities

more common in boys

cause: unknown, genetic link

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5
Q

ASD: Presentation

A
  • avoidance of eye contact
  • delayed speech or language skills
  • rigidity in thinking (upset by change)
  • repetition of words or phrases
  • stereotyped motor behaviors: hand flapping, head banging, body twisting, spinning the wheels on a toy care for hours
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6
Q

ASD: Safety

A

-wondering (nearly 50% of children w/ autism wonder form safe supervision)

often wonder towards bodies of water, therefore safety includes swimming lessons

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7
Q

ASD: Tx

A
  • early intervention
  • goals: reduce behavioral symptoms, promote learning and development (language skills)
  • special programs
  • no meds FDA approved for ASD

meds for symptoms:

  • antipsychotics
  • naltrexone (possible association w/ autism and opioid receptors in brain)
  • clonidine (sleep, attention, focus)
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8
Q

ASD: Related Disorders

A
Tic disorders
Chronic motor or tic disorders
Learning disorders
Motor skills disorders
Elimination disordes
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9
Q

Tic Disorders

A

Tic - sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization
-can have motor, vocal, or combination of both

  • exacerbated by stress
  • genetic component
  • dopamine though to play a role
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10
Q

Tourette Disorder

A

experience both motor AND vocal tics and have symptoms for at least ONE YEAR

assess self-esteem of pt because this can negatively impact self-esteem

child may experience blurting out of obscene words, insults, or making obscene gestures but this is not something they can control and they should not be blamed

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11
Q

Tic Disorder: Tx

A

CBT
Habit reversal training: awareness training to bring greater attention to tic/behavior so a person can gain better control over it

Meds:

  • antipsychotics
  • clonidine

Rest
Exercise
Manage Stress

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12
Q

Learning Disorders

A

problems in achievement in a specific area

  • poor writings skills, reading comprehension, math
  • unlike intellectual disabilities, LD are limited to specific domains

achievement is below what is expected for age, education, and intelligence

low self esteem and poor social skills

Early intervention and assistance:
-IEP (individualized education program): schools plan to help a child improve

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13
Q

Motor Skill Disorders

A

essential feature is impaired coordination severe enough to interfere with academic achievement or ADL’s

Stereotypic Movement Disorder:

  • not secondary to a medical condition that affects motor function
  • onset <3 YO
  • comorbid ADHD, tics, OCD
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14
Q

Communication Disorders

A

deficits in language, speech, and communication

dx occurs when deficit hinders development, academics, or social development

speech disorder = speech and language therapist - help improve communication

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15
Q

Elimination Disorders

A
  • Enuresis: voiding of urine during the day or night into clothing or bed >5YO
  • Encopresis: passage of feces in inappropriate places (usually clothing) >4YO, can be intentional or involuntary
  • ages are chronological or developmental
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16
Q

Enuresis: Tx

A

meds:
-imipramime: TCA (SE = anticholinergic)

behavioral approach to tx: positive reinforcement for continence

17
Q

ADHD

A

marked by:

  • inattentiveness
  • overactivity
  • impulsivity

difficult to dx in children < 4YO b/c you can’t confirm the behavior isn’t normal

can be predominant inattentive pattern, hyperactive/impulsive pattern, or combined type

children sent to specialist to be diagnosed b/c we don’t want them to be misdiagnosed
-pediatric neurologist, psychologist, or child psychiatrist

the key is that it’s consistent, the symptoms occur daily in multiple settings

-r/o bipolar disorder, stress, anxiety

18
Q

ADHD: Etiology

A

cause is unknown

brain images show: decreased metabolism in frontal lobes (which is essential for attention and impulse control)

genetic link

environmental factors

abnormalities in catecholamine or serotonin

19
Q

ADHD: Tx

A

no one tx is more efficacious

medications target impulsiveness and improving attention

stimulants:

  • methylphenidate (Ritalin)
  • amphetamine salts (Adderall)
  • dextroamphetamine

CBT

20
Q

Stimulants: SE

A

insomnia
loss of appetite
weight loss

21
Q

ADHD: Other Tx

A

antihypertensives:
- clonidine
- guanfacine

SNRI:
-atomoxetine

Atypical Antidepressant:
-buproprion (welbutrin)