Neurodevelopmental Disorders Flashcards
IDD criteria
- Low IQ (<70)
- Low adaptive skills
- Onset = developmental period
IDD severity specifier
- Mild, Moderate, Severe, Profound
- Based on adaptive skills
IDD etiology
- Most prenatal = Down’s, Fragile X, FAS
- Some perinatal = asphyxia
- Some postnatal = meningitis, abuse
ASD criteria
- Social communication (reciprocity, nonverbals, relationships)
- Restrictive and repetitive behaviors (fixed interests, stereotypy, rigidity, sensitivity)
- Onset = early developmental period
ASD best prognosis
- IQ > 70
- Language by 5yo
- No comorbidities
ASD and brain structure
- Accelerated brain growth
- Structures affected = cerebellum, corpus callosum, amygdala
ASD and NTs
Lower:
1. Brain serotonin
2. GABA
Higher:
1. Blood serotonin
2. Glutamate
3. Acetylcholine
ASD prevalence
1-2%
3-4x in males
ASD heritability
Monozygotic = 69-95%
Dizygotic = 0-24%
ASD treatment
- ABA (affects IQ and language)
- Medication for comorbidities
ADHD criteria
- Duration > 6 months
- Onset < 12yo
- 2+ settings
- 6+ symptoms (5+ for adults)
ADHD prevalence
- Most prevalent dx in 3-17 yo
- 2x more in males
ADHD heritability
One of the most heritable disorders
- All twins = 76%
- Monozygotic = 71%
- Dizygotic = 41%
ADHD risk factors
- Low birth weight
- Premature birth
- Maternal tobacco/alcohol use
ADHD comorbidities
- ODD*
- CD
- Anxiety
- Depression
- Adulthood SUDs (not due to meds)
ADHD and brain structure
- Smaller, less active brain regions
- Abnormal = PFC, striatum (caudate nucleus and putamen), thalamus, cerebellum, amygdala
ADHD and NTs
Low:
1. Dopamine
2. Norepinephrine
ADHD treatment
Children:
1. First line = therapy (parent training) OR combined
Adults:
1. First line = medication
2. Therapy (CBT)
Three types of tic disorders
- Tourette’s
- Persistent motor or vocal tic disorder
- Provisional tic disorder
Tourette’s criteria
- 1+ vocal tic AND 2+ motor tics
- Duration > 1 year
- Onset < 18yo
Persistent motor or vocal tic disorder
- 1+ vocal tic AND/OR 1+ motor
- Duration > 1 year
- Onset < 18yo
Provisional tic disorder
- 1+ vocal tic AND/OR 1+ motor tic
- Duration < 1 year
- Onset < 18 years
Tic disorders typical course
- Onset 4-6 yo
- Severity peaks 10-12 yo
Tic disorders comorbities
- ADHD*
Tic disorders and brain structure
- Small caudate nucleus
Tic disorders and NTs
Low:
1. Dopamine
Tic disorders treatment
- Medication = antipsychotics, meds for comorbidities
- CBIT
CBIT
Comprehensive Behavioral Intervention for Tics
- Psychoeducation
- Social support
- Habit reversal
- Competing response
- Relaxation
Child-onset fluency disorder (stuttering) criteria
- Speech inconsistent with development
- Persists over time
- 1+ symptoms
Seven types of speech symptoms
- Sound and syllable repetitions
- Sound prolongations
- Broken words
- Audible or silent blocking
- Circumlocutions
- Words pronounced with excessive tension
- Monosyllabic whole-word repetitions
Child-onset fluency disorder typical course
- Onset = 2-7 yo
- 65-85% recovery rate
Child-onset fluency disorder prognosis
Based on the severity at 8 yo
Child-onset fluency disorder treatment
Habit reversal training (competing response = regulated breathing)
Habit reversal training
- Awareness
- Competing response
- Motivation
- Relaxation
- Skills generalization
SLD criteria
- Academic difficulties despite intervention
- 1+ symptoms
- Onset = school-age years
Types of SLD symptoms
- Word reading > comprehension
- Spelling > written expression
- Calculations > reasoning
SLD prevalence
- 5-15%
- 80% of SLDs are in reading (mostly dysphonic dyslexia)
Dysphonic dyslexia
Difficulty connecting sounds to letters
SLD comorbidities
- ADHD*