Neurodevelopmental Disorders Flashcards
This condition usually begins in infancy; people with it have low intelligence that causes them to need special help coping with life. They have difficulty with cognitive tasks and cognitive impairment. Affected in multiple life areas.
Intellectual disability
Severity level: IQ Mild: ~50-70; 85% of patients Moderate: ~30-50; 10% of patients Severe: ~20-30; 5% of patients Profound: low 20s down; 2% of patients
Indicates persons nominally ranked in the IQ range of 71-84 who do not have the coping problems associated with intellectual disability
Borderline intellectual functioning
From early childhood, the patient has impaired social interactions and communication and shows stereotyped behaviors and interests.
Autism spectrum disorder
Specify:
{with}{without} accompanying intellectual impairment
{with}{without} accompanying language impairment
Associated with a known medical or genetic condition or environmental factor
Associated with another neurodevelopmental, mental, or behavior disorder
With catatonia
Use when a child under the age of 5 seems to be falling behind developmentally, but you cannot reliably assess the degree
Global developmental delay
A child’s delay in using spoken and written language is characterized by small vocabulary, grammatically incorrect sentences, and/or trouble understanding words or sentences
Language disorder
A child chooses not to talk, expect when alone or with select intimates (DSM-5 classifies as anxiety disorder)
Selective mutism
Multiple vocal tics (1+) and motor tics (2+) occur frequently throughout the day (longer than 1 year; begin by age 18)
Tourette’s disorder
A patient has either motor OR vocal tics, but NOT both (longer than 1 year; begin by age 18)
Persistent (chronic) motor or vocal tic disorder
Patients are hyperactive, impulsive, or inattentive, and often all three (for 6+ months; onset before age 12)
Specificities
Attention-deficit/hyperactivity disorder (ADHD)
Specify (for the past 6 months):
Predominantly inattentive presentation
Predominantly hyperactive/impulsive presentation
Combined presentation
In partial remission: when the condition persists (into adulthood), enough symptoms may be lost that the full criteria are no longer met but impairment persists
Mild. few symptoms
Moderate. intermediate
Severe. many symptoms, more then required
Multiple examples of negativistic behavior persist for at least 6 months; difficulty with authority
Oppositional defiant disorder (ODD)
A child persistently violates rules or the rights of others
Conduct disorder
The patient eats material that is not food
Pica
There is a persistent regurgitation and chewing of food already eaten
Rumination disorder
At age 4 years or later, the patient repeatedly passes feces into clothing or onto the floor
Encopresis
At age 5 or later, there is repeated voiding of urine (voluntary or involuntary) into bedding or clothing
Enuresis
During the first part of the night, these patients cry out in apparent fear. Often they don’t really wake up at all. This behavior is considered pathological only in adults, not children.
Non-rapid eye movement sleep arousal disorder, sleep terror type
This z-code is used when there is no mental disorder, but a child and parent have problems getting along (ex: overprotection or inconsistent discipline)
Parent-child relational problem
This z-code is used for difficulties between siblings
Sibling relational problem
A variety of z-codes can be used to cover difficulties that arise from neglect or from physical or sexual abuse of children
Problems related to abuse or neglect
A child’s mood is persistently negative between severe temper outbursts
Disruptive mood dysregulation disorder
The patient becomes anxious when apart from parent or home
Separation anxiety disorder
Children repeatedly relive a severely traumatic event, such as car accidents, natural disasters, or war
Post-traumatic stress disorder in preschool children
A boy or girl wants to be of the other gender
Gender dysphoria in children
A caregiver induces symptoms in someone else, usually a child, with no intention of material gain
Factitious disorder imposed on another
These categories serve for patients whose difficulties don’t fulfill criteria for one of the other disorders
Other specified or unspecified neurodevelopmental disorder
Expected to attain 6th grade academic skills; deficiencies in judgment and problem solving; need help with paying bills, shopping, groceries, finding accommodations; many work independently, at jobs requiring little cognitive involvement; memory and language ability can be good, but become lost when confronted with abstract thinking (metaphors); IQ ~50-70; 85% of patients [specify severity of this disorder]
Mild Intellectual Disability
Can learn to read, simple math, handle money. Language use is slow to develop and simple. Need help with self-care, household tasks, making decisions, work (at undemanding jobs; sheltered workshops). IQ ~high 30s to low 50s. 10% of all patients [specify severity of this disorder]
Moderate Intellectual Disability
Communication skills are rudimentary (single words, some phrases); under supervision they may hold a simple job; require supervision for all activities (even self-care); IQ in ~low 20s to high 30s. 5% of all patients [specify severity of this disorder]
Severe Intellectual Disability
Usually results from a serious neurological disorder with sensory or motor disabilities. Limited speech and rudimentary capacity for social interaction (mostly use gestures); need complete help for needs (daily living); may help with simple chores. IQ ~low 20s downward. 1-2% of all patients [specify severity of this disorder]
Profound Intellectual Disability
From early childhood, the patient has impaired social interactions and communication and shows stereotyped behaviors and interests.
The patient has trouble starting conversations or may seem less interested in them than most people.
-OR-
Change provokes some problems in at least one area of activity
Autism Spectrum Disorder requiring support
social communication severity: level 1 (mild)
restricted, repetitive behaviors: level 1 (mild)
From early childhood, the patient has impaired social interactions and communication and shows stereotyped behaviors and interests.
There are pronounced deficits in both verbal and nonverbal communication.
-OR-
Problems in coping with change are readily apparent and interfere with functioning in various areas of activity.
Autism Spectrum Disorder requiring substantial support
social communication severity: level 2 (moderate)
restricted, repetitive behaviors: level 2 (moderate)
From early childhood, the patient has impaired social interactions and communication and shows stereotyped behaviors and interests.
Little response to the approach of others markedly limits functioning. Speech is limited, perhaps to just a few words.
-OR-
Change is exceptionally hard; all areas of activity are influenced by behavioral rigidity. Causes severe distress.
Autism spectrum disorder requiring very substantial support
social communication severity: level 3 (severe)
restricted, repetitive behaviors: level 3 (severe)
Best Treatment Practices
Family Integration Therapy; in adults, Environmental Enrichment to reinstate greater levels of plasticity in adulthood. EE = environment rich in social, physical, cognitive, and inanimate stimulation
