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M2 Neuro/Psych > Neurodevelopmental Disorders- O'Grady > Flashcards

Neurodevelopmental Disorders- O'Grady Flashcards

1
Q

What are the 9 hyperactivity symptoms of ADHD?

A

Fidgeting

Leaves seat when expected to stay

Runs around/feels restless

Unable to play quietly

‘On the go’

Talks excessively

Blurts out answer/conversation

Difficultly waiting

Interrupting/Intruding

*Notice a lot of these are very similar symptoms*

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2
Q

What are the 9 inattentive symptoms of ADHD?

A

Poor attention to details

Difficulty in sustained attention

Not listening when spoken to directly

Poor follow-through on instructions

Difficulty organizing tasks

Avoids tasks requiring sustained effort

Loses materials for tasks

Easily distracted

Forgetful in daily activities

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3
Q

What are the criteria for a diagnosis of ADHD?

A

6 out of 9 hyperactivity symptoms for at least 6 months

6 out of 9 inattention symptoms for at least 6 months

Not explained by other disorders

Before 12, must occur in multiple settings, with functional impact

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4
Q

What 5 qualifiers can be used to describe ADHD?

A
  1. Combined
  2. Primarily Inattentive
  3. Primarily Hyperactive
  4. Partial Remission
  5. Mild/Moderate/Severe
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5
Q

What are 6 potential symptoms of learning disorders?

What criteria is need for diagnosing a learning disorder?

A
  1. Inaccurate or slow/effortful word reading
  2. Difficulty understanding what is read
  3. Difficulty spelling
  4. Difficulty in written expression
  5. Difficulties in mastering number sense, facts calculation
    • I think this is basically trouble adding/subtracting/multiplying/dividing
  6. Difficulties in math reasoning

1 of the 6 symptoms must be present for at least 6 months

Can not be explained by any other problem (EG poor eyesight)

Skills measurably below expected norms

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6
Q

How are learning disorders specifically classified?

A

Reading Impairment

Written Expression

Math Impairment

Mild/moderate/severe

Readin’, Ritin’, and ‘Rithmatic (also how bad it is)

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7
Q

What criteria is needed for diagnosis of Motor-Developmental Coordination disorder?

When is it typically diagnosed?

A

Persistant difficulty in acquisition and execution of coordinated motor skills (EG clumsiness, inaccuracy, slowness) affecting productivity

Usually diagnosed during developmental period (young childhood, or toddlerhood for severe cases)

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8
Q

What criteria are needed to diagnose a motor stereotypic movement disorder?

When is it’s typical onset?

A

repetitive, driven, purposeless movement not explained by OCD or other disorder

Onset during developmental period

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9
Q

What type of disorder is Tourette’s syndrome?

What differentiates it from from other similar disorders?

What does it share with similar disorders?

A

Tic disorder

Tourette’s has multiple motor and vocal tics, but symptoms may wax and wane

Onset before 18, and persists for at least 1 year

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10
Q

Assume the patient is 12 and has no other symptoms or medications

What is the diagnosis if the patient has 1 tic (motor or vocal) that has been present for more than 1 year?

What is the diagnosis if the patient has tics (motor or vocal) that has been present for less than 1 year?

A

Persistant Motor or Vocal Tic Disorder

Provisional Tic Disorder

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11
Q

What should be kept in mind for patients with developmental disorders?

A

Look for the presence of other disorders or syndromes that could explain multiple, concurrent disorders

2x as likely to have a medical problem

3x as likely to have a psychiatric problem

4x as likely to have a preventable mortality

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12
Q

What should the interview of a pediatric patient with a developmental disorder cover?

When should disorders ideally be diagnosed?

A

Review of all previous developmental stages (preschool, school age, adolescent, young adulthood)

Interview the patients’ parents about their experiences

Preschool age, but most are diagnosed during school aged

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13
Q

What motor milestones should be seen at 1 month?

6 months?

12 months?

18 months?

24 months?

A

1 month

  • support head

6 months

  • Thumb/finger grasp
  • sits on their own

12 months

  • walking

18 months

  • build/scribble
  • run/jump

24 months

  • grasp small things
  • draw a circle
  • stairs
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14
Q

At what age should infants start to associate sounds with communication?

At what age should infants begin using words to communicate?

A

8-12 months old

12-24 months old

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15
Q

During months 6-24, infants develop expressive language.

What are the five stages of expressive language development?

A
  1. Canonical (unisyllable utterance can be meaningless)
  2. Reduplicated babbling (mama, dada, papa, etc)
  3. First words
  4. Two word sentences and grammar
  5. ‘W questions’ (where, why, what, when) and prepositions
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16
Q

How should a newborn react to speech?

How should a 1-6 month old react to speech?

How should a 6-24 month old react to speech?

A

Newborn

  • recognize voices, but no meaning

1-6 months

  • turn to voice
  • attention, but no comprehension

6-24 months

  • single nouns (1st stage)
  • increased vocabulary (2nd stage)
  • single word commands (3rd stage)
  • multi-word commands (4th stage)
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17
Q

How is cognition defined?

How is it measured?

A

Cognition is the ability to form rules about your environment

IQ tests can test cognition

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18
Q
A
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19
Q

Define Neurodevelopmental Disorder

A

A group of conditions with onset in the developmental period that produce impairments in Personal, social, academic, or occupational functioning

20
Q

Give three defining characteristics of Intellectual Disability / Intellectual Development Disorder (ID/IDD)

A
  1. Deficits in general mental abilities
  2. Impairment of everyday adaptive functioning
  3. Onset in the developmental period
21
Q

Give some examples of the deficits in **intellectual functioning **seen in ID/IDD

A
  • reasoning
  • problem solving
  • planning
  • abstract thinking
  • judgement
  • academic learning
  • learning from experience
  • practical understanding
22
Q

What IQ level is associated with ID/IDD?

What are some pitfalls/cautions that a clinician should be aware of?

A

IQ: 65-75 (two standard deviations below population mean)

Pitfalls/cautions:

  • Control for ADHD effects
  • cultural appropriateness of test
  • psychometric validity of test
  • Requires appropriate level of clinical experience and judgement in evaluating these disorder
23
Q

Deficits in communication, social participation, and independent living are examples of what aspect of ID/IDD?

A

adaptive functioning

24
Q

Adaptive functioning in ID/IDD can be further broken down into what three (3) domains? Explain.

A
  • Conceptual (academic) - includes things like problem solving, judgement in novel situations, memory, language, etc
  • Social - includes empathy, interpersonal skills, awareness of the thoughts and feelings of others
  • Practical - personal care, job responsibilities, self-management, task organization (job, school)
25
Q

Define **Mild **ID/IDD in terms of the following facets of adaptive functioning:

  • Conceptual
  • Social
  • Practical
A
  • Conceptual: academic difficulty, somewhat concrete problem solving
  • Social: immature social interactions
  • Practical: some support needed for complex daily living tasks
26
Q

Define Moderate ID/IDD in terms of the following facets of adaptive functioning:

  • Conceptual
  • Social
  • Practical
A
  • Conceptual - marked lag in conceptual skills
  • Social - marked differences in social and communication skills
  • Practical - extended teaching of skills needed
27
Q

Define Severe ID/IDD in terms of the following facets of adaptive functioning:

  • Conceptual
  • Social
  • Practical
A
  • Conceptual - little understanding of language, time, money, quantity
  • Social - limited spoken language
  • Practical - support for all ADLs
28
Q

Define Profound ID/IDD in terms of the following facets of adaptive functioning:

  • Conceptual
  • Social
  • Practical
A
  • Conceptual - no symbolic processes
  • Social - nonverbal communication
  • Practical - dependent on others for all ADLs
29
Q

Contrast the following:

Global Development Delay

Unspecified Intellectual Disability

A

Global development delay: cannot test + <5 y.o.

Unspecified: cannot test, >5 y.o., associated mental or physical impairment, severe behavioral disturbace, or co-occurring mental disorder

30
Q

Define Language Disorder

A

Persistent difficulties in language acquisition and use of language accross modalities (speech, reading, sign) due to deficits in comprehension or production that include:

  • reduced vocabulary
  • limited sentence structure
  • impairments in discourse

Note: deficits must be substantial and quantifiably below normal development. They also must not be attributable to other etiologies.

31
Q
A
32
Q

**Speech Sound Disorder **is essentially a deficit of what?

A

Articulation

Must interfere with social, occupational, or academic functioning (also, not attributable to culture i.e. accent?)

Must not be attributable to other etiologies

33
Q

Childhood Onset Fluency Disorder: define

How is this disruptive to the child?

A

Disturbances in the normal fluency and patterning of speech (essentially stuttering). May include:

  • Syllable repetitions
  • Sound prolongations
  • Sound pauses within words
  • Word substitutions (to avoid problem words)
  • Word tension
  • Monosyllable whole word repetition (I-I-I-I s-s-seee him)

Disturbances cause anxiety!

34
Q

Define Social (Pragmatic) Communication Disorder

A

Persistent difficulties in the social use of verbal and non-verbal communication

  • Problems with the semantic aspect of language (i.e. the meaning of what is said)
  • Problems with the pragmatics of language (i.e. using language appropriately in social situtions)

Closely associated with autism and Asperger’s, but other things can cause it too

35
Q

Define: Unspecified Communication Disorder

A

Symptoms characteristic of a communication disorder that cause distress or impairment but do not meet criteria of any specific communication disorder

tl;dr garbage-can diagnosis

36
Q

Autism Spectrum Disorder

Give (3) specific requirements for diagnosis with respect to persistent deficits in social communication and interaction

A
  1. Deficits in social-emotional reciprocity
  2. Deficits in nonverbal communicative behaviors used for social interaction
  3. Deficits in developing, maintaining, and understanding relationships
37
Q

Autism Spectrum Disorder

Give (4) examples of the patterned/stereotyped behaviors observed with this disorder

A
  1. Stereotyped or repetitive motor movements
  2. Insistence on sameness, routines, and ritualized patterns
  3. Highly restricted, fixated interests
  4. Hyper- or hypo-reactivity to sensory inputs with possible unusual fixation on certain aspects of sensory input (the spinning train wheel example)
38
Q

Later presentation of Autism Spectrum Disorder may be correlated with what aspect of the illness?

What must be excluded to make an accurate diagnosis?

A

Prognosis - later presentation tends to correlate positively with higher-functioning autism

Disturbances must not be better explained by intellectual disability or global developmental delay (though ID/IDD can be a co-morbidity…)

39
Q

Discuss the social communication and restricted/repetitive behavior patterns of Level 1, Level 2, and Level 3 ASD

A
  • Level 1
    • Social: noticeable impairments without support, difficulty engaging in social situations, unsuccessful responses to social overtones, decreased social interest
    • Behavior: attempts to interrupt may be redirected, some significant interference with functioning
  • Level 2
    • Social: Marked deficits, even with support; limited and abnormal responses to social overtones
    • Behavior: frequent interference with functioning, distress or opposition when interrupted
  • Level 3
    • Social: severe deficits with minimal social responses or initiatives
    • Behavior: interference with all spheres of functioning, extremely difficult to interrupt or redirect
40
Q

How does the severity of an intellectual disability affect the diagnosis?

A

The more severe the intellectual disability, the early it can be diagnosed.

Profound diability- 6-12 months old

Severe disability- before 12 months

Moderate disability- 1-2 years

Mild disability- 2-5 years

41
Q

What are 10 deficiencies seen in toddlers with autistic spectrum disorders?

What are 4 symptoms that are sensitive, but not specific for autism?

A
  1. Eye contact
  2. Response to name
  3. Joint attention
  4. Pointing to express interest
  5. Interest in other children
  6. Gesturing
  7. Imitation
  8. Shared enjoyment
  9. Empathic responding
  10. Range of facial expressions
  11. Toe walking
  12. W sitting
  13. Sensory sensitivities
  14. Stereotypies (repetitive motor movements)
42
Q

How does diagnosis of developmental disorders change as children enter school age?

What complications can be seen in school aged children?

A

Diagnoses are typically clearer because symptoms are more visible. However, more complications arise.

Education (classroom or special ed)

Therapy (school or private)

Treatment (therapy vs medication)

Social issues (opportunities to play, bond with other kids)

43
Q

What social developments are occuring during adolescence?

A

Erikson’s Identity vs. Role Confusion

Teens need to develop a sense of self and an identity.

Increased social complexity

Increased mood and anxiety disorders

Differences in peers apparent

Increasing independence

44
Q

What Erikson’s Stage of Social Development is most prominent during middle adulthood (40-65 years old)?

A

Generativity vs. Stagnation

Adults need to create or nurture things that will outlast them, often by having children or creating a positive change that benefits other people. Success leads to feelings of usefulness and accomplishment, while failure results in shallow involvement in the world.

45
Q

What Erikson’s Stage of Social Development is most prominent during young adulthood (19-40 years old)?

A

Intimacy vs. Isolation

Young adults need to form intimate, loving relationships with other people. Success leads to strong relationships, while failure results in loneliness and isolation.

46
Q

What are some improved quality of life indicators for persons with neurodevelopmental disorders?

A
  • High school graduation
  • Paid employment
  • Parent knowledge of adult services
  • Parent involvement in transition services
  • Family coping
  • Extended family or non-family support
47
Q

What are important quality of life dimensions for adults with neurodevelopmental disorders?

A
  • Satisfaction
  • Competence and productivity
  • Empowerment and independence
  • Social belonging and community integration
  • Contribution to the community

M2 Neuro/Psych (45 decks)

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