Neurodevelopmental disorders (wk 8) Flashcards

1
Q

what are the criteria for an intellectual disability?

A

-intellectual disability: reflects impairment in 2 areas:
1. Deficits in intellectual fnx, confirmed by both clinical assessment + individualized, standardized intelligence testing

  1. significant limitations in adaptive behavior: behaviors necessary to fnx independently, adequately, appropriately in everyday life
    -communication (eg expressive, receptive, written language)
    -daily living skills (eg eating, dressing, personal hygiene, domestic/community living skills)
    -social skills (eg interpersonal relationships, coping, leisure skills)
    -motor skills (eg movement coordination, ability to manipulate objects using fingers/hands)
  2. Onset during developmental period
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are causes of ID (genetic, prenatal, birth-related, postnatal)?

A

-chromosomal abnormalities (eg Down Syndrome) + genetic mutations

-prenatal factors related to maternal health (eg rubella, HIV, drug/alc use)

–birth-related causes: prematurity, lack of oxygen during prolonged/complicated labor

-postnatal environmental factors: psychological + social deprivation due to lack of stimulation + care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

compare the chromosomes of a typical human cell w someone with down syndrome

A

-typical human cell has 23 pairs of chromosomes; in down syndrome there’s an extra chromosome on pair 21

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

risk of down syndrome increases with ______ AND ______ age

A

maternal; paternal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is phenylketonuria (PKU) and how does it cause ID? how can ID be prevented in children w PKU?

A

-disorder that causes inability to process / metabolize the amino acid phenylalanine. ID occurs when this substance builds up in the brain to toxic lvls

-ID prevented in these children if they follow a v low protein diet
-detected w a blood test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

explain the issue of diagnostic overshadowing and comorbidity

A

-indivs w ID will have comorbidities; perceiving deviant behaviors to be a fnx of the developmental disorder

-indivs w IDs are at ↑ risk of dev’g emotional + behavioral problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how are IDs prevented (genetic, social, toxic, infectious)?

A

-genetic: prenatal screening for genetic defects + genetic counselling for families at risk for known heritable disorders

-social:
-govt programs to ensure adequate nutrition to the underprivileged during prenatal months + most critical years of life
-early intervention in situations involving abuse + deprivation
-early testing + proper diet for PKU

-toxic:
-environmental programs to ↓ exposure to lead, mercury, other toxins
- ↑ public awareness of the risks of alc/drugs during pregnancy

-infectious:
-prevention of congenital rubella syndrome
- ↑ public awareness on the risk of HIV, herpes, other infections
-limiting exposure to cat litter that can cause toxoplasmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the 7 “Essential Daily Ingredients” for Early Intervention (Ramey & Ramey, 1992)?

A

-encouragement of exploration – physical space where infants/toddlers are free to roam/explore knowing they will be protected

-assistance in basic skills – labeling, sorting, sequencing, comparing, noting means-ends relations

-reinforcements of developmental achievements

-guided rehearsal + extension of new skills

-protection from inappropriate disapproval, teasing, or punishment

-rich + responsive language environment

-supportive + predictable environment in terms of opportunities for learning + patterns of intxn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the specifiers of learning disorders?

A

specifiers for functional impairment, with impairment in:
-reading
-written expression
-mathematics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is a learning disorder?

A

-difficulties learning + using academic skills, despite the provision of interventions that target those difficulties
-academic skills substantially + quantifiably below those expected for chronological age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are complications associated with LDs?

A

-associated w greater peer victimization, bullying, social rejection

-greater risk of depression + low self esteem

-if unrecognized can lead to academic failure + drop out from high school

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are disorders listed under Pervasive Developmental Disorders (spectrum disorders)?

A

-autism

-Asperger’s - prev believed to be less impairing than autism, but it was difficult to make that distinction when working w indivs
→ these 2 are now 1 spectrum/category

-Rett’s syndrome: primarily occurs in women; unique pattern of cog/fnxl deterioration incl loss of interest in social contact + hand wringing. Hallmark symptom = Deceleration in head circumference growth

-Child Disintegrative Disorder: marked deterioration in speech + social skills, following several years of normal development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the diagnostic criteria for Autism Spectrum Disorder?

A

A. Persistent deficits in social communication + social intxn across multiple contexts, as manifested by:
-Deficits in social-emotional reciprocity – eg failure to meet people in terms of their interests/feelings; failure to initiate/respond to social intxns
-Deficits in nonverbal communicative behaviors used for social intxn – eg gesturing, facial expression
-Deficits in dev’g, maintaining, understanding relationships

B. Restricted, repetitive patterns of behavior, interests, activities – eg rocking, spinning; intense interests in one area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

in autistic children (first 2yrs of life), what behaviors are exhibited in social interactions?

A

-lack of attachment + comfort seeking behaviors
-rigid when held/resist being held
-absent / delayed smiling, pointing, joint-attn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

in autistic children, what general behaviors are exhibited in social interactions?

A

-behaviors lack reciprocity
-changes in environment upsetting
-limited nonverbal behaviors that typically guide social intxn (eg eye contact)
-limited imitation - symbolic play

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how many autistic individuals are nonverbal?

A

-1/3 to 1/2

17
Q

what are some characteristics often displayed in autistic people’s speech?

A

-Does not communicate meaning
-is abnormal in tone/content

18
Q

what are 2 speech patterns commonly found in autistic people?

A

-echolalia: repetition of other’s words/phrases using similar intonation; not done at the function of communication

-pronoun reversal: referring to oneself as “he” or “she” rather than “I” – thought to be related to difficulty understanding perspectives of others / distinction between self/others

19
Q

describe the behavior and interests of autistic people

A

-restricted, repetitive, unusual behaviors + interests
-eg hand flapping, rocking, unusual repetitive movements

-[ ] on particular aspects of their environment
-eg the wheels on toy cars

-may be preoccupied w objects or patterns

20
Q

describe etiology of autism

A

-genetic factors now considered to play a dominant role in the development of autism spectrum disorders

-there are genetic contributions, but it’s not straightforward
-there’s no one gene for autism
-there’s an interplay between genes + environment

21
Q

what are genetic/epigenetic/environmental risk factors of autism?

A

-↑ parental age (paternal and maternal)

-some prenatal infections (eg rubella)

-some medications (eg valproic acid)

-premature birth

22
Q

what are some non-replicated environmental risk factors of autism?

A

-agricultural pesticides
-pet pesticides

-hazardous air pollutants

-endocrine disruptors

23
Q

what is a predictor of a better prognosis in autistic children?

A

-fluent speech (ie 3-wd phrases produced spontaneously + regularly in an effort to communicate) before age 5

24
Q

describe ‘savants’ in autism

A

-small minority of indivs w autism; exceptional abilities in a spec area (eg math, music, art, unusual feats of memory)

25
Q

what are the components of an autism assessment?

A

-multidisciplinary team: psychologist, psychiatrist, speech + language specialist, occupational + phys therapist, teacher
-Autism Diagnostic Observation Schedule (ADOS): series of activities pulling from typical social intxns, seeing how child/toddler reacts
-Autism Diagnostic Interview - Revised: give p/cg of child; ask them to describe child’s fnxing + symptoms etc

26
Q

what are intervention options for autism?

A
  1. no meds used to treat autism, but meds often used to manage abnormal behaviors + comorbidity (anxiety, depression, mood regulation difficulties)
  2. social skills training – helping indivs dev the skills necessary to connect w others in a social world (eg introducing oneself, joining/exiting a conversation, giving apologies/compliments)
  3. language interventions - class activity
  4. behavioral interventions effective: used to teach children appropriate behavior (eg in classroom, playground)
    -fnxl analysis of antecedents + consequences of behaviors (what leads up to spec behaviors, what is the behavior, what rewards/negative consequences from behavior)
    -positive reinforcement of appropriate behavior
27
Q

how often/when should intervention for autistic children begin? what are characteristics of these interventions?

A

-Intensive intervention effective (~40h/wk)
-Most successful when intervention initiate early (eg child <3/4yrs)

-Carefully ctrled structure in the learning environment
-Effective patterns consider autistic children’s attentional patterns + carefully plan presentation of stimuli
-Important to emphasize generalization + maintenance of treatment effects
-Parent training
-Individual responses vary considerably

28
Q

take home message for developmental disorders: _____ ________ and ___________ are related to a better outcome

A

early diagnosis; intervention