Neuroscience Week 7: Neurodevelopmental disorders Flashcards
Special aspects of the assessment of children
Neurodevelopmental disorders onset
occur in childhood or adolescence
Intellectual disability criteria?
based on both clinical assessment and standardized testing of intelligence
Autism spectrum disorder Dx criteria
Deficits in social communication and interaction and restricted, repetitive patterns of behavior, interests, or activities (with or without) intellectual impairment and/or medical or genetic cause
ADHD Dx criteria
- Very common
- 2 broad groups of symptoms
- inattention
- hyperactivity and impulsivity
Separation anxiety disorder description
developmentally inappropriate and excessive anxiety concerning separation
is normal 10 months - 2 years
Separation anxiety disorder symptoms
6 listed
- anticipatory anxiety when separation is anticipated
- worry of harm or losing caregiver
- school refusal
- fear of being alone
- refusal to sleep alone
- nightmares with separation themes
Separation anxiety disorder Treatment
2 listed
antidepressants and cognitive behavioral therapy
Oppositional Defiant Disorder description
a pattern of negativistic, hostile and defiant behavior lasting at least 6 months
Oppositional Defiant Disorder symptoms
8 listed
- often losing temper
- often argues with adults
- refusing to comply with adults’ rules/requests
- easily annoyed
- deliberately annoys
- often angry and resentful
- spiteful or vindictive
- often blames others
Oppositional Defiant Disorder prevalence
10%
Conduct disorder description
a persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms are violated
Conduct disorder associated with?
40% Antisocial PD as an adult
Conduct disorder onset
duration of at least one year, can start in early childhood
Conduct disorder symptoms
4 listed
- aggression to people or animals
- destruction of property
- deceitfulness or theft
- serious violation of rules
Conduct disorder prevalence
5-10% of adolescents
Case 1
Discuss key clinical characteristics of concern
What are Ashley’s problems?
Restrictive, repetitive, stereotyped patterns
- stereotyped or repetitive movements, use of objects, or speech
- insistence on sameness, inflexible adherence to routines
- ritualized patterns of verbal or non-verbal behaviors
- Highly restricted ,fixed interests
- Hyper or hyporeactivity to sensory input or unusual interest in sensory aspect of environment
Ashley (cont)
Social communication deficits
8 listed
Questions to ask parents?
Best Dx for Ashley
Autism epidemiology
- more common in boys
- 1 in 59 children
Autism effects and comorbidities
7 listed
- ADHD
- Sleep problems
- Anxiety
- Depression
- GI distress
- Epilepsy
- Schizophrenia
Concerns of families and for providers regarding autism
How do I stop the stim?
Autism causes
3 listed
Autism assessment tools
ADOS
Ashley UTI
Autism treatment
- pharmacology for comorbid disorders (depression, anxiety, GI, etc)
- Applied behavioral analysis (time-intensive, 40 hrs/week)
Case 2
discuss possible causes of Brandon’s behavior and distress
Brandon alone interview
describe key clinical characteristics and Brandon’s possible Dx
Case 3
Discuss key clinical features of stevens presentation and possible Dxs
Name instruments which may be used to help Dx and monitor Steven’s symptoms
Rating scales
ADHD epidemiology
ADHD description
- A neurodevelopmental disorder in which an individual’s ability to attend to and control impulses is significantly less than typical child or adult
- Causes impairment in the individuals academic or soical functioning
- is not accounted for by some other medical or psychiatric condition
ADHD subtypes
3 listed
- predominantly inattentive ADHD
- Hyperactive-impulsive presentation
- combined presentation
ADHD symptoms
7 listed
- difficulty in school work or performance
- school or work performance below level of competence
- poor concentration
- lack of organization
- poor discipline
- inability to follow a routine
- forgetfulness
Risk factors for ADHD
- highly heritable (71-90% of the variance in ADHD traits was found to be attributable to genetics)
- maternal smoking during pregnancy
Comorbidities of ADHD
5 listed
ADHD Treatment
Stimulant management in ADHD
- FHx of structural heart defects risk of sudden cardiac death
- monitor height and weight at each visit
ADHD and substance use disorders
untreated ADHD is a risk factor of later onset substance use disorders
Lisdexamfetamine for ADHD
a stimulant pro-drug may be used if there is a concern for medication misuse
Non-stimulant medication options for ADHD
Tourette’s disorder can occur in a triad with?
ADHD and Obsessive compulsive disorder
Tourette’s Disorder symptoms
5 listed
Tourette’s disorder onset
- onset before 18 years of age
- motor tics usually occur first around age 7 to 8
Tourette’s disorder treatment
2 listed
- treated with antipsychotics,
- can also use alpha agents such as clonidine
