Ryst: Developmental Disorders

Question 1

Impairment in ability to receive, send, process and comprehend concepts or symbol systems

Answer 1

communication disorder

Question 2

Problems with articulation, fluency and voice.

Answer 2

speech disorder

Question 3

Impaired comprehension and/or use of spoken, written or other symbol systems.

Answer 3

language disorder

Question 4

Language disorder: Persistent difficulties in the acquisition and use of language across modalities due to deficits in comprehension or production that include any of the following three criteria…

Answer 4

1. reduced vocab
2. limited sentence structure
3. impairments in discourse (communication)

Question 5

Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages

Answer 5

speech sound disorder

Question 6

Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual’s age and language skills, persist over time, marked by occurences of sound/syllable repetitions, broken words, audible or silent blockers, etc

Answer 6

Child-Onset Fluency Disorder (stuttering)

Question 7

T/F: Communication disorders are very common in younger children, but usu do not persist

Answer 7

True

ex: expressive language delay in 10-15% of children under 3, but by school age only 3-7%

Question 8

~1/2 of children with communication disorders also have an Axis I psych disorder. What are the most common comorbidities?

Answer 8

ADHD
ODD
Conduct disorder
anxiety disorders

Question 9

How do you treat communication disorders?

Answer 9

teach specific strategies to change the deficit and increase skills (speech and language therapy)
teach compensatory coping strategies
change the child’s environment

Question 10

(blank) are the biggest assets in helping to improve their child’s development

Answer 10

parents

Question 11

Acquisition and execution of coordinated motor skills is substantially below expected; Difficulties are manifested as clumsiness, as well as slowness and inaccuracy of permformance of motor skills.
Significantly interferes with academic achievement or ADL’s.
Not due to a medical condition and not part of PDD.
If intellectual disability is present, the motor difficulties can’t be better explained by it.

Answer 11

Developmental Coordination Disorder

Question 12

Sudden, repetitive muscular contractions and vocalizations.

Last

Answer 12

Tic

Question 13

T/F: Tics can be simple, or limited to a few muscle groups (eye blinking, jaw thrusting, throat clearing) or complex, involving multiple organized contractions which mimic contextual speech or movement

Answer 13

True

Question 14

Typical age of onset of tic disorders? Peak intensity? Tic reduction years?

Answer 14

5-6; 10-12; 15-17yo

Question 15

If the tics have been present for less than one year, it is a (blank) tic disorder

Answer 15

provisional

Question 16

includes multiple motor AND one or more vocal tics present at some time during the illness; the tics may wax and wane in frequency but have persisted for >1 year since onset.

Answer 16

Tourette’s Disorder

**includes both motor and vocal tics

Question 17

Only motor or only vocal tics for >1 year

Answer 17

Persistent motor or vocal tic disorder

Question 18

Who most commonly gets tics, boys or girls?

Answer 18

boys (18%)

Question 19

T/F: Tic disorders, Family history often positive for ADHD, OCD and tics in first- and second-degree relatives.

Answer 19

True

Question 20

Tic disorders frequently associated with this comorbidity

Answer 20

ADHD

Question 21

First line treatment of tic disorders? Second line? Third line? Another behavioral option?

Answer 21

alpha-2 agonists;
atypical antipsychotics;
typical antipsychotics;
habit reversal training

**with severe pt, combine behavioral therapy w meds

Question 22

T/F: Treatment of tics is challenging, and it’s rare to achieve >50% sustained reduction in tics :(

Answer 22

true

Question 23

Repetetive, seemingly driven, and apparently purposeless motor behavior (hand shaking or waving, body rocking, head banging, self-biting, hitting own body.)

Answer 23

Stereotypic movement disorder

**more rhythmic and fluid than tics

Question 24

Persistent difficulties in the social use of verbal and nonverbal communication
as manifest by deficits in all of the following:
– Deficits in using communication for social purposes, in a manner that is
appropriate for the social context
– Impairment in the ability to change communication to match context or the
needs of the listener
– Difficulties following rules for conversation and storytelling
– Difficulties understanding what is not explicitly stated
2) Deficits result in functional limitations in effective communication, social
participation, social relationships, academic achievement, or occupational
performance.
3) Deficits must be present in the early developmental period, but may not
become fully manifest until social communication demands exceed limited
capacities.
4) Deficits are not better explained by autism spectrum disorder, intellectual
disability (intellectual development disorder), global developmental delay, or
another mental disorder or medical condition.

Answer 24

Social (pragmatic) Communication Disorder

Question 25

Meant to capture children who have significant pragmatic difficulties, relatively intact vocabulary, grammar and speech-sound production abilities, and no history of restricted/repetitive behaviors or interests.

Answer 25

Social communication disorder

Question 26

Social communication disorders associated with these risk factors…

Answer 26

family history of:
autism spectrum disorder
communication disorder

Question 27

Treatment for social communication disorder?

Answer 27

social skills training

speech/language therapy

Question 28

Things included in Autism Spectrum Disorder

Answer 28

A. deficits in social communication and social interaction

B. restricted, repetitive patterns of behavior, interests, activities

C. symptoms are present in the very developmental period, but may not become fully manifested until later in life

D. symptoms cause clinically significant impairment in social, occupational or other important areas of functioning

E. distubrances not better explained by intellectual disability or global developmental delay

Question 29

What three things do you need to meet criteria for “deficits in social communication/interaction” in autism spectrum disorder?

Answer 29

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

Question 30

For a diagnosis of autism spectrum disorder, you need at least two of the following in the category of restricted, repetitive patterns of behavior, interests, activities…

Answer 30

1. Stereotyped or repetitive motor movements, use of objects, or speech
2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of
   verbal or nonverbal behavior
3. Highly restricted, fixated interests that are abnormal in intensity or focus
4. Hyper‐or hyporeactivity to sensory input or unusual interest in sensory aspects of the
   environment.

Question 31

What has happened in the DSM-5 to pervasive developmental disorders, such as Asperger’s Disorder?

Answer 31

they have collapsed these disorders into one all-encompassing category, autism spectrum disorder, which may result in loss of uniqueness/identity/sensitivity in the more specific diagnoses that were previously used

Question 32

In what ways can you specify autism spectrum disorders?

Answer 32

by severity
w or w/o intellectual impairment
w or w/o language impairment
etc

Question 33

What is happening to autism in terms of epidemiology?

Answer 33

prevalence over time seems to be increasing

Question 34

Who gets autism more commonly, males or females?

Answer 34

males 4:1

Question 35

T/F: In families with one child with autism, there is a higher recurrence rate for a second child with autism

Answer 35

True

Question 36

Potential risk factors for autism?

Answer 36

prematurity
low birth weight
parental age

Question 37

Environmental factors contributing to autism?

Answer 37

prenatal rubella
valproic acid in mother
thalidomide

Question 38

What is the gold standard for measuring autism?

Answer 38

ADOS

Question 39

What is used to SCREEN for autism?

Answer 39

M-CHAT

**if they screen positive, need further evaluation for autism

Question 40

What combordities occur with autism spectrum disorder?

Answer 40

genetic syndromes
seizure disorder
intellectual disability
self-injury
catatonia
language impairment

Question 41

T/F: At least 65-70% of Autistic children have at least one psychiatric comorbidity, like social anxiety disorder or ADHD

Answer 41

True

Question 42

(blank) is very common in autism disorders

Answer 42

anxiety

Question 43

How to treat autism?

Answer 43

multidisciplinary model (pediatrician, psychiatrist, speech and language pathologists, etc)
behavioral interventions are most effective and widely used
developmental intervention also important
school interventions
family support

Question 44

Reserved for kids under the age of five years when the clinical severity level cannot by reliably assessed during early childhood. This category is diagnosed when an individual fails to meet expected developmental milestones in several areas of intellectual functioning, and applies to individuals who are too young to participate in standardized testing. This category requires reassessment after a period of time.

Answer 44

Global developmental delay