WEEK 12 Flashcards
Neurodevelopment and Neurocognitive Disorders
Typical childhood development
- Significant brain changes occur in early years
- critical development in all areas
- follows a sequential pattern
- Disruption in early development may disrupt
later development
Attention-Deficit/Hyperactivity Disorder
- definition
A persistent pattern of: - inattention OR - hyperactivity and impulsivity OR - both (combined subtype)
- Substantial clinical presentation less than 12 yrs.
- symptoms must occur across settings
ADHD across the lifespan
- can be identified 3- 4
- adolescents: impulsivity manifests in different areas ( eg. car accidents, teen pregnancy)
- Adulthood: approx. 50% have ongoing difficulties- need to be busy
- inattention, hyperactivity and impulsivity may result in other difficulties (poor academic performance, relationships etc)
ADHD diagnostic issues
- debate: are some children being misdiagnosed? Over diagnosis?
- valid data suggests 5-7% of children meet criteria for ADHD
Gener differences:
- boys 3 x more likely
- reason for gender difference is largely unknown (differences in presentation?)
- focus of research on boys- DSM 5 criteria not applicable to girls??
ADHD Causes
Biological
- genetic influence- multiple genes are responsible
- Mutations occur which create extra copies on one chromosome or deletion of
genes = copy number variants (CNVs). Research has focused on gene associated
with dopamine (GABA, norepinephrine and serotonin also involved).
ADHD Causes
Gene- environment interaction
- environmental factors play a small role (eg. mother smoked during pregnancy- mutation involving dopamine- exhibit symptoms of ADHD)
- eg. maternal stress, parental marital instability
ADHD Causes
Psychologica/ social influences
- Negative response from parents, teachers and peers= contribute to low self esteem and negative self image
- impact on friendships (rejection)
ADHD
Psychosocial treatment
- target broader issues
(i.e., academic performance, decrease disruptive
behaviour, improve social skills) - Increase positive behaviours
Reinforcement programs:
- parent education
- social skills programs
- ADULTS: CBT
ADHD
Biological treatment
Stimulant medication
- reduction in core symptoms (hyperactivity and inattention)
- reinforce the brains ability to focus attention during problem solving tasks
- non stimulant drugs can be effective
- recommended temporarily with psychosocial intervention
Specific Learning Disorder
Performance that is substantially below what would be expected given the person’s: age, IQ and education
- impairment in reading
- impairment in expression (writing)
- impairment in maths
- 5-15 % of youth
Long term impact:
- drop out of school
- unemployment
- suicidal thoughts and attempts
DSM- 5
- disabilities are now combined to assist clinician take a broader view
diagnostic issue: IQ discrepancy vs response to intervention
Specific Learning Disorder
Causes
Genetic and Environmental
- twin and family studies suggest learning disorder run in FAMILY
- Genes affect learning in general rather than specific area
- SES
- cultural expectations
- parental interactions and expectations
- types of school support
Specific Learning Disorder
Causes
Neurological Causes
Structural & functional
differences found in brains of people with SLD using
brain imaging.
Reading:
- Specific areas of the left hemisphere –
involved with word recognition (dyslexia).
Maths disorders: Intraparietal sulcas (left hemisphere)
– critical for development of sense of numbers.
Written expression: No current evidence for specific
brain differences
Specific Learning Disorder
Causes
Treatment approach
- education interventions (specific skill instruction eg. find main idea, facts) (strategy instruction eg. decision making, critical thinking)
- direct instructions (highly scripted lesson plans, teaching for mastery, progress continually assessed)
Autism Spectrum Disorder
Core features in the DSM- 5
Two core features:
- impairment in social communication and interaction
- restricted and repetitive patterns of behaviour, interests or activities
- Impairments are present in early childhood and limit daily function
- Level of severity:
1: requiring support
2: requiring substantial support
3: requiring very substantial support
Autism Spectrum Disorder
DSM- 5 criteria
SOCIAL COMMUNICATION: (Must meet all 3 criteria for DSM-5 diagnosis)
- Deficits in social-emotional reciprocity (e.g., atypical social
approach, difficulty with back & forth conversation) - Deficits in non-verbal communicative behaviours used for social interaction (e.g., poor integrated verbal/non-verbal
behaviors) . - Deficits in developing, maintaining and understanding
relationships (e.g., difficulty with imaginative play, making friendships)
RESTRICTED INTERESTS
(evidence of at least 2 out of the following)
- Stereotyped or repetitive motor movements, use of objects or speech
- insistence of sameness, inflexible adherence to routines or ritualised patterns of verbal and non verbal behaviour
- highly restricted, fixated interests that are abnormal in intensity or focus
- Hyper or hyporeactivity to sensory input
Autism Spectrum Disorder
Stats
- 1 in 59 school aged children
- male: female: 4: 1
- co- morbidities are common
- range of IQ scores (approx. 31% have intellectual disability)
Autism Spectrum Disorder
Genetic influence
- highly complex genetic component
- families with 1 autistic child- 20% chance of having another child
- older parents age may be associated with autism
Neurobiological influences:
- possible role of amygdala
- possible role of oxytocin: role in how we bond with others and social memory
Autism Spectrum Disorder
Intervention approaches
- most focus on teach new adaptive skills and reducing problem behaviours to make functional progress
- behaviour intervention programs
- allied health supports
- social skills groups
