Week 9 - Neurodevelopmental disorders, indigenous culture and mental health Flashcards
Cognition definition
The mental action or process of acquiring knowledge and understanding through thought, experience and the sense
70% of mental health problems have their onset…
During childhood or adolescence
Young people aged 15 to 24 are more likely to experience…
Mental illness and/ or substance use disorders than any other age group
Risk factors of childgood mental illness
▪ biological factors
▪ unhealthy child development
▪ abusive parents
▪ substance abusing parents
▪ family trauma
▪ negative peer relationships
▪ cultural factors
▪ learning disabilities/ academic failure
▪ illness and disability
▪ children in care of family services
▪ children with parents with mental illness
▪ children with multiple risk factors increase likelihood of mental health problems
▪ any of the social determinants of health influence - ie. lack of community resources, etc.
Assessment of children and adolescents
▪ consider the stage of growth and development
▪ assess in the context of family culture and family circumstances
▪ gather information from multiple sources
▪ include the child/ adolescent’s perspective, sense of identity, self esteem
▪ mental status exam - make adaptable to child’s age (using age-appropriate language - examples)
Intellectual Disability (Defined) (Intellectual Developmental Disorder)
Onset during the developmental period with deficits in conceptual, social and practical domains
A. Deficits in intellectual functions, i.e., reasoning, problem solving, IQ score 65-75
B. Deficits in adaptive functioning, ie., social participation, independent living
C. Onset of deficits during the developmental period
Autism Spectrum Disorder epidemiology
approaching 1% of the population
Autism Spectrum Disorder rates
3-5x’s higher in males than in females
Autism Spectrum Disorder onset
12 to 24 months
Autism Spectrum Disorder cause
▪ Remains unknown
▪ Structure/ function of the CNS?
▪ Genetic link
▪ Environmental
▪ Is not related to vaccines or parenting styles
Autism Spectrum Disorder cause
Remains Unknown?
▪ Structure/Function of the CNS?
▪ Genetic Link
▪ Environmental
▪ Is not related to vaccines or parenting styles
Autism Spectrum Disorder diagnosis
▪ Observation/ screening tools
▪ Neurological, cognitive and language testing
Autism Spectrum Disorder is characterized by:
Persistent deficits in social communication and social interaction across multiple contexts including:
A. Restricted, repetitive patterns of behaviour, interests, or activities
B. Symptoms are present in the early developmental period (typically recognized 12-24 months of age)
C. Symptoms cause significant impairment in social, occupational or other areas of functioning
▪ Within the diagnosis, individual characteristics are noted through the use of specifiers
Autism Spectrum Disorder other specifiers include:
With or without accompanying intellectual, language impairment
Autism Spectrum Disorder Impairment in Communication
▪ Delayed language development
▪ Echolalia may be present
▪ Extreme concrete interpretation of language
▪ Pronoun reversals
Autism Spectrum Disorder Interventions
▪ Early Intervention - Special education
▪ Structured environment
▪ Development of language skills
▪ Play therapy for cognitive, social, and emotional skills - including self-control
▪ Applied Behavioural Analysis (ABA)
▪ To learn to “tuck” special interests away
▪ Virtual reality/ computer games
▪ Medications to manage hyperactivity and stereotypical behaviour:
- Antipsychotics/ antidepressants/ anti-anxiety
- Meds for seizures
Attention Deficit Hyperactivity Disorder combination of symptoms
Inattention
Hyperactivity-impulsivity
Three types of ADHD
ADHD, Predominately Inattentive ADHD, Predominately Hyperactive-Impulsive ADHD, Combined Type
ADHD, Predominately Inattentive
▪ Unable to get focused on or stay focused on task/activity.
▪ Individual does not display significant hyperactive/impulsive behaviors
ADHD, Predominately Hyperactive-Impulsive
▪ Person is very active – often acts without thinking
▪ Individual does not display significant inattention problems
ADHD, Combined Type
Individual is inattentive, hyperactive, and impulsive
Attention Deficit Hyperactivity Disorder demographic
▪ Affects 3 to 5% of all children - 4.4% of adults
▪ Symptoms decrease over time in many children
▪ Impulsivity may persist into adulthood
▪ Sometimes ADHD is 1st diagnosed in adulthood
▪ Male to female ration 2:1 - females present more with inattentive features
Attention Deficit Hyperactivity Disorder cause
No clear cause
Temperamental
Environmental
Neurological/ genetic theories
Attention Deficit Hyperactivity Disorder diagnosis
▪ Diagnosis – DSM criteria – no standardized test
▪ Behaviors are the rule – not the exception
▪ Symptoms occur in at least 2 settings with consistent pattern (i.e., school and home)
▪ Can resemble a mood disorder
▪ May have co-occurring disorders, i.e., depression, anxiety, conduct disorder
▪ Emotional aspects and effects on mental health
ADHD, Predominately Inattentive Type Potential Outcome
Risk of worse academic outcome
ADHD, Combined Type Potential Outcome
Risk of worse academic outcome
ADHD, Predominately Hyperactive-Impulsive Potential Outcome
Potential for good academic outcome – but more difficulty with interpersonal injuries or interpersonal relationships
ADHD Treatment
Early identification and timely specialized assessments and interventions including:
▪ Specific skill instruction
▪ Accommodations
▪ Compensatory strategies
▪ Self-advocacy skills – helping the child build their self-esteem
Goal: To provide structure and predictability through help with routines, organization, minimize distraction
ADHD medications
Stimulants - (Methylphenidate/ Ritalin)
▪ Stimulants found to improve core symptoms
▪ Rapid onset; approx 90 min
▪ Short acting - duration of 4 hours
▪ Side effects: nervousness, irritability, difficulty falling asleep or staying asleep, dizziness, nausea.
Antidepressants - (Nortriptyline, Bupropion, Fluoxetine)
Symptoms of ADHD in adults
▪ Inattention and Memory
▪ Hyperactivity
▪ Impulsiveness
▪ Emotional Turmoil
▪ Irritability/Easily Angered
Positive characteristics of persons with ADD/ADHD
▪ Creativity
▪ Enthusiasm
▪ Spontaneity
▪ High Energy
The Adverse Childhood Experiences (ACES) Study
Studies of the last three decades on ACES and traumatic stress have emphasized their impact and the importance of preventing and addressing trauma across all service systems utilizing universal systemic approaches.
