Neurodevelopmental Disorders

Question 1

When interviewing a child/adolescent, who else might you want to interview?

Answer 1

Teachers
Parents
Baby sitters
etc

Question 2

Autism Spectrum Disorder (ASD). When is this dx usually made and what sx do you usually see?

Answer 2

1. Sx usually develop between 12-24 months (kids experience developmental plateau or regression)

Sx:

1. Delayed language development
2. Lack of social interest or unusually social interactions
3. Odd/repetitive behaviors
4. Lack of typical play

Question 3

How do you treat ASD?

Answer 3

Treatment is a multidisciplinary approach to sx including:

1. Education
2. Medical
3. Behavioral
4. Support

Question 4

Two drugs that target the aggression seen in ASD?

Answer 4

1. Risperidone

2. Aripriprazole

Question 5

Dx of ASD includes two criteria. what are they?

Answer 5

1. Deficits in social communication and interaction (including social-emotional reciprocity, nonverbal communication, understanding and maintaining relationships)
2. Restricted, repetitive patterns of behavior, interest or activities (including stereotyped motor movements, insistence on sameness, fixated interested and hyper/hypoactivity)

Question 6

Can ASD because associated with other known medical/genetic conditions (like Down’s) or with another neurodevelopmental, mental or behavioral disorder?

Answer 6

YES.

Question 7

What disorders does ASD include now?

Answer 7

Asperger’s, Autistic Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder NOS

Question 8

What is involved in Social (Pragmatic) Communication Disorder?

Answer 8

the socially awkward child.

1. Problems with meeting/greeting
2. Regulating volume (Donald)
3. Matching communication with context (play talk vs library talk)
4. Appreciating and adhering to social normals of speaking
5. Reading between the lines (understanding humor or metaphors)

This can be an aspect of ASD but there are no repetitive behaviors

Question 9

Now for the Big one. ADHD. What are the sub-categories of this disorder?

Answer 9

1. Primarily inattentive
2. Primarily hyperactive/impulsive
3. Combined type (little bit of both)

Question 10

What are some of the tx options for ADHD?

Answer 10

1. Behavioral management
2. School intervention
3. Meds (stimulants vs. non-stimulants)

Question 11

What is the dx criteria for ADHD?

Answer 11

At least 6 sx in either the inattentive or hyperactive/impulsive domain

Sx develop before age 12 and are present in 2 or more settings (like home and school)

Question 12

Can you be dx with ADHD as an adult?

Answer 12

Kinda. Childhood ADHD can persist into adulthood, but adults don’t suddenly develop ADHD. There must be strong medical evidence that the pt had sx before age 12 in 2 or more settings.

Question 13

Intellectual Disability. This is what used to be called Mental Retardation. What etiologies are associated with this.

Answer 13

1. Morphogenesis errors: malformations, FAS, genetic disorders like trisomy 21, fragile X,
2. Metabolism disorders: Tay Sachs
3. Extrinsic influences: hypoxia, trauma, poisoning.

Question 14

What is the dx criteria for intellectual disability?

Answer 14

Must meet the following 3 criteria

1. Intellectual functions
2. Adaptive functioning
3. Onset of #1 and 2 during developmental period

• Examples of adaptive functioning: communication, self-care, home living, interpersonal skills, safety

Question 15

When do we use the dx of Global Developmental Delay

Answer 15

1. When the intellectual disability scale cannot be reliably determined
2. Not meeting developmental milestones in several areas of functioning
3. Can’t undergo systematic assessments
4. They are under age 5

Question 16

Developmental Coordination Disorder? Just being clumsy?

Answer 16

Not quite. Here you’re not acquiring skills you need given your age or IQ, and it’s interfering with academics, and it is NOT due to ASD or other medical condition.

So, Renuka trying to open the door with her face is NOT reason to believe she has developmental coordination disorder because she is somehow still passing medical school. Yay.

Question 17

What is the dx criteria of Tourette’s?

Answer 17

Need both multiple motor and 1+ vocal tics, but maybe not at the same time. It can change in frequency but should last 1 year after 1st tic appears. You get it before 18.

Question 18

What are some of the tx options for Tourette’s?

Answer 18

1. Habit Reversal Training
2. Atypical antipsychotics: risperidone, aripriazole,
3. Typical antipsychotics: haldol, primozide
4. Alpha adrenergic agonists: guanfacine, clonidine

Question 19

What is an IEP (individualized education plan) or 504 Plan?

Answer 19

These are education plans for kids of learning disorders that offer accommodations. These can include a daily planner, a visualized schedule in the classroom, extended time, or paraphrased instructions.