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NMSP Exam 1 > [CLMD CIS] Clinical Approach to Neurodevelopmental and Attention Disorders [Cooley] > Flashcards

[CLMD CIS] Clinical Approach to Neurodevelopmental and Attention Disorders [Cooley] Flashcards

1
Q

What is a neurodevelopmental disorder?

A

Typically manifest early in development, often before the child enters grade school, and are characterized by developmental deficits that produce iimpairments of:

  • Personal
  • Social
  • Academic
  • Occupational functioning
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2
Q

What are the (5) major categories of neurodevelopmental disorders?

A

Intellectual disability

Communication disorders

Autism spectrum disorder

Attention-deficit/Hyperactivity disorder

Motor disorders

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3
Q

What are the characteristic deficits of intellectual disability?

A

Deficits in:

  • Reasoning
  • Problem solving
  • Planning
  • Abstract thinking
  • Judgement
  • Academic learning
  • Learning from experience
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4
Q

An intellectual disability can cause a secondary impairment of ________________

A

An intellectual disability​ can cause a secondary impairment of ADAPTIVE FUNCTIONING

Adaptive functioning = Communication, social participation, academic/occupational functioning, personal independence at home or in community settings

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5
Q

What is the global developmental delay diagnosis used for?

A

Individuals who are unable to undergo systematic assessments of intellectual functioning

  • Too young
  • Severe head injury
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6
Q

What are the three criteria that must be met to diagnose an intellectual disability?

A
  • Deficits in intellectual functions
  • Deficits in adaptive functioning
  • Onset of intellectual and adaptive deficits during the developmental period
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7
Q

Adaptive functioning deficits have 3 specific domains that you will rate from Mild-Moderate-Severe-Profound.

What are those 3 domains?

A

Conceptual domain

Social domain

Practical domain

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8
Q

What are examples of criteria that fall under the conceptual domain of adaptive functioning deficits?

A

Language/pre-academic skills develop slowly

Reading, writing, mathematics and understanding of time and money lags behind peers

For adults: ongoing assistance needed for conceptual tasks of day-to-day life

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9
Q

What are examples of criteria that fall under the social domain​ of adaptive functioning deficits?

A

Immature in social interactions

Difficulty perceiving peer’s social cues

Social judgement is immature for age

Gullibility

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10
Q

What are examples of criteria that fall under the practical domain of adaptive functioning deficits?

A

Difficulty w/ age-appropriate personal care

Difficulty with complex daily living tasks in comparison to peers

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11
Q

What are examples of communication disorders?

A

Speech sound disorder

Social (pragmatic) communication disorder

Childhood-onset fluency disorder (stuttering)

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12
Q

What are the differences b/w speech, language and communication?

A

Speech = Production of sounds

Language = Use of conventional system of symbols

Communication = Includes any verbal or non verbal behavior that influences the behavior, ideas or attitudes of another individual

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13
Q

Assessments of speech, language and communication abilities must take into account the individual’s ____________________

A

Assessments of speech, language and communication abilities must take into account the individual’s cultural and language context

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14
Q

What are the specific characteristics of language disorder?

A
  • Persistent difficulties in the acquisition and use of language across modalities (spoken, written, sign language etc…)
  • Reduced vocabulary
  • Limited sentence structure
  • Impairments in discourse
  • Difficulties are not attributable to hearing/other sensory impairment
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15
Q

What are the specific characteristics of speech sound disorder?

A
  • Persistent difficulty with speech sound production
  • Limitations in effective communication
  • These difficulties are not attributable to congenital or acquired conditions
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16
Q

What are the specific characteristics of childhood-onset fluency disorder (stuttering)?

A
  • Disturbances in the normal fluency
  • Sound and syllable repetitions
  • Broken words
  • Silent blocking
  • Monosyllabic whole word repetitions (eg “I-I-I-I see him”)
  • Not attributable to a speech-motor or sensory deficit
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17
Q

What are the specific characteristics of social (pragmatic) communication disorder?

A
  • Persistent difficulty in the social use of verbal/non verbal communication
  • Deficits in using communication for social purposes
  • Impairment in ability to change communication to match context
  • Difficulties understanding what is not explicitly stated
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18
Q

What are the specific characteristics of autism spectrum disorder?

A
  • Persistent deficits in social communication and social interaction across multiple contexts
  • Restricted repetitive patterns of behavior, interests or activities
  • Significant impairment in social, occupational or other areas of current functioning
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19
Q

What is the best idication that a child has autism spectrum disorder and not intellectual disability?

A

RESTRICTED INTERESTS or REPETITIVE BEHAVIORS

20
Q

What are the differences between level 1/2/3 for autism spectrum disorder classifications?

A

[least severe] Level 1 = Requiring support

Level 2 = Requiring substantial support

[most severe] Level 3 = Requiring very substantial support

21
Q

What is one of the most consistently useful behavioral intervention for autism spectrum disorder?

A

Education and support for parents, siblings, teachers and caregivers

22
Q

What is an effective method to become more cohesive with an autistic patient?

A

Parallel process

Interpreting what the autistic patient is doing and try to mirror the behavior; a form of reflecting to acheive the same level of interaction

23
Q

What are the only 2 medications that are FDA approved for treating autism spectrum disorder?

A

Risperidone

Aripiprazole

24
Q

What is tourette’s syndrome triad?

A

Childhood onset of multiple motor and vocal tics lasting more than one year

Tics, attention deficit hyperactivity disorder (ADHD) and obessive compulsive symptoms are comorbid in the majority of TS patients, this is the “TS clinical triad”

25
Q

What is executive functioning?

A

Ability to assess a situation and prioritze what is relevant vs irrelevant

26
Q

Where do executive functioning disorders originate in the brain?

A

Prefrontal cortex

27
Q

Where is the most significant region of the cortex related to ADHD?

A

Dorsal anterior midcingulate cortex

28
Q

What are the two types of of attention deficit disorder?

A

Inattentive type

Hyperactive type

29
Q

What are the diagnostic tools to use for ADHD?

A

TOVA : Test of Variables of Attention

Conners continuous performance test

30
Q

American Academy of Pediatrics(AAP) Clinical Practice Guidelines

For preschool aged children (4-5 y/o), what is the first line treatment for ADHD?

What if that doesn’t work?

A

Prescribe evidence based parent and/or teacher administered behavior therapy

Prescribe methylphenidate

31
Q

American Academy of Pediatrics(AAP) Clinical Practice Guidelines

For elementary aged children (6-11 y/o), what is the first line treatment for ADHD?

A

Prescribe FDA approved medications for ADHD and/or behavior therapy

32
Q

American Academy of Pediatrics(AAP) Clinical Practice Guidelines

For adolescents (12-18 y/o), what is the first line treatment for ADHD?

A

Prescribe FDA approved medications for ADHD with the assent of the adolescent

Also preferably add on behavioral therapy on top of the meds

33
Q

What is an excellent alternative for ADHD treatment that is a NON stimulant?

A

Alpha 2 agonists

(Guanfacine, Clonidine)

34
Q

What medication can be used to treat ADHD but should NOT be give to pts with seizure hx?

A

Bupropion

35
Q

What drug inhibits presynaptic NE uptake and has the cholinergic side effects of (dry mouth, insomnia, nausea) and is used to treat ADHD?

A

Atomoxetine

36
Q

What ADHD drug is indicated for ADULTS ONLY?!

A

Modafinil

37
Q

What is the most highly prescribed ADHD medication that is at risk of being abused by non-ADHD patients?

A

Methylphenidate

38
Q

What are the (3) major types of motor disorders?

A

Developmental coordination disorder

Stereotypic movement disorder

Tic disorders

39
Q

What is developmental coordination disorder?

A

The acquisition and execution of coordinated motor skills is substantially below that expected at that age

Manifested as clumsiness

40
Q

What is stereotypic movement disorder?

A

Repetitive, seemingly driven and apparently purposeless motor behavior

The behavior intereres with social, academic and other activities

41
Q

What must you specify in a stereotypic movement disorder upon diagnosis?

A

Specify if:

  • With self-injurious behavior
  • Without self-injurious behavior
  • Associated w/ a known medical/genetic condition

AND SEVERITY:

  • Mild
  • Moderate
  • Severe
42
Q

What is a tic disorder?

A

A tic is a sudden, rapid, recurrent non rhythmic motor movement or vocalization

43
Q

What is the diagnostic criteria for tourette’s disorder?

A

Both multiple motor tics and one or more phonic tics must be present at some time during the illness, although not necessarily concurrently

44
Q

What are some comorbidities associated with tourette’s?

A

ADHD

OCD

Anxiety disorders

Mood disorders

Suicide risk

Disruptive behaviors

Learning disabilities

Sleep disorders

45
Q

What medications are used for tourette’s?

A

Antidopaminergic drugs

Antipsychotics

Dopamine depleters

Botox injections

Anticonvulsants

46
Q

What is persistent (chronic) motor or vocal tic disorders?

A

Single or multiple motor or vocal tics have been present during the illness, but NOT BOTH MOTOR AND VOCAL

NMSP Exam 1 (22 decks)

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