Developmental Disorders-Ryst

Question 1

What is this:

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

Answer 1

communication disorder

Question 2

What is this:

problems with articulation, fluency, and voice. More of a motor probelm with speech.

Answer 2

speech disorder

Question 3

What is this:

impaired comprehension and/or use of spoken, wirtten or other symbol systems

Answer 3

Language disorder

Question 4

What is this:
Persistent difficulties in the acquisition and use of language across modalities due to deficits in comprehension or production that include the following:
-Reduced vocabulary
-Limited sentence structure
-Impairments in discourse

Answer 4

Language disorder according to DSM- 5

Question 5

What is this:
Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages.

Answer 5

Speech sound disorder according to DSM-5

Question 6

What is this:
Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual’s age and language skills, persist over time, and are characterized by frequent or marked occurrences of one or more of the following

Answer 6

Child-Onset fluency disorder (stuttering)

Question 7

What are these components of:
Sound and syllable repetitions
Sound prolongations of consonants as well as vowels
Broken words (pauses within words)
Audible or silent blockers (filled or unfilled pauses in speech)
Circumlocutions
Words produced with an excess of physical tension
Monosyllabic whole-word repetitions

Answer 7

Child onset fluency disorder (stuttering)

Question 8

There is expresive language delay in (Blank) percent of children under 3 years, by school age, only (blank) percent

Answer 8

10-15%

3-7%

Question 9

Mixed receptive-expressive delays in approx (blank) percent of preschoolers and (blank) percent of school-age children

Answer 9

5%

3%

Question 10

There are phonological disorders (moderate to severe) in (blank) percent of early school-age children; up to (blank) percent with mild form

Answer 10

2%

20%

Question 11

There is stuttering in (blank) percent of young children

Answer 11

1%

Question 12

About 1/2 of children with communication disordes also have (Blank). What are the most common?

Answer 12

axis I psychiatric disorders

-ADHD, ODD, Conduct Disorder, anxiety disorder

Question 13

What should be on your differential diagnosis when you see a kid that has seems to have a psych communication disorder?

Answer 13

Hearing impairment
Intellectual Disability
Autism
Selective Mutism

Question 14

What is the treatment for communication disorders?

Answer 14

• Teach specific strategies to change the deficit and increase skills (speech and language therapy)
• Teach compensatory coping strategies
• Change the child’s environment
• Parents are the biggest assets in helping to improve their child’s development (Hanen)*

Question 15

What is this:
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 15

Developmental Coordination Disorder

Question 16

What is this:

sudden, repatitive muscular contraction and vocalization

Answer 16

a Tic

Question 17

How long does a tic last and is it voluntary?

Answer 17

less than 1 second and are voluntary

Question 18

How do tics occur?
How do they progress?
What are simple tics?
What are complex tics?
What is the typical age of onset?
What is the peak onset?
When do you typically get tic reduction?

Answer 18

in bout and wax and wane
rostral to caudal
-limited to a few muscle groups
-mutiple organized contractions which mimic contextual speech or movement (copropraxia coprolalia, echolalia, echopraxia)
-5-6
-10-12
-15-17

Question 19

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

Answer 19

provisional

Question 20

(blank) 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 20

Tourette’s disorder

Question 21

If only motor or only vocal tics for >1 year, then it is a (blank) or (blank)

Answer 21

Persistent (Chronic) Motor or Vocal Tic Disorder

Question 22

How common is tourettes?
How common are chronic tic disorder during school years?
What is the overall prevalence of tics?

Answer 22

0.1%
2-15%
11% girls; 18% boys
*MORE common in boys

Question 23

50% of TD patients meet criteria for (blank) and (blank) percent of children diagosed with ADHD have tics or TD.

Answer 23

ADHD

30-40%

Question 24

For patients with tic disorders, they often have what diseases in their family histories?

Answer 24

ADHD, OCD, tics in first and second degree relatives

Question 25

How do you treat tic disorders?

Answer 25

First line = Alpha-2 Agonists Second line = Atypical antipsychotics Third line = Typical antipsychotics Habit Reversal Training = behavioral technique to reduce tics. Refer to a specialist if moderate to severe TD or substantial comorbidity.

Question 26

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

Answer 26

Sterotypic movement disorder

Question 27

What is this: 1) 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

Answer 27

Social (pragmatic) communication disorder

Question 28

In social (pragmatic) communication disorder, deficits result in (blank) limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance.

Answer 28

functional limitations

Question 29

In social (pragmatic) communication disorder, deficits must be present in the (blank) period, but may not become fully manifest until social communication demands exceed limited capacities.

Answer 29

early developmental period

Question 30

In (blank), 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 30

social (pragmatic) communication disorder

Question 31

What is this: A brand new diagnosis—therefore no information yet about epidemiology. 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 31

social (pragmatic) communication disorder

Question 32

What are the risk factors for social communication disorders?

Answer 32

Family history of Autism Spectrum Disorder, Specific Learning Disabilities or Communication Disorder

Question 33

What is the differential diagnosis for patients with symptoms of social communication disorder?

Answer 33

ASD ADHD Social Phobia Intellectual Disaiblity

Question 34

How do you treat social communication disorder?

Answer 34

Social Skills Training | Speech/Language Therapy

Question 35

(blank) replaces DSM-IV’s autistic disorder, Asperger’s disorder, childhood disintegration disorder, and pervasive developmental disorder not otherwise specified

Answer 35

Autism spectrum disorder

Question 36

What is the criteria for ASD? | Which area is very specific for autism?

Answer 36

A. persistent deficits in social communcation and social interaction across multiple contexts B. restricted, reptetitive patterns of behavior, interests, or activities C. Symptoms must be present in the early developmental period D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning. E. These disturbances are not better explained by intellectual disability or global developmental delay. Area B

Question 37

(blank) and autism spectrum disorder frequently co‐occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

Answer 37

Intellectual disability

Question 38

In ASD, there are persistent deficits in social communication and social interaction across multiple contexts, as manifested by .....?

Answer 38

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 39

In ASD, there is restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of what?

Answer 39

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 40

What are the concerns about ASD in DSM-5? | What did the data show?

Answer 40

Sensitivity has been “sacrificed” in order to improve specificity Merging all pervasive developmental disorders into one may result in loss of uniqueness/identity of Asperger’s Disorder That the DSM-5 made the right decision

Question 41

If you want to make ASD more specific, how do you do this?

Answer 41

- give level of severity - say whether has intellectual impairment - say whether there is a language impairment - say if its assoc. w/ medical, genetic, or environmental factor - associated w/ neurodevelopment, mental or behavioral disorder - w/ catatonia

Question 42

What is the epidemiology of ASD?

Answer 42

t recent CDC prevalence in US is 1/88 Prevalence varies worldwide -rate has been increasing (made be due to increased awarness and better diagnosing) -4:1 male to female ratio

Question 43

What is the etiology of ASD?

Answer 43

- bio based and multi-factorial - genetic (80% or higher) - exhibits recurrence in families - no single genetic anomaly found - environmental factors - risk factors

Question 44

What are the environmental factors associated with ASD?

Answer 44

prenatal rubella, thalidomide and valproic acid.

Question 45

What are the potential risk factors associated with ASD?

Answer 45

prematurity, low birth weight, parental age.

Question 46

How do you diagnose autism?

Answer 46

level 1 screening | level 2 eval

Question 47

What is the level 2 eval?

Answer 47

Review of developmental history/presenting problems with parents Review of available records Direct interaction with/observation of the child. Assessment of intellectual, language and adaptive functioning.

Question 48

What is the most important screeening tool for ASD and should be administered by a primay care physician?

Answer 48

The M-CHAT

Question 49

What is the gold standard measure for ASD? REsearch gold standard? other measures?

Answer 49

ADOS (gold standard) ADI-R (research gold standard) Social Communication Questionnaire M-CHAT (Screening)

Question 50

What are comorbidities associated with ASD?

Answer 50

``` Genetic Syndromes (eg Tuberous Sclerosis) Seizure Disorder Intellectual Disability Language Impairment Self-injury Catatonia ```

Question 51

What is the rate of psychiatric comorbidity in autism?

Answer 51

-65-70% of children

Question 52

What are the 3 most common comorbidites assoc. with autism?

Answer 52

Social anxiety disorder (29.2%) ADHD (28.1%) Oppositional Defiant Disorder (28.1%)

Question 53

``` What are these: Social anxiety disorder (29.2%) ADHD (28.1%) Oppositional Defiant Disorder (28.1%) Generalized Anxiety Disorder (13.4%) Panic Disorder (10.1%) Enuresis (11%) Sub-threshold depression or irritability (10.9%) Major Depression (0.9%) Dysthymic Disorder (0.5%) Conduct Disorder (3.2%) ```

Answer 53

Rates of psych comorbidity in autism

Question 54

What are some psychiatric symptoms that may show up with ASD and cause signif impairment?

Answer 54

``` Hyperactivity/agitation Impulsivity Inattention Restlessness Aggression (Tantrums, self-injury, irritability, emotional lability) Repetitive, obsessive-compulsive type behaviors Tics Sleep problems ```

Question 55

One study found 84.1% of children with autism met criteria for at least one (blank). What are frequent types?

Answer 55

anxiety disorder | separation anxiety and obsessive compulsive behavior

Question 56

Kids with autism may have specific phobias regarding .....?

Answer 56

thunderstorms, dark places, large crowds, dark rooms or closets, going to bed in the dark and closed places.

Question 57

In ASD patients, anxiety may increase (blank) behaviors such as ....? Why do they do these behaviors?

Answer 57

repetitive behaviors | echolalia, hand flapping and repetitive questioning, and these behaviors may be calming.

Question 58

How do you treat ASD? | What is most effective and widely used?

Answer 58

- multi-modal approach - behavioral interventions (most effective and widely used) - developmental intervention - medical interventions - school interventions - family support

Question 59

What are some behavioral interventions for ASD?

Answer 59

Lovaas (EIBI) and Early Start Denver Model

Question 60

What are the medical interventions for ASD (to treat associated or comorbid symptoms rather than core symptoms)? What exactly do they treat?

Answer 60

Risperidone and aripiprazole | Irritability and agitation

Question 61

What is this: reserved for kids under the age of 5, when the clinical severity level cannot be assessed during early childhood. The individual fails to meet expected developmental milestones in several areas of intellectual functionign and aplies to individuals who are too young to participate in standardized testing. This category requires reassessment after a period of time.

Answer 61

Global developmental delay

Question 62

Learning, communication, motor skills disorders, intellectual disability and autism spectrum disorders are (blank) disorders with significant morbidity.

Answer 62

developmental