Neurodevelopment disorder

Question 1

DSM-5

Answer 1

• diagnostic and statistical manual of mental disorders
• created to enable professionals to communicate using common diagnostic language
• attempt to provide professionals with a definitive list of all recognised mental health conditions and their association symptoms
• criteria needed for diagnosis

Question 2

definition of neurodevelopment in the DSM-5

Answer 2

neurodevelopment disorders are a group of conditions with onset in the developmental period. the disorders typically manifest early in development, often before the child enters school and are characterised by the developmental deficits that produce impairments of personal and social, academic or occupational functioning.
-deficits vary from very specific limitations of learning or control of executive functions to global impairment of social skills or intelligence

Question 3

co-occurrence in developmental disorders according to the DSM5

Answer 3

neurodevelopment co-occur

• autism spectrum disorder and intellectual disabilities (intellectual development disorder)
• attention- deficit/hyperactivity disorder (ADHD) and a specific learning difficulty

Question 4

DSM-5 list of neurodevelopmental disorders

Answer 4

• intellectual disability
• communication disorder
• autism spectrum/condition
• attention-deficit/hyperactivity disorder
• specific learning difficulty
• motor disorder

Question 5

definition of intellectual disabilities

Answer 5

a disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains

Question 6

risk factors

Answer 6

• prenatal include genetic syndromes, inborn errors of metabolism, brain malformations, maternal disease, and environmental influences
• perinatal include a variety of labour and delivery related events leading to neonatal encephalopathy
• postnatal include hypoxic injury, traumatic brain injury, severe and chronic deprivation

Question 7

communication disorder

Answer 7

• deficits in language, speech and communication

- speech is the xpr

Question 8

DSM-5 specifiers

Answer 8

Four categories rank ordered- resents an underling continuum- boarders not always totally explicit
Mild- 85%, can generally learn reading and writing skills, may have a job and live independently
Moderate- 10%, may be ale learn some basic reading and writing skills require some oversight/ supervision
Severe- 5%,unlikel to b le to read and write , require assistance in daily lie
Profound- 1%, intensive support, may have medical conditions that require nursing/therapy

Question 9

communication disorder

Answer 9

deficits in language, speech, and communication
persistent difficulties in the acquisition and use of language across modalities (spoken, written, sign language, or others)
1. reduced vocab
2. limited sentence structure
3. impairments in discourse

Question 10

language disorder- DSM_5

Answer 10

the diagnostic category of communication disorder includes

• language disorder
• speech sound disorder
• childhood-onset fluency disorder
• social communication disorder
• other specified and unspecified communication disorder

Question 11

autism spectrum disorder a.

Answer 11

A. persistent deficit in social communication and social interaction cross multiple contexts, as manifested by the following

1. deficit in social emotional reciprocity
2. deficit in nonverbal communicative behaviours
3. deficits in developing, maintaining, and understanding relationships

Question 12

autism spectrum DSM-5 B

Answer 12

B. restricted, repetitive patterns of behaviour (at least two of the following)

1. stereotyped or repetitive motor movements
2. insistence on sameness, inflexible adherence
3. highly restricted, fixated interest
4. hyper or hyperactivity to sensory input

Question 13

autism spectrum DSM-5 C

Answer 13

C. symptoms must be presented in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life)

Question 14

autism spectrum DSM-5 D

Answer 14

D. symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning

Question 15

autism spectrum DSM-5 E

Answer 15

E. these disturbances are not better explained by intellectual disabilities or global development delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnosis of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level

Question 16

Epidemiology of ASD

Answer 16

4: 1 male-to-female ratio (Ehlers & Gillberg, 1993)
- girls often diagnosed later
- female ‘autism phenotype’
- prevalence is about 1% but is diagnosis levels are rising

Question 17

Attention-deficit/hyperactivity disorder (ADHD) DSM-5 A

Answer 17

A. a persistent patter of inattention and/or hyperactivity-impulsivity that interferes with functioning and development. Characterised by inattention and/or hyperactivity/impulsivity. six or more of the following symptoms have persistent for at least 6 months to a degree that is inconsistent with developmental level and that negativity impacts directly on social and academic/occupational activities

Question 18

Attention-deficit/hyperactivity disorder (ADHD) DSM-5 B

Answer 18

Several inattention or hyperactive-impulsive symptoms were present prior to the age of 12 years

Question 19

Attention-deficit/hyperactivity disorder (ADHD) DSM-5 C

Answer 19

C. several inattentive or hyperactive-impulsive symptoms are present in two or more settings

Question 20

Attention-deficit/hyperactivity disorder (ADHD) DSM-5 D

Answer 20

D. there is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational function

Question 21

Attention-deficit/hyperactivity disorder (ADHD) DSM-5 E

Answer 21

E. The symptoms do not occur exclusively during the course of schizophrenia and are not better explained by another mental disorder

Question 22

A. inattention list

Attention-deficit/hyperactivity disorder (ADHD) DSM-5

Answer 22

• often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities
• often has difficulty sustaining attention in tasks or play activities
• often doesn’t seem to listen when spoken to
• often does not follow through with instructions and fails to finish schoolwork, chores, or duties in the workplace
• often has difficulty organising tasks and activities
• often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
• often loses things necessary for tasks or activities
• often easily distracted by extraneous stimuli
• often forgetful in daily activity

Question 23

A. hyperactivity/impulsivity

Attention-deficit/hyperactivity disorder (ADHD) DSM-5

Answer 23

• often fidgets with or taps hands or feet or squirms in seats
• often leaves seat in situation when remaining seated is expected
• often runs about or climbs in situations where it is inappropriate
• often unable to play or engage in leisure activities quietly
• often ‘‘on the go’’ acting as if ‘‘driven by a motor’’
• often talks excessively
• often bursts out an answer before a questions has even been completed
• often has difficulty waiting their turn
• often interrupts of intrudes on others

Question 24

prevalence and risk factors

Attention-deficit/hyperactivity disorder (ADHD) DSM-5

Answer 24

-occurs in most cultures in about 5% of children and about 2.5% in adults
-very low birth weight
-elevated in the first degree biological relatives of individuals with ADHD
The heritability of ADHD is substantial

Question 25

Specific learning difficulties (SpLDs) DSM-5 A

Answer 25

A. difficulties learning and using academic skills, as indicated bu the presence of at least one of the following symptoms that have persisted for at least 6 months, despite the provision of interventions that target those difficulties 1. inaccurate or slow and effortless word reading 2. difficulty understanding the meaning of what is read 3. difficulties with spelling 4. difficulties with written expression 5. divffuclites mastering number senses, number facts, or calculation 6. difficulties with mathematical reasoning

Question 26

Specific learning difficulties (SpLDs) DSM-5 B

Answer 26

B. the affect academic skills are substantially and quantifiably below those expected for the individuals chronological age, and cause significant interference with academic or occupational performance, or with activities of daily life, as conformed by individually administered standardised achievement measures and comprehensive clinical assessment

Question 27

Specific learning difficulties (SpLDs) DSM-5 C

Answer 27

C. the learning difficulties begin during school age years but may not become fully manifest until the demeans for those affected academic skills exceed the individuals limited capacities (e.g., timed test)

Question 28

Specific learning difficulties (SpLDs) DSM-5 D

Answer 28

D. the learning difficulties are not better accounted for by intellectual disabilities, uncorrected visual or auditory acuity, other mental or neurological disorders, psychosocial adversity, lack of proficiency in the language of academic instruction, or inadequate educational instruction

Question 29

Key diagnostic features SpLDs

Answer 29

SpLDs are considered ''specific'' for 4 reasons: 1. they are not attributable to intellectual disabilities 2. the learning difficulty cannot be attributed to more general external factors, such as economic or environmental disadvantage 3. the learning difficulty can not be attributed to a neurological or motor disorder or to vision or hearing disorder 4. the learning difficulty may be restricted to one academic skill or domain (e.g., reading single words) SpLDs are persistent, not transitory

Question 30

Reading

Answer 30

Dyslexia: learning difficulty that involves problems with literacy (2-15%) poor reading comprehension, handwriting, punctuation, dealing with words, mispronunciation and ''swimming'' letters

Question 31

Maths

Answer 31

Dyscalculia: a condition that affects the ability to acquire arithmetical skills Understanding simple numbers, problems learning number facts and procedures, lack of an intuitive grasp of numbers, representation and processing of numbers- problems in parietal lobe

Question 32

Intelligence achievement discrepancy

Answer 32

- Discrepancy = mis match | - discrepency between normal and high intellectual functioning and unexpect

Question 32

Intelligence achievement discrepancy

Answer 32

- Discrepancy = mis match - Discrepancy between normal and high intellectual functioning and unexpectedly low academic achievement has long been considered as the hallmark for SpLDs (U.S. Office of Education, 1977) - used as evidence that na underlying condition is making it unusually hard for a child to learn and perform

Question 33

measuring achievement

Answer 33

academic skills are disrupted along a continuum, so there is no natural cut point that beside to differentiate individuals with and without a SpLDs -large extent arbitrary low achievement scores on one or more standardised tests or subtests within an academic domain are needed for the greatest diagnostic certainty -however, precise scores will vary according to the particular standardised tests that are used

Question 34

Developmental coordination disorder (Dyspraxia) DSM-5 A

Answer 34

A. The acquisition and execution of coordinated motor skills is substantially below that expected given the individual’s chronological age and opportunity for skill learning and use. Difficulties are manifested as clumsiness(e.g., dropping or bumping into objects) as well as slowness and inaccuracy of performance of motor skills (e.g., catching an object, using scissors or cutlery, handwriting, riding a bike, or participating in sports)

Question 35

Developmental coordination disorder (Dyspraxia) DSM-5 A

Answer 35

A. The acquisition and execution of coordinated motor skills is substantially below that expected given the individual’s chronological age and opportunity for skill learning and use. Difficulties are manifested as clumsiness(e.g., dropping or bumping into objects) as well as slowness and inaccuracy of performance of motor skills (e.g., catching an object, using scissors or cutlery, handwriting, riding a bike, or participating in sports)

Question 36

Developmental coordination disorder (Dyspraxia) DSM-5 B

Answer 36

B.The motor skills deficit in Criterion A significantly and persistently interferes with activities of daily living appropriate to chronological age (e.g., self-care and self-maintenance) and impacts academic/school productivity, prevocational and vocational activities, leisure, and play

Question 37

Developmental coordination disorder (Dyspraxia) DSM-5 C

Answer 37

C.Onsetof symptoms is in theearly developmental period

Question 38

Developmental coordination disorder (Dyspraxia) DSM-5 D

Answer 38

D.The motor skills deficits are not better explained by intellectual disabilityor visual impairment and are not attributable to a neurological condition affecting movement (e.g., cerebral palsy, muscular dystrophy, degenerative disorder).

Question 39

Prevalence and risk factors | Developmental coordination disorder (Dyspraxia) DSM-5

Answer 39

- prevalence in ages 5-11 years is 5%-6% - males are more often affect than females (between 2:1 and 7:1) - environmental factors- developmental coordination disorder is more common following prenatal exposure to alcohol an din preterm and low birth weigh children

Question 40

genreal conclusions

Answer 40

A Note on the DSM... -Developed through clinical consensus & voting -Categories are constantly changing -Influenced by culture & fads -Considered quite controversial, esp. DSM-5 https://www.nhs.uk/news/mental-health/news-analysis-controversial-mental-health-guide-dsm-5/ “It is a guide, not a bible” – Allen Frances (https://www.psychologytoday.com/gb/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes) -Based on the medical model Disorders treated in same way as a broken arm – that is, they have a physical cause Symptoms are an outward sign of inner physical disorder -Disorders are related to physical structure and (mal)functioning of the brain -Often viewed as reductionist, sidelines environmental factors, argued to be damaging/unhelpful