Neurodevelopmental Disorders Flashcards
(31 cards)
What is ADHD?
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopment disorder featuring the core features of difficulty maintaining attention, excessive energy and activity, and impulsivity. It is more than twice as common in males.
Causes of ADHD?
Genetic (there is significant heritability)
Pregnancy-related factors (e.g., maternal smoking, premature birth and low birth weight)
Environmental factors
When do symptoms of ADHD start?
The symptoms start in childhood and should be consistent across settings. When a person displays symptoms only at work or school but is calm and focused at home, this is suggestive of an environmental effect rather than an underlying diagnosis.
Features of ADHD
All the features of ADHD can be part of a normal spectrum of behaviour. When many of these features are present, and they are adversely affecting the person, ADHD may be considered. Symptoms include:
Short attention span
Easily distracted
Quickly moving from one activity to another
Quickly losing interest in a task
Inability to persist with and complete tasks
Constantly moving or fidgeting
Impulsive behaviour
Disruptive behaviour
Difficulty managing time
What can be used to screen for ADHD?
The Adult ADHD Self-Report Scale (ASRS) can be used as a screening test to support a referral.
Management of ADHD
A specialist will make the diagnosis after a detailed assessment, including a history dating back to childhood.
Managing strategies for parents include:
A positive approach
Structured routines
Clear boundaries
Plenty of physical activity
A healthy diet (certain foods may exacerbate the symptoms)
Self-management strategies for ADHD
Self-management strategies for adults to help manage symptoms include organisation techniques, a healthy diet, exercise, and a sleep routine. Reasonable adjustments to the workplace may be helpful.
Medications for ADHD
Medication is an option after conservative management has failed, or in severe cases. This should be coordinated by a specialist. The medication are central nervous system stimulants. Examples are:
Methylphenidate
Lisdexamfetamine
Dexamfetamine
Atomoxetine
What needs to be monitored when taking ADHD meds?
Monitoring requirements whilst taking medications include heart rate, blood pressure, weight and mood changes.
What is ASD?
Autistic spectrum disorder (ASD) includes a range of impairments in social interaction, communication and behaviour.
Autistic spectrum disorder is defined in the DSM-5. It takes previously recognised diagnoses (Asperger’s syndrome, autistic disorder and pervasive developmental disorder) and groups them into one spectrum.
Describe the autism spectrum
On one end of the autistic spectrum, patients have normal intelligence and the ability to function in everyday life but display difficulties with reading emotions and responding to others. This was previously known as Asperger’s disorder. On the other end, patients can be severely affected and unable to function in typical environments.
Features of ASD - 3 categories
They can be categorised as deficits in social interaction, communication and behaviour
When are features of ASD usually observed before ?
the age of 3 years.
Deficits in social interaction in ASD
Lack of eye contact
Delay in smiling
Avoiding physical contact
Unable to read non-verbal cues
Difficulty establishing friendships
Not displaying a desire to share attention (e.g., not playing with others)
Deficits in communication in ASD
Delay, absence or regression in language development
Lack of appropriate non-verbal communication (e.g., smiling, eye contact, responding to others and sharing interest)
Difficulty with imaginative or imitative behaviour
Repetitive use of words or phrases
Deficits in behaviour in ASD
Greater interest in objects, numbers or patterns than people
Stereotypical repetitive movements (e.g., self-stimulating movements, such as hand-flapping or rocking)
Intense and deep interests that are persistent and rigid
Repetitive behaviour and fixed routines
Anxiety and distress with experiences outside their regular routine
Extremely restricted food preferences
How is ASD diagnosed
An autism specialist should make the diagnosis. Diagnosis usually involves assessment by psychiatrists and clinical psychologists. It involves a detailed evaluation of the patient’s current and historical behaviour and communication.
Management of ASD
Autistic spectrum disorder is a life-long condition and cannot be cured. Management depends on the severity of the condition. Patients with mild impairments may be highly functioning and not require any formal support.
A multidisciplinary team can help support patients and carers (e.g., parents) with greater impairments. For example:
Child and adolescent mental health services (CAMHS)
Psychologists
Speech and language specialists
Dieticians
Paediatricians
Social workers
Specially trained educators and special school environments
Charity organisations (e.g., National Autistic Society)
Epidemiology of ASD
The prevalence of ASD has increased over time, primarily as a result of changes in definitions and increased awareness.
Recent estimates suggest a prevalence of 1-2%.
ASD is three to four times more common in boys than girls.
Around 50% of children with ASD have an intellectual disability.
What are learning disabilities?
Learning disability is a general umbrella term encompassing a range of different conditions that affect the ability of the child to develop new skills. The amount they are affected varies from mild to severe. In mild cases the child may simply need extra time and help with learning new skills. In severe cases there can be significant intellectual impairment and they may need help with all activities of daily living.
Dyslexia
Dyslexia refers to a specific difficulty in reading, writing and spelling.
Dysgraphia
Dysgraphia refers to a specific difficulty in writing.
Dyspraxia
Dyspraxia, also known as developmental co-ordination disorder, refers to a specific type of difficulty in physical co-ordination. It is more common in boys. It presents with delayed gross and fine motor skills and a child that appears clumsy.
Auditory processing disorder
Auditory processing disorder refers to a specific difficulty in processing auditory information.
