Neurodevelopmental Disorders

Question 1

What are the key diagnostic criteria for attention deficit/ hyperactivity disorder?

Answer 1

• A persistent pattern of inattention and/or hyperactivity/ impulsivity that interferes with functioning or development, as characterized by 1 and/or 2 in DSM5
• several inattentive or hyperactive-impulsive symptoms were present prior to age 12
• several inattentive or hyperactive-impulsive symptoms are present in two or more settings
• there is clear evidence that the symptoms interfere with, or reduce the quality of social, academic or occupational functioning

Question 2

When do most parents first observe symptoms of ADHD?

Answer 2

Most parents first observe excessive motor activity when the children are toddlers

Question 3

When is ADHD typically first diagnosed?

Answer 3

• Disorder usually first diagnosed in elementary school years – when school adjustment is compromised
• ADHD tends to be relatively stable through adolescence. In most individuals, symptoms attenuate during late adolescence and early adulthood.

Question 4

What is the prevalence of ADHD in elementary school children?

Answer 4

Prevalence: 3-5% of elementary school children

Question 5

Is ADHD more common in boys or girls?

Answer 5

More common in boys than in girls

Question 6

What do genetic studies reveal about ADHD?

Answer 6

• Genetic studies reveal that ADHD is an inheritable condition – may be exacerbated /diminished by the child’s environment (diathesis-stress)
• ADHD has been associated with variations in dopamine receptor genes (DRD4 and DRD5) and a dopamine transporter gene (DAT1)

Question 7

What do studies of the brain reveal about where ADHD results from?

Answer 7

Studies of the brain reveal that ADHD results from developmental abnormalities in the circuits of the frontal/cortical, striatum, and thalamus regions of the brain

Question 8

what is the diathesis stress theory of ADHD?

Answer 8

• Diathesis-stress theory of ADHD
• • Hyperactivity develops when predisposition to disorder is coupled with an authoritarian upbringing (Bettelheim)
• • Attention-seeking and hyperactivity
• • Reinforced by getting attention, thus increasing (mis)behaviours in frequency or intensity
• Note. These psychological theories are not supported by research

Question 9

What are the treatments of ADHD?

Answer 9

• Behavioural therapies have shown some promise
• Stimulants (i.e. Methylphenidate (MPH) = Ritalin)
• 80% of physicians have at some point, seen a patient with ADHD
• 84% of these had prescribed MPH (67% of all)
• MPH use is on the rise

Question 10

What are the autism spectrum disorders in the DSM-IV-TR?

Answer 10

• Pervasive developmental disorder not otherwise specified (PDD-NOS)
• Rett syndrome
• Autism
• Childhood Disintegrative disorder
• Asperger syndrome

Question 11

What is Rett’s disorder?

Answer 11

• Very rare; found only in girls
• Development normal until 1st-2nd year of life
• Head growth decelerates
• Loses ability to use hands purposefully
• Stereotyped movements such as handwringing or hand washing
• Walks in an uncoordinated manner
• Poor speech

Question 12

What is childhood disintegrative disorder?

Answer 12

• Very rare
• Normal development in the first 2 years of life then significant loss of:
• • Social, play, language, and motor skills

Question 13

What is aspberger’s syndrome?

Answer 13

• Now regarded as a mild form of autism spectrum disorder
• Poor social relationships
• Stereotyped behaviour
• Language and intelligence are intact

Question 14

What are the key diagnostic criteria of autism spectrum disorder?

Answer 14

• Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history
• Restricted repetitive patterns of behaviour, interests, or activities, as manifested by at least two of the following, currently or by history

Question 15

What are the psychological bases of ASD?

Answer 15

Psychoanalytic and behavioural perspectives believed that parents play a crucial role in ASD

Question 16

What are the biological bases of Autism spectrum disorder?

Answer 16

- Genetic Factors: Risk of autism in siblings of people with the disorder is about 75
times greater (Fragile X syndrome; Chromosomal abnormalities)
- Linked genetically to broader spectrum of deficits in communicative and social areas
- Autism reflects exceeding complex genetic variation with potentially more than 1,000 genes being involved

Question 17

What are the most effective treatments for ASD?

Answer 17

• Most effective treatments use modelling and operant conditioning techniques
• Early intensive behavioural intervention (EIBI)
• Most effective if delivered early (start before age 5), intensively (20 hours or more per week for more than two years)
• Children with higher initial cognitive levels and fewer early social interaction deficits show best response to EIBI

Question 18

What is critical in providing a better chance of success for people with ASD?

Answer 18

Early intervention is critical to providing a better chance of success in school and in living independently

Question 19

What are the most commonly used medications for treating ASD?

Answer 19

Most commonly used medications for treating problem behaviours in autistic children are anti-psychotics