Neurodevelopmental disorders: Clinical

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Neurodevelopmental disorders: Clinical

USMLE® Step 2 questions

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A 3-year-old boy is brought to the pediatrician so his parents can discuss some concerns they have with his development. Their son does not make eye contact when spoken to and has yet to meet any of his language milestones. The caregivers at his daycare have noticed that he does not like playing with other children and spends most days sitting quietly alone, playing with a set of blocks. He is at the 50th percentile for both height and weight. Physical exam is within normal limits with no significant findings. This child will most likely be diagnosed with which of the following? 


Pediatric neurodevelopmental disorders cause developmental deficits in areas like movement, language, and cognition, which can interfere with how a person functions independently in society.

In some cases there are specific genes that are thought to play a role. But there are also a number of environmental risk factors like maternal use of alcohol, tobacco, or illicit drugs during pregnancy; preterm birth; and prenatal or childhood exposure to environmental contaminants like lead.

Now the range of deficits can vary from a tic disorder that affects facial movements to global impairments in language and cognition.

Sometimes, there are deficits and delays in achieving development milestones like having fluent speech by age 6.

The neurodevelopmental disorders frequently co-occur; for example, individuals with autism spectrum disorder often have cognitive disability, and many children with attention-deficit/hyperactivity disorder or ADHD also have a learning disorder. Usually the symptoms occur in the early developmental period, but sometimes they’re not fully seen until a person is older like in some learning disorders.

For diagnosis, the areas where the deficits are must be substantially below those expected for the individual’s chronological age, and they significantly interfere with most of the daily activities that are appropriate to their chronological age, and impact academic productivity, prevocational and vocational activities, leisure, and play.

According to DSM-5, there are twelve conditions that can be divided into six categories: autism spectrum disorder; ADHD; specific learning disorder; intellectual disabilities which consists of intellectual disability and global developmental delay; communication disorders which include language disorder, speech sound disorder, childhood-onset fluency disorder, and social communication disorder; and motor disorders which is made up of developmental coordination disorder, stereotypic movement disorder, and tic disorders.


Neurodevelopmental disorders are a group of conditions that affect the development and function of the brain and nervous system. These disorders can affect the way a person thinks, learns, communicates, and behaves, and they often have an impact on other aspects of a person's daily life.

Examples of neurodevelopmental disorders include:

Autism spectrum disorder: This is a complex disorder that affects communication and social interaction. People with autism may also have repetitive behaviors or interests, and they may have difficulty with sensory processing. Attention deficit hyperactivity disorder (ADHD): This disorder is characterized by difficulty paying attention, impulsivity, and hyperactivity. It can affect a person's ability to focus, follow instructions, and complete tasks. Cerebral palsy: This is a group of conditions that affect movement and muscle tone. It results from damage to the brain before or during birth or early childhood. Speech sound disorder: It is associated with difficulty in producing the sounds involved in speech, which interferes with intelligibility or prevents delivering a message. Intellectual disability: It is characterized by deficits in intellectual functions, such as reasoning, problem-solving, or planning. individuals with intellectual disability fail to achieve independence and social responsibility as expected for their developmental age.


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