Neurodevelopmental disorders Notes

NOTES NOTES NEURODEVELOPMENTAL DISORDERS GENERALLY, WHAT ARE THEY? PATHOLOGY & CAUSES ▪ Mental disorders causing difficulties in everyday activities/skills (e.g. communication, learning), occurring over an extended period, beginning during development ▪ Often causes social isolation/anxiety → depression SIGNS & SYMPTOMS ▪ See individual disorders DIAGNOSIS ▪ See individual disorders TREATMENT CAUSES ▪ Genetic, environmental ▪ Not curative ▪ See individual disorders COMPLICATIONS ▪ Reduced success in various areas of life (esp. social, academic) ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) osms.it/ADHD PATHOLOGY & CAUSES ▪ Developmental disorder characterized by inattentiveness/hyperactivity/impulsiveness, lasting for > six months TYPES ▪ Inattentive, hyperactive/impulsive, or both CAUSES ▪ Genetic, environmental ▪ Associated with neurotransmitter activity (low amounts of dopamine/norepinephrine) COMPLICATIONS ▪ Reduced success in various areas of life (esp. social, academic) OSMOSIS.ORG 711

SIGNS & SYMPTOMS ▪ Inattentiveness (careless mistakes, not listening, easily distracted) ▪ Hyperactivity/impulsiveness (restlessness) ▪ Developmental delay (e.g. in linguistic/ social/ motor skills) DIAGNOSIS ▪ For inattentive diagnosis, ≥ six of following (≥ five if age > 16) ▫ Makes careless mistakes/overlooks details ▫ Struggles to stay focused ▫ Doesn’t appear to listen ▫ Doesn’t follow instructions ▫ Has poor organizational skills ▫ Avoids mentally-engaging tasks ▫ Often loses things ▫ Is easily distracted ▫ Is forgetful ▪ For a hyperactive/impulsive diagnosis, ≥ six of following (≥ five if age > 16) ▫ Often fidgets ▫ Struggles to stay seated ▫ Restless ▫ Struggles to keep quiet ▫ Likes to keep moving ▫ Talks before others have finished ▫ Doesn’t like waiting ▫ Interrupts/bothers others ▪ Symptoms for either category must ▫ Persist > six months ▫ Present < 12 years old ▫ Present in multiple settings ▫ Affect day-to-day functioning ▫ Not caused by other condition TREATMENT MEDICATIONS ▪ Stimulants to slowly release neurotransmitter (e.g. amphetamines = Adderall/ methylphenidate = Ritalin) PSYCHOTHERAPY ▪ Behavioral therapy focused on decreasing distractions/improving time management, organizational skills AUTISM SPECTRUM DISORDER (ASD) osms.it/autism PATHOLOGY & CAUSES ▪ Developmental disorder characterized by difficulties with social interaction/ communication as well as restricted/ repetitive behaviors, interests, activities ▪ Encompasses autism, Asperger syndrome, childhood disintegrative disorder, and PDDNOS (pervasive developmental disorder not otherwise specified) 712 OSMOSIS.ORG CAUSES ▪ Genetic, environmental COMPLICATIONS ▪ Reduced success in various areas of life (esp. social, academic)

Chapter 96 Neurodevelopmental Disorders SIGNS & SYMPTOMS ▪ Difficulties with social interaction, communication (doesn’t understand others’ emotions/respond to them, struggles to make friends) ▪ Restricted/repetitive nature regarding particular behaviors/interests/activities DIAGNOSIS ▪ Struggles with social interaction/ communication ▫ Poor emotional reciprocity (doesn’t respond to/communicate emotions, thoughts) ▫ Poor non-verbal communication (especially poor understanding thereof) ▫ Impaired joint attention (doesn’t share interests with others) ▫ Difficulty in developing/maintaining relationships ▪ Restricted/repetitive behaviors, interests, or activities, with ≥ two of following ▫ Repetition of particular movements/ phrases ▫ Specific routines/rituals, resistant to change ▫ Restricted interests (e.g. highly specific knowledge in a subject) ▫ Highly sensitive to/interested in surroundings ▪ Symptoms must have been present in development, and affect day-to-day functioning ▪ Not caused by other condition TREATMENT PSYCHOTHERAPY ▪ Educational programs, behavioral therapy tailored to individual DISRUPTIVE, IMPULSE CONTROL, AND CONDUCT DISORDERS osms.it/conduct-disorder PATHOLOGY & CAUSES ▪ Mental disorders characterized by impulsive behaviors or a general lack of self-control ▪ No underlying motives for resulting behaviors ▪ Tend to start in childhood and persist into adulthood ▪ Includes ▫ Conduct disorders ▫ Intermittent explosive disorder ▫ Oppositional defiant disorder ▫ Pyromania ▫ Kleptomania CAUSES ▪ Generally unknown (genetic + environmental); tend to run in families MNEMONIC Conduct disorders are seen in Children Antisocial personality disorder is seen in Adults OSMOSIS.ORG 713

SIGNS & SYMPTOMS ▪ Persistent, aggressive or harmful behaviors ▫ May involve aggression or harm towards other individuals or animals ▫ May involve damage to or stealing physical property DIAGNOSIS ▪ Multiple impulsive behaviors observed over an extended period of time 714 OSMOSIS.ORG TREATMENT PSYCHOTHERAPHY ▪ Focused on therapy, not medications ▪ Cognitive behavioral therapy, social skills training, anger management, parent management training

Chapter 96 Neurodevelopmental Disorders LEARNING DISABILITY osms.it/learning-disability PATHOLOGY & CAUSES ▪ Difficulty with learning/developing certain skills TYPES ▪ Dyslexia: difficulty reading ▪ Dysgraphia: difficulty writing ▪ Dyscalculia: difficulty with mathematics CAUSES ▪ Genetic, environmental ▪ Not due to lack of intelligence/desire to learn/education COMPLICATIONS ▪ Reduced success in various areas of life (esp. academic) SIGNS & SYMPTOMS ▪ Difficulty with learning/developing certain skills ▫ Dyslexia: slow, effortful reading/poor understanding ▫ Dysgraphia: poor spelling, grammar, handwriting ▫ Dyscalculia: poor arithmetic ▪ Often comorbid with anxiety, depression DIAGNOSIS ▪ ≥ one of following for at ≥ six months ▫ Poor reading skills ▫ Poor reading comprehension ▫ Difficulties with spelling ▫ Other difficulties with written language ▫ Trouble with mathematics ▫ Trouble with mathematical reasoning ▪ Academic skills significantly lower than what would otherwise be expected, as confirmed by testing ▫ Learning difficulties must begin during school years but may not be problematic until later ▪ Not caused by other condition/ environmental factor TREATMENT OTHER INTERVENTIONS ▪ Modified approaches to education (e.g. one on one tutoring) ▪ Specific techniques/workarounds dependent on symptoms (e.g. using specific fonts to alleviate dyslexia) OSMOSIS.ORG 715

TOURETTE SYNDROME osms.it/tourette-syndrome PATHOLOGY & CAUSES DIAGNOSIS ≥ two motor tics, ≥ one vocal tic Must last ≥ one year from first tic Must start < 18 years old Not caused by other condition/substance ▪ Developmental disorder characterized by tics (rapid, repeated, involuntary, often inappropriate movements/vocalizations) ▫ Simple: short, involving particular body part ▫ Complex: comprised of multiple simultaneous tics ▪ ▪ ▪ ▪ TYPES MEDICATIONS ▪ Motor tics: repeating movements of others (echopraxia), making obscene gestures (copropraxia) ▪ Vocal tics: repeating same words/ phrases (echolalia, palilalia), blurting out inappropriate language (coprolalia) CAUSES ▪ Genetic, environmental COMPLICATIONS ▪ Often comorbid with anxiety, depression SIGNS & SYMPTOMS ▪ Simple/complex tics of either/both types 716 OSMOSIS.ORG TREATMENT ▪ Antipsychotics/epilepsy medications (only in severe cases) ▪ Botox injections may decrease appearance of facial tics PSYCHOTHERAPY ▪ Cognitive behavioral therapy ▪ Habit reversal training