Title 20 AbPsy - Neurodevelopmental Disorders.pdf ✅

20 – Neurodevelopmental Disorders PY111 | ABPSY | 2023 - 2024 OUTLINE 1. Overview of Neurodevelopmental Disorders 2. Attention-Deficit/Hyperactivity Disorder 3. Specific Learning Disorder 4. Autism Spectrum Disorder 5. Intellectual Disability (Intellectual Developmental Disorder) 6. Prevention of Neurodevelopmental Disorders PERSPECTIVES ON NEURODEVELOPMENTAL DISORDERS (NDD) PERSPECTIVES ON NEUROCOGNITIVE DISORDERS Neurodevelopmental Disorders – a group of disorders that: ● Manifest early in development (when a child’s nervous system is still developing) ● Characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning ● Neurodevelopmental disorders frequently co-occur (ex. individuals with ASD often have intellectual disability) WHAT IS NORMAL? WHAT IS ABNORMAL? ● Childhood is considered particularly important, because the brain changes significantly for several years after birth ○ This is also when critical developments occur in social, emotional, cognitive, and other important competency areas ○ These changes mostly follow a pattern – the child develops one skill before acquiring the next, and subsequent skills often build upon one another ○ Any disruption in the development of early skills will disrupt the development of later skills ● Understanding this type of developmental relationship is important for several reasons ○ Knowing what processes are disrupted will help us understand the disorder better and may lead to more appropriate intervention strategies ○ Knowledge of development is important for understanding the nature of psychological disorders ATTENTION-DEFICIT/HYPERACTIVITY DISORDER ATTENTION-DEFICIT/HYPERACTIVITY DISORDER Attention-Deficit/Hyperactivity Disorder – involves characteristics of inattention or hyperactivity and impulsivity ● One of the most common reasons children are referred for mental health services in the United States ● The primary characteristics of ADHD include a pattern of inattention, such as being disorganized 1 | @studywithky
or forgetful about school or work-related tasks, or of hyperactivity and impulsivity CLINICAL DESCRIPTION ● People with this disorder have a great deal of difficulty sustaining their attention on a task or activity ● As a result, their tasks are often unfinished, and they often seem not to be listening when someone else is speaking ● Some people with ADHD display motor hyperactivity ● Children with this disorder are often described as fidgety in school, unable to sit still for more than a few minutes ● Acting apparently without thinking is also a common complaint made about people with ADHD ● DSM-5 differentiates two categories of symptoms ○ Inattention: may not pay enough attention to details, making careless mistakes ○ Hyperactivity and Impulsivity ■ Hyperactivity: includes fidgeting, having trouble sitting for any length of time, and always being on the go ■ Impulsivity: includes blurting out answers before questions have been completed and having trouble waiting turns STATISTICS ● Some people believe that children who are just normally “active” are being misdiagnosed with ADHD ● Children were more likely to receive the label of ADHD in the United States than anywhere else ● Some have argued that ADHD in children is simply a cultural construct ● Boys are 2 to 3 times more likely to be diagnosed with ADHD than girls, and this discrepancy increases for children being seen in clinics ○ Most research over the past several decades has used young boys as participants ○ More boys also displayed these behaviors, which made it easier to find participants to study ● Kathleen Nadeau ○ Argued that more research is needed on ADHD in girl ○ Girls experience significant struggles that are often overlooked because their ADHD symptoms bear little resemblance to those of boys ● Children with ADHD are first identified as different from their peers around age 3 or 4 ○ Parents describe them as active, mischievous, slow to toilet train, and oppositional ○ Symptoms of inattention, impulsivity, and hyperactivity become increasingly obvious during the school years ○ During adolescence, the impulsivity manifests itself in different areas ● Several other DSM-5 disorders, also found in children, appear to overlap significantly with oppositional defiant disorder (ODD), conduct disorder, and bipolar disorder CAUSES ● Researchers have known for some time that ADHD is more common in families in which one person has the disorder ○ These families display an increase in psychopathology in general, including conduct disorder, mood disorders, anxiety disorders, and substance abuse ○ Shared genetic deficits may contribute to the problems experienced by individuals with these disorders ● ADHD is considered to be highly influenced by genetics ○ Environmental influences play a relatively small role ○ Mutations occur that either create extra copies of a gene on one chromosome or result in the deletion of genes (copy number variants) ○ Additions or deletions of one or more genes result in disrupted development ● Strong genetic influence in ADHD does not rule out any role for the environment ○ Children with a mutation involving the dopamine system (DAT1 genotype) were more likely to exhibit the symptoms of ADHD if their mothers smoked during pregnancy ○ Other factors include maternal stress and alcohol use, and parental marital instability and discord ● Negative responses by parents, teachers, and peers to the affected child’s impulsivity and hyperactivity may contribute to feelings of low self-esteem, especially in children who are also depressed TREATMENT 2 | @studywithky
Psychosocial Interventions ● Improving academic performance ● Decreasing disruptive behavior ● Social Skills Training: teaching the child how to interact appropriately with peers ● Reinforcement Programs ○ Rewarding the child for improvements ○ Punishing misbehavior with loss of rewards ● Parent Education Programs ○ Teaching families how to respond constructively to their child’s behaviors and how to structure the child’s day to help prevent difficulties ● Cognitive-Behavioral Therapy (CBT) ○ For adults with ADHD ○ To reduce distractibility and improve organizational skills Biological Interventions ● Stimulants ○ Methylphenidate (Ritalin, Adderall) and other non-stimulant medications such as atomoxetine (Strattera), guanfacine (Tenex), and clonidine ○ Have proven to be helpful in reducing the core symptoms of hyperactivity and impulsivity, and in improving concentration on tasks COMMUNICATION DISORDERS OVERVIEW OF COMMUNICATION DISORDERS Communication Disorders – disorders of speech and language in children ● Disorders of Speech: include lack of speech fluidity (stuttering); inaccurately produced or appropriately used speech sounds; and developmental verbal dyspraxia ● Disorders of Language: include problems with formation of words (morphology) or sentences (syntax), language meaning (semantics), and use of contexts (pragmatics) ● These disorders are highly comorbid with each other LANGUAGE DISORDER Language Disorder – use of spoken and written language persistently lags behind age expectations ● Compared to age-mates, patients will have small vocabularies, impaired use of words to form sentences, and reduced ability to employ sentences to express ideas ● A new category to cover language-related problems including spoken and written language that are manifested in receptive and expressive language abilities ● Both vocabulary and grammar are usually affected ● Duration: early childhood; chronic ● Disability: work/educational, social, or personal impairment ● May not require special intervention Speech Sound Disorder (SSD) – patient has problems producing sounds of speech, compromising communication ● Phonological Disorder: substituting one sound for another or omitting certain sounds completely ● Difficulty can arise from inadequate knowledge of speech sounds or from motor problems that interfere with speech production ● Consonants are affected most often (lisping) ● Other examples include errors in the order of sounds (spaghetti → gaspetti) ● Onset: early childhood ● Disability: work/educational or social impairment Childhood-Onset Fluency Disorder (Stuttering) – problems speaking smoothly, most notably with sounds that are drawn out or repeated; there may be pauses in the middle of words 3 | @studywithky
● Marked tension while speaking, and repetition of entire words or substitution of easier words ● Results in anxiety, frustration, or even physical tension about the act of speaking ● Momentary panic that ensues may cause people to take extreme measures to avoid difficult sounds or situations ● Stuttering occurs especially with consonants, initial sounds of words, first word of a sentence, and words that are accented, long, or seldom used ● Psychosocial intervention involves parent counseling to teach how to talk to their children ● Behavioral Intervention ○ Regulated-Breathing Method: person is instructed to stop speaking when a stuttering episode occurs and then to take a deep breath (exhale, then inhale) before proceeding ○ Altered Auditory Feedback ■ Electronically changing speech feedback to people who stutter ■ Can improve speech, as can using forms of self-monitoring, in which people modify their own speech for the words they stutter Social (Pragmatic) Communication Disorder – difficulty in using language for social reasons, adapting communication to fit context, following conventions of conversation, and understanding implied communications ● Describes patients who, despite adequate vocabulary and ability to form sentences, still have problems with the practical use of language ● Principal skills in pragmatics ○ Using language to pursue different tasks ○ Adapting language in accord with the needs of a particular situation or individual ○ Adhering to the conventions of conversation ○ Understanding implied communications ● They have difficulty understanding and using the pragmatic aspects of social communication, to the point that their conversations can be socially inappropriate ● They do not have the restricted interests and repetitive behaviors that would qualify them for ASD ● Usually first identified by age 4 ● Intervention involves individualized social skills training (e.g., modeling, role playing) with an emphasis on teaching important rules necessary for carrying on conversations with others SPECIFIC LEARNING DISORDER OVERVIEW OF SPECIFIC LEARNING DISORDERS Specific Learning Disorder – characterized by performance that is substantially below what would be expected given the person’s age, intelligence quotient (IQ) score, and education 4 | @studywithky