Neurodevelopmental Disorders Module

Neurodevelopmental Disorders

• This module covers disorders beginning in childhood, diverging from typical development.
• Disorders are understood in the context of normal development.
• These disorders often persist throughout a person's life.

Topic Learning Objectives

• TLO 24: Examine developmental disorders in the context of child and adolescent development theories.
• TLO 25: Evaluate normal from delayed intellectual functioning in individuals.
• TLO 26: Explain childhood to adolescent psychological disorders.

Introduction

• A child's behavior should be viewed in the context of normal childhood development.
• Behaviors are considered abnormal if not appropriate for the child's age.
• Neurodevelopmental disorders begin in childhood and persist throughout life.

Childhood Disorders

• Childhood disorders differ from adult disorders in their clinical presentation:
  • Emotional disturbances may be short-lived and less specific.
• Many childhood disorders severely impact future development.
• Examples include eating problems (overeating, self-starvation), elimination problems, sleep disturbances, communication problems, attention problems, learning disorders, anxiety disorders, depression, and conduct disorders.
• These are called "developmental" due to significant deviations from typical childhood/adolescent development.
• Specific examples:
  • Children who don't speak by a certain age
  • Children who are terrified to go to school at a certain age
  • Children who wet their bed past a certain age
  • Children with speech/language issues (stuttering, reversing letters/words)

Special Psychological Vulnerabilities of Young Children

• Young children are exceptionally vulnerable to psychological problems.
• They have less self-understanding and have not fully developed an understanding of expectations and resources.
• "Immediately perceived threats are disproportionately important".
• Children are less equipped to cope with stressful situations compared to adults.
• Issues like suicide or violence against another person are misunderstood by children.
• Children have more dependency on others, making them vulnerable to rejection/disappointment if needs aren't met by those around them.
• Lack of experience in dealing with adversity makes manageable problems seem insurmountable.

Intellectual Disability

• Characterized by intellectual and adaptive deficits appearing in childhood.
• DSM-5 uses the term "intellectual developmental disorder" for compatibility with ICD.

Diagnostic Criteria for Intellectual Disability

• Three sets of criteria are used:

  • Deficits in general intellectual abilities (reasoning, problem-solving, judgment, learning).
  • Impairment in adaptive functioning across various life areas(communication, social participation, independent living).
  • Onset before age 18

• Severity levels: Mild, moderate, severe, profound based on adaptive functioning needs.

Etiology of Intellectual Disability

• Genetic Abnormalities: Some Intellectual disabilities result from genetic abnormalities like,
  • Infantile Cerebral Lipoidosis
  • Phenylketonuria
  • Galactosemia
• Environmental Hazards: During pregnancy, factors like infections or exposure to toxins can cause intellectual disabilities.

Fragile X Syndrome

• Genetic disorder, found mostly in males.
• Characterized by physical and cognitive traits and challenges in social interaction /communication.
• Physical characteristics may include a large head circumference, a large forehead and long face, flat feet, large body size, and large testicles.

Down Syndrome (Trisomy 21)

• Extra chromosome on pair 21.
• Leading cause of mental deficiency, characterized by a range of physical characteristics and an intellectual disability.
• Common physical traits include a small round skull, large protruding tongue, and short limbs.

Autism Spectrum Disorder

• Neurodevelopmental disorder.
• Characterized by challenges in social interaction, communication, and repetitive behaviors.
• Key characteristics:
  • Social deficits (difficulty in social interaction/relationships).
  • Language deficits.
  • Repetitive behaviors.
• Cognitive deficits, self-stimulation, and maintaining sameness.

Attention Deficit/Hyperactivity Disorder (ADHD)

• Characterized by persistent difficulties with inattention, hyperactivity and impulsiveness.
• Impacts a child's ability to focus, control behavior.
• Problems are present across multiple settings.
• Possible causes include environmental and/or genetic/biological factors, family influences.

Disruptive, Impulse-Control, and Conduct Disorders

• Marked by persistent violations of rules and rights of others.
• Three core traits that often cause difficulties for those with these conditions:
  • Disinhibition
  • Excessive Constraint
  • Negative Emotionality

Anxiety and Depression in Children and Adolescents

• It's important that children are not spared from stress/anxiety.
• Anxiety-related disorders include separation anxiety.
• Depression and mood disorders are also common.
• There are developmental nuances in diagnoses.

Eating Disorders

• Characterized by severe disturbances in eating behaviors that affect physical and emotional well-being.
• Types include: anorexia nervosa, bulimia nervosa
• Complex interplay of genetic factors and sociocultural influence.