neurodevelopmental disorders neurodevelopmental disorders new combination of disorder in the dsm-5

Neurodevelopmental Disorders

Neurodevelopmental disorders new combination of disorder in the DSM-5

Overview of Neurodevelopmental Disorders

Developmental disorders First diagnosed = infancy, childhood, adolescence Attention deficit hyperactivity disorder (ADHD) Specific learning disorders Autism spectrum disorder Intellectual Disability

Attention Deficit/Hyperactivity Disorder (ADHD)

Central features Inattentive Hyperactive Impulsivity

DSM-5 differentiates two categories of symptoms Problems of inattention Problems of Hyperactivity and impulsivity

Attention Deficit/Hyperactivity Disorder (ADHD)

Impairments Behavioral Cognitive Social Academic

ADHD: Statistics

Prevalence 3% to 9% worldwide 11% of children in the U.S. aged 4 to 17

Onset 3 or 4 years

Boys : Girls = 3:1

Possible cultural construct

ADHD: Statistics

Adults with ADHD Lower level jobs 2.5 fewer years of education More likely to be divorced, have substance use

problems and antisocial personality disorder High risk behaviors

High comorbidity ODD Mood disorders

ADHD: Causes

Genetics Familial component Copy number variants—CNVs Dopamine

DRD4, DAT1, DRD5 genes and Ritalin Norepinephrine GABA Serotonin

ADHD: Causes

Neurobiological contributions Smaller brain volume

3-4%

The role of toxins Allergens and food additives

No evidence Maternal smoking

Increases risk Interacts with genetic predisposition

ADHD: Causes

Psychosocial and social factors Negative responses

Teachers Peers Adults

Peer rejection Low self-esteem Poor self-image

Treatment of ADHD

Treatment of two fronts Psychosocial intervention

Improving academic performance, decreasing disruptive behavior, and improving social skills

Behavioral interventions before medication Parent training Social skills training

Biological intervention

Treatment of ADHD: Biological

Goals Reduce impulsivity and hyperactivity Improve attention

Stimulants 4 million currently treated Ritalin


Other Medications Adderall Strattera Tenex Clonidine


Effects of medications Improve compliance Decrease negative behaviors Do not affect learning and academic performance Possible abuse issues Side effects

Psychopharmacogenetics The study of how your genetic makeup influences

your response to certain drugs

Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that, affects how one perceives and socializes with others

DSM-5 combined the following into Autism spectrum disorder (ASD) Autistic disorder Asperger’s disorder Childhood disintegrative disorder

Rett disorder is now diagnosed as ASD with a qualifier


Pervasive developmental disorder “Not otherwise specified” dropped in DSM-5

Social (Pragmatic) Communication was added to the DSM-5


Two major characteristics of ASD Communication and social interaction Restricted, repetitive patterns of behavior,

interests, or activities

Three levels of severity Level 1— “Requiring support” Level 2— “Requiring substantial support” Level 3— “Requiring very substantial support” Described qualitatively and, as yet, has no

quantitative equivalent


Impairment in social communication and social interaction Fail to develop age-appropriate social relationships Social communication and social interaction

Joint attention Deficits in nonverbal communication

Prosody


Impairment in social communication and social interaction 25% never acquire speech Echolalia Conversational impairments


Restricted, repetitive patterns of behavior, interests, or activities Restricted patterns

Behaviors Interests Activities

Maintenance of sameness Stereotyped and ritualistic behaviors

Autism Spectrum Disorder : Statistics

Prevalence: 1 in every 50 births Male to female estimate being 4.4 to 1 IQ interaction

38% intellectual disabilities Occurs worldwide

Causes of Autism Spectrum Disorder : Psychological and Social Dimensions

Historical views Failed parenting

Perfectionistic, cold, and aloof High socioeconomic status Higher IQs

Lack of self-awareness Limited self-concept Behavioral correlates

Echolalia Self-injury

Causes of Autism Spectrum Disorder : Biological

Significant genetic component Familial component

20% risk of second child with autism 100 fold increase in risk

Numerous genes on a number of our chromosomes involved

Oxytocin receptor genes Bonding and social memory

Older parents increased risk


Neurobiological influences Amygdala

Larger size at birth = higher anxiety, fear Elevated cortisol Neuronal damage Similar size when older Fewer neurons

Oxytocin Lower levels


Neurobiological influences Vaccinations

Mercury No increased risk Negative effect of not vaccinating

Treatment of Autism Spectrum Disorder

Psychosocial treatments Behavioral approaches

Skill building Reduce problem behaviors Communication and language training Increase socialization Naturalistic teaching strategies

Early intervention is critical


Biological treatments Medical intervention has had little positive impact

Decrease agitation Tranquilizers SSRIs


Integrated treatments Preferred model Multidimensional, comprehensive focus

Children Families Schools Home

Community and social support

Prevention of Neurodevelopmental Disorders

Early intervention At-risk children, families Head Start Program

Educational Medical Social supports

Genetic screening Detection and correction Prenatal gene therapy

neurodevelopmental disorders neurodevelopmental disorders new combination of disorder in the dsm-5

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