Intellectual disability, ADHD, ASD

The DMS-5 criteria for intellectual disability requires significant limits in both _________ and ________?

Intellectual functioning and adaptive behavior

What is the onset for intellectual disability?

Before the age of 18

Global Developmental Delay (GDD)

Term used for children under the age of 5 until they’re of school age to be reassessed

How is intellectual functioning measured and what is the typical range?

IQ tests; 85-115

What is the IQ score that suggests intellectual disability?

<70

Intellectual functioning is the general ability to…

reason, plan, and solve problems; think abstractly and understand complex ideas; learn from experience

Why do you think limitations in adaptive behavior limit someone’s everyday life?

It’s the measure of how a person typically performs and not their performance potential.

Define adaptive behaviors.

Everyday skills for living, working, and socializing needed to live independently

Define mild intellectual disability.

Struggles with academic skills, immature social and communication skills, can be independent in self-care but may need support with IADLs, employment is possible with appropriate support

Define moderate intellectual disability

Marked delays in academics and communication, social/relationships often limited and needs support in daily interactions, can perform self-care with teaching and ongoing support, employment possible in supervised settings

Define severe intellectual disability

Limited understanding of written language and numbers, speech limited and often communicates through single words/phrases, needs support in all ADLs and constant supervision, employment not typical

Define profound intellectual disability

Very limited understanding, dependent on caregivers for nearly all needs, nonverbal or very limited communication, requires round-the-clock support for ADLs/mobility/safety, work and independent living not possible

What is the etiology of intellectual disability?

ID can have many causes but we usually don’t know the exact reason. There can be biomedical and environmental influences.

Name a few biomedical influences for ID.

Genetic causes such as single gene disorders and chromosomal disorders, and birth defects.

Name a few environmental factors of ID.

Prenatal factors such as exposure to drugs or alcohol, maternal conditions, low birth weight; perinatal factors such as mechanical injuries or hypoxia; postnatal factors such as infections, head trauma, or lack of stimulation

What is the most common childhood neurodevelopmental disorder?

ADHD

What is ADHD characterized by?

Persistent and maladaptive symptoms of inattention, hyperactivity, and impulsivity

What is the average onset of ADHD and who is more likely to be diagnosed?

~7 years old with boys being more likely to be diagnosed than girls

What are the 4 subtypes of ADHD?

Predominantly inattentive, predominantly hyperactive, combined, and other specified/unspecified

What are the 3 core features of ADHD?

Inattention, hyperactivity, and impulsivity

What are some inattention symptoms of ADHD?

Careless mistakes, trouble sustaining attention, poor organization, frequently loses items, easily distracted

What are some hyperactivity symptoms of ADHD?

Fidgeting, squirming, tapping, difficulty playing quietly, talks excessively

What are some impulsivity symptoms of ADHD?

Blurt out answers to questions before finished, difficulty waiting turn, interrupts other’s conversations/activities

What is the etiology of ADHD?

Cause unknown but influenced by genetic and environmental factors

What is the prevalence of ADHD in children vs adults in the U.S.?

7-11% of children, 4-5% of adults

What are a few interventions for ADHD?

Pharmacological such as stimulants or non-stimulants; behavioral such as CBT, coaching, or mindfulness

Define autism spectrum disorder.

Developmental disorder marked by difficulties in social interaction and communication, along with restricted or repetitive behaviors and interests.

There are 3 main areas of social communication that are persistent deficits in autistic individuals. What are they?

Social-emotional reciprocity, nonverbal communication, and relationships

Describe the restricted/repetitive behaviors in ASD individuals.

Repetitive movements or speech such as lining up toys, rigid routines/sameness such as same routes/foods and distress with change, and intense or unusual interests

What are some co-occuring conditions in ASD?

Sensory reactivity, motor impairments, food selectivity, sleep disruptions

What are the levels of ASD severity?

Level 1 - requires support, level 2 - requires substantial support, level 3 - requires very substantial support

Describe the etiology of ASD.

The causes are complex but genetics plays a strong role. Children born to older parents are higher risk, and parents with an autistic child have a 2-18% chance of having a second autistic child. Twins also have an increased chance of ASD.

Who is more likely to be diagnosed with ASD?

Boys are 4 times more likely to be diagnosed than girls.

Name a few co-morbid conditions with ASD.

Allergies, asthma, epilepsy, PANDAS, feeding/eating disorders, anxiety, bipolar, ADHD, Tourette’s, OCD

What are some treatments for ASD?

No single cure; pharmacologic therapy (must address sleep), alternative medicines, holistic and strength-based approach (OT, SLP, ABA)