Childhood Disorders

Neurodevelopmental disorders from the DSM-5

1. Intellectual disability
2. Communication disorders
3. Autism Spectrum disorders
4. Attention-deficit/Hyperactivity disorders
5. Motor disorders

2 groupings of neurodevelopmental disorders

1. Disorders first diagnosed at early age
2. Disorders that can be diagnosed anytime

Developmental psychopathology

subfield devoted to studying the origins and course of maladjustment in the context of normal growth

List of disruptive behavior disorders

1. ADHD
2. ODD
3. conduct disorder

General characteristics of ADHD

-impulsivity
-excessive motor activity (hyperactivity)
-difficulty concentrating

DSM-5 criteria for ADHD (simplified)

-six or more inattentive symptoms persisting for at least six months
-six or more hyperactivity and impulsivity symptoms for at least six months
-symptoms must be present before the age of 12
-several symptoms must be present in two or more settings (ex. home and school)

Causal factors of ADHD

1. genetics (high twin concordance rate)
2. cortical immaturity (esp in the frontal lobe - related to planning, motoric function, and impulsivity
3. low birth weight
4. prenatal exposure to nicotine or alcohol

Treatments for ADHD

1. stimulant drugs (Ritalin, Adderall) (dopamine)
2. parent training and classroom management
3. family therapy (educate family, helps with comorbidities)

Oppositional Defiant Disorder (ODD)

-recurrent pattern of negativistic, defiant, and hostile behavior toward AUTHORITY FIGURES
-usually starts before 8, if starts earlier, more negative outcomes
-if continues on, will be diagnosed with conduct disorder, then antisocial personality disorder in adulthood

3 categories of symptoms for ODD

1. angry/irritable mood
2. argumentative/defiant behavior
3. vindictiveness (strong desire to get back at someone who has wronged you/seek revenge)

How to meet criteria for ODD

at least four symptoms from any of the three categories for at least 6 months

Conduct disorder

persistent pattern of behaviors involving the violation of societal rules and the indifference to the rights of others

4 categories of symptoms for conduct disorder

1. aggression to people and animals (initiating fights, bullying, cruelty to animals)
2. destruction of property
3. deceitfulness or theft (cons others, pyromaniac, steals)
4. serious violation of rules

How to meet criteria for conduct disorder

-presence of at least 3 of the 15 criteria (within the 4 categories) within the past 12 months
-if 18 or older, criteria is not met for antisocial personality disorder

Specifiers of conduct disorder

-childhood onset (before 10)
-adolescent onset

Risk factors for conduct disorder

-low SES
-parental stress

Causal factors for conduct disorder

1. genetic predisposition (higher levels of testosterone, inherited characteristics like lower emotional intelligence and difficult temperament)
2. psychosocial factors (hostile family environment, peer rejection and affiliation)

Treatments for conduct disorder

-modify child's environment (parent training, like learning effective discipline
-CBT
-prozac (mainly used to treat comorbidities)

Definition of neurodevelopmental disorders

-group of conditions with onset in the developmental period (typically manifesting before grade school)
-deficits that produce impairments in personal, social, academic, or occupational functioning

List of developmental disorders

1. specific learning disorder
2. autism spectrum disorder
3. intellectual disorder

Specific learning disorder

a problem in a specific learning area not due to intellectual disability or poor educational opportunities

DSM-5 specifiers for specific learning disorder

1. mathematics disorder (dyscalculia)
2. reading/spelling disorder (dyslexia)
3. disorder of written expression (dysgraphia)

Dyslexia

-read very slow, flip letters, memory deficits (especially with spelling), distort words (add, remove, rearrange)
-typically present before 2nd grade (7 year old)

How to meet criteria for specific learning disorder

-one of the specifier's symptoms present for at least 6 months, despite tutoring
-symptoms may not fully manifest until the demands for those affected academic skills exceed the individual's limited capacities

Causal factors for specific learning disorder

-all biological
1. genetic (high monozygotic twin concordance rate, chromosome 6 link)
2. brain abnormalities affecting visual and auditory information processing (TEMPORAL LOBE, LEFT HEMISPHERE, LESS ACTIVATION)
3. low birth weight, prematurity
4. prenatal nicotine and alcohol exposure (especially later use)

Treatments for specific learning disorder

-accommodations/specialized learning environment (put in environments to succeed)

Definition of autism spectrum disorder

developmental disorder, involving wide range of problematic behaviors including:
1. deficits in communication and social interaction
2. restricted and fixated interests
3. repetitive behaviors

Symptoms/associated features of autism spectrum disorder

1. social deficit
-don't need or give affection
-don't engage in reciprocal play
-don't make friends
2. language deficit
-delays in development of language
-may be nonverbal
3. echolalia = repeat back what you say
4. self-stimulation
-rocking, spinning
5. preservation of sameness (like routine)
6. marked impairment in intellectual ability

Causal factors for autism spectrum disorder

1. genetic
-high twin concordance rate
-genetic mutations
-age of parent when conceived
2. damage/deficiency in CNS
-overall enlargement of the brain
-lack of synaptic pruning during development
-less well connected neurons

Treatments for Autism Spectrum Disorder

-no drug to target disorder itself (some drugs used for other symptoms, like anticonvulsants)
-selective, long-term programs show great improvement but are costly

Definition of intellectual disability

general deficits in intellectual abilities and adaptive functioning, beginning before age 18

DSM-5 criteria for intellectual disability

the following three criteria must be met:
-deficits in intellectual functioning (reasoning, problem solving, abstract thinking, etc.)
-deficits in adaptive functioning that result in lack of personal independence and social responsibility)
-onset of these deficits during developmental period

*on a scale from mild to severe

Causes of intellectual disability

1. chromosomal and genetic disorders
a) down syndrome
b) fragile X syndrome
c) PKU
2. infectious diseases (rubella and syphilis most commonly)
3. prenatal alcohol exposure
4. environmental toxins (heavy metals)
5. birth complications
6. psychosocial factors