10.6 Neurodevelopmental disorders

Neurodevelopmental disorders

Child neuropsychology

• Study of the brain in development & its repercussions on behaviour both in cases of brain injury or diffusion & in healthy children.

• The evolutionary neurobiology of the brain is therefore

The incidence → developmental disorders

• 17% of the school-age population has one or more developmental disorders

What are the differences between Child Neuropsychology vs. Adults

• The infant brain is in a stage of rapid development, something that does not happen in an adult.

• The brain of an adult has the most established connections & therefore, less neuronal plasticity & worse prognosis in case of brain damage.

• Damage in children is usually more diffuse due to the low specificity of the brain.

Classification of common Neurodevelopmental disorders

• Intellectual disability (ID)

• Communication disorders

• Autisms Spectrum Disorder

• Attention-Deficits / Hyperactivity Disorder ADHD

• Specific Learning Disorder (SLD)

Intellectual disability (ID) → main characteristics

• deficits in intellectual functioning (reasoning, problem solving, & learning)

• deficits in adaptive functioning in conceptual, social & practical domains

• onset during the developmental period (childhood)

Intellectual disability (ID) → areas affected

• Understanding & using language

• social skills (interpersonal relationships)

• practical skills (self-care, independence)

Communication disorder → main characteristics

• persistent difficulties in the acquisition, use or understanding of language, speech &/or communication

• may affect expressive &/ or receptive language, speech sound production, fluency or social (pragmatic) communication

Communication disorder → examples / areas affected

• limited vocabulary

• grammatical difficulties

• speech sound errors

• difficulty using language appropriately in social context

Autism spectrum disorder → main characteristics

• Persistent difficulties in social communication & social interaction

• restricted & repetitive patterns of behaviour, interests, or activities

• symptoms present from early development & affect daily functioning

Autism spectrum disorder → examples / areas affected

• difficulties with social reciprocity (understanding social cues)

• repetitive behaviours or restricted interests

• preference for routines & sameness

• sensory sensitivities (common)

Attention-Deficits / Hyperactivity Disorder ADHD → main characteristics

• persistent pattern of inattention &/or hyperactivity-impulsivity

• interferes with functioning or development

• symptoms are present in multiple settings (home, school) & are not better explained by another condition.

Attention-Deficits / Hyperactivity Disorder ADHD → examples / areas affected

• difficulty sustaining attention

• easily distracted

• impulsivity (acting without thinking)

• Hyperactivity (excessive motor activity, difficulty remaining seated)

Specific learning disorder → main characteristics

• persistent difficulties in acquiring & using academic skills, despite appropriate instructions & intervention

• affects reading, written expression &/or mathematics

• not explained by intellectual disability, lack of educational opportunity or another neurological condition.

Specific learning disorder → examples / areas affected

• reading (inaccurate or slow reading)

• written expression (e.g., spelling, grammar, organization)

• mathematics (number sense, calculation, problem solving)

Intellectual disability

• there are limits to a person’s ability to learn at an expected level

• might take longer into developing motor skills (eg.: sitting down or walking

• In school → might struggle with semantic memory, social rules & problem solving.

• Males are more likely to be diagnosed, & poverty is a mayor risk.

Causes of intellectual disabilities

• during gestation

• after birth due to severe head injury, stroke or infection

disorders associated with intellectual disabilities

• cerebral palsy

• hydrocephalus

• fetal alcohol syndrome

• fragile-x syndrome

• down syndrome

Cerebral palsy

• Disorder primarily motor function caused by brain trauma in the course of fetal development or birth.

• It also comes with cognitive & emotional impairment.

Hydrocephalus

• Characterized by increased volume of CSF, by an obstruction in the flow.

Fetal Alcohol syndrome

• Physical malformations & intellectual impairment observed in children born of mothers which used alcohol during the pregnancy.

Fragile-X syndrome

• Characterized by facial abnormalities & mental disabilities ranging from subtle learning disorders to severe intellectual impairment.

• It associated with attention deficits, hyperactivity, anxiety & unstable mood & behaviour.

Down syndrome

• Congenital condition caused by the presence of an additional copy of the chromosome 21 → Trisomy 21

Communications disorders

• a variety of speech & language disorders that present as problems in communication or oral motor function.

• referred as a problems in speech comprehension or speech expression that significantly interferes with n individual’s achievement &/or quality of life.

Communications disorders → types

• Language disorder

• Speech sound disorder

• Childhood-Onset Fluency Disorder

• Social Communication Disorder

Language disorder:

• Presents difficulties in learning & using spoken, written, or sign language.

• Ex.: delay in first words

Speech sound disorder

• Problems in articulation & pronunciation of a native language

Childhood-Onset Fluency Disorder

• Commonly called as stuttering.

• It is a condition in which standard fluency & rhythm of speech are interrupted, often causing the repetition of whole words & syllables.

 Social Communication Disorder

• involves difficulties in the social uses of verbal & nonverbal communication in everyday contexts, affects the development of social relationships & discourse comprehension.

Autism Spectrum Disorder (ASD)

• Display symptoms of impaired social interaction, an idiosyncratic & narrow range of interests, language & communication abnormalities, and, in some cases intellectual impairment.

• More prevalent in men than women

• Can have a exceptional ability.

• The diagnose must be done through DSM-5 must say the severity of A axis (social communication) & B axis (restrictive & repetitive behaviour)

Autism Spectrum Disorder (ASD) → common symptoms

• Difficulties to interact socially.

• Insistence on sameness.

• Stereotypy: hand flapping or rocking.

• Unusual attachment to objects.

• Resistance to change in routine.

• Echolalia.

• Sometimes, aggressive or self-injurious behaviour.

Learning disorders

• Affect the ability of the child to acquire & apply reading, writing or math skills.

• It is distinct to intellectual development disorders, as they have average intelligence.

  • dyslexia

  • dyscalculia

Autism; criteria

ADHD → characteristics

• core behavioural symptoms impulsivity, hyperactivity &/or inattention

• Child with ADHD have a 60% chance to have a second disorder & up to a 30% chance to have three or more.

• Mayor issues in Executive Functions and WM

According to DSM-5 it must have →

• Inattention

• Hyperactivity & impulsivity

Inattention

• Characterized by six or more symptoms, including avoiding tasks & distractibility as well as inability to pay attention to details, hold attention on tasks, listen follow instructions, organize and finish work.

Hyperactivity & impulsivity

• Characterized by six or more symptoms including fidgeting, not remaining seated, running about, talking excessively, & inability to play & to take turns.

dyslexia

• reading-related disorder

Dyscalculia

• math-related disorder