SHS 433 Exam 1 Review

neurodevelopmental disorder - known genetic etiology

present at birth

changes in neurodevelopment are related to genetic alteration

examples: fragile X syndrome, Down syndrome, Williams syndrome

neurodevelopmental disorder - acquired etiology

acquired at or around birth

changes in neurodevelopment are related to injury/damage

examples: fetal alcohol syndrome, cerebral palsy, TBI in childhood

neurodevelopmental disorder - multifactorial etiology

broader view compared to known genetic/acquired etiology

changes in neurodevelopment are related to multiple genetic and environmental factors (either a combination or interaction)

examples: ASD, ADHD, developmental dyslexia

DSM-5 - definition

created by APA

an official guide to diagnosis

used by clinical psychologists, psychiatrists, etc

focuses on cognitive and mental health disorders (specified or unspecified)

requires criteria to be met for a diagnosis (behavioral and functioning)

ICD-11 - definition

created by WHO

standard diagnostic tool for epidemiological, clinical, and health management

used by physicians, nurses, and other providers

includes mental, behavioral, or neurodevelopmental disorders (specified or unspecified)

• note: more broad than DSM-5 (in terms of disorders included)

requires criteria to be met for diagnosis (behavioral and functioning)

how views of neurodevelopmental disorders have changed (3 in total)

became more accepting/complex over time

19th century views:

• viewed as “defective”

20th century views:

• some focused on finding the deficit/cause

• others looked for a more nuanced understanding — beginning of the developmental approach (not only the neurological aspects)

21st century views:

• better execution of the developmental approach because of new technology

• also become more socially focused

6-month key milestones (2 in total)

• strings vowels together

• copies sounds

9-month key milestones (2 in total)

• responds to own name

• raises arms to be picked up

12-month key milestones (3 in total)

• uses simple gestures

• says “mama” or “dada”

• plays simple social games

18-month key milestones (2 in total)

• says several single words

• points to show others something interesting

2-year key milestones (4 in total)

• uses 50 words

• puts 2 words together

• follows simple instructions

• notices when others are upset

3-year key milestones (3 in total)

• carries on a conversation using 2-3 word sentences

• copies adults and friends

• shows affection

4-year key milestones (2 in total)

• tells stories

• plays cooperatively

developmental milestone - definition

a behavior, ability, or skill that emerges at a particular age in most children

easily observed and described

based around the 75th percentile

serves as a way to track developmental progress

delay in development - definition

lag in achieving milestones in 1 or more areas

developmental deviance - definition

nonsequential unevenness in the achievement of milestones in 1 or more areas (i.e., meeting more complex milestones but not more basic ones)

developmental disassociation - definition

significant difference in rates of development between two or more areas (e.g., for dyslexia, average or above average cognitive skills but poor reading skills)

global developmental delay - definition

significant delay in all domains of development

developmental disability - definition

a group of chronic conditions that are attributable to an impairment in physical, cognitive, speech/language, psychological, or self-care that are manifested during the developmental period (birth to 21 years of age)

disability - definition

decreased in the ability to perform some action, engage in some activity, or participate in some real-life situation or setting due to a physical or mental condition

broader than developmental disability

other considerations for defining disability - behavioral/functional

DSM-5 and ICD-11

other considerations for defining disability - etiological

cause of the disability (e.g., genetic)

other considerations for defining disability - societal/cultural

International Classification of Functioning, Disability and Health Model (ICF) - created by WHO in 2001

more holistic framework; considers how individual and environmental factors interact

includes 5 domains: body functions, body structures, activity, participation, and environmental/personal factors

other considerations for defining disability - legal

Individuals with Disabilities Education Improvement Act (IDEA)

ensures that all children with disabilities are entitled to a free, appropriate public education

emphasizes adequate preparation for further education, employment, and/or independent living

sets guidelines for education (3-21 years old) and early intervention (2 years and younger)

screening vs diagnostic test

screening: screens for a particular condition and separates those who are at risk from those who are not; does not definitively diagnose

diagnostic: confirms or excludes the presence of a disease or condition

3 levels of diagnosis - definitions and examples of each

note: inverted triangle

specific impairments (top):

• definition: looks at what signs and symptoms are impacting daily life (i.e., difficulties)

• example: poor social skills

disorders/symptom-cluster (middle):

• definition: looks at different behaviors or symptoms that make up a category

• example: ADHD, Autism

etiological (bottom):

• definition: cause of the disability (can do a genetic test to determine this)

• example: Down syndrome

diagnostic process - general outline (5 steps)

1. caregiver interview

2. review of pertinent medical/educational records

3. direct clinical assessment

4. determination of categorical diagnoses (disorders/symptom-clusters)

5. consideration of etiologic possibilities and appropriate investigations (etiologic)

diagnostic process - sources of information (6 in total)

• medical history

  • prenatal, perinatal, neonatal, and beyond

• developmental and behavioral history (most informative)

  • milestone checks

• family history

  • information from at least 3 prior generations (important for identifying genetic risks)

• social history

  • parental education, culture, abuse, crises, and interventions received

• physical examination

  • abnormal growth, dysmorphic features, congenital abnormalities, and neurologic abnormalities

• developmental testing and neurobehavioral status exam

  • social deficits and maladaptive behavior (through formal observation, tests, interviews, school/early intervention evals, etc)

behavioral phenotype - definition

heightened probability that people with a given syndrome will exhibit certain behavioral or developmental characteristics relative to those without the syndrome

other things to note:

• does not mean that every person with a specific syndrome will show ALL characteristics of the syndrome

• characteristics are not always unique to a syndrome (behavioral overlap)

within-syndrome variability

there is a range of behavior WITHIN a syndrome = individuals with the same syndrome may present differently

influenced by genes, the environment, and gene-environment interactions

co-morbidities

when an individual presents with 2 or more syndromes

requires a thorough evaluation to determine this (example: for a child with Down syndrome, are their behaviors also expected of an average child with Down syndrome?)

many behavioral overlaps between syndromes; current divide on whether this means there is a co-occurrence

Dynamic System Theory

time period: 21st century

key points:

• focuses on how new systems develop from the interaction of less complex systems and skills (e.g., moving arm at random to grasping objects)

Neuroconstructivism (Karmiloff-Smith)

time period: 21st century

key points:

• emphasizes that development is dynamic and an ongoing process that develops based on experiences and biological underpinnings

  • development is experience-dependent - need the experience for something to develop

Two-Group Approach (Zigler)

time period: 20th century

key points:

• promoted developmental matching - match children with unknown etiology to TD children on developmental level

• found that development happens in a similar way, just not at the same rate

Zigler Opposition

time period: 20th century

key points:

• development will proceed as expected, but at a delayed rate and stop at a lower level

Defect Theorists

time period: 20th century

key points:

• NDD results from a core deficit in broad cognitive systems and any symptom could be traced back to this core deficit

• viewed NDD in a negative light (i.e., “finding” or “fixing” the issue)

Whole Child/Ecological Model (Broffenbrenner)

time period: 20th century

key points:

• focuses on both temporal and ecological aspects of development and how they interact (i.e., look at the child within their environmental system and see how that shapes their development)

Transactional Model (Sameroff)

time period: 20th century

key points:

• emphasizes that not only is the child changing, but so is their environment

  • looks at the interaction between the two and their positive/negative effects

Langdon Down

time period: 19th century

key points:

• classified disabilities into 3 types: congenital, accidental, and developmental - focused on etiology and classification

• first to describe physical features of Down syndrome

William Wetherspoon Ireland

time period: 19th century

key points:

• focused on classification: 9 related to medical conditions and the 10th category related to “idiocy by deprivation”