Disorders in Childhood

ADHD symptoms

◦Persistent pattern of Inattention and/or Hyperactivity-impulsivity

◦Symptoms prior to age of 12 years

◦Present in two or more settings

◦Interfere with or reduce quality of functioning

2 categories of symptoms of ADHD

1. inattention

2. hyperactivity/impulsivity

subtypes of ADHD

◦Combined Presentation

◦Predominately Inattentive

◦Predominately hyperactive/impulsive

prevalence of ADHD

◦5% of school-age children

• 3-9% prevalence even in places with much different cultural expectations

◦3:1 male to female ratio

course of ADHD

◦Usually seen first in ages 3-4

◦Symptoms emerge and become more impairing in childhood and adolescence

◦50-65% experience symptoms into adulthood

is ADHD heritable?

yes, strongly

NT causes of ADHD

• Dopamine – not enough available

• Probably mix of multiple NTs (NE, serotonin, GABA)

genetic causes of ADHD

strongly heritable

brain causes of ADHD

frontal lobe (inhibitory control)

prenatal influences (in the context of genetic risk) for ADHD

◦Maternal smoking during pregnancy + certain form of dopamine gene = higher risk for ADHD

◦Maternal stress

◦Maternal alcohol use

◦Prenatal and birth complications

psychological & social causes of ADHD

◦Reaction by social circle (peers, teachers, parents) can be negative and can reinforce negative self-image

psychosocial treatments of ADHD

◦Create structured behavioral program of reinforcements and consequences

◦Social skills training

biological treatment of ADHD

Stimulant medications and non-stimulant medications

• Concern: potential for abuse and side effects

combined approach ADHD treatment

Combined treatments work best when you want to target symptoms beyond the core symptoms of ADHD

do girls or boys tend to present predominantly inattentive ADHD?

girls

symptoms of autism spectrum disorder

◦Difficulties in social communication and social interaction

• social-emotional reciprocity

• nonverbal communication used socially

• making and keeping friends

◦Restricted, repetitive behaviors, interests, or activities

• Stereotyped, repetitive motor movements or speech

• insistence on sameness, inflexible

• Restricted, fixated interests

• Hyper or hypo reaction to sensory input

what percent of people with autism spectrum disorder have savant skills?

30%

prevalence of autism spectrum disorder

◦1 in 50, rise in recent years is mostly due to change in diagnosis and awareness of disorder

◦4:1 male to female ratio

when can social differences in autism be observed?

2 years

genetic causes of autism spectrum disorder

**moderately genetically heritable

• If one child in fam has autism, 20% chance of another child

• Maybe oxytocin receptor gene

• Higher risk of autism among older parents (de novo mutations)

neurobiological causes of autism

◦Larger amygdala in early childhood contributes to higher levels of anxiety/stress

◦Lower levels of oxytocin in blood and brain

prenatal and perinatal complications that cause autism

Use of Pitocin to initiate labor slightly increases risk

behavioral treatments of autism

Use shaping and discrimination training to teach children skills, such as language or non-verbal behaviors

treatment of autism

◦Use shaping and discrimination training to teach children skills, such as language or non-verbal behaviors

◦Pharmacological treatments to address other symptoms (such as anxiety, agitation)

◦Educational, social, and vocational support