1.1 Understanding and working with neurodevelopmental complexity (E)

Traditional umbrella terms

Terms like ADHD or autism that assume one condition is the primary diagnosis and that comorbidity is not common.

Neuro

The argument that all psychiatric issues have their origins in the brain and should be considered as "neuro."

Neurodevelopmental problems

Criticized for implying that these issues only exist during the developmental stage.

ESSENCE

Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations, a comprehensive approach that acknowledges comorbidity, overlapping symptoms, and changing presentations over time.

Tailored support and treatment

The application of ESSENCE that emphasizes examining every child with autistic or ADHD symptoms for other problems and providing early assistance through a cohesive team of professionals.

Developmental issues

Intellectual disability (ID) and autism (ASD) can cause long-term problems, including social difficulties and psychiatric problems in teenagers.

ESSENCE neutrality

ESSENCE doesn't align with either neuropsychiatry or neurodevelopment but emphasizes the link between early-onset symptomatic conditions and clinical examinations.

ESSENCE development

Ongoing research worldwide for 45 years involving new methods, genetics, brain chemistry, brain imaging, and finding common ground on how different conditions should be grouped.

Prevalence of ESSENCE

Approximately 10% of the population, higher in boys (13%) than girls (7%), with around 8% of boys and 2% of girls seeking medical attention before the age of 10.

When to suspect ESSENCE

In children displaying signs of abnormal development, behavioral disorders, or significant mood swings or problems that have been present for an extended period.

Outcome of ESSENCE

Long-term problems persist into adulthood, including difficulties in social interaction, communication, learning, reading and writing, motor coordination, and attention.

Prevalence in adulthood

Approximately 5% of the adult population still exhibits diagnosable ESSENCE-related problems, with additional individuals grappling with underlying issues.

Comorbid conditions

Most adults with ESSENCE meet criteria for additional diagnoses such as depression, anxiety, pain disorder, personality disorders, and drug addiction.

Functional implications

A significant portion of those affected end up on early retirement, unemployment benefits, or welfare, and a notable percentage of individuals with ADHD become involved in the criminal justice system.

Positive outcomes

In cases of autism and Tourette's syndrome, positive outcomes can occur with early diagnosis, information, and support, leading to artistic aptitude, creative thinking, and success in various fields.

Comorbidity in ESSENCE

It is common for individuals with ESSENCE to have multiple co-occurring conditions.

Gender differences

Most conditions within the ESSENCE group are more commonly observed in boys, highlighting a potential gender bias in diagnosis and recognition.