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8 Common Co-morbid Conditions in NDD - Coggle Diagram
8 Common Co-morbid Conditions in NDD
Co-morbidity
Two disorders/illnesses occur, simultaneously or sequentially
In psychology: one or more disorders that exitsts alongside a primary diagnosis
Can be psychological, biological/physiological in nature - all affect the primary condition
FEEDING AND EATING DIFFICULTIES
AUTISM
Causes
Problems with sensory processing
Sensory hyper sensitivities
Reject foods they know bc they don't like texture or temperature
Inadequate nutrition
Picky eating (food selectivity) leads to parents worrying about diet
Study shows not much difference in macro-nutrients compared to TD kids
Prevalent eating difficulties
Prefers certain texture, only eat certain foods (picky eating), eating styles can be serious e.g., eating things not meant to be eaten, eating too quick, eating too much
DOWNS SYNDROME
Causes
Probably a physical cause - high palate in the mouth
Anatomical differences (jaw, pallet) & physiological differences (weak facial muscles) = result in open mouth and tongue protrusions
Hypersensitive or hyposensitive
To touch around their mouth - causes feeding problems, chewing, maintaining smooth sequence of feeding, problems coordinating
WILLIAMS SYNDROME
Causes
Oral-motor abilities difficulties - low muscle tone or gastrointestinal conditions
Early feeding problems
Can't suck properly, problems with chewing, inefficient motor patterns
Biological in nature
Low muscle tone + gastrointestinal conditions
The problems interrelate
E.g., low muscle tone, cardiovascular difficulties, hypercalcaemia etc. all contribute to feeding problems
TREATMENT FOR FEEDING AND EATING PROBLEMS
Reinforcement
Rewards, punishment, positive, costs
Simultaneous presentation
Present liked food w/ non-liked food
Increasing portion size
Gradually, until they like the non-liked food (e.g., portion of milk in a drink they already like)
Slower eating
A pager vibrates telling them when they should take a bite
Interventions
For severe feeding problems - 3 hours per day, intensive mean sessions & behaviour protocols, oral-motor therapy, oral-motor exercises, children can be treated successfully
DEVELOPMENTAL COORDINATION DIFFICULTIES/MOTOR DIFFICULTIES
AUTISM
High correlation between ADOS & motor errors made - wide range of motor related behaviours
It's a central feature of autism & should be tackled in interventions
Early motor abilities predict language skills - longitudinal cross-domain influences
WILLIAMS SYNDROME
Again, due to oral-motor coordination difficulties
Can't plan, coordinate, execute complex sensory movements, can explain why there's a delay in expressive language
SOCIAL EMOTIONAL & MENTAL HEALTH DIFFICULTIES
There's lots of heterogeneity - but 25% SEMH group in clinically impaired range for DCD, 15% had borderline clinical difficulties
Need to think about movement interventions which help with coordination
DCD leads to lots of difficulties = social isolation, mental health, getting dressed, riding a bike, executive function difficulties - it persists past childhood, adults w/ DCD have more depression & anxiety
SENSORY PROCESSING DIFFICULTIES
AUTISM
Oversensitive or undersensitive
Inappropriate playing w. toys, can't stand labels
Seek or avoid auditory, tactile or vestibular input
Due to their sensory issues - e.g., sit in unusual positions
Difficulties w. sensory modulation
Can't ignore irrelevant info
Linked to other comorbidities
Repetitive behaviours, restricted behaviours, intolerance to uncertainty, anxiety
So repetitive behaviours regulate their arousal from anxiety - anxiety could be due to sensory problems, so restricted & repetitive behaviours self-soothe OR they create stimulation
Intolerance of uncertainty (e.g., when routines change) make them anxious
WILLIAMS SYNDROME
Sensory modulation is atypical
Across the different sensory modalities
Under-responsiveness, low energy, difficulties w/ auditory filtering etc. notice sensory events, screen out sounds
Influence their executive function - hypersensitivity to loudness
Sensory neural hearing loss - physiological base
Various sensory issues
Sensory sensitivities, reduction in sensory response, 15-20% normal population have sensory processing problems,
We experience a myriad of sensations on a daily basis, efficient detection & integration helps us regulate and function - sometimes we have sensation problems where it gets overwhelming e.g., tired, ill, heat, we all have different thresholds
Kids w. sensory impairments have behavioural difficulties (attention, arousal levels, planning, they're oppositional)
INTERVENTIONS for ASD
Sensory-integration therapy
Exposure to different sensory-rich activities to improve how children respond
Tactile system, vesicular system, proprioceptive system
Sensory-based intervention
Support the child in their self-regulation (when arousal is high or low)
Weighted blankets, weighted vests, resistance bands
PSYCHIATRIC CONDITIONS
AUTISM
Depression
Anxiety
Treatment for anxiety using CBT
Adapting CBT
Gender dysphoria
DOWNS SYNDROME
Depression
Dementia
Extreme slowing
Psychosis
HEARING IMPAIRMENT
Prevalence
50.3% have psychiatric conditions
ADHD
Autism
Social and environmental difficulties
Being abused/peer groups/emotional difficulties
WILLIAMS SYNDROME
ADHD
Phobia
Depression
Anxiety