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NEURODEVELOPMENTAL DISORDER, Genetic and neurobiological contributions,…

- - - - 5% of school-aged children
      - most commonly diagnosed in the United States
        
        11% of children labeled with ADHD in
        2011-2012
      - 5-9% meet criteria including adults
      - the estimated prevalence of childhood ADHD is 5.29%
        
        Boys are three to four times more likely to be
        diagnosed with ADHD than girls.
    - - Symptoms usually appear around age 3-4
      - Half of children with ADHD continue to have difficulties as adults
      - Impulsivity decreases, but inattention remains
      - Gender differences
  - - - Genetic contributions
        
        run in families
        
        mutations occur - create extra copies of a gene or deletion of genes (CNVs)
        
        Norepinephrine, GABA and serotonin also implicated
        
        Neurobiological correlates of ADHD
        
        Smaller brain volume
        
        Inactivity of the frontal cortex and basal ganglia
        
        Abnormal frontal lobe development and functioning
        
        masalah working memory
        
        The role of toxins
        
        Food additives
        
        smoking
    - - ADHD children are often viewed negatively by
        others
  - - - Goal: reduce impulsivity and
        hyperactivity, improve attention
      - Stimulant medications
        
        Ritalin, Dexedrine, Adderall
        
        risk for later
      - non-stimulant medications
        
        Strattera and Qelbree
        
        aren’t always as effective
      - Other medications - limited efficacy
        
        Imipramine and clonidine (antihypertensive)
      - Effects of medications
        
        decrease negative behaviors
        
        Do not affect learning/academics directly
        
        Benefits are not lasting
    - - Reinforcement programs
      - parent education programs
      - Social skills training
    - - for adults to increase attention and
        organization
- - - - 5 to 15%
      - Highest rate - wealthier regions but low SES more likely to have difficulties
      - Reading difficulties most common - 7%
    - - Drop out of school
      - unemployed
      - suicidal thought
      - negative school experiences
    - - childhood-onset fluency disorder (stuttering)
      - langguage disorder
  - - - genes
        
        located on chromosomes 1, 2, 3, 6, 11, 12, 15, and 18
      - surroundings
    - - three areas of the left hemisphere - dyslexia
      - left parietotemporal area
        
        word analysis
      - left occipitotemporal area -
        recognizing word form
      - left hemisphere—the
        intraparietal sulcus - sense of numbers - mathematics disorder
    - - Motivational factors
      -  Socioeconomic status
      -  Cultural expectations
      -  Parental interactions
      -  Child management practices
- - - - 10% to 33% don’t acquire effective speech
  - - - Failure to develop age-appropriate social
        relationships
        
        Trouble initiating and maintaining relationships
        
        Trouble with nonverbal communication
        
        lack appropriate expressions, tone
        
        Trouble with social reciprocity
        
        Deficits in joint attention
        
        inability to communicate interest in
        an external stimulus and another person at the same time
        
        repeat the speech of others
        
        echolalia
    - - maintenance of
        sameness
        
        extremely upset if even a small change
        was introduced
      - Severe forms -
        Stereotyped or ritualistic behavior
        
        spinning, waving hands, rocking
      - Less severe - interest in very specific
        subjects
  - - - 4-5:1
    - - 31% show intellectual disabilities
  - - - Failed parenting
      - lack of self-awareness
  - - - Amygdala
        
        Larger size at birth
        
        Elevated cortisol
        
        Neuronal damage
      - Vaccinations do NOT increase the risk of autism
  - - - Behavioral approaches
    - - Some drugs decrease agitation
        
        Tranquilizers
        
        SSRIs
    - - Preferred model: Multidimensional,
        comprehensive focus
- - - - 9 in 10 people with ID have mild
        impairment (IQ 50-70)
  - - - neglect, abuse
    - - exposures to toxins in the womb
    - - problems with delivery
    - - infection and head injury
    - - Chromosomal
        disorders
        
        Down
        Syndrome
        
        xtra 21 cromosome
      - Multiple genetic
        mutation
        
        De novo disorders
      - Lesch-Nyham syndrome
        
        Intellectual disability, symptoms of cerebral palsy self-injurious behavior, including finger and lip
        biting
        
        Only males are affected,- e X
        chromosome in males does not have normal gene to balance.
      - Phenylketonuria (PKU)
        
        cannot break down phenylalanine, which
        is found in some foods
      - Fragile X syndrome- abnormality on the X chromosome
        
        Symptoms
        
        Gender differences
        
         Primarily affects males- do not have second X cromosome
        
         Women with Fragile X have mild symptoms
        
         Learning disabilities
        
         Hyperactivity
        
         Short attention span
  - - - Basic skills
        
        dressing, hygiene
      - Social skills
      - Practical skills
        
        paying bill
    - - use picture
        books
        
        make a request
        by pointing to a picture
    - - presses a button to produce complete spoken sentences
    - - Participate in community life
      - Benefit from education
      - Build meaningful relationships