Psychiatry; Neurodevelopmental disorders pptx

A brief and concise presentation on Neurodevelopmental disorders. Created by SOuth African Psychiatrist Dr Mthoko, for presentation to 4rth year medical students at Namibia's medical school.

1. NEURODEVELOPMENTAL DISORDERS Ndahambelela Mthoko UNAM 20 January 2022

2. Conditions Intellectual disabilities Communication disorders Autism spectrum disorder Attention-deficit/hyperactivity disorder Specific learning disorder Motor disorders

3. N eurodevelopmental Disorders Characterized by: Onset in the developmental period Developmental deficits produce impairments of personal, social, academic, or occupational functioning Frequently co-occur

4. Intellectual Disabilities

5. Intellectual Disabilities Intellectual Disability (Intellectual Developmental Disorder) Global Developmental Delay Unspecified intellectual disability

6. Intellectual disability (ID) Essential features: Deficits in general mental abilities: reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience. Impairments of adaptive functioning: conceptual, social, and practical. Onset of intellectual and adaptive deficits during the developmental period.

7. Adaptive functioning The conceptual (academic) domain: competence in memory, language, reading, writing, math reasoning, acquisition of practical knowledge, problem solving, and judgment in novel situations. The social domain: awareness of others’ thoughts, feelings, and experiences; empathy; interpersonal communication skills; friendship abilities; and social judgment The practical domain: learning and self-management across life settings, including personal care, job responsibilities, money management, recreation, etc.

8. Intellectual Disability: Specifiers levels of severity Mild Moderate Severe Profound

9. Global developmental delay C hildren under the age of 5 years Individual fails to meet expected developmental milestones in several areas of intellectual functioning. Individuals are unable to undergo systematic assessments of intellectual functioning, This category requires reassessment after a period of time

10. Unspecified intellectual disability Individuals over the age of 5 years - standardized testing is difficult or impossible Example: sensory impairment severe problem behavior This category requires reassessment after a period of time

11. Intellectual Disability: Associated Features There may be Difficulties with social judgment; assessment of risk; self-management of behavior, emotions, or interpersonal relationships; or motivation in school or work environments. Lack of communication skills may predispose to disruptive and aggressive behaviors. Because of a lack of awareness of risk and danger, accidental injury rates may be increased Lack of awareness of risk may result in exploitation by others and possible victimization, fraud, unintentional criminal involvement, false confessions, and risk for physical and sexual abuse.

12. Intellectual Disability: Risk Factors . Prenatal etiologies - genetic syndromes, brain malformations, maternal disease and environmental influences (alcohol, other drugs, toxins). Perinatal causes - a variety of labor and delivery-related events leading to neonatal encephalopathy. Postnatal causes - hypoxic ischemic injury, traumatic brain injury, infections, seizure disorders

13. Intellectual Disability: Comorbidity Attention-deficit/hyperactivity disorder Autism spectrum disorder Stereotypic movement disorder Impulse-control disorders Depressive and bipolar disorders Anxiety disorders Major neurocognitive disorder

14. Intellectual Disability: Evaluation Pre- and perinatal medical history Identification of genetic and nongenetic etiologies Assessment of intellectual capacity and adaptive functioning Evaluation for associated medical conditions (e.g., cerebral palsy, seizure disorder) Evaluation for co-occurring mental, and behavioral disorders. Screening for suicidal thoughts Sources of information include developmental, medical, educational, and mental health evaluation .

15. Common types of IQ tests Stanford-Binet Intelligence Scale. Universal Nonverbal Intelligence. Peabody Individual Achievement Test. Wechsler Individual Achievement Test. Wechsler Adult Intelligence Scale. Woodcock Johnson III Tests of Cognitive Disabilities.

16. Communication disorders

17. Communication disorders Language disorder Speech sound disorder Social (pragmatic) communication disorder Childhood-onset fluency disorder (stuttering). Other specified and unspecified communication disorders There is deficits in language, speech, and communication.

18. Language Disorder Persistent difficulties in the acquisition and use of language due to deficits in comprehension or production that include: Reduced vocabulary Limited sentence structure Impairments in discourse The language deficits are evident in spoken communication, written communication, or sign language. Functional limitations in effective communication, social participation, academic achievement, or occupational performance. The difficulties are not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition and are not better explained by intellectual disability

19. Speech Sound Disorder Persistent difficulty with speech sound production that prevents verbal communication of messages. The disturbance causes limitations in effective communication that interfere with social participation, academic achievement, or occupational performance The difficulties are not attributable to congenital or acquired conditions, such as cerebral palsy, cleft palate, deafness or hearing loss, traumatic brain injury, or other medical or neurological condition

20. Childhood-Onset Fluency Disorder (Stuttering ) Characterized by disturbances of the normal fluency and motor production of speech, including repetitive sounds or syllables, prolongation of consonants or vowel sounds, broken words, blocking, or words produced with an excess of physical tension, monosyllabic whole-word repetitions The disturbance causes anxiety about speaking or limitations in effective communication, social participation, or academic or occupational performance The disturbance is not attributable to a speech-motor or sensory deficit, dysfluency associated with neurological insult (e.g., stroke, tumor, trauma), or another medical condition and is not better explained by another mental disorder

21. Social (Pragmatic) Communication Disorder Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following: Deficits in using communication for social purposes Impairment of the ability to change communication to match context or the needs of the listener Difficulties following rules for conversation and storytelling Difficulties understanding what is not explicitly stated The symptoms are not attributable to another medical or neurological condition, and are not better explained by ASD, ID, GDD, or another mental disorder.

22. Unspecified Communication Disorder Applies to presentations in which symptoms characteristic of communication disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for communication disorder or for any of the disorders in the neurodevelopmental disorders diagnostic class.

23. Autism spectrum disorder

24. Autism spectrum disorder Characterized by Persistent deficits in social communication and social interaction across multiple contexts, including deficits in social reciprocity, nonverbal communicative behaviors used for social interaction, and skills in developing, maintaining, and understanding relationships. The presence of restricted, repetitive patterns of behavior, interests, or activities e.g. stereotyped or repetitive motor movements, insistence on sameness, inflexible adherence to routines, hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment

25. Specify if Autism spectrum disorder With or without accompanying intellectual impairment With or without accompanying language impairment Associated with a known medical or genetic condition or environmental factor Associated with another neurodevelopmental, mental, or behavioral disorder[s] With catatonia

26. Autism spectrum disorder : Specify current severity: Severity is based on social communication impairments and restricted, repetitive patterns of behavior Level 1 requiring support Level 2 requiring substantial support Level 3 requiring very substantial support