NEURODEVELOPMENTAL
DISORDERS
NEURODEVELOPMENTAL DISORDERS
+Children usually lack the abstract cognitive
abilities
+Verbal skills to describe what is happening.
+Limited sense of a stable
+Normal self to allow them to discriminate
unusual.
Common Mental Health Problems
+Mood
+Anxiety disorders
+Eating disorders
Intellectual disability
+Correct diagnosis term for what was once called mental
retardation.
+Term often used in a disparaging manner to bully
+below-average intellectual functioning
+IQ <70
+Degree of disability is based on IQ and cognitive
functioning.
Causes of Intellectual disability
+Hereditary conditions (Tay-Sachs disease or
fragile X chromosome syndrome).
+Trisomy 21 or maternal alcohol intake.
+Fetal malnutrition, hypoxia, infections & trauma.
+Medical conditions of infancy such as infection,
lead poisoning and environmental influences
+Mood and behavior disturbances
AUTISM SPECTRUM
DISORDERS
AUTISM SPECTRUM DISORDERS
+DSM-5 diagnosis
+Characterized by pervasive and usually severe
impairment of reciprocal social interaction skills,
communication deviance, and restricted stereotypical
behavioral patterns.
+Previous PDDs (Rett disorder, childhood disintegrative
disorder, & Asperger disorder).
AUTISM SPECTRUM DISORDERS
+Formerly called autistic disorder or just autism
+Five times more prevalent in boys than girls.
+Usually identified by 18 mos and no later than 3 years of
age.
+Persistent deficits in communication
+Social interaction accompanied by restricted, stereotyped
patterns of behavior and interested/activities.
AUTISM SPECTRUM DISORDERS
+Displays little eye contact.
+Make few facial expressions
+Use limited gestures to communicate.
+Limited capacity to relate to peers or parents.
+Lack of spontaneous enjoyment
+Express no moods or emotional
+Not engage in play or make-believe with toys
AUTISM SPECTRUM DISORDERS
+Stereotyped motor behaviors (hand flapping, body
twisting or head banging).
+80% of cases of autism are rarely onset, with
developmental delays starting in infancy.
+20% have seemingly normal growth and developmental
until 2 to 3 years of age.
+Developing regression or loss of abilities begins.
AUTISM SPECTRUM DISORDERS
+They stop talking and relating to parents and peers and begin to
demonstrate behaviors previously described.
+Have a genetic link
+Controversy continues about whether measles, mumps and
rubella (MMR) vaccinations contribute to the development
+20% of adults with ASD achieve most independently living
outcomes
+46% require substantial level of support in most independent
living outcomes.
Goal of treatment
+Reduced behavioral symptoms (stereotyped motors
behavioral symptoms)
+Promote learning and development.
+Comprehensive and individualized treatment (special
education and language therapy, cognitive behavioral
therapy for anxiety and agitation).
Treatment
Symptoms: temper tantrums, aggressiveness, self-
injury, hyperactivity, and stereotyped behaviors
+Haloperidol
+Resperidone
+Aripiprazole
Treatments
Stimulants to diminish self-injury and hyperactive and
obsessive behaviors:
+Naltrexone
+Clomipramine
+Clonidine
RELATED DISORDERS
Tic Disorders
+Sudden, rapid, recurrent, nonrhythmic,
stereotyped motor movement or vocalization.
+Stress exacerbates tics
+Diminished during sleep and when the person is
engaged in an absorbing activity.
Common simple motor tics
+Blinking
+Jerking the neck
+Shrugging the shoulders.
+Grimacing, and coughing
Common Simple Vocal tics
+Clearing the throat
+Grunting
+Sniffing
+Snorting
+Backing
Complex Vocal tics
+Repeating words or phrases
+Coprolalia
+Palilalia
+Echolalia
Complex motor tics
+Facial gestures
+Jumping
+Touching or smelling an object.
Tic Disorders
+Genetics
+Abnormal transmission of the neurotransmitter
dopamine
Treatment
+Risperidone
+Olanzapine
Tourette disorders
+Multiple motor tics and one or more vocal tics
+Which occur many times a day for more than 1 year.
+The person has significant impairment in academic,
social, or occupational areas and feels ashamed and
self-conscious.
Transient Tic disorder
+Involve single or multiple vocal or motor tics
+Occurrences last no longer than 12 months.
Learning Disorders
+Diagnosed when a child’s achievement in reading,
mathematics, or written expression is below that expected
for age, formal education, and intelligence.
+Reading and written expressions disorders are usually
identified in the first grade.
+Low self-esteem and poor social skills are common.
+Some have problems with employment or social
adjustment.
MOTOR SKILLS DISODER
+Impaired coordination severe enough to interfere with
academic achievement or activities of daily living.
+Cerebral palsy or muscular dystrophy.
+Evident as a child attempts to crawl or walk
+An older child tries to dress independently or
manipulate toys.
Developmental coordination disorder
+Often co-exist with a communication disorder.
+Schools provide adaptive physical education
+sensory integration programs
+EX: A child with tactile defensiveness might be involved
in touching and rubbing skin surfaces.
Stereotypic movement disorder
+Characterized by rhythmic, repetitive behaviors
+Onset is prior to age 3 years and persist into
adolescence.
+Common in individuals with intellectual disability.
+ADHD, OCD and tics/Tourette syndrome.
Communication Disorders
+Language disorders
+Speech sound disorder
+Social communication disorder
Elimination Disorders
+Encopresis (Involuntary)
+Enuresis- can be treated with imipramine (Tofranil)
+Both encopresis and enuresis more common in boys.
+Impairment associated with elimination disorders.
+Sluggish cognitive tempo (SCT)- day dreaming,
trouble focusing and paying attention, mental fogging
etc.
ATTENTION-DEFICIT/HYPERACTIVITY
DISORDER
ATTENTION-DEFICIT/HYPERACTIVITY
DISORDER
+Characterized by inattentiveness, overactivity, and
impulsive.
+Common disorder, especially in boys
+Accounts for more child mental health referrals.
+Persistent pattern of inattention and/ or hyperactivity
and impulsivity.
+5% to 8% of school-aged children with 60% to 85%
having symptoms persisting into adolescence.
ATTENTION-DEFICIT/HYPERACTIVITY
DISORDER
+Others situations/disorders that may look similar
to ADHD: bipolar disorders, and behavioral acting
out in response to family stress.
+A key feature of ADHD is the consistency of the
child’s behavior, everyday, in almost all situations.
ONSET AND CLINICAL COURSE (ADHD)
+Usually identified and diagnosed when the child begins
preschool or school
+As infants, children with ADHD are often fussy and
temperamental and have poor sleeping patterns.
+Toddlers, may be described as “always on the go” and “into
everything”, at times dismantling toys and cribs.
+As child starts school- symptoms of ADHD begin to interfere
with behavior and performance
ONSET AND CLINICAL COURSE (ADHD)
+Child fidgets constantly in and out of assigned seats.
+Makes excessive noise by tapping or playing with
pencils or other objects.
+Normal environment noises, such as someone
coughing, distract the child.
+Child interrupts and blurts out answer before questions
are completed.
+Academic performance suffers.
ONSET AND CLINICAL COURSE (ADHD)
+Socially, peers may ostracize or even ridicule the child
for his or her behavior.
+Forming positive peer relationships is difficult because
the child cannot play cooperatively or take turns and
constantly interrupts others.
+Studies have shown, that both teachers and peers
perceive children with ADHD as more aggressive,
bossier, and less likable.
ONSET AND CLINICAL COURSE (ADHD)
+Approximately 60% to 85% of children diagnosed with
ADHD continue to have problems in adolescence.
ETIOLOGY
+May cortical-arousal, information-processing, or maturation
abnormalities in the brain.
+Combined factors, such as environmental toxins, prenatal
influences, heredity, damage to brain structure and functions.
+Prenatal exposure to alcohol, tobacco, and lead severe
malnutrition in early childhood increase the likelihood of ADHD.
+Decrease metabolism in the frontal lobes.
+Decrease blood perfusion of the frontal cortex.
ETIOLOGY
+Frontal cortical atrophy
+Decreased glucose use in the frontal lobes.
+Genetic link.
Risk factors for ADHD
+Family history
+Male relatives with antisocial personality disorders
+Female relatives with somatization disorder
+Socioeconomic status
+Male gender
+Marital or family discord
TREATMENT
Goal of treatment:
+Managing symptoms
+Reducing hyperactivity
+Impulsivity
+Increasing the child’s attention
Psychopharmacology
+Methylphenidate (Ritalin)
+Amphetamine compound (Adderall)
+Dextroamphetamine (Dexedrine)
+Pemoline (Cylert)
+Atomoxetine (Strattera)
Psychopharmacology
+Giving stimulants during daytime hours usually
effectively combats insomnia.
+Eating a good breakfast with the morning dose and
substantial nutritious snacks late in the day and at
bedtime helps the child maintain an adequate dietary
intake.
Strategies for Home and School
+Behavioral strategies
+Environmental strategies
+Therapeutic play
+Dramatic play
+Creative Play
BULLYING
BULLYING
+Repeated negative actions of one or more students
towards a victim.
+Entails a systematic abuse of power involving repetition,
harm, and unequal power.
+Playful teasing, one-time aggression, and joking are not
bullying
+Often youth who are being bullied visit the school
nurse’s office due to somatic symptoms.
Types of Bullying
+Verbal bullying (Slander & name calling)
+Relational bullying
+Physical bullying
+Cyberbullying
MENTAL HEALTH PROMOTION
MENTAL HEALTH PROMOTION
+Early detection and successful intervention
+SNAP-IV Teacher and Parent Rating Scale
+Signs of Developmental delay
+Parental concerns about the safety of immunizations
+Morbidity rate
+Promote health through adulthood and strategies in
preventing psychiatric disorders.
