1. Neurodevelopmental Disorders
Neurodevelopmental disorders new combination of disorder in the DSM-5

2. Overview of Neurodevelopmental Disorders
First diagnosed = infancy, childhood, adolescence
Attention deficit hyperactivity disorder (ADHD)
Specific learning disorders
Autism spectrum disorder
Intellectual Disability

3. Attention Deficit/Hyperactivity Disorder (ADHD)
Central features
Inattentive
Hyperactive
Impulsivity
DSM-5 differentiates two categories of symptoms
Problems of inattention
Problems of Hyperactivity and impulsivity

4. Attention Deficit/Hyperactivity Disorder (ADHD)
Impairments
Behavioral
Cognitive
Social
Academic

5. ADHD: Statistics Prevalence 3% to 9% worldwide
11% of children in the U.S. aged 4 to 17
Onset 3 or 4 years
Boys : Girls = 3:1
Possible cultural construct

6. ADHD: Statistics Adults with ADHD Lower level jobs
2.5 fewer years of education
More likely to be divorced, have substance use problems and antisocial personality disorder
High risk behaviors
High comorbidity
ODD
Mood disorders

7. ADHD: Causes Genetics Familial component Copy number variants—CNVs
Dopamine
DRD4, DAT1, DRD5 genes and Ritalin
Norepinephrine
GABA
Serotonin

8. ADHD: Causes Neurobiological contributions Smaller brain volume 3-4%
The role of toxins
Allergens and food additives
No evidence
Maternal smoking
Increases risk
Interacts with genetic predisposition

9. ADHD: Causes Psychosocial and social factors Negative responses
Teachers
Peers
Adults
Peer rejection
Low self-esteem
Poor self-image

10. Treatment of ADHD Treatment of two fronts Psychosocial intervention
Improving academic performance, decreasing disruptive behavior, and improving social skills
Behavioral interventions before medication
Parent training
Social skills training
Biological intervention

11. Treatment of ADHD: Biological
Goals
Reduce impulsivity and hyperactivity
Improve attention
Stimulants
4 million currently treated
Ritalin

12. Treatment of ADHD: Biological
Other Medications
Adderall
Strattera
Tenex
Clonidine

13. Treatment of ADHD: Biological
Effects of medications
Improve compliance
Decrease negative behaviors
Do not affect learning and academic
performance
Possible abuse issues
Side effects
Psychopharmacogenetics
The study of how your genetic makeup influences your response to certain drugs

14. Autism Spectrum Disorder
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that, affects how one perceives and socializes with others
DSM-5 combined the following into Autism spectrum disorder (ASD)
Autistic disorder
Asperger’s disorder
Childhood disintegrative disorder
Rett disorder is now diagnosed as ASD with a qualifier

15. Autism Spectrum Disorder
Pervasive developmental disorder “Not otherwise specified” dropped in DSM-5
Social (Pragmatic) Communication was added to the DSM-5

16. Autism Spectrum Disorder
Two major characteristics of ASD
Communication and social interaction
Restricted, repetitive patterns of behavior, interests, or activities
Three levels of severity
Level 1— “Requiring support”
Level 2— “Requiring substantial support”
Level 3— “Requiring very substantial support”
Described qualitatively and, as yet, has no quantitative equivalent

17. Autism Spectrum Disorder
Impairment in social communication and social interaction
Fail to develop age-appropriate social relationships
Social communication and social interaction
Joint attention
Deficits in nonverbal communication
Prosody

18. Autism Spectrum Disorder
Impairment in social communication and social interaction
25% never acquire speech
Echolalia
Conversational impairments

19. Autism Spectrum Disorder
Restricted, repetitive patterns of behavior, interests, or activities
Restricted patterns
Behaviors
Interests
Activities
Maintenance of sameness
Stereotyped and ritualistic behaviors

20. Autism Spectrum Disorder : Statistics
Prevalence:
1 in every 50 births
Male to female estimate being 4.4 to 1
IQ interaction
38% intellectual disabilities
Occurs worldwide

21. Causes of Autism Spectrum Disorder : Psychological and Social Dimensions
Historical views
Failed parenting
Perfectionistic, cold, and aloof
High socioeconomic status
Higher IQs
Lack of self-awareness
Limited self-concept
Behavioral correlates
Echolalia
Self-injury

22. Causes of Autism Spectrum Disorder : Biological
Significant genetic component
Familial component
20% risk of second child with autism
100 fold increase in risk
Numerous genes on a number of our chromosomes involved
Oxytocin receptor genes
Bonding and social memory
Older parents increased risk

23. Causes of Autism Spectrum Disorder : Biological
Neurobiological influences
Amygdala
Larger size at birth = higher anxiety, fear
Elevated cortisol
Neuronal damage
Similar size when older
Fewer neurons
Oxytocin
Lower levels

24. Causes of Autism Spectrum Disorder : Biological
Neurobiological influences
Vaccinations
Mercury
No increased risk
Negative effect of not vaccinating

25. Treatment of Autism Spectrum Disorder
Psychosocial treatments
Behavioral approaches
Skill building
Reduce problem behaviors
Communication and language training
Increase socialization
Naturalistic teaching strategies
Early intervention is critical

26. Treatment of Autism Spectrum Disorder
Biological treatments
Medical intervention has had little positive impact
Decrease agitation
Tranquilizers
SSRIs

27. Treatment of Autism Spectrum Disorder
Integrated treatments
Preferred model
Multidimensional, comprehensive focus
Children
Families
Schools
Home
Community and social support

28. Prevention of Neurodevelopmental Disorders
Early intervention
At-risk children, families
Head Start Program
Educational
Medical
Social supports
Genetic screening
Detection and correction
Prenatal gene therapy