PSY3032 Study Guide - Final Guide: Pervasive Developmental Disorder, Leo Kanner, Organophosphate
21 Jun 2018
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Lecture 8 ADHD & Autism Spectrum Disorder
Neurodevelopmental disorders
Disorders with an onset during a child’s developmental period
The more prevalent childhood disorders are often divided into two broad
domains, externalizing disorders and internalizing disorders
Neurodevelopmental difficulties occur on a spectrum
When diagnosing a neurodevelopmental disorder, special considerations are
made with regard to a child’s age and developmental level
To be considered a disorder, symptoms must be associated with significant
impairment in functioning
-Personal
-Social
-Academic
-Occupational
Can present diagnostic dilemma
The same or similar symptoms can present across different disorders
“Tick Box’ approach not useful
WHY is the child presenting the symptoms
Example symptom: repetitive behaviour
Autism spectrum disorder
-Line up toys, bangs same button on toy robot repetitively, spins cutlery
Anxiety
-Line up toys, repeatedly checks to make sure the door is locked; repeatedly
places pencils in size order (=feelings of control)
ADHD
-Makes weird loud noise repeatedly in class; always moving body about in
chair, repeatedly swings feet, knocks table; play drums with fingers
Important to diagnose correctly, and this changes treatment approach
Attention Deficit Hyperactivity Disorder (ADHD)
Inattention
Fails to give close attention to details, make careless mistakes
-Accidentally skipping a line when practising handwriting; writing a number
in the wrong column during maths; mixing up addition and multiplication
sign on a maths exam
Difficulties sustaining attention
-Difficulties remaining focused during lectures; trouble following the plot in
movies; get distracted by brothers when doing homework
Doesn't listen
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Lecture 8 ADHD & Autism Spectrum Disorder
-Ignores when I call his name; “selective hearing’; only listens when she is
interested in the topic
Doesn't follow through on instructions
Difficulty organising tasks and activities
Avoids tasks that require sustained effort
Losing things
-Absent minded! Can never find the book needed for school. Always losing
mobile phone. Left jumper in McDonalds… found times
Distracted
Forgetful
ADHD
When hyperactive behaviours are extreme for the developmental
period, persistent across conditions and linked to significant
impairments in functioning
Characteristics:
-Inattention
-Hyperactivity
-Difficulty interacting with peers
Subtypes:
-Predominately inattentive
-Predominately hyperactivity
-Combined type
Hyperactivity and impulsivity
Need six or more
Often fidgets, taps feet/hands, squirms
Gets out of seat
Runs or climbs
Unable to play quietly
Always on the go
Talks excessively
Interrupts during conversation
Difficulty waiting turn
Interrupts/ intrudes (during activities, takes over)
Clinically significant?
Is it ADHD, or just normal behaviour?
Clinically significant: behaviours occur more than most other children the same
age and developmental level
Occur across different settings
Linked to significant impairment in functioning
Other difficulties
Peer relationships difficulties: 50-70%
-Behaviour aggressive/ intrusive
-Negative behaviours more likely in unstructured play environment
-Experience greater levels of rejection by peers
School avoidance
Poor academic achievement
Inappropriate social behaviours
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Lecture 8 ADHD & Autism Spectrum Disorder
-Turn taking, sharing, cooperation
Comorbidities
Oppositional defiant disorder
Specific Learning Disorder
Language delay
Conduct disorder
Anxiety
Depression
Prevalence:
-3-7% school aged
-65-80% still in adolescence
-<4% adults (males, unemployed, divorced, white)
Prevalence of around 7% in an Australian sample
-Based on DSM-IV criteria
Some studies suggest an increase in diagnosis over time (specially US)
-8-11% v 3-7%
Significant variability in study prevalence rates
-~3% prevalence rate in California
However a recent meta-analysis could not find evidence for an increase in
number of children who met criteria for ADHS over time
Variability across studies due to:
-Diagnostic criteria; source of information
-Different funding models
Development and Course
Difficult to diagnose in children under 4
M:F ratio 3:1
Difficulties become evident in school years when demands of school exceed
capacity
65-80% of ADHD still meet criteria when adolescents
ADHD in adulthood
-Severity of symptoms may reduce
-Reduction in overt hyperactive symptoms
-Difficulties with restlessness, inattention, poor planning and impulsivity may
persist
-~15% continue to meet DSM criteria and ~60% continue to exhibit some
symptoms
Aetiology:
Genetics
Heritability estimates 70-80% from adoption and twin studies
Candidate genes
-DRD4, DRD5 (dopamine receptor)
-DAT1 (dopamine transporter)
However, single gene unlikely to account for ADHD
Gene x environment interaction most likely
Prenatal factors= nicotine and alcohol, low birth weight
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find more resources at oneclass.com
Document Summary
Disorders with an onset during a child"s developmental period. The more prevalent childhood disorders are often divided into two broad domains, externalizing disorders and internalizing disorders. When diagnosing a neurodevelopmental disorder, special considerations are. Academic made with regard to a child"s age and developmental level. To be considered a disorder, symptoms must be associated with significant impairment in functioning. The same or similar symptoms can present across different disorders. Why is the child presenting the symptoms. Line up toys, bangs same button on toy robot repetitively, spins cutlery. Line up toys, repeatedly checks to make sure the door is locked; repeatedly places pencils in size order (=feelings of control) Makes weird loud noise repeatedly in class; always moving body about in chair, repeatedly swings feet, knocks table; play drums with fingers. Important to diagnose correctly, and this changes treatment approach. Fails to give close attention to details, make careless mistakes.
