Neurodevelopmental disorder – show themselves early in life and often persist as the
person grows older, so the term childhood disorder is misleading. All childhood
disorders are presumed to be neurologically based.
¬ In childhood, brain changes signiﬁcantly for several years after birth; this is also
the time when critical developments occur in social, emotional, cognitive and
other important competency areas. \from a developmental perspective, the
absence of early and meaningful social relationships has serious consequences.
¬ Identifying a disorder such as autism at an early age is important for these
children so their social deﬁcits can be addressed before they affect other skill
domains. Knowledge of normal development is important for understanding the
nature of childhood psychological disorders such as autism.
ADHD Attention Deﬁcit/Hyperactivity Disorder
One of the most common reasons children are referred for mental health services.
Primary characteristics include a pattern of inattention (like being disorganized, forgetful
about school or work-related tasks), hyperactivity, and impulsivity. These deﬁcits can
signiﬁcantly disrupt academic efforts as well as social relationships.
¬ Clinical Description
o People with this disorder have a great deal of difﬁculty sustaining their
attention on a task or activity.
o In addition to inattention, some display motor hyperactivity. Impulsivity is a
common complaint made about people with ADHD.
o DSM 5 differentiates two categories of symptoms
―▯Inattention: appear not to listen
―▯Hyperactivity and impulsivity: hyperactivity includes ﬁdgeting,
having trouble sitting for any length of time, and always being on
the go. Impulsivity: includes blurting out answers before questions
are completed and having trouble waiting turns.
o Either the ﬁrst or second set of symptoms need to be present for diagnosis
o Genetic research on both ADHD and learning disabilities suggests that
they may share a common biological cause.
o Estimated to occur in 6% of school-aged children. Boys outnumber girls
o 68% of children with ADHD have ongoing difﬁculties through adulthood.
Children with ADHD seem to be less impulsive, although inattention
o Study with men with ADHD in adulthood: employed in jobs but signiﬁcantly
lower positions with 2.5 years fewer in education. Less likely to hold higher
degrees. More likely to be divorced and to have substance use problems
and antisocial personality disorder.
o Often comorbid with learning disorders
¬ Causes o ADHD is more common in families in which one person has the disorder.
These families display an increase in psychopathology in general. Shared
genetic deﬁcits may contribute to the problems. Considered to be highly
inﬂuenced by genetics.
o Environmental inﬂuences play a relatively small role in the cause of the
disorder. Multiple genes are responsible for ADHD.
o Genetic: mutations that occur that either create extra copies of a gene on
one chromosome or result in the deletion of genes (copy number variants)
o Dopamine, GABA, serotonin, and norepinephrine are implicated in ADHD.
Strong evidence that ADHD is associated with dopamine D4 receptor
gene, the dopamine transporter gene (DAT1), and the dopamine D5
receptor gene. DAT1 is of particular interest because methylphenidate
(Ritalin) (one of the most common medical treatments for ADHD) inhibits
this gene and increases the amount of dopamine available.
o The goal is to link attention deﬁcits to speciﬁc brain dysfunctions.
o Researchers found that children with a speciﬁc mutation involving the
dopamine system (DAT1 genotype) were more likely to exhibit the
symptoms of ADHD if their mothers smoked during pregnancy. But it may
not be a direct link because other factors are involved like genes and SES
o The volume or overall size of the brain is smaller in ADHD. Three areas of
the brain appear smaller than typical: the frontal cortex, the basal ganglia,
and the cerebellar vermis.
o There may be a small but measurable impact of artiﬁcial food colours and
additives on the behavior of young children. Other research now points to
the possible role of the pesticides found in food as contributing to an
increased risk of ADHD.
o Two: biological and psychosocial interventions
o The goal of biological treatments is to reduce the children’s impulsivity and
hyperactivity and to improve their attentional skills.
o Psychosocial treatments generally focus on broader issues such as
improving academic performance, decreasing disruptive behavior, and
improving social skills
o Medication has proven helpful for approx. 70% of cases in at least
temporarily reducing hyperactivity and impulsivity and improving
concentration on tasks.
o Ritalin improved both motor planning and response inhibition performance
in children with ADHD.
o Antidepressant and drug used for HBP seem to improve compliance and
decrease negative behaviors in many children but they do not appear to
produce substantial improvement in learning and academic performance.
o Stimulant medication reinforces the brain’s ability to focus attention during
problem-solving tasks. Use of stimulants and psychosocial in combination
help improve children’s academic and social skills. o The ﬁrst concern about the use of stimulant medications in treating ADHD
pertains to stimulant drugs’ potential for abuse. A second concern is that
these medications may be overprescribed and their long-term effects are
o Some portion of children with ADHD do not respond to meds and so there
are behavioral interventions to help children at home and in school. Other
programs incorporate parent training.
o Generally, a combined approach is superior.
Speciﬁc Learning Disorder
This is characterized by academic performance that is substantially below what would
be expected given the person’s age, IQ, and education.
¬ Clinical Description
o Dyslexia is when they can read but have difﬁculty doing so.
o The criteria require that the person perform academically at a level
signiﬁcantly below that of a typical person of the same age, cognitive
ability, and educational background
o This disability cannot be caused by a sensory difﬁculty such as trouble
with hearing or sight. There are varying severities.
o Frequency of diagnosis seems to be increasing in wealthier regions
o Learning disability is one of the two most common disabilities in children
up to 14 years of age. In fact, more than half of all Canadian school
children classiﬁed as having a disability have a learning disability.
o Difﬁculties with reading are the most common of the learning disorders
and occur in approximately 5% to 15% of the general population.
Mathematics disorder appears in approx. 6% of the population.
o Learning disorders may be related to the later development of other
mental health problems and are also at an increased risk for substance
o The negative outcomes for adults may be mitigated by providing the
proper supports, such as having a positive relationship with caring adults
and providing accommodations in postsecondary education and
o Language disorder, previously called stuttering, is closely related to
o Complex origin: genetic, neurobiological, and environmental factors.
o Genetics of disorders of reading are complex, and genes on
chromosomes 2, 3, 6, 15, and 18 have all been repeatedly linked to these
o There are structural and functional differences in the brains of people with
¬ Treatment o To assess learning disorders is to administer two types of tests and
compare the scores between them
―▯Intelligence tests like the Wechsler Intelligence Scales are thought
to tap academic aptitude or potential
―▯Achievement tests tap performance in particular areas [reading,
writing, and math].
o If a signiﬁcant discrepancy exists between aptitude and actual
achievement in a particular subject, then a speciﬁc learning disorder is
o Learning disorders primarily require educational intervention.
o Biological treatment is for those with a comorbid ADHD diagnosis.
o Educational efforts an broadly be categorized into:
―▯Efforts to remediate directly the underlying basic processing of
―▯Efforts to improve cognitive skills through general instruction in
listening, comprehension, and memory.
―▯Targeting the behavioral skills needed to compensate for speciﬁc
problems the student may have with reading, mathematics, or
o Good way is to teach behavioural skills necessary to improve academic
o Integrated program: Phonology and Strategy Training Program for reading
Autism Spectrum Disorder
A neurodevelopmental disorder that, at its core, affects how one perceives and
socializes with others. A new disorder on the DSM 5: social (pragmatic) communication
disorder, includes the difﬁculties seem in ASD, but without restricted, repetitive patterns
of behavior. Individuals in this disorder do not easily learn the social rules when
communicating with others.
Three major characteristics of ASD are expressed in DSM 5:
1. Impairments in social communication and interaction
2. Restricted, repetitive patterns of behavior, interests, or activities
3. Impairments present in early childhood and they limit daily functioning.
¬ The degree of impairment in each of these characteristics that presumably
distinguish individuals previously diagnosed with the separate disorders of
autism, Asperger’s, and pervasive developmental disorder.
¬ To accommodate the range of difﬁculties in the two symptom clusters, the DSM 5
introduced three levels of severity: Level 1 – “Requiring support” Level 2 –
“Requiring substantial support” Level 3 – “Requiring very substantial support”
Impairment is Social Communication and Social Interaction
¬ People with ASD fail to develop age-appropriate social relationships ¬ Deﬁned by the inclusion of three aspects – problems with social reciprocity,
nonverbal communication, and initiating and maintaining social relationships. All
these must be present for a diagnosis.
¬ Social reciprocity for individuals with more severe symptoms of ASD involves the
inability to engage in joint attention. It might present itself as appearing self-
focused and not showing interest in things other people care about.
¬ People with ASD lack a theory of mind. Argued to be a deﬁcit in nonverbal
communication. It can involve problems with a range of actions in persons with
severe forms of ASD (not pointing to things you want) and among those with
milder forms of ASD (standing too close to someone).
¬ Those with the less severe form of ASD may also lack appropriate facial
expressions or tone of voice (prosody). Give the appearance of general
¬ The deﬁcits in social reciprocity and nonverbal communication can combine to
inﬂuence the third symptom – problems maintaining relationships.
¬ Approx. 25% do not develop speech proﬁciency sufﬁcient to communicate their
needs effectively. Some who do have speech may have unusual communication.
On the other end of the spectrum, these individuals can be very verbal, but
because of the social deﬁcits and their tendency to have restricted interests, they
often have one sided conversations about the topics they want to discuss.
¬ Another aspect of the communication deﬁcits of children with ASD is a lack of
spontaneous pretend play or social imitative play appropriate to the child’s
Restrictive, Repetitive Patterns of Behavior