Developmental disorder

Developmental disorder
Classification and external resources
Specialty psychiatry
ICD-10 F80-F84
ICD-9-CM 299, 315

Developmental disorders is a group of psychiatric conditions originating in childhood that involve serious impairment in different areas. There are several ways of using this term.[1] The most narrow concept is used in the category "Specific Disorders of Psychological Development" in the ICD-10.[1] These disorders comprise language disorders, learning disorders, motor disorders and autism spectrum disorders.[2] In broader definitions ADHD is included, and the term used is neurodevelopmental disorders.[1] Yet others include antisocial behavior and schizophrenia that begins in childhood and continues through life.[1] However, these two latter conditions are not as stable as the other developmental disorders, and there is not the same evidence of a shared genetic liability.[1]

Developmental disorders are present from early life. They usually improve as the child grows older, but they also entail impairments that continue through adult life. There is a strong genetic component, and more males are afflicted than females.[1]

Emergence

Learning disabilities are diagnosed when the children are young and just beginning school. Most learning disabilities are found under the age of 9.[3]

Young children with communication disorders may not speak at all, or may have a limited vocabulary for their age.[4] Some children with communication disorders have difficulty understanding simple directions or are unable to name objects.[4] Most children with communication disorders are able to speak by the time they enter school, however, they continue to have problems with communication.[4] School-aged children often have problems understanding and formulating words.[4] Teens may have more difficulty with understanding or expressing abstract ideas.[4]

Causes

The scientific study of the causes of developmental disorders involves many different theories. Some of the major differences between these theories involves whether or not environment disrupts normal development, or if abnormalities are pre-determined.[5] Normal development occurs with a combination of contributions from both the environment and genetics. The theories vary in the part each factor has to play in normal development, thus affecting how the abnormalities are caused.[6]

One theory that supports environmental causes of developmental disorders involves stress in early childhood. Researcher and child psychiatrist Bruce D. Perry, M.D., Ph.D, theorizes that developmental disorders can be caused by early childhood traumatization.[7] In his works he compares developmental disorders in traumatized children to adults with post-traumatic stress disorder, linking extreme environmental stress to the cause of developmental difficulties.[7] Other stress theories suggest that even small stresses can accumulate to result in emotional, behavioral, or social disorders in children.[8]

Types

Autism spectrum disorder (ASD)

Diagnosis

The first diagnosed case of ASD was published in 1943 by American psychiatrist Leo Kanner. There is a wide range of cases and severity to ASD so it is very hard to detect the first signs of ASD. A diagnosis of ASD can be made accurately before the child is 3 years old, but the diagnosis of ASD is not commonly confirmed until the child is somewhat older. The ages of diagnosis can range from 9 months to 14 years however the mean age of diagnosis is 13 months. On average each case of ASD is tested at three different diagnostic centers before confirmed. Early diagnosis of the disorder can diminish familial stress, speed up referral to special educational programs and influence family planning.[9]

In the brain

The cause of ASD is still uncertain. Autism spectrum disorder is a disorder of the cortex, which controls higher functions, sensation, muscle movements, and memory. What is known is that a child with ASD has a pervasive problem with how the brain is wired. The distribution of white matter, the nerve fibers that link diverse parts of the brain, is abnormal. An ASD child’s brain grows at a very rapid rate and is almost fully grown by the age of 10.[9]

Symptoms

Still a lot of information is unclear about ASD and the symptoms have a wide range of severity. Signs include impairments in social interactions, communication and repetitive or restricted patterns of interest or behaviors. There are also different symptoms at different ages based on developmental milestones. Children between 0 and 36 months with ASD show a lack of eye contact, seem to be deaf, lack a social smile, do not like being touched or held, have unusual sensory behavior and show a lack of imitation. Children between 12 and 24 months with ASD show a lack of gestures, prefer to be alone, do not point to objects to indicate interest, are easily frustrated with challenges, and lack of functional play. And finally children between the ages 24 to 36 months with ASD show a lack of symbolic play and an unusual interest in certain objects, or moving objects.[9]

Treatment

There is no cure for ASD and proper treatment depends on the case and what is most struggled with. Autism spectrum disorder is like many other disorders where when diagnosed early, can be better treated. Different types of therapy are helpful such as music therapy and physical therapy. Other treatments include auditory training, discrete trial training, facilitated communication, and sensory integration therapy.[9]

Attention deficit hyperactivity disorder (ADHD)

Attention deficit hyperactivity disorder is a neurodevelopmental disorder that is characterised by significant levels of hyperactivity, inattentiveness, and impulsiveness. There are three subtypes of ADHD: predominantly inattentive, predominantly hyperactive, and combined (which presents as both hyperactive and inattentive subtypes).[10]

Treatment options

Treatment of ADHD often includes a combination of counseling, medications and dietary changes.

Medications commonly used in the treatment of ADHD are primarily stimulants such as methylphenidate and amphetamine and non-stimulants such as atomoxetine, bupropion, clonidine and guanfacine.

SSRI antidepressants are often unhelpful, and can worsen symptoms of ADHD.[11]

Symptoms

Symptoms of ADHD include inattentiveness, impulsiveness, and hyperactivity. Many of the behaviors that are associated with ADHD include poor control over actions resulting in disruptive behavior and academic problems. Another area that is affected by these disorders is the social arena for the person with the disorder. Many children that have this disorder exhibit poor interpersonal relationships and struggle to fit in socially with their peers.[10]

See also

References

  1. 1 2 3 4 5 6 Michael Rutter, Dorothy V. M. Bishop, Daniel S. Pine, Stephen Scott, Jim Stevenson, Eric Taylor, Anita Thapar, eds. (2008). Rutter's Child and Adolescent Psychiatry, Fifth Edition. Dorothy Bishop and Michael Rutter. Blackwell Publishing Ltd. pp. 32–33. ISBN 978-1-4051-4549-7.
  2. ↑ http://priory.com/psych/ICD.htm
  3. ↑ National Joint Committee on Learning Disabilities. (1982). Learning disabilities: Issues on definition. Asha, 24 (11), 945-947.
  4. 1 2 3 4 5 Communication Disorders. (n.d.). Children's Hospital of Wisconsin in Milwaukee, WI, Retrieved December 6, 2011, from http://www.chw.org/display/PPF/DocID/
  5. ↑ Karmiloff, Annette. "Development itself is key to understanding developmental disorders". Page 1. Published October 1, 1998. Retrieved on November 26, 2011 from: http://www.sciencedirect.com/science/article/pii/S1364661398012303.
  6. ↑ Karmiloff, Annette. "Development itself is key to understanding developmental disorders". Page 1. Published October 1, 1998. Retrieved on November 26, 2011 from: http://www.sciencedirect.com/science/article/pii/S1364661398012303
  7. 1 2 Perry, Bruce D. and Szalavitz, Maia. "The Boy Who Was Raised As A Dog", Basic Books, 2006, p.2. ISBN 978-0-465-05653-8
  8. ↑ Payne, Kim John. “Simplicity Parenting: Using the Extraordinary Power of Less to Raise Calmer, Happier, and More Secure Kids”, Ballantine Books, 2010, p. 9. ISBN 9780345507983
  9. 1 2 3 4 Dereu, Mieke. (2010). Screening for Autism Spectrum Disorders in Flemish Day-Care Centers with the Checklist for Early Signs of Developmental Disorders. Springer Science+Business Media. 1247-1258.
  10. 1 2 Tresco, Katy E. (2004). Attention Deficit Disorders: School-Based Interventions. Pennsylvania: Bethlehem.
  11. ↑ C. W. Popper (1997). "Antidepressants in the treatment of attention-deficit/hyperactivity disorder". The Journal of clinical psychiatry. 58 Suppl 14: 14–29. PMID 9418743.
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