Abnormal Psychology Exam 4 Chapter 13 Neurodevelopmental and Neurocognitive Disorders

Approximately _____% of individuals with ASD do not develop speech proficiency sufficient to communicate their needs effectively.

-25% -In those with some speech, sometimes their communication is unusual (echolalia or one sided conversations).

Attention-deficit/hyperactivity disorder (ADHD) - statistics

-5.2% of the child population across all regions of the world -Boys are two to three times more likely to be diagnosed than girls -Boys tend to be more aggressive and girls tend to display more internalizing behaviors (such as, anxiety and depression) -First identified around three to four years of age -About half of the children have ongoing difficulties in adulthood -Oppositional defiant disorder (ODD), conduct disorder, and bipolar disorder may overlap

Facial agnosia

-Type of agnosia characterized by a person's inability to recognize even familiar faces.

Agnosia

-Inability to recognize and name objects; may be a symptom of dementia or other brain disorders.

Intellectual disability (ID)

-A diagnosis received when one achieves a significantly below-average score on a test of intelligence and by limitations in the ability to function in areas of daily life. Significantly subaverage intellectual functioning paired with deficits in adaptive functioning such as self-care or occupational activities, appearing before the age of 18. -Deficits in areas such as conceptual, social, and practical. -Throughout history received treatment that can best be described as shameful - more than any other group -Manifestations of ID vary - some individuals function well (even independently) while others require considerable assistance -Experience impairments affect most areas of functioning -language and communication skills are often the most obvious (some may never learn to use speech) -IQ cut off score of approximately 70 (somewhat arbitrary) -ID mild - IQ score between 50-55 and 70; ID moderate - IQ score between 35-40 to 50-55; ID severe - 20-25 to 35-40; ID profound - below 20-25 -A person must also have significant difficulty in areas such as communication, self-care, home living, social and interpersonal skills, use of community resources, self-direction, functional academic skills, work, leisure, health, and safety -Defined by society -Achievement depends partly on their education and the community support available to them

Chorionic villus sampling (CVS)

-A genetic test conducted during early pregnancy that samples cells found in the placenta (chorionic villi) and assesses possible genetic or chromosomal problems in the villus. -This is not always desirable because it is an invasive procedure - inserting a needle that could cause unwanted damage to the developing fetus. There is now more sophisticated tests of a mother's blood that can be used to detect Down syndrome as early as the first trimester of pregnancy. -Some estimate that a prenatal diagnosis of Down syndrome leads to a choice for an elective abortion more than 50% of the time.

Subcortical dementia

-Affects primarily the inner areas of the brain, below the outer layer called the cortex -Neurocognitive disease resulting from HIV is sometimes called this -Alzheimer's disease is a cortical dementia -More likely to experience severe depression and anxiety -In general, motor skills including speech and coordination are impaired early on

Classes of neurocognitive disorder based on etiology

-Alzheimer's disease (more than half with neurocognitive disorder exhibit this type) -Vascular injury -Frontotemporal degeneration -Traumatic brain injury -Lewy body disease -Parkinson's disease -HIV infection -Substance use -Huntington's disease -Prion disease -Another medical condition

Intellectual disability (ID) - statistics

-Approximately 90% of people with ID fall under the label of mild intellectual disability (IQ of 50 to 70) -1% to 3% of the general population -Course is chronic -Prognosis varies considerably

Joint attention

-Attention shared by two persons toward an object after one person has indicated interest in the object to the other person; this social interaction is limited or absent in people with autism spectrum disorder.

Specific learning disorder - statistics

-Between 5% and 15% across youth of various ages and cultures -With better access to diagnostic services, more children are identified -Disproportionality - racial differences - societal views of disability, racism, and inequitable assessment are among factors that contribute to disproportionality -Students are more likely to drop out of school, more likely to be unemployed, and more likely to have suicidal thoughts and attempt suicide -Negative outcomes for adults may be mitigated by providing the proper supports, such as having a positive relationship with caring adults and proving accommodations in postsecondary educational and employment settings

Intellectual disability - treatment

-Biological treatment for ID is currently not a viable option -Parallels that of people with more severe forms of ASD - attempting to teach them skills they need to become more productive and independent -Individuals with mild ID, intervention is similar to that of people with learning disorders. Specific learning deficits are identified and addressed to help the student improve such skills as reading and writing. At the same time, these individuals often need additional support to live in the community. -The expectation for all people with ID is that they will in some way participate in community life, attend school and later hold a job, and have opportunity for meaningful social relationships. Advances in electronic and educational technologies have made this goal realistic even for people with profound ID. -A skill is broken into its component parts (task analysis) and people are taught each part in succession until they can perform the whole skill (i.e. basic self-care as dressing, bathing, feeding, and toileting). - Typically most individuals can be taught to perform some skills (success is measured by level of independence). -Communication training -Sign language -Augmentative communication strategies -Teach people how to communicate their need or desire -"Supported employment" - involves helping an individual find and participate satisfactorily in a competitive job (this can certainly be cost effective) -Today, teaching strategies to help these students learn are being used in regular classrooms and in preparing them to work at jobs in the community.

Traumatic brain injury (TBI)

-Brain damage caused by a blow to the head or other trauma that injures the brain and results in diminished neurocognitive capacity

Substance/medication-induced neurocognitive disorder

-Brain damage caused by prolonged use of drugs, often in combination with a poor diet. -Include at least one - aphasia, apraxia, agnosia, or a disturbance in executive functioning

Communication disorders - language disorder

-Closely related to specific learning disorder -Getting on'e meaning or message across to others (expressive language disorder), or understanding the meaning coming from others (receptive language disorder)

Communication disorders - childhood-onset speech fluency disorder (stuttering)

-Closely related to specific learning disorder -Disturbance in the fluency and time patterning of speech (for example, sound and syllable repetitions or prolongations)

Head trauma

-Injury to the head and, therefore, to the brain, typically caused by accidents; can lead to cognitive impairments, including memory loss

Neurocognitive disorder due to HIV infection

-Less common type of neurocognitive disorder that affects people who have HIV; may lead to impaired thinking in advanced stages -HIV itself seems to be the cause

Neurocognitive disorder due to Alzheimer's disease

-Condition resulting from a disease that develops most often in people 50 and older, characterized by multiple cognitive deficits that develop gradually and steadily. -Impairment of memory, orientation, judgment, and reasoning -Inability to integrate new information results in failure to learn new associations - often forget important events or lose objects -Interest in non-routine activities narrows. -Tend to lose interest in others and as a result become more socially isolated -As this disease progresses they can become agitated, confused, depressed, anxious, or even combative -Many of these difficulties become more pronounced late in the day - "sundowner syndrome" -Also display one or more other cognitive disturbances, including aphasia, apraxia, agnosia, or difficulty with activities such as planning, organizing, sequencing, or abstracting information. -Negative effects on social and occupational functioning -A diagnosis can be made by using brain scans or simplified mental status exams -Deterioration is slow during the early and late stages but more rapid during the middle stages -Average survival time is four to eight years -Usually appears during our 60s or 70s -Afflict more than 5.3 million Americans and millions worldwide -May occur more often in people who are poorly educated - educational level may predict a delay in observation of symptoms. Unfortunately, people who attain a higher level of education also decline more rapidly once symptoms become more severe, suggesting that education does not prevent Alzheimer's disease but just provides a buffer period of better functioning - educational achievement may somehow create a mental "reserve," a learned set of skills that helps someone cope longer with the cognitive deterioration that marks the beginning of neurocognitive deficits. Some people adapt more successfully than others and thus escape detection longer. - the cognitive reverse hypothesis suggests that the more synapses a person develops throughout life, the more neuronal death must take place before the signs of dementia are obvious - both skill development and the changes in the brain with education may contribute to how quickly the disorder progresses. -May be more prevalent among women - a tentative explanation involves the hormone estrogen. -Found roughly the same numbers across all ethnic groups

Neurocognitive disorder due to traumatic brain injury

-Condition resulting from jarring of the brain and caused by a blow to the head or other impact; symptoms persist for at least a week after the initial trauma. -Teens and young adults are at greatest risk especially accompanied by alcohol abuse or lower SES -Traffic accidents, assaults, falls, suicide attempts, and bomb blasts in combat are common causes.

Frontotemporal neurocognitive disorder

-Condition that damages the frontal or temporal regions of the brain; behavior or language is negatively affected

Intellectual disability

-Considerable deficits in cognitive abilities

Neurocognitive disorder - prevention

-Control your blood pressure -Do not smoke -Lead an active physical and social life -We can't change genetics!

Delirium - causes

-DSM-5 recognizes several causes of delirium among its subtypes -Substance-induced delirium and delirium not otherwise specified include disruptions in the person's ability to direct, focus, sustain, and shift attention. -Delirium may be experienced by children who have high fevers or who are taking certain medications. -Improper use of medication -Adverse drug reactions -Delirium may be the cause of many falls seen in the elderly -Often occurs during the course of dementia - as many as 50% of people with dementia suffer at least one episode of delirium -Delirium is often reversed in a short amount of time. -Older age -Sleep deprivation -Immobility -Excessive stress

Parkinson's disease

-Degenerative brain disorder principally affecting motor performance (for example, tremors and stooped posture) associated with reduction in dopamine. Dementia may be a result as well. -Affects 100 to 300 people in every 100,000 people worldwide -Stooped posture -Bradykinesia - slow body movements -Tremors -Jerking in walking -Soft monotone voice -75% of people who survive more than 10 years of Parkinson's disease develop neurocognitive disorder

Attention-deficit/hyperactivity disorder (ADHD)

-Developmental disorder featuring maladaptive levels of inattention, excessive activity, and impulsiveness -One of the most common reasons children are referred for mental health services in the US. -Problems with inattention and hyperactivity and impulsivity - one of these have to be present for someone to be diagnosed with ADHD -Different presentations are called subtypes and they include the inattentive subtype (ADD - absence of hyperactivity) and the hyperactive/impulsive subtype. Other individuals meet criteria for both inattention and hyperactivity/impulsivity, and these individuals are labeled with the combined subtype. -Academic performance often suffers, especially as the child progresses in school. -Likely to be unpopular and rejected by peers -May be a result of genetic factors as well as environmental influences such as hostile home environment and gene-environment interactions.

What is the most common specific learning disorder?

-Difficulties with reading -7%

Alzheimer's disease

-Disease of the cerebral cortex that causes an atypical form of senile dementia, discovered in 1906 by German psychiatrist Alois Alzheimer

Human immunodeficiency virus type 1 (HIV-1)

-Diseases that causes AIDS

Neurocognitive disorder due to Parkinson's disease

-Disorder characterized by progressive decline in motor movements; results from damage to dopamine pathways

Neurocognitive disorder - biological treatment

-Disorder resulting from known infectious diseases, nutritional deficiencies, and depression can be treated if it is caught early -However no known treatment exists for the types of neurocognitive disorder that account for the vast majority of cases -Glial cell-derived neurotrophic factor - a substance that may preserve or perhaps restore neurons (may someday be used to help reduce or reverse the progression of degenerative brain diseases -Transplanting stem cells (fetal brain tissue) into the brains of people? -New drugs to help prevent much of the damage inflicted by the blood clots characteristic of stoke? -Current research is focused on a treatment for dementia of the Alzheimer's types because it affects so many people -Cholinesterase inhibitors such as donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl) have had modest impact on cognitive abilities in some patients - these drugs make acetylcholine available to the brain (acetylcholine is deficient in people with Alzheimer's disease) - people improve to the point where they were six months earlier but this gain is not permanent -Modest exercising -To date, however, no medical interventions are available that directly treat and therefore stop the progression of the conditions that cause the cerebral damage in Alzheimer's disease -Antidepressants are commonly recommended to alleviate depression and anxiety that often accompany the cognitive decline -Antipsychotic medication is sometimes used for those who become unusually agitated -Research is looking into vaccines and there may be some hope!

True or False: Whereas intellectual disability and specific learning disorder are believed to be present from birth, most neurocognitive disorders develop much later in life.

-True

Autism spectrum disorder (ASD) - causes

-Does not appear to have a single cause -Biological and psychosocial influences -Historically ASD was seen as a result of failed parenting. Mothers and fathers were characterized as perfectionistic, cold, and aloof, with relatively high SES, and higher IQs than the general population (this is proven wrong later). -Lack of self awareness of own existence (this is proven wrong later) -Contrary to the myth, individuals do not have savant abilities (exceptional mental ability) -Genetics of ASD are highly complex with a moderate genetic heritability. Many genes are involved, but each one has only a relatively small effect. -Families that have one child with ASD have about a 20% chance of having another child with the disorder -Brain chemical - oxytocin? - shown to have a role in how we bond with others and in our social memory -Amygdala (area of the brain involved in emotions such as anxiety and fear) - same size but fewer neurons in this structure. Earlier research proposed that the amygdala was enlarged early in life - causing excessive anxiety and fear. With continued stress, the release of the stress hormone cortisol damages the amygdala, causing the relative absence of neurons in adulthood. -Lower levels of oxytocin in their blood. Giving oxytocin to people with ASD improved their ability to remember and process information with emotion content. -Mercury - specifically, the mercury previously used as a preservative in childhood vaccines (thimerosal) is responsible for the increases seen in ASD. Concern is that parents are not vaccinating their children (measles, mumps and rubella). - Highly controversial

Creutzfeldt-Jakob disease

-Extremely rare condition that causes dementia -Type of prison disease -Affects only one in every million individuals

Attention-deficit/hyperactivity disorder (ADHD) - psychosocial intervention

-Focus on broader issues such as improving academic performance, decreasing disruptive behavior, and improving social skills -Reinforcement programs reward the child for improvements and at times, punish misbehavior with loss of rewards. -Other programs teach families how to respond constructively to their child's behavior and how to structure the child's day to help prevent difficulties -Social skills training -CBT for adults -Most clinicians recommend a combination of approaches designed to individualize treatments

Copy number variants

-Genes that are deleted as a result of mutations these deletions may play a role in the developmental of ADHD and other disorders

Huntington's disease

-Genetic disorder marked by involuntary limb movements and progressing to dementia -People can live for 20 years after the first signs of the disease appear -Researchers believe that all patients with Huntington's disease would eventually display neurocognitive impairments if they lived long enough -Approximately 50% of the offspring of an adult with Huntington's disease will develop the disease (autosomal dominant disorder) -There seems to be a deficit to an area on chromosome 4 - Finding that one gene that a causes a disease is unusual. Research typically points to multiple gene (polygenic) influences

Specific learning disorder - causes

-Genetic factors, neurobiological factors, and environmental factors -Runs in families -There are not different genes responsible for reading disorders and mathematics disorders. Instead, there genes that affect learning and they may contribute to problems across domains (reading, mathematics, writing) -Home reading habits - reading to children at risk for reading disorders can lessen the impact of the genetic influence -Structural as well as functional differences in the brain -Three areas of the left hemisphere appear to be involved in problems with dyslexia (word recognition) - Broca's area, an area in the left parietotemporal area, and an area in the left occipitotemporal area -The intraparietal sulcus seems to be critical for the development of a sense of numbers and is implicated in mathematics disorder. -No current evidence for specific deficits responsible for disorders of written expression

De novo disorders

-Genetic mutations occurring in the sperm or egg or after fertilization

Major neurocognitive disorder (dementia)

-Gradual deterioration of brain functioning that affects memory, judgment, language, and other advanced cognitive processes

Attention-deficit/hyperactivity disorder (ADHD) - causes

-Highly influenced by genetics (multiple genes are involved and it is more common in families and these families display an increase in psychopathology in general) (copy number variants) -Dopamine, norepinephrine, serotonin, and gamma-aminobutyric acid (GABA) are implicated in the causes -One study found that children with a specific mutation involving the dopamine system were more likely to exhibit the symptoms of ADHD if their mothers smoked during pregnancy -Other research is pointing at maternal stress and alcohol use, and parental marital instability and discord -Maternal alcohol consumption and low birth weight -The overall volume of the brain is slightly smaller -A number of areas in the brain appear to be affected especially those involved in self-organizational abilities. - These changes seem less pronounce in persons who receive medication (stimulant medicine has a "growth enhancing effect") -Toxins such as allergens and food additives -Artificial food colors and additives -Pesticides found in foods -Negative responses by parents, teachers, and peers affect a child's impulsivity and hyperactivity and may contribute to feelings of low self-esteem

Intellectual disability (ID) - causes

-Hundreds of known causes -Environmental (for example, deprivation, abuse, and neglect -Prenatal (for example, exposure to disease or drugs while still in the womb) -Perinatal (for example, difficulties during labor and delivery) -Postnatal (for example, infections and head injury) -Fetal alcohol syndrome -Pregnant woman's exposure to disease and chemicals and poor nutrition -Lack of oxygen (anoxia) during birth -Malnutrition -Head injuries during the developmental period -Multiple genetic influences - chromosomal disorders, single-gene disorders (some may involve a dominant gene), mitochondrial disorders, and multiple genetic mutations -As many as 30% of cases of ID have no identified etiology -De novo disorders -Phenylketonuria (PKU) -Lesch-Nyhan syndrome -Down syndrome -Fragile X syndrome -Cultural-familial intellectual disability

Aphasia

-Impairment or loss of language skills resulting from brain damage caused by stroke, Alzheimer's disease, or other illness or trauma. -Not among people with subcortical dementia

Deterministic genes

-In genetics, genes that lead to nearly a 100% chance of developing the associated disorder. These are rare in the population.

Susceptibility genes

-In genetics, genes that only slightly increase the risk of developing the disorder, but in contrast to the deterministic genes, these are more common in the population.

Causes of neurocognitive disorder (specifically Alzheimer's disease) - psychological and social influences

-May help determine onset and course -Psychosocial factors help influence who does and who does not develop certain forms of neurocognitive disorder -Lifestyle such as diet, exercise and stress (influences cardiovascular disease and therefore helps determine who experiences vascular neurocognitive disorder) -Whether a person abuses drugs -Hypertension and strokes are more prevent among African Americans and subgroups of Asian of Americans than non-Hispanic whites - this may explain why vascular neurocognitive disorder is more often observed in members of these groups -Neurocognitive disorder caused by head trauma and malnutrition are relatively prevalent in preindustrial and rural societies -Not getting enough vitamins B9 and B12 -Occupational safety and economic conditions influencing diet affect the prevalence of certain neurocognitive disorders -Education -Having certain skills to cope better -The early stages of confusion and memory loss may be better tolerated in cultures with lowered expectations of older adults - In certain cultures, such as the Chinese, younger people are expected to take the demands of work and care from older adults after a certain age, and symptoms of dementia are viewed as signs of normal aging (neurocognitive disorder may go undetected for years in these societies)

Cultural-familial intellectual disability

-Mild form of intellectual disability that may be caused largely by environmental influences

Mild neurocognitive disorder

-Modest impairment in cognitive abilities that can be overcome with accommodations such as extensive lists or elaborate schedules

Causes of neurocognitive disorder (specifically Alzheimer's disease) - biological influences

-Most common cause of neurocognitive disorder is Alzheimer's disease -Neurofibrillary tangles - large numbers of tangled, strand-like filaments within the brain cells -Amyloid plaques (also referred to as neuritic or senile plaques) - accumulate between neurons in the brain -Over time the brains of people with Alzheimer's disease atrophy (shrink) to a greater extent than expected for normal aging. -Deterministic genes such as amyloid beta peptides and Presenilin 1 and Presenilin 2 genes - will inevitably lead to Alzheimer's disease (fortunately, these genes are rare in the general population) (a small number of people will be helped if research can find a way to interfere with these genes) -Susceptibility genes such as apolipoprotein E4 (apo E4) (more common in the general population)(many people will be helped if research can find way to interfere with this gene) -Deposits of amyloid beta or Ab are believed by some researchers to cause the cell death associated with Alzheimer's disease

Specific learning disorder

-Neurodevelopmental disorder characterized by academic performance that is substantially below what would be expected given the person's age, intelligence quotient (IQ) score, and education. -"Unexpected underachievement" -Disorders of reading, written expression, or mathematics -Rate this disorder on levels of severity -Response to intervention - identifying a child as having a specific learning disorder when the response to a known effective intervention (for example, an early reading program) is significantly inferior to the performance of peers. This provides an early warning system and focuses on providing effective instruction.

Autism spectrum disorder (ASD)

-Neurodevelopmental disorder characterized by significant impairment in social interactions and communication and restricted patterns of behavior, interest, and activity -Impairments in social communication and social interaction (problems with social reciprocity (a failure to engage in back and forth social interactions), non-verbal communication, and initiating and maintaining social relationships - all three must be present) AND restricted, receptive patterns of behavior, interests, or actives (maintenance of sameness and stereotyped and ritualistic behaviors) -May not be interested in social situations -DSM-5 - three levels of severity (according to support required)

Neurocognitive disorder due to Huntington's disease

-Neurological disorder that follows a subcortical pattern and is notable for causing involuntary limb movements

Neurocognitive disorder due to Lewy body disease

-Neurological impairment that affects people with Lewy body disease, in which protein deposits damage brain cells and gradually cause motor impairments and loss of alertness. -Second most common type of neurocognitive disorders (after Alzheimer's disease) -Signs of this disorder come on gradually and include impairment in alertness and attention, vivid visual hallucinations, and motor impairment

Neurodevelopmental disorders

-Neurologically based disorders that are revealed in a clinically significant way during a child's developing years.

Autism spectrum disorder (ASD) - Treatment

-No completely effective treatment exists -Instead of focusing on eliminating social communication problems focus is on enhancing communication and daily living skills and reducing problem behaviors -Discrimination training -Naturalistic teaching strategies -Incidental teaching -Pivotal response training -Milieu teaching -Teach social skills, including the use of peers who do not have ASD as trainers -Behavioral intervention - programs specifically targeting joint attention and play skills - intensive early behavioral intervention may "normalize" the functioning of the developing brain -Programs that teach appropriate social interaction, problem-solving, self-control, recognizing emotions in others, expanding their often narrow range of interests, and improving their understanding of non-literal idioms. -Medical intervention has had little positive impact on the core symptoms of social and language difficulties. A variety of pharmacological treatments are used to decrease agitation, with the major tranquilizers and serotonin-specific reuptake inhibitors being the most helpful. - It is unlikely that one drug will work for everyone. -Early intervention for very young children with ASD holes the most hope for significant changes in core symptoms of this disorder. The treatment of choice for older children and those not responsive to early intervention combines various approaches to the many facets of this disorder. -For children, most therapy consists of school education with special psychological supports for problems with communication and socialization. -Behavioral approaches have been most clearly documented as benefiting children in this area. -Pharmacological treatments can help some of them temporarily -Parents need support -As children with ASD grow older, intervention focuses on efforts to integrate them into the community, often with supported living arrangements and work settings - some people are able to live in their apartments with only minimal support from family members while others require more extensive efforts to support them in their community (great range of abilities)

Autism spectrum disorder (ASD) - statistics

-Once thought to be rare although recent research estimates an increase in occurrence -1 in 68 eight-year-old children -Male to female - 4.5 to 1 -Identified in every part of the world -31% have intellectual disabilities -The higher children score on IQ tests, the less likely they are to need extensive support (vice versa)

True or False: There is a debate about the elimination of separate categories for autistic disorder and Asperger's disorder in the DSM-IV.

-True -To some it is a culture identity

Neurocognitive disorders - statistics

-One new case is identified every seven seconds -Can develop at almost any age, although it is more frequent in adults -Five million people in the US -More than 5% un people older than 65 and 20% to 40% in those older than 85 -The prevalence of neurocognitive disorder due to Alzheimer's disease is projected to greatly increase in older adults, partly as a result of the increase of baby boomers who will become senior citizens -Up to 100% of people 100 years or older showed signs of neurocognitive disorder -Black men and women are at a higher risk for mild neurocognitive disorder than white men and women -Adults are generally living longer and therefore more at risk for developing neurocognitive disorder, it is not surprising that the disorder more prevalent (greater increases among women and chances of developing it increases rapidly after the age of 75) -Caring for these people costs $100 billion per year in the US -Family members often care for the afflicted person around the clock (this is a personal and financial commitment)

Fragile X syndrome

-Pattern of abnormality caused by a defect in the X chromosome resulting in intellectual disability, learning problems, and unusual physical characteristics. -Primarily affects males -Women who carry fragile X syndrome commonly display mild to severe learning disabilities. Men with this disorder display moderate to severe levels of ID and have higher rates of hyperactivity, short attention spans, gaze avoidance, and perseverative speech. -Large ears, testicles, and head circumference are common -1 in every 4,000 males and 1 in every 8,000 females

Childhood disintegrative Disorder

-Pervasive developmental disorder involving severe regression in language, adaptive behavior, and motor skills after a 2- to 4-year period of normal development.

Amniocentesis

-Prenatal medical procedure that allows the detection of abnormalities (for example, Down syndrome) in the developing fetus. It involves removal and analysis of amniotic fluid from the mother. -This is not always desirable because it is an invasive procedure - inserting a needle that could cause unwanted damage to the developing fetus. There is now more sophisticated tests of a mother's blood that can be used to detect Down syndrome as early as the first trimester of pregnancy. -Some estimate that a prenatal diagnosis of Down syndrome leads to a choice for an elective abortion more than 50% of the time.

Vascular neurocognitive disorder

-Progressive brain disorder involving loss of cognitive functioning, caused by blockage of blood flow to the brain, that appears concurrently with other neurological signs and symptoms -Long term consequence of a stroke (third-leading cause of death in the US) -One of the most common causes of neurocognitive disorder -The particular skills that are impaired differs from person to person -1.5% of people 70 to 75 and increases to 15% of people 80 and older -The risk for men is slightly higher than among women -The onset of vascular dementia is typically sudden

Rett disorder

-Progressive neurodevelopmental disorder featuring constant hand-wringing, intellectual disability, and impaired motor skills -Affects mostly females

Delirium - prevention

-Proper medical care for illness and therapeutic drug monitoring -Structured multidisciplinary interventions that target the prevention of delirium during hospital stays in older patients - re-orientating the patient, providing vision and hearing aids as needed, increasing sleep and physical activity, maintaining proper hydration and nutrition, involving the patient in therapeutic activities, and reducing dosages of psychoactive drugs - however, these programs require a lot of resources from hospitals to put into place consistently

Naturalistic teaching strategies

-Psychosocial treatment for children with ASD -Instructional techniques that are used with children having neurodevelopmental disorders and that move away from traditional desk instruction toward more natural social interactions

Discrimination training

-Psychosocial treatment for children with ASD -Reinforce the child with food and praise for making any sound while watching the teacher, After the child masters that step, reinforce the child only if she made a sound after the teacher made a request -Once the child reliably makes sounds after the teacher's request, the teacher uses shaping to reinforce only approximations of the requested sound

Delirium

-Rapid-onset reduced clarity of consciousness and cognition, with confusion, disorientation, and deficits in memory and language. -Present in approximately 20% of older adults who are admitted into acute care facilities such as emergency rooms. -Most prevalent among older adults, people undergoing medical procedures, cancer patients, and people with acquired immune deficiency syndrome (AIDS). -The effects of delirium may be more lasting than once thought - some continue to have problems on and off and some even lapse into a coma and may die. -Many medical conditions that impair brain functions have been linked to delirium, including intoxication by drugs and poisons; withdrawal from drugs such as alcohol and sedative, hypnotic, and anxiolytic drugs, infections, head injury, and various other types of brain trauma.

Pick's disease

-Rare neurological disorder that results in presenile dementia -A frontotemporal neurocognitive disorder -Produces symptoms similar to Alzheimer's disease -Believed to last for five to ten years and has a genetic component -Usually occurs relatively early in life - during a persons 40s or 50s - therefore considered an example of early onset neurocognitive disorder

Neurocognitive disease due to prion disease

-Rare progressive neurodegenerative disorder caused by prions, proteins that can reproduce themselves and cause damage to brain cells -There is no known treatment (can not be destroyed by chemical radiation - thought to have no DNA or RNA and the course of this disorder is always fatal -Prisons are not contagious in humans and have only been contracted through cannibalism or accidental inoculations (blood transfusions from an infected person)

Phenylketonuria (PKU)

-Recessive gene disorder involving the inability to break down a food chemical whose buildup causes intellectual disability, seizures, and behavior problems. PKU can be detected by infant screening and prevented by a specialized diet.

True or False: Factors such as socioeconomic status, cultural expectations, parental interactions and expectations, and child management practices, together with existing neurological deficits and types of support provided in the school, seem to determine the outcome of children with specific learning disorder.

-True -Psychological and motivational factors!

Attention-deficit/hyperactivity disorder (ADHD) - biological intervention

-Reduce the child's impulsivity and hyperactivity and improve their attention skills -The first types of medication used were stimulants (methylphenidate (ritalin, adderall) (most clinicians recommend them temporarily in combination with psychosocial interventions) (there are now concerns about their potential abuse - a lot of college kids abuse them) -Several non-stimulants were also used such as atomoxetine (strattera), guanfacine (tenex), and chlonidine -Antidepressants (imipramine) and a drug used for treating high blood pressure (clonidine) may have similar effects as atomoxetine -Currently, the use of drug treatment tends to be trail and error -Some portions of children do not respond to medications. In addition, most children who fo not respond only show improvement in ability to focus their attention but not show gains in the improvement areas of academics and social skills. In addition, the medications often result in unpleasant side effects, such as insomnia, drowsiness, or irritability

Echolalia

-Repeating the speech of others

Specific learning disorder - treatment

-Requires educational intervention (biological (drug) treatment is typically restricted to those individuals who may also have comorbid ADHD) -Educational efforts can be broadly categorized into - specific skills instruction (including instruction on vocabulary, finding the main idea, and finding facts in readings) and strategy instruction (efforts to improve cognitive skills through decision making and critical thinking) -Direct Instruction program - Systematic instruction and teaching for mastery. Children are constantly assessed, and plans are modified based on progress. -Behavioral interventions can change the way the brain works and we can use such interventions to help individuals with problems -brains start to function in ways similar to the brains of their peers

Neurocognitive disorders - causes

-Several medical conditions -Abuse of drugs or alcohol that produce negative changes in cognitive functioning -Infection -Depression -Stroke (destroys bloos vessels) -Syphilis and HIV -Severe head injury -Introduction of certain toxic or poisonous substances -Diseases such as Parkinson's, Huntington's, and Alzheimer's.

Delirium - treatment

-The first step is addressing the underlying causes. For example, delirium brought on by withdrawal from alcohol or other drugs is usually treated with haloperidol or other antipsychotic medications. Infections, brain injury, and tumors are given the appropriate medical intervention, which often then resolves the accompanying delirium. The antipsychotic drugs haloperidol or olanzapine are also prescribed for individuals in acute delirium when the cause is unknown. -First line of treatment is psychosocial intervention. Goal is to reassure the individual to help him or her deal with agitation, anxiety, and hallucinations of delirium. Inclusion of a family member may be of great comfort for the patient. Personal belongs such as photographs may also be comforting. A patient who is included in treatment decisions retains a sense of control that can aid in the patient's ability to cope with anxiety and agitation. Some evidence suggest that this type of support can also delay institutionalization for elderly patients.

Psychopharamacogentics

-The study of how your genetic makeup influences your response to certain drugs -The hope for this field is that medications can be matched or even "designed" for individuals to better complement their specific needs

Neurocognitive disorder - psychosocial treatments

-These types of treatments may be able to delay the onset of severe cognitive decline -Focus on enhancing the lives of people with neurocognitive disorder, as well as those of their families -Individuals can be taught skills to compensate for their lost abilities -"Memory wallets" - white index cards that have declarative statements helping the individual carry a conversation (i.e. "My husband John and I have three children.") -Tablets and phones can now be programmed to "speak" for the person -Cognitive stimulation - word games, tests of memory of faces, and practice with numbers (may delay onset) -Exercise (can help with depression) -Instruction for caregivers on how to handle behavior problems -"Smart home" - can monitor the location of the patient and warn caregivers if they are in a dangerous situation (ethical concerns are being raised - invades privacy) -Teaching communication skills in a manner similar to programs for persons with autism spectrum disorder may reduce aggressive behaviors -Assertiveness training for caregivers - we do not want elder abuse -Supportive counseling -Early on caregivers need basic information on the causes and treatment of neurocognitive disorder, financial and legal issues, and locating help for the patient and family. -As the disorder progresses caregivers will need help managing behavioral difficulties (wandering away or violent outbursts) and developing effective ways to communicate with the patient. Clinicians also assist the family with decisions about hospitalizations and, finally, help them adjust during bereavement.

True and False: Current thinking in ADHD treatment points to using parent-and/or teacher-delivered behavioral interventions for young children before attempting medication

-True

True or False: Although delirium and neurocognitive disorder can occur together, neurocognitive disorder has a gradual progression as opposed to delirium's acute onset; people with neurocognitive disorder are not disoriented or confused in the early stages, unlike people with delirium.

-True

True or False: As many as 50% to 70% of chronic alcohol users show cognitive impairment, and 7% of those with an alcohol use disorder also meet criteria for a neurocognitive disorder.

-True

True or False: Behavioral interventions for safety training, substance-use treatment and prevention, and behavioral medicine are examples of crucial roles played by psychologists in helping to prevent certain developmental disorders.

-True

True or False: Common side effects of neurocognitive disorders are delusions (irrational beliefs), depression, agitation, aggression, and apathy.

-True

True or False: Girls with ADHD are more likely than boys to have the inattentive subtype and are less likely to have symptoms of hyperactivity, opposition, and other disruptive behaviors.

-True

True or False: Neurocogntiive disorders - A person can remember how to talk and may remember events from many years ago but will have trouble remembering what happened in the past hour.

-True

True or False: The child develops one skill before acquiring the next, and subsequent skills often build upon one another.

-True

Down syndrome

-Type of intellectual disability caused by a chromosomal aberration (chromosome 21) and involving characteristic physical appearance. Sometimes known as trisomy 21. -Characteristic facial features - folds in the corners of their upwardly slanting eyes, a flat nose, a small mouth with a flat roof that makes the tongue protrude somewhat. -Tend to have congenital heart malfunctions -Adults with down syndrome also have a greatly increased risk of dementia of the Alzheimer's type - also occurs earlier than usual (sometimes in their early 20s) -As the age of the mother increases, so does her chance of having a child with Down syndrome -However, more children with Down syndrome are born to younger mothers simply because younger mothers have more children.

Prosody

-Vocal characteristics such as tone and stress; people with autism spectrum disorder often have trouble recognizing and interpreting these vocal cues

Pervasive developmental disorders - not otherwise specified

-Wide-ranging, significant, and long-lasting dysfunctions that appear before the age of 18

Neurocognitive disorder - treatment in general

-With extensive brain damage, no known treatment can restore lost abilities -The goals of treatment are - trying to prevent certain conditions, such as substance abuse or strokes, that may bring on neurocognitive disorder, trying to delay the onset of symptoms to provide better quality of life, and attempting to help these individuals and their caregivers cope with advancing deterioration -More than 60% of caregivers of people with neurocognitive disorder - usually relatives - have the symptoms characteristic of one or more anxiety disorders and/or clinical depression. Compared to the public, these caregivers use more psychotropic medications and report stress symptoms at three times the normal rate - this stress may place the caregiver at an increased risk for developing neurocognitive disorder themself

Lesch-Nyhan syndrome

-X-linked gene disorder characterized by intellectual disability, signs of cerebral palsy, and self-injurious behavior -Only males are affected