Neurodevelopmental Disorders
What is it?
The neurodevelopmental disorders are a group of conditions with onset in the developmental period. They typically manifest early in development, often before the child enters grade school, and are characterised by developmental deficits that produce impairments of personal, social, academic, or occupational functioning.
Types and Symptoms
Intellectual disability/intellectual developmental disorder is characterised by deficits in general mental abilities, such as reasoning, problem solving, planning, abstract thinking, judgement, academic learning, and learning from experience.
Global developmental day is diagnosed when an individual fails to meet expected developmental milestones in several areas of intellectual functioning.
The communication disorders include language disorder, speech sound disorder, social communication disorder, and childhood onset fluency disorder. The first three disorders are characterised by persistent deficits in development and use of language, speech, and social communication respectively.
Childhood onset fluency disorder is characterised by disturbances of the normal fluency and motor production of speech, including repetitive sounds or syllables, prolongation of consonants or vowel sounds, broken words, blocking, or words produced with an excess of physical tension. They begin early in life and may produce lifelong functional impairments.
Autism spectrum disorder is characterised by persistent deficits in social communication and social interaction across multiple contexts, including deficits in social reciprocity, nonverbal communicative behaviours used for social interaction, and skills in developing, maintaining, and understanding relationships. It also includes deficits in language and communication. There is the presence of restricted repetitive patterns of behaviour, interests or activities there too. Lastly, sensory issues may also be present.
Attention-deficit/hyperactivity disorder is defined by impairing levels of inattention, disorganisation, and/or hyperactivity-impulsivity. Inattention and disorganisation entail inability to stay on task, seeming not to listen, and losing materials, at levels that are inconsistent with age or developmental level. Hyperactivity-impulsivity entails overactivity, fidgeting, inability to stay seated, intruding into other people’s activities, and inability to wait. ADHD often persists into adulthood, with resultant impairments of social, academic and occupational functioning.
The neurodevelopmental motor disorders include developmental coordination disorder, stereotypic movement disorder, and tic disorders.
Developmental coordination disorder is characterised by deficits in the acquisition and execution of coordinated motor skills and is manifested by clumsiness and slowness or inaccuracy of performance of motor skills that cause interference with activities of daily living.
Stereotypic movement disorder is diagnosed when an individual has repetitive, seemingly driven, and apparently purposeless motor behaviours, such as hand flapping, body rocking, head banging, self biting, or hitting.
Tic disorders are characterised by the presence of motor or vocal tics, which are sudden, rapid, recurrent, nonrhythmic, stereotyped motor movements or vocalisations.
Specific learning disorder is diagnosed when there are specific deficits in an individual’s ability to perceive or process information efficiently or accurately. It first manifests during the years of formal schooling and is characterised by persistent and impairing difficulties with learning foundational academic skills in reading, writing, and/or maths.
Causes
While the exact causes of neurodevelopmental disorders are not fully understood, research suggests that a combination of genetic, environmental, and neurological factors contribute to their development. Here are some common factors believed to play a role in the causes of neurodevelopmental disorders :
- Genetic Factors : Genetic abnormalities and variations are often associated with neurodevelopmental disorders. These disorders can run in families, indicating a genetic predisposition. Specific gene mutations or chromosomal abnormalities may increase the risk of developing neurodevelopmental disorders, although the precise genetic mechanisms involved can vary across different conditions.
- Prenatal and Early Childhood Factors : The prenatal period and early childhood are critical for brain development. Various prenatal and early childhood factors can contribute to neurodevelopmental disorders, including:
- Maternal factors : Maternal infections, exposure to toxins or drugs during pregnancy, maternal malnutrition, and maternal stress levels can impact foetal brain development.
- Birth complications : Certain birth complications, such as prematurity, low birth weight, oxygen deprivation, or trauma during birth, can increase the risk of neurodevelopmental disorders.
- Early childhood experiences : Adverse early childhood experiences, including neglect, abuse, trauma, or exposure to environmental toxins, can affect brain development and contribute to the development of neurodevelopmental disorders.
- Neurological Factors : Abnormalities or disruptions in brain structure, connectivity, or functioning can contribute to neurodevelopmental disorders. These abnormalities may arise during early brain development, affecting the formation of neural circuits or the pruning of synapses.
- Environmental Factors : Environmental factors, such as exposure to toxins, pollutants, or certain infections during critical periods of brain development, may increase the risk of neurodevelopmental disorders. Additionally, factors like socioeconomic status, access to healthcare, and educational opportunities can influence the occurrence and severity of these disorders.
- Interactions between Genetic and Environmental Factors : It is increasingly recognized that the causes of neurodevelopmental disorders involve complex interactions between genetic vulnerabilities and environmental influences. Genetic predispositions may increase susceptibility to specific environmental factors, resulting in the manifestation of the disorder.
Treatment
The treatment for neurodevelopmental disorders focuses on managing symptoms, improving functioning, and providing support for individuals with these conditions. Treatment plans are typically tailored to the specific needs and challenges associated with each disorder. Here are some common approaches used in the treatment of neurodevelopmental disorders :
- Early Intervention : Early identification and intervention are crucial for maximising outcomes. Early intervention programs provide a range of services, including therapies, educational support, and parent training. These programs aim to address developmental delays, promote skill development, and support the overall well-being of the child and family.
- Behavioural and Educational Therapies : Behavioural therapies, such as Applied Behavior Analysis (ABA) and Cognitive-Behavioral Therapy (CBT), are often used to address behavioural challenges and teach adaptive skills. These therapies focus on reinforcing positive behaviours, reducing problem behaviours, and teaching social, communication, and self-help skills. Educational interventions, such as special education services and individualised education plans (IEPs), provide tailored support within educational settings.
- Medication : In some cases, medication may be prescribed to manage specific symptoms associated with neurodevelopmental disorders. Medications can help alleviate symptoms such as hyperactivity, impulsivity, aggression, anxiety, or mood instability. Psychiatric medication should be prescribed and monitored by a qualified healthcare professional.
- Speech and Language Therapy : Speech and language therapy is beneficial for individuals with communication difficulties, including language delays, speech articulation issues, or social communication challenges. Speech therapists work on improving communication skills, expressive and receptive language abilities, and social interaction.
- Occupational Therapy : Occupational therapy focuses on improving fine motor skills, sensory processing, self-care abilities, and overall functional skills. Occupational therapists work with individuals to develop strategies for daily living, sensory integration, and motor coordination.
- Social Skills Training : Social skills training aims to improve social interaction, social communication, and interpersonal skills. It helps individuals develop appropriate social behaviours, empathy, perspective-taking, and understanding of social cues. Group therapy or structured social skills programs can be beneficial.
- Parent and Family Support : Providing support and education to parents and families is essential. Parent training programs help caregivers develop effective strategies for managing challenging behaviours, promoting skill development, and accessing necessary resources. Support groups and counselling can also provide emotional support and guidance for families.
- Assistive Technology : Assistive technology, such as communication devices, adaptive tools, or assistive software, can enhance communication, learning, and independent functioning for individuals with neurodevelopmental disorders.
