Neurodevelopmental disorder
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Neurodevelopmental disorder | |
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Specialty | Psychiatry, neurology |
Neurodevelopmental disorders are a group of conditions that begin to emerge during childhood (or the development of the nervous system). According to the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) published in 2013, these conditions generally appear in early childhood, usually before children start school, and can persist into adulthood.[1] The key characteristic of all these disorders is that they negatively impact a person's functioning in one or more domains of life (personal, social, academic, occupational) depending on the disorder and deficits it has caused. All of these disorders and their levels of impairment exist on a spectrum, and affected individuals can experience varying degrees of symptoms and deficits, despite having the same diagnosis.[1][2]
The DSM-5 classifies neurodevelopmental disorders into six overarching groups.
- Intellectual disability (Intellectual Development Disorder)
- Communication disorders
- Autism spectrum disorder (ASD)
- Attention-deficit/hyperactivity disorder (ADHD)
- Neurodevelopmental motor disorders
- Specific learning disorders
These disorders are commonly comorbid conditions, meaning that a person affected by one of these disorders will usually meet criteria for a second disorder.[1][2]
Classification
Intellectual disability (intellectual development disorder)
Intellectual disabilities (IDs), or intellectual development disorder, are defined by the DSM-5 as "deficits in general mental abilities".[1] They affect a person's ability to process information, learn or retain information, think critically or abstractly, and solve problems. They ultimately inhibit a person's ability to adapt to their surroundings, to the extent that individuals may fail to meet milestones of independent functioning or social responsibility in one or more activities of daily living.[1] Global developmental delay (GDD) is categorized under intellectual disability and "is diagnosed when an individual fails to meet expected developmental milestones in several areas of intellectual functioning."[1]
Communication disorders
Autism spectrum disorder (ASD)
Autism spectrum disorder (ASD)
Attention-deficit/hyperactivity disorder (ADHD)
Attention deficit hyperactivity disorder (ADHD)
Neurodevelopmental motor disorders
Specific learning disorders
Currently being researched
There are neurodevelopmental research projects examining potential new classifications of disorders including:
- Nonverbal learning disorder (NLD or NVLD), a neurodevelopmental disorder thought to be linked to white matter in the right hemisphere of the brain and generally considered to include (a) low visuospatial intelligence; (b) discrepancy between verbal and visuospatial intelligence; (c) visuoconstructive and fine-motor coordination skills; (d) visuospatial memory tasks; (e) reading better than mathematical achievement; and (f) socioemotional skills.[3][4][5] While Nonverbal learning disorder is not categorized in the ICD or DSM as an discrete classification, "the majority of researchers and clinicians agree that the profile of NLD clearly exists (but see Spreen, 2011, for an exception[6]), but they disagree on the need for a specific clinical category and on the criteria for its identification."[7]
Presentation
Consequences
The multitude of neurodevelopmental disorders span a wide range of associated symptoms and severity, resulting in different degrees of mental, emotional, physical, and economic consequences for individuals, and in turn families, social groups, and society.[8]
Causes
The
Social deprivation
Deprivation from social and emotional care causes severe delays in brain and cognitive development.
Genetic disorders
A prominent example of a genetically determined neurodevelopmental disorder is
Less commonly known genetically determined neurodevelopmental disorders include Fragile X syndrome. Fragile X syndrome was first described in 1943 by Martin and Bell, studying persons with family history of sex-linked "mental defects".[15] Rett syndrome, another X-linked disorder, produces severe functional limitations.[16] Williams syndrome is caused by small deletions of genetic material from chromosome 7.[17] The most common recurrent Copy Number Variant disorder is
Immune dysfunction
Immune reactions during pregnancy, both maternal and of the developing child, may produce neurodevelopmental disorders. One typical immune reaction in infants and children is PANDAS,[19] or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection.[20] Another disorder is Sydenham's chorea, which results in more abnormal movements of the body and fewer psychological sequellae. Both are immune reactions against brain tissue that follow infection by Streptococcus bacteria. Susceptibility to these immune diseases may be genetically determined,[21] so sometimes several family members may have one or both of them following an epidemic of Strep infection.[citation needed]
Infectious diseases
Systemic infections can result in neurodevelopmental consequences, when they occur in infancy and childhood of humans, but would not be called a primary neurodevelopmental disorder. For example HIV[22] Infections of the head and brain, like brain abscesses, meningitis or encephalitis have a high risk of causing neurodevelopmental problems and eventually a disorder. For example, measles can progress to subacute sclerosing panencephalitis.
A number of
Some cases of schizophrenia may be related to congenital infections, though the majority are of unknown causes.[23]
Metabolic disorders
In a child,
A non-diabetic fetus can also be subjected to glucose effects if its mother has undetected gestational diabetes. Maternal diabetes causes excessive birth size, making it harder for the infant to pass through the birth canal without injury or it can directly produce early neurodevelopmental deficits. Usually the neurodevelopmental symptoms will decrease in later childhood.[27]
Phenylketonuria, also known as PKU, can induce neurodevelopmental problems and children with PKU require a strict diet to prevent intellectual disability and other disorders. In the maternal form of PKU, excessive maternal phenylalanine can be absorbed by the fetus even if the fetus has not inherited the disease. This can produce intellectual disability and other disorders.[28][29]
Nutrition
Excesses in both maternal and infant diets may cause disorders as well, with foods or
Physical trauma
Brain trauma in the developing human is a common cause (over 400,000 injuries per year in the US alone, without clear information as to how many produce developmental sequellae)
Placenta
Although it not clear yet as strong is the correlation between placenta and brain, a growing number of studies are linking placenta to fetal brain development.[39]
Diagnosis
Neurodevelopmental disorders are diagnosed by evaluating the presence of characteristic symptoms or behaviors in a child, typically after a parent, guardian, teacher, or other responsible adult has raised concerns to a doctor.[40]
Neurodevelopmental disorders may also be confirmed by
Management
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See also
- Developmental disability
- Epigenetics
- Microcephaly
- Teratology
- TRPM3-related neurodevelopmental disorders
References
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- ^ "Folate (Folacin, Folic Acid)". Ohio State University Extension. Archived from the original on 2021-08-26. Retrieved 2008-08-06.
- ^ "Folic scid: topic home". Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. Archived from the original on 2021-08-26. Retrieved 2008-08-02.
- ^ "The basics about spina bifida". Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. Archived from the original on 2021-08-26. Retrieved 2008-08-02.
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- ^ Fetal alcohol syndrome: guidelines for referral and diagnosis (PDF). Archived 2009-04-23 at the Wayback Machine CDC (July 2004). Retrieved on 2007-04-11
- ^ "Facts About TBI" (PDF). U.S. Centers for Disease Control and Prevention. Archived from the original on 2021-08-26. Retrieved 2008-08-06.
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- ^ Neurodevelopmental Disorders (PDF), America's Children and the Environment (3 ed.), EPA, August 2017, p. 12, archived (PDF) from the original on 2021-07-20, retrieved 2019-07-10
Further reading
- ISBN 978-0-262-20116-2.
- Brooks DR, Fleischhacker WW (2006). Neurodevelopmental Disorders. Berlin: Springer. ISBN 978-3-211-26291-7.
External links
- Neurodevelopmental Disorders at Curlie
- A Review of Neurodevelopmental Disorders – Medscape review