| Developmental disorder | |
|---|---|
| Classification and external resources | |
| ICD-10 | F80-F84 |
| ICD-9 | 299, 315 |
Developmental disorders occur at some stage in a child's development, often retarding the development. These may include, psychological or physical disorders. The disorder is an impairment in the normal development of motor or cognitive skills that are developed before age 18 in which they are expected to continue indefinitely with. Developmental disorders usually have no cure.[1]
They can be grouped into specific developmental disorder and pervasive developmental disorders.
It is sometimes equated with developmental disability.[2]
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Developmental disorders, specifically psychological disorders, generally emerge during the adolescent years.[3] For anxiety disorders, the average age of showing an anxiety disorder is 11 years.[3] Depression has a median age of 30, but early signs have been found in younger children, especially young girls.[3] This leads to a greater finding of depression in females when they are adults. Schizophrenia is also typically diagnosed during late teens, early adulthood.[3] Some disorders that have been diagnosed in childhood tend to decrease in severity moving into adulthood, disorders such as Tourette’s syndrome for instance.[3] Only about 10% of children with seizures continue to have those seizures when they reach maturity.[3] Mental retardation is usually diagnosed before the age of 18 when individuals are tested to find out if their intelligence is below average in their age group.[4] Learning disabilities are diagnosed when the children are young and just beginning school. Most learning disabilities are found under the age of 9.[5]
Young children with communication disorders may not speak at all, or may have a limited vocabulary for their age.[6] Some children with communication disorders have difficulty understanding simple directions or are unable to name objects.[6] Most children with communication disorders are able to speak by the time they enter school, however, they continue to have problems with communication.[6] School-aged children often have problems understanding and formulating words.[6] Teens may have more difficulty with understanding or expressing abstract ideas.[6] Conduct disorder is usually diagnosed between the ages of 10 and 14.[7] Repeated use of alcohol and illegal drug use are red flags for conduct disorder.[8] Oppositional Defiant Disorder, before puberty, is more common in boys; however, after puberty, it is equally common in boys and girls.[9] Roughly half the children with attention-deficit/hyperactivity disorder (ADHD) have oppositional defiant disorder (ODD).[10]
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[11]. Normal development occurs with a combination of contributions from both the environment and genetics, what varies are te belief of what part each factor has to play in normal development, thus afecting how the abnormalities are caused[12].
One theory that supports environmental causes of developmental disorders is one that 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[13]. 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[14]. Other stress theories suggest that even small stresses can accumulate to result in emotional, behavioral, or social disorders in children[15].
The first diagnosed case of ASD was in 1938 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 3 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.[16]
The cause of ASD is still uncertain. ASD 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.[17]
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. For children between 0 and 36 months with ASD show lack of eye contact, seem to be deaf, lack of social smile, doesn’t like being touched or held, unusual sensory behavior, lack of imitation. For children between 12 and 24 months with ASD show lack of gestures, prefer to be alone, lack of pointing to object to indicate interest, easily frustrated with challenges, and lack of functional play. And finally children between the ages 24 to 36 months with ASD show lack of symbolic play and an unusual interest in certain objects, or moving objects.[18]
There is no cure for ASD and proper treatment depends on the case and what is most struggled with. ASD is like many other disorders where when diagnosed early, can be better treated. Different types of therapy are helpful like vitamin therapy, anti-yeast therapy, music therapy, and physical therapy. Other treatments include auditory training, discrete trial training, facilitated communication, and sensory integration.[19]
Attention deficit disorder and attention deficit hyperactivity disorder are psychiatric disorders that are marked by significant levels of hyperactivity, inattentiveness, and impulsiveness. There are three types of these disorders; inattentive, hyperactive/impulsive, and a combination (inattentive, hyperactive and impulsive).[20]
The different kinds of medicines that can be taken to treat attention deficit (hyperactivity) disorder include central nervous system stimulants, antidepressants, antihypertensives, and selective norepinephrine reuptake inhibitors. Examples of central nervous system stimulants include Ritalin, Concerta, and Metadate (methylphenidate), Adderall (amphetamine and dextroamphetamine mixed salts) and Dexedrine (dextroamphetamine sulfate). Examples of the antidepressants, antihypertensives, and selective norepinephrine reuptake inhibitors are bupropion, clonidine and atomoxetine, respectively.
Symptoms of ADD/ADHD include inattentiveness, impulsiveness, and hyperactivity. Many of the behaviors that are associated with ADD/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 are afflicted with this disorder exhibit poor interpersonal relationships and struggle to fit in socially with their peers.[21]
Down syndrome is a genetic disorder that results from having an extra copy of Chromosome 21. In humans, a fertilized egg normally has 23 pairs of chromosomes. The development of the body and brain is changed due to this extra copy of Chromosome 21. This is also referred to as trisomy 21 because there are three copies of Chromosome 21 in these individuals. In 1866, John Langdon Down and Edouard Seguin published work that described many of the symptoms related to this condition. In 1959, Dr. Jerome Lejeune discovered that the disorder was linked to an extra chromosome 21. One next year, Paul Polani observed a case of Down syndrome that was caused by alteration of material from the 15 and 21 chromosomes. The US-based national Birth Defects Precention Network analyzed that the prevalence of Down syndrome is 1 in every 732 live birth. Evidence shows that 80% of trisomy 21 pregnancies end in miscarriages. [22]
The main cause of Down syndrome is non-disjunction during the meiosis process. Down syndrome can also be caused by Mosaicism and translocation of genetic material between chromosome 21 and another chromosome. Mosaicism is the cause of roughly 1% of cases. It is the result of errors in mitosis after fertilization. Translocation is the cause of about 4% of cases and can be transferred from a parent to the child. Studies show that younger mothers of children with Down syndrome that were taking oral contraceptives and smoking cigarettes during the time of conception were more likely to have had meiosis II errors rather than meiosis I. Also, children whose parents have already had a child with Down syndrome are at higher risk of having Down syndrome themselves. [23]
Some physical characteristics include small hands and feet, a flat face, irregular ear shape, poor muscle tone, and short necks. The majority of people with Down syndrome are in the mild to moderate intellectual disability range. The IQ scores of individuals with down syndrome spans between 40 and 70. Verbal tasks are more difficult for individuals with Down syndrome. Academic performance is impacted due to poor problem-solving skills. Language developmental delays are common in individuals with Down syndrome. Although these individuals face the challenge of expressive language development, they tend to show more competence with non-verbal communication skills. They may also have slow motor skills. [24]
There is no cure for Down syndrome. In the late 1960s, it was common for parents to institutionalize a child with Down syndrome. Since the mid 1970s, children with Down syndrome were provided and guaranteed a public education. Intervention should occur at a young age in order to for the individuals with Down syndrome to lead healthy, productive lives. This disorder has some risks that include developing early-onset Alzheimer's disease. Between 5-10% of children with Down syndrome meet the criteria for autism as well.[25]
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