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Neurodevelopmental disorders

Last updated: June 24, 2021

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Neurodevelopmental disorders are a class of psychiatric disorders characterized by childhood-onset, potentially lifelong deficits resulting in the impairment of personal, social, academic, and occupational function. The specific causes of neurodevelopmental disorders are unknown but assumed to be multifactorial, with certain associations having been established (e.g., fragile X syndrome, tuberous sclerosis, Rett syndrome, epilepsy, low birth weight).

Intellectual disability is characterized by impaired mental abilities (e.g., abstract thinking, academic learning, problem solving) that cause impairments in adaptive functioning (e.g., communication, independent living). Global developmental delay is defined as a significant delay in ≥ 2 of the major developmental domains (gross motor, fine motor, language, cognition, and social milestones) in children < 5 years of age. Childhood-onset fluency disorder (stuttering) is characterized by disturbances in the normal fluency of speech that manifests with sound and syllable repetition, sound prolongation, and broken words. Specific learning disorders are characterized by persistent impairment in a specific function, i.e., reading, written expression, or maths. The disorder typically manifests in the first few years of schooling and results in poor academic performance in the corresponding discipline.

Other neurodevelopmental disorders, including autism spectrum disorder and attention deficit hyperactivity disorder, are discussed in separate articles.

For information regarding neurodevelopmental motor disorders, including stereotypical movement disorder, and tic disorders (Tourette syndrome, persistent motor tic disorders, persistent vocal tic disorder, and sporadic transient tic disorder), see “Tourette syndrome.”

References: [1][3][4]

References:[5][6]

  • Definition: : A condition characterized by disturbances in the normal fluency of speech with onset in the early developmental period.
  • Prevalence: 5–10% of preschool children [7]
  • Clinical features
    • Onset of symptoms typically between age 2–7 years
    • Sound and syllable repetition
    • Sound prolongation of letters
    • Repetition of monosyllabic words
    • Broken words and speech blocking
    • Substitution of words to avoid problematic words
    • Secondary maladaptive behavior (e.g., word avoidance, mannerisms, avoidance of speaking) may develop in some patients
  • Diagnostic criteria (DSM-5)
    • Persistent disturbances in the normal fluency of speech
    • Stuttering results in anxiety related to speaking, impaired social participation, and/or poor academic performance in childhood
    • Not attributable to sensory impairment or speech-motor deficit, or other medical condition (e.g., stroke, CNS trauma)
  • Management [7]
    • Spontaneous resolution in 65–85% of preschool children with disfluency by the age of 7 years
    • Speech therapy for severe or persistent cases
      • Develop compensatory techniques to improve fluency
      • Treat maladaptive behavior
  • Definition
    • A neurodevelopmental disorder that occurs due to a combination of genetic, epigenetic, and environmental factors and results in difficulties learning and applying specific academic skills
    • Features should be present for more than 6 months despite academic interventions to address these problems.
  • Prevalence: 5–15% in the school-age population [3]
  • Clinical features
    • Inability to acquire age-appropriate academic skills, such as reading (most common), spelling, writing, operations with numbers,or mathematical reasoning
    • General cognitive abilities (e.g., reasoning, abstract thinking) are normal (in contrast to intellectual disability)
  • Management
    • Academic support (e.g., individualized learning programs)
    • Regular school psychology consultations
    • Individual or family psychotherapy
    • Extracurricular activities to improve academic and social inclusion

References: [3]

  1. Vasudevan P, Suri M. A clinical approach to developmental delay and intellectual disability. Clin Med (Northfield Il). 2017; 17 (6): p.558-561. doi: 10.7861/clinmedicine.17-6-558 . | Open in Read by QxMD
  2. Harrison JN, Cluxton-Keller F, Gross D. Antipsychotic Medication Prescribing Trends in Children and Adolescents. Journal of Pediatric Health Care. 2012; 26 (2): p.139-145. doi: 10.1016/j.pedhc.2011.10.009 . | Open in Read by QxMD
  3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM–5). undefined. 2013 . doi: 10.1176/appi.books.9780890425596 . | Open in Read by QxMD
  4. Marrus N, Hall L. Intellectual Disability and Language Disorder. Child Adolesc Psychiatr Clin N Am. 2017; 26 (3): p.539-554. doi: 10.1016/j.chc.2017.03.001 . | Open in Read by QxMD
  5. Intellectual Disability. http://www.merckmanuals.com/en-ca/professional/pediatrics/learning-and-developmental-disorders/intellectual-disability. Updated: February 1, 2016. Accessed: July 1, 2017.
  6. Thomaidis L, Zantopoulos GZ, Fouzas S, Mantagou L, Bakoula C, Konstantopoulos A. Predictors of severity and outcome of global developmental delay without definitive etiologic yield: a prospective observational study. BMC Pediatr. 2014; 14 (40). doi: 10.1186/1471-2431-14-40 . | Open in Read by QxMD
  7. Sander RW, Osborne CA. Stuttering: Understanding and Treating a Common Disability. American Family Physician. 2019 .