T13: Abnormal Behavior in Childhood and Adolescence

• Echolalia which involves in repeating the speech of others, was once thought to be a sign of autism spectrum disorder.
• Attention-Deficit/Hyperactivity Disorder (ADHD) is a condition characterized by a pattern of inattention, such as being disorganized or forgetful about school or work-related tasks, or of hyperactivity and impulsivity. These deficits can significantly disrupt academic efforts, as well as social relationships.
• Oppositional Defiant Disorder (ODD) is a DSM-5 disorder that includes behaviors such as “often loses temper”, “argues with adults”, “often deliberately annoys people”, “touchy and easily annoyed by others”, and “often spiteful and vindictive.”
• Conduct disorder can be a precursor to antisocial personality disorder—is also observed in many children with ADHD.
• Bipolar disorder is one of the mood disorders—also overlaps significantly with ADHD. This overlap can complicate diagnosis in these children.
• Methylphenidate (Ritalin) is one of the most common medical treatments for ADHD that inhibits this gene and increases the amount of dopamine available.
• Specific learning disorder, which is defined as a significant discrepancy between a person’s academic achievement and what would be expected for someone of the same age—referred to by some as “unexpected underachievement". To meet the criteria of diagnosis, a person’s disability should not be caused by a sensory difficulty, such as trouble with sight or hearing, and should not be the result of poor or absent instruction.
• Dyslexia is a difficulty of decoding single words or word recognition.
• Three areas of the left hemisphere appear to be involved in problems with dyslexia (word recognition)— Broca’s area (which affects articulation and word analysis), an area in the left parietotemporal area (which affects word analysis), and an area in the left occipitotemporal area (which affects recognizing word form)
• A different area in the left hemisphere which is Intraparietal sulcus seems to be critical for the development of a sense of numbers and is implicated in mathematics disorder.
• Autism spectrum disorder (ASD) is a neurodevelopmental disorder that, at its core, affects how one perceives and socializes with others.
• Rett disorder, a genetic condition that affects mostly females, is diagnosed as ASD with the qualifier “associated with MeCP2 mutation” (the gene involved).
• Social (Pragmatic) Communication Disorder is a condition in which there is a difficulties in social communication seen in ASD, but without restricted, repetitive patterns of behavior. These individuals do not easily learn the social rules when communicating with others (e.g., interrupting, talking too loudly, not listening to others).
• Three aspects to meet the diagnosis of ASD:

  1. Problems with social reciprocity.
  2. Deficits in nonverbal communication.
  3. Problems maintaining social relationship.
• Intellectual disability (ID) previously known as "mental retardation" is a disorder evident in childhood as significantly below-average intellectual and adaptive functioning. People with ID experience difficulties with day-to-day activities to an extent that reflects both the severity of their cognitive deficits and the type and amount of assistance they receive.
• DSM-5 identifies ID difficulties in three domains:

  1. Conceptual (e.g., skill deficits in areas such as language, reasoning, knowledge, and memory).
  2. Social (e.g., problems with social judgment and the ability to make and retain friendships).
  3. Practical (e.g., difficulties managing personal care or job responsibilities).
• De Novo Disorder is a condition in which there is a genetic mutation occurring in the sperm or egg or after fertilization which is also present in those children with ID of unknown origin.
• Phenylketonuria (PKU) is a recessive disorder characterized by an inability to break down a chemical in our diets called phenylalanine. The majority of people with this disorder had ID.
• Lesch-Nyhan syndrome, an X-linked disorder, in which only males are affected is characterized by ID, signs of cerebral palsy (spasticity or tightening of the muscles), and self-injurious behavior, including finger and lip biting.
• Down syndrome, the most common chromosomal form of ID, was first identified by the British physician Langdon Down in 1866. It is caused by the presence of an extra 21st chromosome and is therefore sometimes referred to as trisomy 21.
• It has been possible to detect the presence of Down syndrome—but not the degree of ID— through amniocentesis, a procedure that involves removing and testing a sample of the fluid that surrounds the fetus in the amniotic sac, and through chorionic villus sampling (CVS) in which a small piece of placenta tissue is removed and tested.
• Fragile X Syndrome is a second common chromosomally related cause of ID. It is caused by an abnormality on the X chromosome, a mutation that makes the tip of the chromosome look as though it were hanging from a thread, giving it the appearance of fragility. It primarily affects males.
• Cultural–familial intellectual disability, people with these characteristics are thought to have cognitive impairments that result from a combination of psychosocial and biological influences, although the specific mechanisms that lead to this type of intellectual disability are not yet understood.
• Impulse Control Disorder is a condition in which a person experiences increasing tension leading up to the act and, sometimes, pleasurable anticipation of acting on the impulse.
• Three Impulse Control Disorders:

  • Intermittent Explosive Disorder
  • Kleptomania
  • Pyromania
• Intermittent explosive disorder has episodes in which they act on aggressive impulses that result in serious assaults or destruction of property.
• Kleptomania is a condition in which there is a recurrent failure to resist urges to steal things that are not needed for personal use or their monetary value. It usually occurs when person begins to feel a sense of tension just before stealing, which is followed by feelings of pleasure or relief while the theft is committed.
• Pyromania is an impulse-control disorder that involves having an irresistible urge to set fires. The person feels a tension or arousal before setting a fire and a sense of gratification or relief while the fire burns.