The brain and the nervous system are the largest sources of impairment among
people suffering from neurodevelopmental disorders. Children with ADD/ADHD,
autism, learning disabilities, cerebral palsy, conduct problems, intellectual
disability (which is often known as mental retardation), and vision and
hearing impairments belong to the group of neurodevelopmental diseases.
Neurodevelopmentally affected children often have problems with behavior,
memory, learning, speech and language, motor capacities, or other brain
functions. Some of the neurodevelopmental disorders are lifelong, but with an
increasing age kid’s symptoms and behavioral patterns are frequently changed
or altered. These diseases often pose a difficult diagnostic and treatment
challenge, the approach usually being a combination of medications,
professional counseling, school- and home-based interventions.
The neurodevelopmental disorders have a few features in common. Those are:
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An onset that is invariably during infancy or childhood;
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An impairment or delay in the development of functions that are strongly
related to biological maturation of the central nervous system; and
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A steady course that does not involve the remissions and relapses that
tend to be characteristic of many mental disorders.
Generally, the dysfunctions concerned are expressively language, visuo-spatial
skills or/and motor coordination. This development is typically associated
with the worsening of the condition as days go by. Generally, the history is
that of a delay or impairment which was already present as far back as when it
could be reliably detected in the pediatrician and the child experienced no
prior period of normal development. The prevalence of the majority of these
malaises in male children is significantly higher compared to female ones.
It is characteristic of developmental disorders that a family of similar or
related disorders is common, and there is presumptive evidence that genetic
factors play an important role in the aetiology of many cases. Environmental
factors often influence the developmental functions affected but in most cases
they are not of paramount influence. However, although there is generally good
agreement on the overall conceptualization of disorders, the etiology in most
cases is unknown and there is continuing uncertainty regarding both the
boundaries and the precise subdivisions of developmental disorders.
Moreover, two types of conditions are included in this block that do not
entirely meet the broad conceptual definition outlined above. First, there are
disorders in which there has been an undoubted phase of prior normal
development, such as the childhood disintegrative disorder, the
Landau-Kleffner syndrome, and some cases of autism. These conditions are
included because, although their onset is different, their characteristics and
course have many similarities with the group of developmental disorders;
moreover it is not known whether or not they are etiologically distinct.
Second, there are disorders that are defined primarily in terms of deviance
rather than delay in developmental functioning; this applies especially in
autism. Furthermore, there is overlap with other developmental disorders in
terms of both the features of individual cases and familial clustering.
A lot of neurodevelopmental issues are driven by genetics, and some cases of
illnesse, for instance, intellectual disability, are linked to a certain
genes. Instead of having just one single, obvious cause, the source of
neurodevelopmental diseases is mostly complex and they consist of many diverse
contributing factors. It is probably a blend of genetic, biochemical,
psychological factors and environment risk factors that account for these
diseases. Not only individual exposure to harmful maternal substance use of
drugs, alcohol and tobacco, lower socioeconomic status, preterm birth, low
birthweight, the physical environment, and prenatal or childhood exposure to
specific environmental contaminants can affect neurodevelopment, but also
these contributory environmental factors.
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Attention Deficit Hyperactivity Disorder (ADHD)
The disorder referred to as
Attention Deficit Hyperactivity Disorder
(ADHD) is characterized by high level hyperactivity-impulsivity and/or
inattention observed across different situations and are most often, and
weightier than that experienced by other people in the same developmental
phase. Specific studies have shown that ADHD has a negative impact on an
academic success, and presents a barrier to career progress as well as to
personal relations with peers and family members.
The term of the disorder has transformed over the course of time as the
medical specialists have deepened their knowledge on ADHD. The phrase
"Attention Deficit Disorder" was first used by the American Psychiatric
Association during 1980s, and it was changed to "Attention
Deficit/Hyperactivity Disorder" in 1987. Some children with ADHD exhibit only
hyperactivity or impulsivity, while others may exhibit mainly inattentive
characteristics, but in general, the majority of children with ADHD reveal a
mixed pattern of hyperactivity/impulsivity and inattentional behavior. The
main ADHD symptoms a person can experience may differ at some time. Parents
report that about 60% of their ADHD children have a learning disorder, and the
same number show conduct disorder. It is very common for children with
ADHD
to have co-existing conditions.
Signs and symptoms of other diseases might mimic those of ADHD, such as
reported for
anxiety disorder
attacks every year. The numbers have experienced a , depression, and learning
difficulties. Similar to the diagnosis of other mental diseases, an ADHD
diagnosis involves some degree of clinical judgment on the part of the
physician. ADHD has strong clinical validity, which means that affected
children share similarities, exhibit symptoms, respond to treatment, and are
generally consistently identified by clinicians despite the heterogeneity
among children diagnosed with the illness and the difficulties involved in
diagnosis.
While several researches on ADHD have focused on the brain activity parts
associated with the behaviors typical for the disease, the same number of
studies starting from a different perspective of brain activity are needed.
Though these findings do not provide a definite answer, the last research has
confirmed that children with ADHD more likely than average have problems with
the certain practical skills (together known as executive function),
especially those related to planning ahead and to monitoring and regulating
their own behavior. These skills comprise of response inhibition one s
capacity to suppress automatic reactions in circumstances where they are not
required, working memory characterized by the maintenance of information in
the working space while at the same time focusing on a different task,
planning which is an ability to arrange a series of action in order to achieve
a particular goal (target), and cognitive flexibility which is one s capacity
to adapt a strategy or plan when circumstances change.
The attention regulation problem, which includes hyperactive behavior, is also
among the primary symptoms, children with ADHD typically experience. The
symptoms include difficulties with vigilance or paying attention to a task for
an extended time and alertness, or being ready to respond to new tides of
information..
These factors are sometimes even more complicated then that; we have
literatures that suggests that the combination of both environmental and
genetic ones may contribute to ADHD. A sort of study of the prenatal
conditions, one of the most studied environmental factors, lies at the bottom
of environmental factors research. A substantial number of investigations have
led to the given reason that baby s ADHD symptoms may have been affected if
the mother is smoking during pregnancy. On the other hand, these lines of
study do not yet conclude, as scientists assume that whether other
smoking-related factors, including but not limited to genetics, maternal
mental health, stress, use alcohol and those births with low birthweight, have
something to do with the mentioned association or not, is another study.
Pregnant women s alcohol intake and ADHD are found to be a possible gap in
research production, this being less substantial and clear. On the other hand,
it has emerged that low birth weight and premature birth increased ADHD risk
at school.
Learning Disability
Learning disability (LD) is a general term which covers a neurological
disorder that produces the complex interaction between the child’s brain to
the external stimuli via the receiving, processing, retaining, and responding
to information. The child with a learning disability will probably find it
hard to learn the needed skills like reading, writing, listening, speaking,
thinking and mathematics. However, children’s learning disabilities differ and
one might be able to learn some skills better than others. The majority of
kids with disabilities in learning normally they have the general or extra
normal intelligence, but there are differences in the brain processing the
information.
In most cases, the functions affected include language, visuo-spatial skills
and/or motor coordination. It is characteristic for the impairments to lessen
progressively as children grow older (although milder deficits often remain in
adult life). Usually, the history is of a delay or impairment that has been
present from as early as it could be reliably detected, with no prior period
of normal development. Most of these conditions are several times more common
in boys than in girls.
People may get as many as the neurodevelopment pathologies as learning
disabilities is not well understood. Genetically, it is not surprising that
such an individual might come to be a student of the same school, as
family-history may be a factor in the development of disabilities. Maternal
troubles during pregnancy and at the time of birth, for instance, the drug or
alcohol consumption of expectant mother, or low weight of the baby, lack of
oxygen at the time of delivery, or pre-term or prolonged labor, may be leading
to neurodevelopment abnormalities.
As can be seen that other neurodevelopmental outcomes to have more than
studies related to learning disabilities so as compared to other pollutants.
It has been reported in several works that children who have been affected by
lead exposure either in learning difficulties of the classroom, while they are
of the IQ. Lead exposures have led towards the reduced capability of retaining
and retrieving memory, limited rule learning, following directions, planning,
speech processing as well as verbal abilities, impairments in the classroom
performance of children. Several other reports document linkages between
environmental pollutants and learning disabilities for example; a specific
research that found a relation between maternal smoking, childhood exposure to
secondhand smoke and learning disability diagnoses among the children reported
that; also, associations of mercury exposure to language problems among
children and inability to memorize and links of PCB exposure to poorer
performance in babies than non-exposed babies.
Autism Spectrum Disorders
Autism spectrum disorders
(ASDs) are a group of developmental disabilities defined by significant
social, communication, and behavioral impairments. The term “spectrum
disorders” refers to the fact that although people with ASDs share some common
symptoms, ASDs affect different people in different ways, with some
experiencing very mild symptoms and others experiencing severe symptoms. ASDs
encompass autistic disorder and the generally less severe forms, Asperger’s
syndrome and pervasive developmental disorder-not otherwise specified
(PDD-NOS). Children with ASDs may lack interest in other people, have trouble
showing or talking about feelings, and avoid or resist physical contact. A
range of communication problems are seen in children with ASDs: some speak
very well, while many children with an ASD do not speak at all. Another
hallmark characteristic of ASDs is the demonstration of restrictive or
repetitive interests or behaviors, such as lining up toys, flapping hands,
rocking his or her body, or spinning in circles.
This group of disorders is characterized by qualitative abnormalities in
reciprocal social interactions and in patterns of communication, and by
restricted, stereotyped, repetitive repertoire of interests and activities.
These qualitative abnormalities are a pervasive feature of the individual’s
functioning in all situations, although they may vary in degree. In most
cases, development is abnormal from infancy and, with only a few exceptions,
the conditions become manifest during the first 5 years of life. It is usual,
but not invariable, for there to be some degree of general cognitive
impairment but the disorders are defined in terms of behavior that is deviant
in relation to mental age.
These pervasive developmental disorders can be further classified into
childhood autism, atypical autism, rett’s syndrome and asperger’s syndrome.
Childhood autism is a pervasive developmental disorder defined by the presence
of abnormal and/or impaired development that is manifest before the age of 3
years, and by the characteristic type of abnormal functioning in all the three
areas of social interaction, communication, and restricted, repetitive
behaviour. This disorder occurs in boys three to four times more often than in
girls
Atypical autism is another pervasive developmental disorder that differs from
autism in terms either of age of onset or of failure to fulfil all three sets
of diagnostic criteria. Thus, abnormal and/or impaired development becomes
manifest for the first time only after the age of 3 years; and/or there are
insufficient demonstrable abnormalities in one or two of the three areas of
psychopathology required for the diagnosis of autism (namely, reciprocal
social interactions, communication, and restrictive, stereotyped, repetitive
behavior) in spite of characteristic abnormalities in other area(s). Atypical
autism arises most often in profoundly retarded individuals whose very low
level of functioning provides little scope for exhibition of the specific
deviant behaviors required for the diagnosis of autism; it also occurs in
individuals with a severe specific developmental disorder of receptive
language.
Rett’s syndrome is a condition of unknown cause, so far reported only in
girls, which has been differentiated on the basis of a characteristic onset,
course, and pattern of symptomatology. Typically, apparently normal or
near-normal early development is followed by partial or complete loss of
acquired hand skills and of speech, together with deceleration in head growth,
usually with an onset between 7 and 24 months of age. Hand-wringing
stereotypies, hyperventilation and loss of purposive hand movements are
particularly characteristic. Social and play development are arrested in the
first 2 or 3 years, but social interest tends to be maintained.
Asperger’s syndrome is a disorder of uncertain nosological validity,
characterised by the same kind of qualitative abnormalities of reciprocal
social interaction that typify autism, together with a restricted,
stereotyped, repetitive repertoire of interests and activities. The disorder
differs from autism primarily in that there is no general delay or retardation
in language or in cognitive development. Most individuals are of normal
general intelligence but it is common for them to be markedly clumsy; the
condition predominantly occurs in boys.
Intellectual Disability
The most commonly used definitions of intellectual disability (also referred
to as mental retardation) emphasize subaverage intellectual functioning before
the age of 18, usually defined as an IQ less than 70 and impairments in life
skills such as communication, self-care, home living, and social or
interpersonal skills. Different severity categories, ranging from mild to
severe retardation, are defined on the basis of IQ scores.
“Intellectual disability” is used as the preferred term for this condition in
the disabilities sector, but the term “mental retardation” continues to be
used in the contexts of law and public policy when designating eligibility for
state and federal programs.
Intellectual Disability is a condition of arrested or incomplete development
of the mind, which is especially characterized by impairment of skills
manifested during the developmental period, which contribute to the overall
level of intelligence, i.e. cognitive, language, motor, and social abilities.
Retardation can occur with or without any other mental or physical disorder.
However, individuals suffering from intellectual disability can experience the
full range of mental disorders, and the prevalence of other mental disorders
is at least three or four times greater in this population than in the general
population. In addition, people with intellectual disability are at a greater
risk of exploitation and physical/sexual abuse. Adaptive behaviour is always
impaired, but in protected social environments where support is available this
impairment may not be at all obvious in subjects with intellectual disability.
Intelligence is not a unitary characteristic but is assessed on the basis of a
large number of different, more-or-less specific skills. Although the general
tendency is for all these skills to develop to a similar level in each
individual, there can be large discrepancies, especially in people suffering
from intellectual disability. Such individuals may show severe impairments in
one particular area (e.g. language), or may have a particular area of higher
skill (e.g. in simple visuo-spatial tasks) against a background of severe
intellectual disability. This presents problems when determining the
diagnostic category in which a retared person shall be classified into.
If the proper standardised IQ tests are used, the IQ range of 50 to 69 is
indicative of mild intellectual disability in which understanding and use of
language tend to be delayed to a varying degree, and executive speech problems
that interfere with the development of independence may persist into adult
life.
IQ range of 35 to 49 is indicative of moderate intellectual disability.
Discrepant profiles of abilities are common in this group, with some
individuals achieving higher levels in visuo-spatial skills than in tasks
dependent on language, while others are markedly clumsy but enjoy social
interaction and simple conversations while others have only enough language to
communicate their basic needs. Some never learn to use language, though they
may understand simple instructions and may learn to use manual signs to
compensate to some extent for their speech disabilities.
Individuals falling under the IQ range of 20 to 34 are classified under the
category of severe intellectual disability. Most individuals in this category
suffer from a marked degree of motor impairment or other associated deficits,
indicating the presence of clinically significant damage to or maldevelopment
of the central nervous system.
Individuals with IQ falling under 20 are severely limited in their ability to
understand or comply with requests or instructions. Most such individuals are
immobile or severely restricted in mobility, incontinent, and capable at most
of only very rudimentary forms of nonverbal communication. They possess little
or no ability to care for their own basic needs, and require constant help and
supervision.
Researchers have identified some causes of intellectual disability, including
genetic disorders, traumatic injuries, and prenatal events such as maternal
infection or exposure to alcohol. However, the causes of intellectual
disability are unknown in 30–50% of all cases. The causes are more frequently
identified for cases of severe retardation (IQ less than 50), whereas the
cause of mild retardation (IQ between 50 and 70) is unknown in more than 75%
of cases. Exposures to environmental contaminants could be a contributing
factor to the cases of mild retardation where the cause is unknown. Exposure
to high levels of lead and mercury have been associated with intellectual
disability. Furthermore, lead, mercury, and PCBs all have been found to have
adverse effects on intelligence and cognitive functioning in children, and
recent studies have reported associations of a number of other environmental
contaminants with childhood IQ deficits, including organophosphate pesticides,
PBDEs,75 phthalates,79 and PAHs.83,180 Exposure to environmental contaminants
that reduce IQ has the potential to increase the proportion of the population
with IQ less than 70, thus increasing the incidence of intellectual disability
in an exposed population.
Some Statistics for Different Disorders under the category of
Neurodevelopmental disorders:
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From 1997 to 2013, the proportion of children ages 5 to 17 years reported to
have ever been diagnosed with attention-deficit/hyperactivity disorder
(ADHD) increased from 6.3% in 1993 to 10.7% in 2012 and 9.9% in 2013.
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In 2010–2013, 13.1% of children from families living below the poverty level
were reported to have
ADHD
compared with 9.1% of children from families living at or above the poverty
level. This difference was statistically significant.
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In 2013, 8.2% of children ages 5 to 17 years had ever been diagnosed with a
learning disability. There was little change in this percentage between 1997
and 2013.
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For the years 2010–2013, the percentage of boys reported to have a learning
disability (10.4%) was higher than for girls (6.6%). This difference was
statistically significant.
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For the years 2010–2013, the percentage of children reported to have a
learning disability was higher for children living below the poverty level
(12.8%) compared with those living at or above the poverty level (7.4%), a
statistically significant difference.
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The percentage of children ages 5 to 17 years reported to have ever been
diagnosed with autism rose from 0.1% in 1997 to 1.2% in 2013. This
increasing trend was statistically significant.
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For the years 2010–2013, the rate of reported autism was more than four
times higher in boys than in girls, 1.9% and 0.4%, respectively. This
difference was statistically significant.
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For the years 2010–2013, the prevalence of autism was similar for children
living below the poverty level and those living at or above the poverty
level.
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In 2013, 1.4% of children ages 5 to 17 years were reported to have ever been
diagnosed with intellectual disability (mental retardation). This percentage
fluctuated between 0.6% and 0.9% from 1997 to 2010, and was between 1.3% and
1.4% from 2011 to 2013.
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In 2010–2013, 17% of children from families with incomes below the poverty
level were reported to have intellectual disability, compared with 1.1% of
children from families at or above the poverty level, a statistically
significant difference.