Neurodevelopmental and Neurocognitive Disorders

Until the twentieth century, little account was taken of the special characteristics of psychopathology in children; maladaptive patterns considered relatively specific to childhood, such as autism, received virtually no attention at all (Butcher & Hooley, 2014). Today there is more attention paid to children with maladaptive behaviors and scientific research has been done that demands more attention is paid to specific children’s behaviors, not the behaviors of adult as there are no fair comparisons that allow the diagnosis and treatments of adult and children’s behaviors to be equal. Neurodevelopment disorders in children result in maladaptive behavior which appears in different life periods and deems the once popular view that children were “miniature adults” untrue with more focus on the special problems of children using the DSM-5, along with professional knowledge and ethics as a guideline to an unbiased diagnosis and treatment (Butcher & Hooley, 2014).

A Neurocognitive disorder however, creates a loss of performance and of all learned skills. Depending on the cause, the onset can be slow or gradual with a deteriorating course. There is no simple relationship between the extent of brain damage and degree of impaired functioning. Some people who have severe damage develop no severe symptoms, whereas some with slight damage have extreme reactions (Butcher & Hooley, 2014, p. 506). The neurodevelopment disorder discussed in this essay will be “attention-deficit/hyperactivity disorder” (ADHD), and the neurocognitive disorder discussed will be “Alzheimer’s disease.” This essay will discuss behavioral criteria, incidence rates, and it will propose two options for treatment based on two different theoretical models for each disorder.

Neurodevelopmental Disorder: ADHD
According to Butcher, Hooley & Mineka (2014, p. 546), “In conduct disorder, a child engages in persistent aggressive or antisocial acts. The possible causes of conduct disorder or delinquent behavior include biological factor, personal pathology, family patterns, and peer relationships.” Societal changes have also increased the expression of ADD and ADHD behavior. Children exposed to hazardous materials such as lead may begin to exhibit symptoms similar to ADHD behaviors which are ADHD-like can be attributed to allergies, dietary imbalances, and/or overexposed to sugar or too much television. It is important to get a professional diagnosis when children are thought to have ADHD and not rely on teachers and others in the child’s school who view the child’s behaviors. As one doctor stated in the ERR video, “teachers should not diagnose children, they are not professionals.” Decreased physical activity and family interactions may contribute to the rising numbers of behavioral problems in children (ERR, 2014). The behavior criteria for ADHD are:

•A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, are: •Inattention: six or more of the following symptoms have persisted for at least six months to a degree that is inconsistent with developmental level: •Fails to give close attention to details or makes careless mistake in schoolwork, at work, or during other activities: •Has difficulty sustaining attention in tasks or play activities: •Does not respond when spoken directly to, mind seems to be elsewhere: •Does not follow through on instructions and fails to complete task at hand: • Has difficulty organizing tasks and activities, avoids, dislikes, or is reluctant to engage in tasks: •Loses things necessary for tasks or activities, is often easily distracted by extraneous stimuli, and is often forgetful in daily activities:

•Hyperactivity and impulsivity: six or more of the following symptoms have persisted for at least six months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: •Often fidgets with or taps hands or feet or squirms in seat: • Often leaves situations when remaining seated is expected: •Often runs about or climbs in situations where it is inappropriate •Often unable to engage or play in leisure activities quietly: •Often talks excessively, blurts out an answer before a question has been asked; has difficulty waiting for his or her turn, and interrupts or intrudes on others (Butcher, J. N., Hooley, J. M., Mineka, 2014). The causal factors for ADHD in children have been much debated. It still remains unclear to what extent the disorder results from environmental or biological factors (Carr et al., 2006;

Hinshaw et al., 2007), and recent researchers believe that biological factors such as genetic inheritance will turn out to be important precursors to the development of ADHD (Durston, 2003). But firm conclusions about any biological basis for ADHD must await further research (Butcher & Hooley, 2014, p. 513). Treatment for ADHD that focuses on controlling behavior with drugs has been promising. One particular treatment involved the effectiveness of MTA fading procedures. According to the article, the findings suggest that in contrast to the hypothesized deterioration in the relative benefit of behavioral modification between nine and 14 months (after completion of fading), the MTA behavior generalization and maintenance procedures implemented through nine months apparently yield continuing improvement through 14 months, with preservation of the relative position of behavior compared to other treatment programs (Arnold, L. E.; Chuang, S.; Davies, M.; Abikoff, H. B.; Conners, C. K.; Elliott, G. R.; March, J. S., 2004).

Treatment using video game format (Topiak et al, 2008), focuses on brain functioning of individuals with ADHD, which is thought to be characterized by excess slow wave activity relative to non-diagnosed individuals, the goals of neurofeedback in this population focus on increasing fast wave activity by providing positive feedback for the individual consciously altering brain wave patterns (Bidwell, C. L., McClemon, J. F., Kollins, S. H. 2011).

Neurocognitive Disorder: Alzheimer’s Disorder
Brain impairment in adults are the causes of neurocognitive disorders and they are often much more specific than is the case for other disorders. In the DSM-5, the disorders that used to be known as “delirium, dementia, and amnesic and other cognitive disorders” are now grouped into a new diagnostic category called Neurocognitive Disorders (Butcher, J. N., Hooley, J. M., Mineka, S., (2014). Clinical signs of brain damage are persistent in older children and adults with neurocognitive disorders because the brain does not have the power to regenerate cell bodies and neural pathways when they are damaged. Brain injury causes a loss in established functioning. Often, the person who has sustained this loss is painfully aware of what he or she is no longer able to do. This loss adds psychological burden to the physical burden of having the lesion (Butcher, J. N., Hooley, J. N., Mineka, S., 2014, p. 484). The behavioral criteria for Alzheimer’s disorder are:

•Impairment of memory; the individual cannot remember current events, although memories of past happenings in the past remain more intact.
•Impairment of orientation; the individual may not know where he or she is, what the day is, or who familiar people are.
•Impairment of emotional control or modulation
•Impairment of controls over matters of propriety and ethical conduct
•Impairment of receptive and expressive communication
•Impairment of visuospatial ability (Butcher, J. N., Hooley, J. M., Mineka, S., 2014, p. 487).

According to Butcher, Hooley, and Mineka (2014), The incident rates for Alzheimer’s disorder have been estimated to double about every five years after a person reaches the age of 40 (Hendrie, 1998). Whereas fewer than one percent of 60 to 64 year olds have the disease, up to 40 percent those aged 85 and older (Jalbert et al., 2008). In the United States, more than five million people are living with this disease. Worldwide, the figure is over 35 million (Selkoe, 2012). By 2030 it is expected that this number will rise to a staggering 66 million (Vreugdenhil et al., 2012). For reasons that are not yet clear, women seem to have a much greater risk of developing Alzheimer’s disease than men (Jalbert, et al., 2008). The causal factors of Alzheimer’s are cognitive decline that is often rapid. Sometimes the disease begins early in life and affects people in their 40’s or 50’s.

Considerable evidence suggests a substantial genetic contribution in early onset Alzheimer’s disease, although different genes may play a role in different families. Genes also play a role in late onset Alzheimer’s disease. Cases of early onset Alzheimer’s disease appear to be caused by rare genetic mutations, so far, three such mutations have been identified (Ballard, et al., 2011). One involves the APP (amyloid precursor protein) gene, which is located on chromosome 21. Mutations of the APP gene are associated with an onset of Alzheimer’s disease somewhere between 55 and 60 years of age (Butcher, J. N., Hooley, J. M., Mineka, S., 2014). Treating Alzheimer’s with the medication, Rolipram, according to a recent study, “has shown persistent improvement in synaptic and cognitive functions in an Alzheimer’s mouse model after treatment with Rolipram.”

The article states, evidence suggests that after Alzheimer disease (AD) begins as a disorder of synaptic function, caused in part by increased levels of amyloid beta-peptide 1-42 (Abeta42). One course of long-term systemic treatment with Rolipram improves LTP and contextual learning in the double-transgenic mice. Most importantly, this beneficial effect can be extended beyond the duration of administration (Gong, B., Vitolo, O. V., Trinchese, F., Liu, S.; et al, (2004). Music and art therapy are equally effective treatments for Alzheimer’s disease. According to the Alzheimer’s association, “Music and art can enrich the lives of people with Alzheimer’s disease. Both allow for self-expression and engagement, even after the dementia has progressed.” Despite extensive research efforts, we still have no treatment for Alzheimer’s disease that will restore functions once they have been destroyed or lost. Current treatments, targeting both patients and family members, aim to diminish agitation and aggression in patients and reduce distress in caregivers as much as possible (Butcher, J. N., Hooley, J. M., Mineka, S., 2014).

References
Arnold, L. E., Chuang, S., Davies, M., Abikoff, H. B., Conners, C. K., Elliott, G. R., March, J. S. (2004). Nine months of multicomponent behavioral treatment for ADHD and effectiveness of MTA fading procedures. Journal of Abnormal Child Psychology, 32(1), 39-51. doi:http://dx.doi.org/10.1023/B:JACP.0000007579.61289.31 Bidwell, C. L., McClemon, J. F., Kollins, S. H. (2011). Cognitive enhancers for the treatment of ADHD. Pharmacology, Biochemistry, and Behavior, doi:10.1016/jpbb.2011.05.002 Butcher, J. N., Hooley, J. M., Mineka, S. (2014). Abnormal psychology (16th ed.). Pearson Publishing Gong, B., Vitolo, O. V., Trinchese, F., Liu, S., et al. (2004). Persistent improvement in synaptic and cognitive functions in an Alzheimer mouse model after rolipram treatment. Journal of Clinical Investigation, 114(11), 1624-34. Retrieved from http://search.proquest.com/docview/200554229?accountid=458 Music, art, and Alzheimer’s (n.d.) Retrieved, June 15, 2014 from