Cerebral Palsy, Intellectual Disability and Autism Spectrum Disorder

00:01 Here we have Cerebral Palsy, the static disorder of primarily motor deficit of cerebral origin.

00:09 Seizures are a common comorbidity and developmental delay or intellectual disability may be seen.

00:16 Incidence, pretty high -- 3 per 1,000 live births.

00:21 Different types: Spastic being the most common, hypertonic; You can have hypotonic (flaccid), ataxic, dystonic, which is athetoid, or mixed types of cerebral palsy.

00:37 Distribution: Hemiplegic, quadriplegic, or diplegic which then includes both the legs and the arms and you have a diplegic type of gait where you have circumduction that’s taking place of the legs as the patient’s moving from one side to the other.

00:54 Different distributions in terms of your patient with cerebral palsy, you pay attention to the diplegic gait please.

01:02 Risk factors: Prematurity, extremely common; low birth weight; chorioamnionitis -- infection of the placenta; prenatal virus infection, prenatal strokes, perinatal hypoxic-ischemic insult; all possible causes of cerebral palsy.

01:20 Intellectual disability, what does this mean to you? Below average intellectual function, usually an IQ of less than 70, below average adaptive behavior.

01:32 Not to be confused with developmental delay, the failure to reach a developmental milestone is developmental delay versus intellectual disability.

01:41 Continue discussion of intellectual disability, trauma could be a passive etiology, prenatal - postnatal.

01:47 Hypoxic-ischemic encephalopathy, TORCH organisms infection, chromosomal abnormalities such as Down Syndrome or Fragile X.

01:56 Metabolic disorders such as cretinism or accumulation of what's on is here a ganglioside or GM2, or from Tay-Sachs disease.

02:05 Toxins, fetal alcohol syndrome unfortunately being one of the most common causes of acquired intellectual disability in the US.

02:12 And we have perinatal hypoxic ischemic insult -- all possible causes of intellectual disability.

02:19 Now let’s move to Autism Spectrum Disorder.

02:21 According to DSM-5, Autism Spectrum Disorder is characterized by persistent deficits in social communication.

02:28 Patients have the impairment in social interaction and emotional reciprocity, restricted verbal and non-verbal communication skills, abnormal language development, lack of facial expression and impaired in personal relationships very early in life.

02:44 They also exhibit repetitive stereotypical patterns such as flipping objects, putting things in a row, performing rituals and rigid thinking.

02:55 Symptoms usually start before the age of three.

02:57 Children typically do not exhibit separation anxiety when they're separated from their caregiver and they show indifference to the external world.

03:06 These lead to severe functioning impairment.

03:10 The patient’s symptom etiology should not be better explained by intellectual disability or developmental delay.