00:00
This lecture is going to be talking about neurodevelopmental disorders. Let's take a minute
to think about that word, neurodevelopmental disorders that begin in the developing
brain. Some of these disorders are intellectual developmental disorder, autism spectrum
disorder, and attention deficit hyperactivity disorder. So, neurodevelopmental disorders
are brain function impairments and they result from alterations in the growth and
development of the brain during gestation affecting memory, emotional responses,
self-control, and learning abilities. Intellectual developmental disorders has an intellectual
as well as an adaptive aspect to it and it begins in the developmental period. So, the
brain as it is developing and we know that the brain develops from the first hours of the
fetus development right through to the age of about 27. So, when we're thinking about
these disorders, we think about their intellectual capacity. The person who is
developmentally disabled intellectually will have difficulties over their life span in learning
as well as in adapting to different situations. One percent of children are affected by IDD,
intellectual developmental disorder. And the severity is categorized as mild, moderate,
severe, or profound and that depends upon the child's ability to participate in social,
academic, and practical arenas. So what do we mean by that? We're talking about
academics being learning abilities in school, social being able to connect with others and
practical arenas. Those practical arenas are learning how to take care of yourself, bathing,
feeding, toileting. The risk factors that increase the likelihood of IDD can be biological,
psychosocial, or a combination of the two. Five percent are due to genetic factors which
are chromosomal disorders like Down syndrome, Klinefelter syndrome, and Fragile X
syndrome. Metabolism errors include phenylketonuria, hyperglycemia, and Tay-Sachs
disease. Thirty percent of IDD will occur during the embryonic development and that can
be secondary to the maternal use of substance, for example fetal alcohol syndrome or
perhaps the maternal illness when a mom is infected during pregnancy with something
like Rubella or complications of pregnancy for example a mom who has uncontrolled
diabetes or perhaps has toxemia during pregnancy. Now 10% are due to issues that occur
during pregnancy and that perinatal period. So if it's during pregnancy, if the fetus is now
suffering some malnutrition or has a viral infection or is prematurely born. When you think
about the suffering malnutrition, this is why it is so important that when a woman becomes
pregnant we really focus on her diet and the fact that she should be taking prenatal
vitamins so that she is able to give the substance and the nutrition that that fetus is
going to need in order to develop correctly and healthily. Now during the birthing process,
IDD can also be an outcome if there is trauma to the head or if there is maternal placenta
previa or if there's the prolapse of the umbilical cord causing oxygen deprivation to the
infant. Five percent are general medical conditions during infancy or childhood. For
example, infections affecting brain development and growth and that might include
meningitis or encephalitis, lead poisoning, and other kinds of poisonings as well as ingestion
of certain medications. Now you may have heard a lot about TBI or traumatic brain injuries.
05:11
These are physical traumas, head injuries that occur to a child. It could be falling off of a
swing and getting a concussion or perhaps asphyxiation also will cause a traumatic brain
injury. Now 15% to 20% is deprivation of nutritional and impoverished emotional
environments. So if a person is born into poverty for example and they do not have food,
they do not have subsistence that will allow their brain to have healthy growth and
development, they can have an increased risk for IDD. And if they are born into an
environment where there is a lot of trauma where the child is emotionally neglected or
abused, that impoverished emotional environment can also increase the likelihood of
developing IDD. Social stimulation is very important for normal brain growth so we want to
make sure that that newborn, that infant has some social stimulation is able to connect
with others from a very early age. Poor prenatal as well as perinatal care from the mom
can also result in IDD. So, we need to be able to take care and focus on mom. Other
mental and brain disorders can also result in IDD, for example a child with autism spectrum
disorder, children who have seizure disorders may develop IDD.