TYPES OF

DEVELOPMENTAL DISORDERS
Ms. Angeline Miriam George
Assistant Professor
Department of Clinical Psychology - SRIHER
 Contents
Ø Definition of Developmental Disorder

Ø Risk Factors & Causes of Developmental Disorders

Ø Types of Developmental Disorders

Ø Neurodevelopmental - ADHD, ASD, LD

Ø Motor Developmental Disorder – CP, DCD, MD

Ø Sensory Developmental Disorder – SPD

Ø Cognitive Developmental Disorder – ID

Ø Communication Developmental Disorder – PDD, SCD

Ø Behavioural Disorders – CD, ODD

Ø Emotional Disorder – Separation Anxiety, Sibling Rivalry

 Developmental Disorder

● Developmental disorders, refer to a range of problems characterised by

impairments in physical, learning, language, or behaviour areas.
● Onset - childhood, impact on day-to-day functioning, and last for the rest of
a person’s life.
● Developmental delay is a condition in which a child is not achieving skills
(i.e., not reaching developmental milestones) at the expected time. Delays
can occur in social/emotional, communication, motor, and/or cognitive
domains. They can be transitory or, if they continue, can be diagnosed as a
developmental disability. (American Academy of Paediatrics)
● Acting early can help in early intervention and can make a great difference.
Causes & Risk Factors
Genetics & Chromosomal conditions

Parental health and behaviours during pregnancy

Complications during birth, after birth

Maternal infections during pregnancy

Trauma

Exposure to high levels of environmental toxins

 Types of Developmental Disorder

Motor
Sensory Cognitive
Neurodevelopmental Developmental
Developmental Developmental
- ADHD, ASD, LD Disorder – CP, DCD,
Disorder – SPD Disorder – ID
MD

Communication Emotional Disorder –

Behavioural
Developmental Separation Anxiety,
Disorders – CD, ODD
Disorder – PDD, SCD Sibling Rivalry
 Neurodevelopmental Disorder
Ø Neurodevelopmental disorders are impairments associated primarily with the functioning of the neurological
system and brain.
Ø Neurodevelopmental disorders (NDs) are types of disorder that influence how the brain functions and alters
neurological development, causing difficulties in social, cognitive, and emotional functioning.
Ø Examples of neurodevelopmental disorders in children include attention-deficit/hyperactivity disorder (ADHD),
autism, learning disabilities.
Ø Children with neurodevelopmental disorders can experience difficulties with language and speech, motor skills,
behavior, memory, learning, or other neurological functions.
Ø Some disorders are permanent
Ø NDs usually onset during stages of development which makes them most present in toddlers, children, and
adolescents, but continue to persist into adulthood, or may go undiagnosed until one is an adult.
 ATTENTION DEFICIT
HYPERACTIVE DISORDER
Attention Deficit Hyperactive Disorder
• ADHD is characterized by A child with ADHD might:
symptoms of inattention and/or • daydream a lot
impulsivity and hyperactivity • forget or lose things a lot
which can significantly impact • squirm or fidget
many aspects of behavior as well • talk too much
as performance, both at school • make careless mistakes or take
and at home unnecessary risks
• has a strong genetic, neuro- • have a hard time resisting
biologic, and neurochemical basis temptation
• have trouble taking turns
• have difficulty getting along with
others
Types of ADHD
Predominantly Inattentive Presentation
hard for the individual to organize or finish a task, to pay
attention to details, or to follow instructions or
conversations. The person is easily distracted or forgets
details of daily routines.

Predominantly Hyperactive-Impulsive Presentation: The person fidgets and

talks a lot. It is hard to sit still for long (e.g., for a meal or while doing
homework). Smaller children may run, jump or climb constantly. The individual
feels restless and has trouble with impulsivity. Someone who is impulsive may
interrupt others a lot, grab things from people, or speak at inappropriate times.
It is hard for the person to wait their turn or listen to directions. A person with
impulsiveness may have more accidents and injuries than others.

Combined Presentation: Symptoms of the above two types are

equally present in the person.
Causes of ADHD
 Diagnosis of ADHD
• Clinical assessments
• Assessment tools and rating scale
• The Vanderbilt Assessment Scale.
• The Child Attention Profile (CAP)
• Behavior Assessment System for Children (BASC)
• Child Behavior Checklist/Teacher Report Form (CBCL)
• Conners Rating Scale
• Clinical interviews with the individuals and parents/teachers for children and adolescents
or partners for adults with ADHD.
 TREATMENT FOR ADHD
(multimodal treatment approach)

Medication Behaviour Occupational Educational

Therapy Therapy Techniques
 Treatment for ADHD
Ø Medications: Medications, such as stimulants, can help improve attention and focus.
amphetamine/dextroamphetamine (Adderral), methylphenidate (Ritalin), dexamphetamine
(Dexedrine)
Ø Behaviour Therapy: It aims to strengthen an individual’s positive behaviours and eliminate
disruptive behaviours. to change the child's physical and social environments to help the child
improve his behavior.
Ø Behavioural Parent Training:
Ø Occupational Therapy: Organisation and planning, sensory processing difficulties, developing
self-regulation skills, fine and gross motor skills, developing independence in everyday tasks
Ø Educational Techniques: IEP, Multisensory learning, Build on strengths, build skills that they
lack
Ø Complimentary Treatment:
Ø The Feingold Diet cuts out artificial colourings, flavourings, and preservatives to decrease
hyperactivity.
Ø Activities that work the brain as well as the body, like martial arts, gymnastics, ballet, or ice
skating, seem to be more helpful for kids who have ADHD than simple aerobic exercises
like running.
SPECIFIC LEARNING
DISABILITY
 WHAT IS LD
WHAT ARE THE CAUSES OF LD

Learning disabilities
are disorders that affect the
Central Nervous System
ability to understand or use
spoken or written language, do
Hereditary mathematical calculations,
coordinate movements, or direct
Problems during pregnancy and
childbirth attention.

Incidents after birth

Types of LD
 Characteristics
problems with reading inconsistent school performance
comprehension
spoken language behaviors such as impulsiveness

writing low tolerance for frustration

reasoning ability short attention span (restless,

easily distracted
Hyperactivity letter and number reversals (sees difficulty understanding and
"b" for "d" or "p", "6" for "9", following instructions unless they
"pots" for "stop" or "post") are broken down to one or two
tasks at a time
Inattention poor reading (below age and grade
level)
frequent confusion about personal disorganization impulsive and/or inappropriate
directions and time (right-left, (difficulty in following simple behavior (poor judgment in social
up-down, yesterday-tomorrow) directions/schedules situations, talks and acts before
thinking
 Diagnosis of LD
● Identifying a learning disability is a complex process.
● The first step is to rule out vision, hearing, and developmental issues that can overshadow the
underlying learning disability.
● Once these tests are completed, a learning disability is identified using psycho educational
assessment, which includes academic achievement testing along with a measure of intellectual
capability.
● This test helps determine if there is any significant discrepancy between a child's potential and
performance capability (IQ) and the child's academic achievement (school performance).
 EDUCATIONAL IMPLICATIONS
Ø IEP
Ø Remedial Education
Ø Multi Sensory Teaching
Ø Using different Teaching method – Assistive technology & Educational
material

Ø ACCOMODATIONS
ü Alternative Assignment
ü Test Accommodation
ü Extended Time for test
ü Test to be read to the student
ü To be dictated into tape recorder for transcription
 Management of LD

Dyslexia Dysgraphia Dyscalculia

• Intensive teaching • Special tools • Visual techniques

techniques • Use of technology • Memory aids
• Classroom modifications • Reducing the need for
• Use of technology writing
 AUTISM
SPECTRUM
DISORDER
 ASD
● Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by the
following:
• Difficulties in communication, including verbal and nonverbal communication.
• Deficits in social interactions.
• Restricted, repetitive patterns of behavior, interests or activities and sensory problems
• Many of those with ASD can have delayed or absence of language development, intellectual
disabilities, poor motor coordination and attention weaknesses.
● Early signs of this disorder can be noticed by parents/caregivers or paediatricians before a child
reaches one year of age. However, symptoms typically become more consistently visible by the
time a child is 2 or 3 years old.
 Causes & Risk Factors
There is no clear-cut cause of ASD
There are many different factors that have been identified that may make a child more likely to have
ASD, including environmental, biologic, and genetic factors.
Ø Although we know little about specific causes, the available evidence suggests that the following
may put children at greater risk for developing ASD:
Ø Having a sibling with ASD
Ø Having certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous
sclerosis
Ø Experiencing complications at birth
Ø Being born to older parents
 Diagnosis
● Diagnosing ASD can be difficult since there is no medical test, like a blood test, to diagnose the
disorder.
● Health care professional look at the child’s behavior and development to make a diagnosis.
● ASD can sometimes be detected at 18 months of age or younger.
● Screening Tools & Diagnostic Tools
○ M-CHAT
○ Screening Tool for Autism in Toddlers and Young Children (STAT)
○ Autism Diagnostic Observation Schedule (ADOS)
○ Childhood Autism Rating Scale (CARS)
 Management of ASD
● Current treatments for ASD seek to reduce symptoms that interfere with daily functioning and
quality of life.
● ASD affects each person differently, meaning that people with ASD have unique strengths and
challenges and different treatment needs.
● Treatment plans usually involve multiple professionals and are catered to the individual.

Medication
• A health care provider may prescribe medication to treat specific symptoms. (Irritability,
Aggression, Repetitive behavior, Hyperactivity, Attention problems, Anxiety and depression)

Behavioural, psychological, and educational interventions

● Structured and intensive, and they may involve caregivers, siblings, and other family members.
● Learn social, communication, and language skills
● Reduce behaviors that interfere with daily functioning
● Increase or build upon strengths
● Learn life skills necessary for living independently
 Behavioural Approaches
● Applied Behavior Analysis (ABA): encourages desired behaviours and discourages undesired
behaviours to improve a variety of skills.
● Two ABA teaching styles are Discrete Trial Training (DTT) and Pivotal Response Training
(PRT)
Developmental Approaches
● Developmental approaches focus on improving specific developmental skills, such as language
skills or physical skills, or a broader range of interconnected developmental abilities
● Speech and Language Therapy helps to improve the person’s understanding and use of speech and
language.
● Occupational Therapy teaches skills that help the person live as independently as possible.

• Sensory Integration Therapy to help improve responses to sensory input that

may be restrictive or overwhelming.
• Physical Therapy can help improve physical skills, such as fine movements of
the fingers or larger movements of the trunk and body.
 Intellectual Disability
Mental retardation is defined as significantly sub-average general intellectual
functioning, associated with significant deficit or impairment in adaptive
functioning, which manifests during the developmental period (before 18
years of age).
Mild Mental Moderate Mental Severe Mental Profound Mental
Retardation Retardation Retardation Retardation
• 85-90% of all cases • 10% of all persons • Often recognised early • 1-2% of all persons
in life with poor motor with mental retardation
• They often progress up • They drop out of development • The achievement of
to the 6th class (grade) school after the 2nd (significantly delayed developmental
in school and can class (grade). They can developmental milestones is markedly
achieve vocational and be trained to support milestones) and absent delayed.
social self-sufficiency themselves by or markedly delayed • They often need
with a little support. performing semi- speech and other nursing care or ‘life
skilled or unskilled communication skills. support’ under a
• ‘educable’ work under • ‘dependent’. carefully planned and
supervision. structured environment
• ‘trainable’
 Etiology
Genetic
a) Inborn errors of metabolism (Phenylketonuria, taysachs)
b) presence of three of Chromosome 21 (trisomy 21)
c) Mutation on the X chromosome (fragile X syndrome)

Perinatal causes
a) Infections (rubella, syphilis, CMV, Toxoplasmosis)
b) Prematurity
c) Birth trauma
d) Hypoxia
e) Intrauterine growth retardation
f) Acquired physical disorders in childhood (CP, encephalopathy)
Psychosocial
Lack of intellectual stimulation, emotional deprivation, economic condition,
 MANAGEMENT OF MR
● There is no cure for ID / MR.

• Early Interventions

• Developmental Therapy

• Occupational Therapy

• Special education

• Speech Therapy

• Behavior Modification Therapy

MOTOR DEVELOPMENATAL
DISORDER
 CEREBRAL PALSY
● Cerebral palsy (CP) is a group of disorders that affect a person’s ability to move and maintain
balance and posture. CP is the most common motor disability in childhood
● CP is caused by abnormal brain development or damage to the developing brain that affects a
person’s ability to control his or her muscles
The types of cerebral palsy include:
• Ataxic cerebral palsy: This type is caused by cerebellum damage resulting in issues with motor
control and movement.
• Athetoid/dyskinetic cerebral palsy: Caused by basal ganglia and/or cerebellum damage;
symptoms include fluctuating muscle tone and involuntary movements.
• Hypotonic cerebral palsy: This rare type, also caused by cerebellum damage, is characterized by
floppy muscles, excess flexibility, and poor mobility.
• Spastic cerebral palsy: The most common type of cerebral palsy, caused by damage to the motor
cortex or pyramidal tracts and characterized by tight muscles and jerking movements.
• Mixed cerebral palsy: Multiple areas of brain damage can cause patients to have more than one
type of cerebral palsy.
 Causes
Common causes of Cerebral Palsy include:
• Bacterial and viral infections such as meningitis
• Bleeding in the brain (hemorrhaging)
• Head injuries sustained during birth or within the first few years of infancy
• Lack of oxygen to the brain (asphyxia) before, during, or after birth
• Prenatal exposure to drugs and alcohol
• Prenatal exposure to raw/undercooked meat or fish
 DIAGNOSIS OF CP
● Imaging tests used to diagnose cerebral palsy include:
• Computed tomography (CT) scans
• Cranial ultrasounds
• Electroencephalograms (EEG)
• Magnetic resonance imaging (MRI) scans
Developmental Assessment
 Cerebral Palsy treatment
Actively treating the symptoms of cerebral palsy is the best way to ensure the highest quality of life for
a child as they transition into adulthood.
 Medication
● Medication may be used to treat some symptoms of cerebral palsy, including involuntary movement, seizures, and
spasticity.

● Common classes of medications for children with cerebral palsy include:

• Anticholinergics (neurotransmitter blockers)
• Anticonvulsants (suppress neurons that cause seizures)
• Antidepressants
• Anti-inflammatories (reduce pain and inflammation)
• Baclofen (muscle relaxer)
• Benzodiazepines (treats anxiety, seizures, and insomnia)
• Botox (treats spasticity)
• Nerve blocks
• Other muscle relaxants
• Stool softeners
 THERAPY
There are many different therapy options to help treat cerebral palsy symptoms. Therapy can be used to improve
mobility and brain cognition.
• Physical therapy: Helps relieve pain and muscle stiffness, as well as improve balance, coordination, and
overall mobility. Physical therapists will use specialized equipment to help your child move more freely and
live more independently.
• Occupational therapy: Helps children with cerebral palsy learn how to complete everyday tasks and activities
by improving fine motor skills and cognitive abilities.
• Speech therapy: Helps children to improve their communication and language skills. This type of therapy gives
children the confidence to learn and socialize. Speech therapy can also help children who have difficulty eating
and swallowing.
• Alternative therapy: Helps children focus on themselves as individuals and lets them overcome physical and
mental obstacles. Alternative therapy includes hippotherapy (which involves riding horses), music therapy,
aquatic therapy, acupuncture, and more.
Surgery Assistive devices Mobility aids
Surgery may be recommended for can help individuals with cerebral Aim to help children with cerebral
children with severe mobility and palsy that experienced issues with palsy move freely and can greatly
muscle issues communication, hearing, and improve their quality of life and
vision. independence.

Cerebral palsy surgery can: Types of assistive devices include: Types of mobility aids include:
Correct fixed joints and tendons Cochlear implants Crutches
Correct foot deformities Electronic communication boards Lifts
Correct muscle contractures Eye-tracking devices Power scooters
Correct spinal curvatures (scoliosis) Typing aids Orthotic devices
Improve balance and coordination Writing aids Standers
Improve posture Walkers
Prevent hip dislocation Walking sticks
Wheelchairs
 DEVELOPMENTAL COORDINATION DISORDER
● Developmental coordination disorder, a chronic and usually

permanent condition found in children, is characterized by

motor impairment that interferes with the child's activities of

daily living and academic achievement.

● DCD is part of the continuum of cerebral palsy

● No specific cause; Risk factors: prenatal and postnatal insults

● Diagnosis can be done by – Detailed history collection,

clinical examination (Neuromotor examination), Screening

Questionnaire (Developmental Coordination Disorder

Questionnaire, Movement ABC-2 checklist)

 Characteristics of Children With DCD
• Hypotonia, persistence of primitive reflexes, and immature
Gross Motor balance reactions that interfere with gross motor
development
• Awkward running pattern, fall frequently, drop items

Fine Motor • Difficulty with handwriting or drawing

• Difficulty with gripping and dressing

• Less socially desirable means of gaining recognition and

Psychosocial friends
• Anxiety
 Treatment for DCD

OCCUPATIONAL PSYCHOSOCIAL EDUCATIONAL

THERAPY THERAPY SUPPORT

• Fine motor skills • Behaviour • Kids might also

• Gross motor skills Management get accommodations
• Motor planning • Process-oriented in class.
treatment - strong
motivation effect,
fostered by positive
feedback and a sense
of self-competence
Communication disorders
● Impairment in understanding, expressing language and production of speech

Language Speech sound Social

disorder disorder Communicatio
n disorder
• Deficit in • Impairment in Stuttering
vocabulary, sound production • Persistent deficits
tenses, production • Substitute one Involuntary in using verbal
of complex sound for another disruptions in the and non- verbal
sentences and or omit sounds flow of speech communication
recall of words. for social
purposes
Language disorder
● Types- Expressive (language cannot be expressed)
● Receptive (language cannot be understood)
Diagnosis:
● selective deficits in expressed or received language skills
● confirmed by standardized tests
● severity determined by child’s verbal, sign language, interaction
with others
● severe cases- presents by 18 months
● Epidemiology

● 3% to 5% of school aged children

● two- three times > males

● history of relatives with other communication disorders

● Etiology

● subtle cerebral damage and maturational lags

● associated with left handedness and ambilaterality

● concordance of monozygotic twins

● genetic, environmental, educational factors

Course and Prognosis
● depends on severity
● child’s motivation to participate in therapies
● timely institution of speech and other interventions
● 50% mild cases recover spontaneously
● severe cases display language impairment
● Prognosis in expressive type > receptive type

Treatment
● Remedial: Language therapy
● Psychotherapy: used as a positive model
● Supportive parental counselling
● Family therapy
 Behavioural Disorders
● Oppositional defiant disorder (ODD) and Conduct Disorder (CD) are among the
prevalent disruptive behaviours in both children and adolescents.
● CD is a “repetitive and persistent pattern of behavior in which the basic rights of
others or major age-appropriate societal norms or rules are violated”.
● ODD longstanding pattern of hostile, defiant, or disobedient behavior.
 Disruptive behavior disorders
Result in impaired social or academic function in a child
Oppositional defiant disorder
• Enduring pattern of negative, hostile
behavior in absence of serious violation of
societal norms or rules
Conduct disorder
• aggression and violations of the rights of
others
• specific behaviors: bullying, threatening or
intimidating others
• beginning before age 13 years
Etiology
● Family instability, physical, sexual victimization, SES, negligent conditions
● Coexist with ADHD, LD, Communication disorders
● Abnormal serotonin levels

Treatment
● Psychotherapy: individual or family therapy
● Pharmacotherapy: Antipsychotics, Lithium, stimulants
● Behaviour Therapy
EMOTIONAL DISORDERS
SIBLING RIVALRY
● Sibling rivalry is defined as the competition between siblings for the love, approval and
attention from one or both parents, which is usually present among siblings to some extent.
● Sibling rivalry is particularly heightened when children are very close in age and of the same
gender
● Signs of Sibling Rivalry
Children show some of these signs
○ fighting- physical and verbal injury, frustration, demanding, attention, tattling, bulling,
name calling, regressive acts like thumb sucking, bed-wetting, baby talk, temper
tantrums.
○ Older children may show these signs: arguing constantly, competing for their friends,
sports with grading, taking other one objects and stealing it, playing with loved one pets
or other people to irritate other one.
● Parental Empowerment Programme (PEP)
○ Parents as Teachers
○ Effective Praise
○ Preventive Teaching
○ Corrective Teaching
○ Teaching Self-Control
○ Teaching your child to problem solve
○ Setting goals through the use of charts and contracts
○ Family Traditions and Family Meetings
 Childhood Anxiety Disorders

• Excessive, • Child who can • Inappropriate

recurrent distress speak and social
about understand relatedness
anticipating or refuses to talk in • Types: Inhibited
being away from social situations type,
loved ones Disinhibited type
Seperation Selective Reactive
Anxiety Mutism attachment
disorder disorder
● Etiology

● biological offspring

● neurophysiological correlation of behavioral inhibition

● Increased ANS activity

● Differential diagnosis

● Generalized Anxiety disorder

● Panic disorder with agoraphobia

● Course and prognosis

● variable, related to age of onset, duration, development of comorbidity

● slower recovery: earlier onset and later age at diagnosis

● guarded: coexistent depression

● Treatment
● Psychotherapy: CBT
● Family Intervention
● Behavioral modification
● Pharmacotherapy: SSRI