Neuropsychologic assessment is a cornerstone in the process of diagnosing neurodevelopmental disabilities in children and is frequently a component of a multidisciplinary evaluation. From it can be derived recommendations for the different contexts of a child's life (e.g., family, care team, school).Studies have consistently reported an increased prevalence of psychiatric comorbidity (PC) in individuals with neurodevelopmental disorders (NDDs) compared with typically developing controls, with high rates of anxiety disorders in autism spectrum disorders and challenging behaviors in children and adolescent with intellectual disability. Psychiatric assessment in this population should include multiple sources of information, derived from multiple contexts and using multiple methods, with accurate detection of contributing and trigger factors. It is important to focus on detecting change from the child's baseline functioning and to use, when possible, ad hoc instruments for assessing PC in the NDD population. Modifications in the setting and assessment procedures should be scheduled based on the child's age, developmental level, and sensory sensitivities. Simultaneously, validated screening instruments, which dimensionally assess the symptomatology of several NDDs and psychiatric disorders, are warranted to not only assist in the identification of PCs in NDDs but also discriminate among different NDDs. Changes from DSM-IV-TR to DSM-5 have had an impact on the diagnosis of several disorders in children and adolescents and, subsequently, on the current diagnostic tools, requiring appropriate and prompt modifications of the available instruments.Developmental language disorders (DLD) are prevalent and persistent among school-age children but are often underrecognized. This chapter discusses the ways in which the various components of communication are impacted by these disorders and outlines the differences in expression seen in different languages. Research on biological and psychologic roots of the syndrome is also reviewed. As yet, no single definitive cause has been identified; the disorders are likely to result from a constellation of genetic, biological, and cognitive weaknesses that are influenced by environmental experiences. Basic methods of assessment and differential diagnosis are presented and the principles guiding the development of intervention programs are discussed.Despite rapidly evolving technologies, an accurate and thorough clinical neurologic assessment is still crucial to understanding presenting symptoms and signs. It is the most exciting but also challenging part of the diagnostic puzzle, essential to establishing a rational working hypothesis and a consistent management plan. Flexibility, creativity, and social skills are needed to elicit the child's participation. History taking is of the utmost importance, requiring not only time and perseverance, but also knowledge and effective communication to obtain relevant and precise information. Understanding what is being tested and distinguishing the normal from the abnormal are indispensable in reaching a correct clinical interpretation. The clinician needs to tailor an individualized approach for each patient according to the chief complaint, clinical context, and the child's chronologic and developmental age. The questions about the nature, localization, and etiology must be addressed first and then summarized and developed into a reasonable diagnostic hypothesis and differential diagnosis. This chapter aims to guide the reader through a situation-related approach from history taking and neurologic examination to a systematic, step-by-step interpretation of the information and findings. It also provides some practical advice on how to avoid common pitfalls.Neurophysiological studies, including electroencephalography (EEG) and evoked potentials (EPs), are helpful bedside tools for assessing neurologic function and helping with prediction of long-term neurodevelopmental outcomes following brain injury in preterm and term newborns. In this chapter, we describe the use of electroencephalography, including both amplitude-integrated EEG and continuous video EEG, and EPs, including visual, somatosensory, and brainstem auditory EPs, in the neonatal period. We review the current literature on the utility of these neurophysiological studies in the prediction of long-term outcomes in preterm and term newborns.Interdisciplinary assessment (IA) is defined as the integration of clinical contributions by healthcare professionals from distinct disciplines into a comprehensive diagnostic and prognostic evaluation. This process requires the professionals to independently and simultaneously consider and gage clinical information collected via a variety of methods and from a variety of informants. https://www.selleckchem.com/products/tunicamycin.html A shared perception of the clinical situation is progressively achieved via team meetings. IA helps clinicians to overcome the many challenges posed in today's context for assessment and treatment planning in the field of neurodevelopmental disorders. Most national and international guidelines recommend the inclusion of IA in the diagnostic workup for complex cases (e.g., autism spectrum and attention deficit hyperactivity disorder). Hence, IA should always be part of the neurodevelopmental disorder diagnostic process in children in general and preterm infants in particular.Children and adolescents with neurodevelopmental disorders often show complex developmental disorders, including multiple areas of dysfunction such as emotional regulation and behavior, school integration, and learning difficulties. These multidimensionally impaired children share some common features with children with autism spectrum disorders (ASDs). However, paradoxically, they could qualify as diagnostically homeless. Several proposals have been formulated to categorize subgroups of these children, whose diversity and overlap in clinical expression emphasize the importance of using a multidimensional assessment inscribed in a developmental perspective. Here, we review these different classification proposals and describe a multidimensional approach that, in addition to a categorical approach, could constitute a complementary point of view. We believe that this multidimensional perspective allows one to address the child holistically, taking into account his or her interactive experience with the environment, and achieve a functional diagnosis enabling the elaboration of a tailored therapeutic plan and better school inclusion.
Neuropsychologic assessment is a cornerstone in the process of diagnosing neurodevelopmental disabilities in children and is frequently a component of a multidisciplinary evaluation. From it can be derived recommendations for the different contexts of a child's life (e.g., family, care team, school).Studies have consistently reported an increased prevalence of psychiatric comorbidity (PC) in individuals with neurodevelopmental disorders (NDDs) compared with typically developing controls, with high rates of anxiety disorders in autism spectrum disorders and challenging behaviors in children and adolescent with intellectual disability. Psychiatric assessment in this population should include multiple sources of information, derived from multiple contexts and using multiple methods, with accurate detection of contributing and trigger factors. It is important to focus on detecting change from the child's baseline functioning and to use, when possible, ad hoc instruments for assessing PC in the NDD population. Modifications in the setting and assessment procedures should be scheduled based on the child's age, developmental level, and sensory sensitivities. Simultaneously, validated screening instruments, which dimensionally assess the symptomatology of several NDDs and psychiatric disorders, are warranted to not only assist in the identification of PCs in NDDs but also discriminate among different NDDs. Changes from DSM-IV-TR to DSM-5 have had an impact on the diagnosis of several disorders in children and adolescents and, subsequently, on the current diagnostic tools, requiring appropriate and prompt modifications of the available instruments.Developmental language disorders (DLD) are prevalent and persistent among school-age children but are often underrecognized. This chapter discusses the ways in which the various components of communication are impacted by these disorders and outlines the differences in expression seen in different languages. Research on biological and psychologic roots of the syndrome is also reviewed. As yet, no single definitive cause has been identified; the disorders are likely to result from a constellation of genetic, biological, and cognitive weaknesses that are influenced by environmental experiences. Basic methods of assessment and differential diagnosis are presented and the principles guiding the development of intervention programs are discussed.Despite rapidly evolving technologies, an accurate and thorough clinical neurologic assessment is still crucial to understanding presenting symptoms and signs. It is the most exciting but also challenging part of the diagnostic puzzle, essential to establishing a rational working hypothesis and a consistent management plan. Flexibility, creativity, and social skills are needed to elicit the child's participation. History taking is of the utmost importance, requiring not only time and perseverance, but also knowledge and effective communication to obtain relevant and precise information. Understanding what is being tested and distinguishing the normal from the abnormal are indispensable in reaching a correct clinical interpretation. The clinician needs to tailor an individualized approach for each patient according to the chief complaint, clinical context, and the child's chronologic and developmental age. The questions about the nature, localization, and etiology must be addressed first and then summarized and developed into a reasonable diagnostic hypothesis and differential diagnosis. This chapter aims to guide the reader through a situation-related approach from history taking and neurologic examination to a systematic, step-by-step interpretation of the information and findings. It also provides some practical advice on how to avoid common pitfalls.Neurophysiological studies, including electroencephalography (EEG) and evoked potentials (EPs), are helpful bedside tools for assessing neurologic function and helping with prediction of long-term neurodevelopmental outcomes following brain injury in preterm and term newborns. In this chapter, we describe the use of electroencephalography, including both amplitude-integrated EEG and continuous video EEG, and EPs, including visual, somatosensory, and brainstem auditory EPs, in the neonatal period. We review the current literature on the utility of these neurophysiological studies in the prediction of long-term outcomes in preterm and term newborns.Interdisciplinary assessment (IA) is defined as the integration of clinical contributions by healthcare professionals from distinct disciplines into a comprehensive diagnostic and prognostic evaluation. This process requires the professionals to independently and simultaneously consider and gage clinical information collected via a variety of methods and from a variety of informants. https://www.selleckchem.com/products/tunicamycin.html A shared perception of the clinical situation is progressively achieved via team meetings. IA helps clinicians to overcome the many challenges posed in today's context for assessment and treatment planning in the field of neurodevelopmental disorders. Most national and international guidelines recommend the inclusion of IA in the diagnostic workup for complex cases (e.g., autism spectrum and attention deficit hyperactivity disorder). Hence, IA should always be part of the neurodevelopmental disorder diagnostic process in children in general and preterm infants in particular.Children and adolescents with neurodevelopmental disorders often show complex developmental disorders, including multiple areas of dysfunction such as emotional regulation and behavior, school integration, and learning difficulties. These multidimensionally impaired children share some common features with children with autism spectrum disorders (ASDs). However, paradoxically, they could qualify as diagnostically homeless. Several proposals have been formulated to categorize subgroups of these children, whose diversity and overlap in clinical expression emphasize the importance of using a multidimensional assessment inscribed in a developmental perspective. Here, we review these different classification proposals and describe a multidimensional approach that, in addition to a categorical approach, could constitute a complementary point of view. We believe that this multidimensional perspective allows one to address the child holistically, taking into account his or her interactive experience with the environment, and achieve a functional diagnosis enabling the elaboration of a tailored therapeutic plan and better school inclusion.
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