Developmental Disorders

Autism spectrum disorder (ASD)
Diagnosis
The first diagnosed case of ASD was in 1938 by American psychiatrist Leo Kanner. A diagnosis of ASD can be made accurately before the child is 3 years old but the diagnosis of ASD is not commonly confirmed until the child is somewhat older. The ages of diagnosis can range from 9 months to 14 years however the mean age of diagnosis is 13 months. On average each case of ASD is tested at 3 different diagnostic centers before confirmed. Early diagnosis of the disorder can diminish familial stress, speed up referral to special educational programs and influence family planning.
In the brain
The cause of ASD is still uncertain. ASD is a disorder of the cortex, which controls higher functions, sensation, muscle movements, and memory. What is known is that a child with ASD has a pervasive problem with how the brain is wired. The distribution of white matter, the nerve fibers that link diverse parts of the brain, is abnormal. An ASD child’s brain grows at a very rapid rate and is almost fully grown by the age of 10.

Symptoms
Signs include impairments in social interactions, communication and repetitive or restricted patterns of interest or behaviors. There are also different symptoms at different ages based on developmental milestones. Children between 0 and 36 months with ASD show lack of eye contact, seem to be deaf, lack of social smile, doesn’t like being touched or held, unusual sensory behavior, lack of imitation; 12 and 24 months with ASD show lack of gestures, prefer to be alone, lack of pointing to object to indicate interest, easily frustrated with challenges, and lack of functional play; 24 to 36 months with ASD show lack of symbolic play and an unusual interest in certain or moving objects.

Treatment
There is no cure for ASD and proper treatment depends on the case and what is most struggled with. Different types of therapy are helpful such as music therapy and physical therapy. Other treatments include auditory training, discrete trial training, facilitated communication, and sensory integration.

Down syndrome
Down syndrome is a genetic disorder that results from having an extra copy of Chromosome 21. In humans, a fertilized egg normally has 23 pairs of chromosomes. The development of the body and brain is changed due to this extra copy of Chromosome 21. This is also referred to as trisomy 21 because there are three copies of Chromosome 21 in these individuals.

Causes
The main cause of Down syndrome is non-disjunction during the meiosis process. Down syndrome can also be caused by Mosaicism and translocation of genetic material between chromosome 21 and another chromosome. Mosaicism is the cause of roughly 1% of cases. It is the result of errors in mitosis after fertilization. Translocation is the cause of about 4% of cases and can be transferred from a parent to the child. Studies show that younger mothers of children with Down syndrome that were taking oral contraceptives and smoking cigarettes during the time of conception were more likely to have had meiosis II errors rather than meiosis I. Also, when parents already have a child with Down syndrome, the risk is higher for their next children also to have Down syndrome.

Signs/symptoms
Physical characteristics include small hands and feet, a flat face, irregular ear shape, poor muscle tone, and short necks. The majority of people with Down syndrome are in the mild to moderate intellectual disability range. The IQ scores of individuals with down syndrome spans between 40 and 70. Verbal tasks are more difficult for individuals with Down syndrome. Academic performance is impacted due to poor problem-solving skills. Language developmental delays are common in individuals with Down syndrome. Although these individuals face the challenge of expressive language development, they tend to show more competence with non-verbal communication skills. They may also have slow motor skills.

Treatment and risks
There is no cure for Down syndrome. In the late 1960s, it was common for parents to institutionalize a child with Down syndrome. Since the mid 1970s, children with Down syndrome were provided and guaranteed a public education. Intervention should occur at a young age in order to for the individuals with Down syndrome to lead healthy, productive lives. This disorder has some risks that include developing early-onset Alzheimer's disease. Between 5-10% of children with Down syndrome meet the criteria for autism as well Mental retardation (MR)
Generalized disorder appearing before adulthood, characterized by significantly impaired cognitive functioning and deficits in two or more adaptive behaviors. It has historically been defined as an Intelligence Quotient score under 70. Once focused almost entirely on cognition, the definition now includes both a component relating to mental functioning and one relating to individuals' functional skills in their environment. As a result, a person with a below-average intelligence quotient may not be considered mentally retarded. Syndromic mental retardation is intellectual deficits associated with other medical and behavioral signs and symptoms. Non-syndromic mental retardation refers to intellectual deficits that appear without other abnormalities.

Signs and Symptoms
The signs and symptoms of mental retardation are all behavioral. Most people with mental retardation do not look like they have any type of intellectual disability, especially if the disability is caused by environmental factors such as malnutrition or lead poisoning. The so-called "typical appearance" ascribed to people with mental retardation is only present in a minority of cases, all of which involve syndromic mental retardation.
Children with mental retardation may learn to sit up, to crawl, or to walk later than other children, or they may learn to talk later. Both adults and children with mental retardation may also exhibit some or all of the following characteristics:
a) Delays in oral language development
b) Deficits in memory skills
c) Difficulty learning social rules
d) Difficulty with problem solving skills
e) Delays in the development of adaptive behaviors such as self-help or self-care skills
f) Lack of social inhibitors
Children with mental retardation learn more slowly than a typical child. Children may take longer to learn language, develop social skills, and take care of their personal needs, such as dressing or eating. Learning will take them longer, require more repetition, and skills may need to be adapted to their learning level. Nevertheless, virtually every child is able to learn, develop and become a participating member of the community.

Causes
 Genetic conditions. Sometimes disability is caused by abnormal genes inherited from parents, errors when genes combine, or other reasons. The most prevalent genetic conditions include Down syndrome, Fragile X syndrome (common amongboys), Neurofibromatosis, congenital hypothyroidism,Williamssyndrome, Phenylketonuria (PKU), and Prader-Willi syndrome.
 Problems during pregnancy. Mental disability can result when the fetus does not develop properly. For example, there may be a problem with the way the fetus' cells divide as it grows. A woman who drinks alcohol or gets an infection like rubella during pregnancy may also have a baby with mental disability.
 Problems at birth. If a baby has problems during labor and birth, such as not getting enough oxygen, he or she may have developmental disability due to brain damage.
 Exposure to certain types of disease or toxins. Diseases like whooping cough, measles, or meningitis can cause mental disability if medical care is delayed or inadequate. Exposure to poisons like lead or mercury may also affect mental ability.
 Iodine deficiency, affecting approximately 2 billion people worldwide, is the leading preventable cause of mental disability in areas of the developing world where iodine deficiency is endemic. Iodine deficiency also causes goiter, an enlargement of the thyroid gland. More common than full-fledged cretinism, as retardation caused by severe iodine deficiency is called, is mild impairment of intelligence.
 Malnutrition is a common cause of reduced intelligence in parts of the world affected by famine.
 Absence of the arcuate fasciculus.

Asperger’s Syndrome
Asperger’s syndrome is a developmental disorder that makes it very hard to interact with other people. Your child may find it hard to make friends because he or she is socially awkward. People with Asperger's syndrome have some traits of autism. For example, they may have poor social skills, prefer routine, and not like change. But unlike those who have autism, children with Asperger's syndrome usually start to talk before 2 years of age, when speech normally starts to develop. Asperger’s syndrome is a lifelong condition, but symptoms tend to improve over time. Adults with this condition can learn to understand their own strengths and weaknesses. And they can improve their social skills. Both Asperger's syndrome and autism belong to the group of disorders called pervasive developmental disorders.
Causes
The exact cause of Asperger's syndrome is not known. And there is no known way to prevent it. It tends to run in families. So researchers are doing studies to look for a genetic cause.
Symptoms
Asperger’s syndrome is usually noticed at age 3 or later. Symptoms vary, so no two children are the same. Children with Asperger’s:
 Have a very hard time relating to others. It doesn't mean that they avoid social contact. But they lack instincts and skills to help them express their thoughts and feelings and notice others’ feelings.
 Like fixed routines. Change is hard for them.
 May not recognize verbal and nonverbal cues or understand social norms. For example, they may stare at others, not make eye contact, or not know what personal space means.
 May have speech that’s flat and hard to understand because it lacks tone, pitch, and accent. Or they may have a formal style of speaking that’s advanced for their age.
 May lack coordination; have unusual facial expressions, body postures, and gestures; or be somewhat clumsy.
 May have poor handwriting or have trouble with other motor skills, such as riding a bike.
 May have only one or a few interests, or they may focus intensely on a few things. For instance, they may show an unusual interest in snakes or star names or may draw very detailed pictures.
 May be bothered by loud noises, lights, or strong tastes or textures. Diagnosis
If you are concerned about your child’s behavior or communication style, talk to your child’s doctor. He will ask you about your child’s development and ask if other people have noticed your child’s social problems.
The doctor may refer you to a specialist to confirm or rule out Asperger’s syndrome. The specialist may test your child’s learning style, speech and language, IQ, social and motor skills, and more.
Treatment
Treatment is based on your child’s unique symptoms. It may change often so that it’s most useful for your child. Doctors, teachers, and mental health counselors can help your child improve his or her behavior and build social and learning skills. School programs, job training, and counseling can help too. Many children with Asperger's syndrome also have other conditions, such as ADHD or obsessive-compulsive disorder. So they may need other treatments, such as medicine. At home, you can help build your child’s confidence and skills. Use rules and daily routines, visual aids, and role-playing. Focus on your child’s strengths. Encourage your child to explore interests at home and at school. And stay informed about what is happening in your child's classroom. Federal law requires public schools to have programs for people ages 3 through 21 with special needs. Contact your school district to find out what services your child can be a part of.