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THE SPECTRUM OF

NEURODEVELOPMENTALDISABILITIES

Joselyn C. Alonzo-Eusebio, M.D.

Developmental Pediatrician

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Decline in prevalence of infectious diseases

Decrease mortality in LBW and severely premature infants

Increased survival of neurologically compromised children

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Newest “morbidity” in childhood disorders

NEURODEVELOPMENTAL DISORDERS

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NEURODEVELOPMENTAL DISORDER

any disorder which is potentially capable of producing a chronic handicap that would adversely affect the quality of a child’s or adolescent’s life

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CLASSIFICATION OF DEVELOPMENTAL DISORDERS

I. Disorders primarily manifesting as a motor handicap

A. Cerebral palsy

II. Disorders primarily manifesting as a cognitive handicap

A. Mental retardation

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III. Disorders with specific deficits in processing

A. Peripheral processing disorders

1. Hearing impairment

2. Visual impairment

B. Central processing disorders

1. Autism

2. Attention Deficit Disorder

3. Learning Disabilities

IV. Seizures

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PREVALENCE

15-20% of the pediatric population have neurodevelopmental disabilities

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ESTIMATED PREVALENCE OF DEVELOPMENTAL DISORDERS & OTHER CHRONIC CONDITIONS

DisorderDisorder Case per 1,000 Case per 1,000

Attention Deficit/Hyperactivity Dis 100.0Speech & language disorders 70.0Learning disorders 75.0Asthma 29.0Mental retardation 20.0Arthritis 3.5Cerebral palsy 2.0Severe hearing impairment 1.5Diabetes mellitus 1.0Autism 0.4Visual impairment 0.4

Gortmaker, Walker, et al 1990

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HI2%

LD3%

GDD16%

DLD16%

MR20%

ASD32%

CP4%

ADHD7%

SPECTRUM OF NEURODEVELOPMENTALDISABILITIES AT NDC - PCMC (2000)

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DEVELOPMENTAL CONCERNS

Newborn Physiologic stabilityDysmorphismsNeurologic syndromes

High risk neonateCong malformationCNS dysfunction

Infancy Gross motor abilities Disorders ofmotor development

Preschool Language abilities Disorders oflanguage development

School Age School performanceBehaviors

Disorders ofcognitive developmentBehavior problems

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DEVELOPMENTAL DELAY

Specific concern on development Difficult to clearly delineate what is

normal and what is abnormal Guide : average level of established

norms The further away from the average a

child is the more likely he is to be delayed

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• Individualized

• Multidisciplinary

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To enable the child reachhis optimal developmental potential

Early recognition and early intervention…