What Is Developmental Dyspraxia?

Pervasive developmental disorder is a group of comprehensive mental developmental disorders that begin in infancy and childhood. It is mainly manifested as barriers to interpersonal communication, barriers to communication, and abnormalities in interests and behaviors. Symptom severity varies widely between individuals. Psychiatric symptoms are usually obvious within 5 years of age, and can slowly improve afterwards. Most children are accompanied by mental retardation. The American Handbook for the Diagnosis and Statistics of Mental Disorders (DSM-IV, 4th edition) classifies extensive developmental disorders into five categories: autism, Rett's disorder (Rett syndrome), childhood disintegrating disorder (also known as degenerative psychosis Disorders, disintegration disorder), Asperger disorder (Asperger syndrome), and NO specific pervasive developmental disorder (PDD-NOS).

Basic Information

Visiting department

Department of Psychology

Common causes

Genetic factors, perinatal factors, infection and immune factors, etc.

Common symptoms

Childhood autism, Rett syndrome, Asperger syndrome, disintegrating mental disorder in children

Causes of generalized developmental disorders

1. Genetic factors Current research shows that the role of genetic factors in generalized developmental disorders is very clear. Children with disruptive mental disorders and autism may have some common genetic genes.
2. Perinatal factors Autism has more perinatal complications such as birth injury and intrauterine asphyxia than the normal control group.
3. Infection and immune factors Children's autism may be related to viral infection, and children's disintegrating mental disorders may be related to neuroviral infection and immune dysfunction.
4. Other factors such as neuroendocrine and neurotransmitter dysfunction.

Clinical manifestations of generalized developmental disorder

1. Children's autism is more common in boys, and it starts in infants and young children. The main manifestations are: social communication disorders: patients cannot establish normal interpersonal communication with others; speech dysfunction: language development significantly lags behind peers; Narrow interest range and stereotyped behaviors: they often require their living environment to be constant, otherwise they will be irritable, crying, and lose their temper; Intellectual disorder: 75% to 80% of patients with different degrees of developmental disorders , Intelligence damage is characteristic, incomplete development of all aspects of intelligence; neuropsychiatric symptoms: most patients have attention deficit and hyperactivity symptoms.
2. Rett syndrome
The early development of the child was normal, and after 6 to 18 months, stagnation and regression in many aspects such as nervous system and psychological development gradually appeared. Seen only in girls, the main manifestations are: mental retardation: stagnation of interpersonal communication, understanding, language expression ability, then gradually degraded, and finally completely lost, mental retardation reaches the level of severe mental retardation; physical symptoms and signs: physical symptoms Stunted, slow brain development. The loss of sexual activity of the hand is particularly prominent. The stereotypical twisting or hand-washing movements specific to the hand are the most common. The upper limbs are bent and placed before the chest or chin. Ataxia, abnormal tonicity, and most have seizures; ataxia and apraxia of the trunk can occur in mid-childhood, often excessive salivation, tongue failure to chew food properly, and excessive ventilation and incontinence, sometimes Dance-like movements of hand, foot, and agitation occur. Some patients have scoliosis or kyphosis, and eventually lose their motor function completely. The disease progresses rapidly and the prognosis is poor.
3.Asperger syndrome (Asperger syndrome)
Boys are more common, and the symptoms are usually around 7 years of age. The main symptoms are: difficulty in interpersonal communication; difficulty in language communication: despite normal language development, the ability to use language to communicate by then is poor; special interests ; ritualized action. Patients often do not have obvious language and cognitive impairments, and diagnosis of the disease can be ruled out if there is significant language retardation. Most children have normal intelligence, and individual children have outstanding abilities in certain disciplines, and often have significant clumsiness and inflexibility. The disease is more common in boys (8: 1 male to female ratio).
4. Children with disintegrating mental disorders have normal physical and psychological development before the age of two, and most of them start from the age of 3 to 4 years. The ability that has been acquired after the illness will diminish or even be completely lost. The main manifestations are: language development disorders; interpersonal communication disorders; abnormal activities and interests. Some patients have reduced motor skills, second-hand stools, and other self-care abilities, often accompanied by seizures.

Extensive Developmental Disorders

1. Ask a medical history and general physical examination to rule out organic problems such as hearing and visual impairment.
2. Nervous system examination, mental examination, intelligence test, etc .: clarify the patient's development, current mental symptoms and mental development.
3. Routine tests such as blood routine, blood biochemistry, thyroid hormones, auxiliary examinations such as electroencephalogram, skull X-ray film, brain CT, brain MRI, cerebral angiography, etc., to know whether there are physical diseases and organic lesions in the brain.
4. Psychological assessment: Personality tests such as the retrospective personality development scale (WMPI), the Minnesota Personality Scale (MMPI) and the Eysenck Personality Questionnaire developed by Professor Wang Weidong, and the Symptom Self-Assessment Scale. Self-Depression Scale (SDS) and Hamilton Depression Scale (HAMD).

Diagnosis of generalized developmental disorder

1. Usually onset within 5 years of age.
2. Social functions are obviously impaired, especially interpersonal communication is clearly impaired, lack of interest in collective activities, self-entertainment, emotional communication, behavioral communication, and the ability to integrate with social situations is significantly reduced.
3. Obstacles in speech and comprehension are obviously impaired, and words that are not related to the environment are often repeatedly used or make strange noises from time to time.
4. Developmental disorders are also characterized by limitations, repetitions, and stereotypes of behavior, interests, and activities, and adhere to a fixed and constant living environment and lifestyle.

Differential diagnosis of generalized developmental disorder

1. Mental retardation onset before the age of 18, mainly manifested by mental retardation and adaptive capacity as the main characteristics. Language and social skills are commensurate with intelligence.
2. Children with ADHD are mainly manifested as inattention and hyperactivity, but if their performance is criticized and educated, inattention and hyperactivity can be improved for a short time, while children with autism do not have the above characteristics. .

Treatment for generalized developmental disorders

1. Rehabilitation training and special education training Rehabilitation training at home and abroad is currently recognized as the most effective way to improve the core symptoms of autism and improve the quality of life of patients. It is also important for other types of extensive developmental delays. The main recommended rehabilitation training and education methods are: applied behavior analysis, structured education features of autism and related child treatment and education courses, and interpersonal relationship development intervention methods. Families and medical units should work together to strive for early detection, early diagnosis, early intervention, and strengthen the training of children's basic life skills. At the same time, pay attention to speech and attention training. Education should be targeted according to the different situations of children. training.
2. Psychotherapy mostly adopts behavioral therapy. The main purpose is to strengthen the established good habits. According to the learning principle, positive intensive therapy and aversion therapy can be applied to cultivate normal behavior and reduce pathological behavior. Cognitive therapy and home therapy can also be used together. Localized Chinese medicine psychotherapy (TIP) technology can also try to treat.
3. Drug treatment There is currently no special effective drug. If the mental symptoms are obvious, the corresponding drug can be used for symptomatic treatment. For example, children with autism have self-harm behaviors, aggressive and disruptive behaviors, and have psychotic symptoms such as hallucinations and delusions. They can be treated with drugs such as olanzapine, quetiapine, and risperidone. The amount is gradually increased to the appropriate dose range, and the blood routine and blood biochemistry are regularly reviewed. Observe adverse drug reactions and deal with them in a timely manner. Children with attention deficit and hyperactivity symptoms can be treated with drugs such as methylphenidate and tomoxetine. Patients with epilepsy can be treated with sodium valproate or magnesium valproate and oxcarbazepine.