Is ADHD a development Disorder?

Developmental Disorders – An Overview

The term “developmental disorder” or “developmental disability” means a severe, chronic disability of an individual that:
• is attributable to a mental or physical impairment, or combination of mental and physical impairment
• is manifested before the individual attains the age of 22
• is likely to continue indefinitely
• results in substantial functional limitations in three or more of the following areas of major life activity:
o self-care
o receptive and expressive language
o learning
o mobility
o self-direction
o capacity for independent living
o economic self-sufficiency
o reflects the individual’s need for a combination and sequence of special, interdisciplinary, or generic services, individualized support or other forms of assistance that are of lifelong or of extended duration and are individually planned and coordinated.
*As defined by the Developmental Disabilities Assistance and Bill of Rights Act of 2000, Public Law 106-402.
Developmental disabilities are a group of many conditions that result in disability due to an impairment in physical, learning, language, or behavior areas. About one in six children in the U.S. have one or more developmental disabilities or other developmental delays.
For additional information, review these resources (all links open in a new window):
• Developmental Disorders
• Developmental Disabilities
• Intellectual and Developmental Disabilities
• Pervasive Developmental Disorders
Pervasive Developmental Disorders: A Glimpse at Autism

Autism is considered to be the most significant of the pervasive developmental disorders. Autistic individuals generally have impaired social interactions, verbal and nonverbal communication difficulties, and severely limited activities and interests from which they do not like to deviate. Autism itself is a rather broad diagnosis, with individuals suffering extreme retardation and social impairment to individuals who are of normal intelligence but with impaired social skills (Asperger’s Syndrome). There is also another very rare subsection of autism called Savant Syndrome. These individuals display neurological developmental delays in socialization and communication but also have astonishing skills such as perfect pitch, eidetic memory, mathematical skills, pattern recognition, and musical abilities.
Etiology and Features
The etiology of autism can be either congenital or due to CNS disease/ injury. There are several brain differences between autistic brains and normal brains. The cerebellum lobes are markedly reduced in size indicated an inability to swiftly shift attention from one task to the next. Cerebellar Purkinje cells are affected as well. There is a decrease in the number of Purkinje cells as well as a reduction in their synaptic connections. The decrease in these cells prevents the connection between the cerebellum and the cognitive processing centers of the brain. As a result, coordination of motor function is impaired. The limbic system (which we know includes the hippocampus and amygdale) contains nerve cells that are immature and failed to migrate during development to their proper locations. As the limbic system is responsible for relaying information throughout the brain and correlating emotion to that information, this malformation results in the unresponsive, emotionless expressions associated with autism.
In general, there is a pattern of brain lateralization in autistic individuals. Autistics show a dependence on the right brain because there has been damage to the left hemisphere. It has been proposed that this damage is due to an influx of testosterone in the later stages of in utero development. This proposal is supported by the fact that autism is six times more likely to occur in men as in women. Testosterone is neurotoxic and as the left hemisphere develops at a slower rate than the right hemisphere, it is more seriously affected than the right. These findings are most significant in regards to Savants. The right brain is associated with special skills related to the primary senses and nonsymbolic skills. The left brain is associated with higher cognitive skills, including language and sequential and logical thinking. The damage to the left hemisphere and higher memory structures may be the cause of Savant syndrome resulting in the right hemisphere compensating.
It has been postulated that autistics and Savants have difficulty thinking in holistic terms. That is, they get caught up in the details and are often unable to fit the pieces of an image together into a whole. For example, an autistic boy who saw a picture of a giraffe identified it through a detail, the pattern of its coat. When presented with a picture of a leopard, the boy identified it as a giraffe as well, because its coat had spots. Imagine looking at a Monet painting. We see a beautiful painting of water lilies. An autistic individual would see dots. Normal humans are good at seeing the big picture but bad at what Grandin calls “all the tiny little details that go into that picture”. For normal humans, the big picture is not created by accumulating sensory details, but rather by filtering out details. Grandin argues that humans have larger association areas than nonhuman animals and that access to raw sensory data is restricted in order to avoid overloading these association areas. Autistic individuals and animals do not have this filter and therefore experience all of the raw sensory data.
An Autistic on Autism
An autistic woman, Temple Grandin , has put forth an interesting idea, that based on the information presented above, may have some weight. She claims that autistic individuals think like intelligent animals (non-human). Autistic individuals, according to Grandin, think in pre-language symbols and pictures rather than in words. Autistics and animals focus on the details whereas normal individuals can generalize. They do this because the language portion of their brain is not developed (or is not present at all, as with animals). Grandin cites research on verbal overshadowing as evidence for her idea. Verbal overshadowing is a phenomenon in which language suppresses visual memory. For instance, two groups of people watch a video of a bank robbery then do an unrelated task for 20 minutes. One group then does another unrelated task for 5 minutes while the other group spends five minutes writing down everything they can remember about the robber’s face. When tested later, the individuals who wrote down the information about the robber’s face had more difficulty picking out the robber’s photograph from a line-up. Grandin states that language works as a filter of details for normal people whereas animals and autistics do not have that filter and therefore see those details indefinitely.
Grandin also points out the ability of normal individuals to apply logic, rules, and generalizations to stimuli and events. Due to the right hemisphere reliance autistics and animals display, autistics are not able to the same. This, however, is not always a handicap. In an experiment in which rats were compare to humans in their ability to determine when to press a lever in order to receive a reward. The experimenters set it up so that there was no punishment for a wrong response. Humans never figured out the “problem” because they kept trying to figure out the “rule” for receiving a reward, therefore they received far fewer rewards. But the rats figured it out quickly, the best strategy was to press the lever no matter what, they earned more rewards than the humans did. As Grandin puts it, “the problem with normal people is they are too cerebral”. That is, their higher cognitive abilities (language, logic, and rules) override the lower brain processing.
While many scientists reject Grandin’s anecdotal claims that autistics think like animals do, there is some evidence she is correct on certain levels. When autistics acquired language, their savant skills and autistic tendencies to be hypersensitive to details decreased. It is important to remember that while animals do seem to perceive the world in a similar fashion to autistics, they are not overwhelmed by detail as autistics are.
Discussion – Is ADHD a Developmental Disorder?

Considering what you have learned about developmental disorders and the brain, answer the following:
1. What evidence to support or not support that Attention-deficit/hyperactivity disorder (ADHD) a Developmental Disorder?

2. What is the prevalence rate of ADHD in the US and does it impact one sex more than the other? What are the primary causes of ADHD?

3. How easily is ADHD diagnosed? Is it over-diagnosed, and if so, why? How is it ideally treated vs how is it usually treated?
Imagine if you were the parent of a child who was carefully and correctly diagnosed with ADHD. What kind of treatment would you want for your child? Describe the advantages and disadvantages of at least one type of ADHD treatment and why you might choose that approach for your child
J. A. Eisler. (2014). Psychobiology: An Interactive Exploration of the Brain and Behavior.
W.E. Pelham Sr., T.F. Page, A.R. Altszuler, E.M. Gnagy, B.S.G. Molina & W.E. Pelham Jr. (2020). The long-term financial outcome of children diagnosed with ADHD. Journal of Consulting and Clinical Psychology, Vol. 88, No. 2, 160 –171. Retrieved from:https://wepelham3.github.io/papers/pdfs/pelham_et_al-2020-jccp.pdf

 

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Is ADHD a development Disorder? was first posted on March 23, 2020 at 4:32 pm.
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