Current Developmental Disorders Reports

One challenging area of speech-language pathology is evaluating treatment change in children with speech sound disorder (SSD) with a motor basis. A clinician’s knowledge and use of outcome measures following treatment are central to evidence-based practice. This narrative review evaluates the use of outcome measures to assess treatment change in motor-based SSDs. Seven databases were searched to identify studies reporting outcomes of treatment in SSDs between 1985 and 2014. Sixty-six studies were identified for analysis, and reported outcome measures were categorized within the International Classification of Functioning, Disability and Health framework (ICF-CY). The majority of studies used perceptual methods (despite their limitations) to evaluate change at the impairment level of the ICF-CY and only three studies examined participation level factors. Accurate outcome measures that reflect the underlying deficit of the SSD as well as activity/participation level factors need to be implemented to document intervention success in this population.

Early intervention programs have been shown to increase the overall socio-emotional and physical wellbeing of children in early childhood and educational settings. The goal of this narrative review is to explore recent literature that describes implementation of these systems and highlights innovative practices in the early childhood intervention sector. Twenty-three articles were included, and we identified three themes in this review. The literature addressed concepts of innovative techniques in relation to childhood disability interventions; policy practices that promote child, family, and practitioner wellbeing; and attention to the importance of trauma-informed care in education for children and families who face the impacts of social marginalization such as racism and colonization. Notable shifts in the current early intervention paradigms are approaches to understanding disability informed by intersectional and critical theories, as well as systems level thinking that goes beyond focusing on individual intervention by influencing policy to advance innovative practice in the sector.

Research examining brain development in neurodevelopmental disorders has largely comprised small-scale studies on individual disorders. Findings have confirmed neurodevelopmental disruption and deviation; however, comorbidity between disorders continues to challenge our understanding of brain-behaviour associations. This review discusses early brain development and the etiological factors that may give rise to atypical developmental trajectories, along with neuroimaging insights into neurodevelopmental disorders. Evidence related to the behavioural, neurological, genetic and environmental factors impacting on brain development is examined. Large neuroimaging databases are currently being used to identify early alterations in brain development and areas of divergence and convergence between disorders are reviewed. Investigative approaches based on diagnostic groups continue to challenge our ability to elucidate regions of the brain linked to behavioural phenotypes, especially those known to be shared across disorders.

The purpose of this study was to evaluate what effect teaching multiple functional communicative responses (FCRs) as outlined in serial functional communication training (FCT) had on resurgence of problem behavior and FCRs during extinction challenges. Researchers then evaluated what effect implementing a lag schedule of reinforcement following serial FCT had on resurgence of problem behavior and FCRs during extinction challenges compared with serial FCT. Recent findings evaluated the effect of a serial FCT procedure on resurgence of problem behavior, and the persistence of FCRs in an applied setting to determine if serial FCT would decrease the total number of responses of problem behavior during the resurgence (extinction) test while simultaneously increasing the total number FCRs as compared with the traditional (single) FCT condition for two children. They observed more manding (use of FCRs) and a smaller percentage of total responding occupied by problem behavior during serial FCT relative to traditional FCT. However, they also observed that problem behavior occupied the largest percentage of total relapse, demonstrating a primacy effect. The results of the present study indicate that teaching multiple FCRs in a serial FCT context is not sufficient to ensure the persistence of FCRs and significant delays or elimination of the resurgence of problem behavior during extinction challenges. Implementing a lag-2 schedule of reinforcement produced some desired effects, such as a higher total frequency of FCRs; however, resurgence of problem behavior was observed at higher rates and short latencies.

The main purpose of this review is to understand how attention deficit hyperactivity disorder (ADHD) affects geriatrics (elderly population). ADHD is a common neuropsychiatric condition, which is not well studied in geriatrics. Current literature does not have too much information on effects of ADHD in geriatrics. ADHD in elderly population is accompanied by various comorbidities such as anxiety and depression. This review will provide an overview of existing literature on prevalence of ADHD in elderly population along with the comorbidities and available treatment options for the same.

Social ties are essential to the health and wellness of people with intellectual and developmental disabilities (IDD); however, a better understanding of factors that promote and support the development of social relationships is needed to develop effective policies and interventions to promote wellness. Three factors that influence the formation and maintenance of social ties for people with IDD are individual capacity, interpersonal supports, and organizational or community supports. The benefits of a strong social network and the dangers of isolation have been well established in people with and without IDD. Yet, there is a lack of research and planning around how best to support people with IDD in developing and maintaining social relationships. Policy and organizational changes as well as increased research attention is needed to promote the health and wellness of people with IDD by nurturing relationships.

The aim of this review is to identify key considerations for health providers delivering self-management support to adults with intellectual and developmental disabilities (IDD) living with chronic health conditions. There is an emerging body of evidence to inform the delivery of self-management support for adults with IDD living with chronic health conditions. The most extensive research on this topic relates to diabetes self-management, with a small number of studies on general chronic disease self-management. Three over-arching themes were identified: (1) acknowledging autonomy, responsibility, and risk; (2) building the capacity of caregivers, and (3) attending to emotional needs and psychosocial factors. To facilitate wellness, it is critical that health providers are equipped with the knowledge and resources required to provide appropriately tailored self-management supports for people with IDD living with a range of chronic health conditions. This review extends our current understanding of this approach and identifies both unique considerations and tensions that exist for this population and their caregivers.

This review summarizes the shared and distinct clinical features of obsessive-compulsive disorder Tourette’s disorder (TD), and their comorbidity, in addition to state of the literature on differential diagnosis of these disorders, and best-practice treatment guidelines for their comorbid presentation. OCD and TD are each marked by recurrent behaviors and maintained via alleviation of adverse internal processes. They also share clinical features, comorbidities, and etiology, complicating diagnosis. Differential diagnosis draws on consideration of the nature of repetitive behaviors, obsessions, and sensory phenomena through validated assessment measures. Comorbid OCD and TD are associated with earlier age of symptoms, greater male preponderance, and more symmetry, repeating, touching, tapping, blinking, staring behaviors, and sensory. Tourettic OCD (TOCD) represents a unique challenge in which tic-like compulsions are accompanied by sensory phenomena. For TOCD, a longer cognitive behavioral therapy course may be warranted, with supplemental habit reversal training provided as needed; augmentation of selective serotonin reuptake inhibitors with neuroleptics is recommended. Repetitive transcranial magnetic stimulation, deep brain stimulation, and cannabis-based medicines provide novel means of targeting their comorbidity. Understanding of broader symptom context and use of validated assessment measures can inform diagnosis and treatment decisions for OCD and TD. More research is needed to explore combined treatments and novel therapeutics for comorbid OCD and TD.

Comorbidity complicates behavioral treatment for youth with Tourette’s syndrome (TS). The Comprehensive Behavioral Intervention for Tic (CBIT) is a first-line intervention, and several clinical guidelines exist to assist clinicians in developing effective treatment plans for youth with TS. Unfortunately, there is currently little guidance on how to alter CBIT and similar evidence-based behavioral interventions in complex cases of TS with comorbidity. We present potential treatment adaptations for youth with TS and comorbidities and discuss factors that may impact clinical decision-making. Behavioral treatments have produced favorable tic-related outcomes (e.g., reducing the severity and functional impact of tics); however, less consideration has been given to the sequelae of comorbidity, including the accompanying behaviors and underlying emotional distress that may interfere with treatment such as emotional dysregulation, poor distress tolerance, attention/executive functioning deficits, low motivation, impulsivity, avoidance, and oppositional behaviors. Current understanding of adaptations for behavioral treatment suggests beginning with a comprehensive assessment, followed by detailed treatment planning with the collaboration of the patient, caregivers, and healthcare team. Future research is needed to further examine best practices for youth with TS and comorbid conditions.