NEURODEVELOPMENTAL DISORDERS
Abstract
Neurodevelopmental disorders occur as a result of abnormal development off the brain. The most common neurodevelopment disorders are Autism Spectrum Disorder (ASD), Attention Deficit-Hyperactive Disorder (ADHD), and dyslexia, among others (Bull,2011). A common condition is Down’s Syndrome that occurs when an individual has an extra chromosome. Over the years, studies have found out that children with Down’s Syndrome may also meet the diagnostic criteria for other developmental disorders. For instance, it is common to see a child with Down’s Syndrome may show some characteristics of ASD. Since we are currently discussing abnormalities behaviors and also because I have a friend with a daughter with Rubenstein Ray I Syndrome who has to go through Autism test to determine how much help she will need. There is still a lot to be done to learn about children with DS who also have ASD.
Key Words: Autism Spectrum Disorder, Down’s Syndrome, Neurodevelopment disorders, Chromosomes.
Introduction
DSM-5 is a handbook used by a health professional in America and other parts of the world. A condition of importance for this essay is Autism and Down’s Syndrome. DSM-5 classifies Down’s Syndrome as an intellectual disability. The brain of a child is not like the adult brain but rather a continuously developing brain subject to connections and modifications arising from the continuous stimulation. Modern studies indicate that children with Down’s Syndrome are at risk of having ASD. To diagnose Autism among patients with Down’s Syndrome, we need to have proper clinical judgments. It is common to see young children showing autism symptoms but not have the condition. Children with Down’s Syndrome and Autism are more challenged when compared with their counterparts who only have one of the illnesses. A 2018 UK study indicated that nearly 40% of people who have Down Syndrome meet the criteria for Autism (Delvin & Scherer,2012). For this paper, I will focus on the neurodevelopmental disorders in children, particularly Down’s Syndrome, and its relationship with Autism Spectrum Disorder (ASD). I will then address the challenges that arise as a result of diagnosing Autism Spectrum Disorders among Down Syndrome children.
Historical
Daniel Miler’s life is a perfect illustration of the changing attitudes in Down’s Syndrome. Back in the 1960s, people born with the condition had to go to government institutions at birth. The reports of life are such that institutions remain grim. In the past, people saw these people as people pretending not to read or speak to stay unnoticed. Other stories talked about children who still wear diapers because of poor toilet-training (Delvin & Scherer,2012). Although many parents were fully aware of such conditions, few did not heed to the advice of institutionalizing their children. Many parents believed they were better off if they stayed hidden and away from the bullying of the world. Later on, in 1970, the American government began moving people from these homes and sending them back to the community (Delvin & Scherer, 2012). These changes are now the pillar of improvements in the life expectations and health of people with the condition. A condition previously considered as unworthy is slowing becoming acceptable in our societies. The campaigners on disability rights now have some concerns. For instance, the ultrasounds and antenatal tests offered to mothers at risk of giving birth to children with the condition.
Today, health workers recognize that people living with Down’s Syndrome may also have other psychiatric related illnesses such as ASD. Since the philosophy is new to the medical field, there is little in about children and adults with the DS-ASD condition. As a parent, it is reasonable to worry if you think your child is not developing well. This worry is real because when it comes to DS-ASD, there is little information. It can be difficult if, as a parent, you notice your child developing habits associated with ADHD.
Cause of the Illness
The body cells contain genes grouped along with the chromosomes. Usually, each cell will have 46 chromosomes inherited from the parents. Down syndrome occurs when some or all the cells in the body have an extra full or partial copy of chromosome 21. The disease is caused by the nondisjunction error that results in the chromosome 21 extra copy. When this error occurs, the chromosomes from one pair move into a single cell, leaving no chromosomes for the pair (Lott & Diersenm,2010).
In most cases, the error occurs randomly during egg or sperm formation. Up to date, there is no environmental factor or the parent’s behavioral activities linked to Down’s Syndrome. Further, the studies by Delvin 7 Scherer,2012, have indicated that there are significant types of chromosomal changes that can result in the condition. Of these changes are the complete trisomy, translocation trisomy, and mosaic trisomy of chromosome 21. Important to note is that parents who do not have the condition can pass it to their children if they carry a translocation in the chromosome and lead to the disease in the child. To this end, studying the chromosomes of parents may help reveal if the condition arose as a result of the translocation of chromosome 21 in the parent. Genetic counselors help such patents to understand the risk of delivering a child with the disease. According to the National Down Syndrome Society, at least 1 in 700 babies born in America have downs syndrome. The illness is said to the most common developmental disorder in America.
Treatment
Generally, there is no standard treatment for Downs syndrome conditions, especially in cases where the patients also diagnosed with ASD. DS-ASD management and treatment of the disease focus on the intellectual and physical needs of the individual (Bull,2011). More so, its treatments may focus on the patient’s limitations and strengths. People suffering from the condition can receive care at home. As earlier mentioned, people with down syndrome are at a higher risk of several other illnesses. A majority of conditions associated with Down’s Syndrome may require immediate care right from birth. However, children suffering from such diseases need to receive the same medical care as the other “normal” children. In the treatment of the condition, specialists can offer a range of services ranging from early interventions to assistive devices. According to Ram & Chinen,2011 early, responses can improve the outcomes of the children with the condition. Interventions begin after birth and until age 3. From age 3, children can receive interventions through their schools. Under federal children, most children with the condition can receive free and appropriate public education. Other than the early interventions, the child can receive treatment therapies throughout his./her life.
Treatment therapies promote independence, productivity, and better development. Some of the conventional treatment therapies include physical therapies that involve taking the child through exercises and activities that can improve their skills, increase their muscle strength while also improving their balance and posture (Ram & Chinen,2011). Another possible approach is language therapy that helps the child improve their communication while also promoting the effective use of language. Occupational therapy is yet another approach to take when trying to help such children. It helps come up with ways of adjusting the daily conditions and tasks to match the needs and abilities of the affected children (Ram & Chinen,2011). Another possible approach to take in treating the illness is the use of supplements and drugs. Amino acids, medications, and supplements are known to affect brain activity. Prescribing them to the patients may affect their brain activity. Often the interventions for children with DS-ASD involve the use of assistive devices that improves their learning while also making it easier for them to complete given tasks.
Prevention
The prevention of Down’s syndrome and related psychiatric conditions continue to pose a significant challenge in the health system. Studies by Ram & Chinen, 2011 reveal that preventing the disease can be challenging. However, parents can follow some steps that may help reduce the risk. Older mothers are likely to give birth to babies with the condition. To mitigate such risks, doctors and specialists advise women to have babies before the age of 35 (Ram & Chinen,2011). Knowing if they are a risk of Down’s Syndrome may help a couple decide whether or not to keep a pregnancy. The primary prevention of the condition focuses on antenatal screening, which can detect about 90% of pregnancies characterized by Down’s Syndrome (Ogston, Mackintosh & Myers, 2011). Upon diagnosis, a mother can have therapeutic abortions.
Researches in early 1900 found out that children born with the conditions are often the last born in the family. A recent study conducted on mice added some information on the relationship between the age of the mother and the risk of Down’s Syndrome. Some proteins help keep the chromosomes together; they are the securin and cohesin (Ogston, Mackintosh & Myers,2011). A lower amount of these proteins makes the chromosome pairs to become loosely connected. Researchers found out that older mice have significantly low levels of such proteins suggesting that the older the egg, the lower the levels of these proteins. Being loosely apart leads to instability in the chromosomes. Meaning that it is more likely that the chromosome will end up opening unevenly. Such instances may lead the mice to have offerings with the abnormal alignment of the chromosome. Even though the studies were on mice, they might as well apply to humans. Eventually, therapists may use this information to reduce the risk of Down’s Syndrome among older women.
Recently, health professionals identified “secondary’ prevention. Recent researches have indicated that Folic acid plays a crucial role in the prevention of Down’s Syndrome. Specialists advise women to take folic supplements during and before pregnancy as it reduces the risk of the condition. Since there is limited information about DS-ASD, parents need to stay alert and also educate themselves about the disease. Families need to work together to build a health professionals’ team to help their children achieve the best outcomes.
Cross-Cultural
Cultures play a significant role in the treatment of neurodevelopmental disorders. The different world cultures have a different view on the cause, prevention, and treatment of neurodevelopmental disorders. Many a time, the mother carries the “blame” for the disability. They consider it as a punishment for wrongdoings or moving away from traditional cultures. The general community may hold the affected family responsible and fail to support or sympathize with them. To offer, the appropriate care, professional needs to put into consideration the cultural awareness a and understanding of the people in question. ( Bull,2011). Different cultures happen to have various health and health-seeking believes. Many families demonstrate the influence of their cultural believes and their isolation. Studies by Ram & Chinen, 2011 illustrate that an individual’s cultural needs are the need to access care and treatment regardless of his/her cultural background. Small families living in almost non-existent social groups face many demands and do not function so well. Even though the community is continuing to embrace people who have Down’s Syndrome and ASD, some cultures still find it difficult to coexist with people with the condition.
For instance, Down’s Syndrome patients in Taiwan still face stigma. In Africa, mothers, and women who bore children with Down’s Syndrome report to feel guilt and shame. Also, in the Caribbean and Africa, they were chased out of their matrimonial home( Delvin & Scherer,2012). The researchers further indicate that it is likely that the Taiwan government keeps people with Down’s Syndrome in secret. Different cultures perceive disabilities differently. Children living with DS-ASD needs support, the more the reason to create awareness.
Biblical Worldview
The community needs to recognize and celebrate individuals living with DS-ASD as a valuable creature of God since governments and societies all over the world do not seem to appreciate them. The catholic church emphasizes the need to protect the life of all individuals, regardless of their situation. Also, the community needs to celebrate people and not their disorders. They need to make their churches as places where people living with neurodevelopmental disorders can feel comfortable. Christians believe that God fearfully and wonderfully makes all humans. To this end, they might realize that not all children living with Down’s Syndrome are angels and that not all parents perceive the experiences of living with these children the same way. In the book of Ephesians 2:1-5, we see that God, who saved the race when it was dead, is the same God that ordains the children living with the condition. According to Ogston, Mackintosh & Myers,2011, the idea that God keeps people alive and allows them to rest on his promises is enough proof that he also ordains the hardship that might come along with raising a disabled child. Children diagnosed with Down’s Syndrome should be loved and not aborted. You can embrace the role that God has given you by loving and supporting families living with Down’s Syndrome. Christians believe that regardless of the situations, Down’s Syndrome is still God’s doing and has nothing to do with them falling short of the glory of God. God knew that someone would give birth to a child with the condition but still went ahead to create the children with Downs Syndrome.
Finally, Down’s Syndrome as one of the neurodevelopmental problems affects at least 1 in every 1000 children in America (Bull,2011). Recent researches have indicated a relationship between Down’s Syndrome and other neurodevelopmental diseases. For instance, it is now common to see a child with Down’s Syndrome diagnosed with ASD. There is still a lot to learn about the relationship between Down’s Syndrome and ASD. But before information on the two is made available, parents can take a leading role in recognizing the possibility of such conditions in their children. Down’s syndrome is a major neurodevelopmental problem, but there is still inadequate information about its prevention and treatment. Its treatment focuses on improving the functionality and performance of the affected children (Lott& Dierssen, 2010). Different cultures have different ideas when it comes to the cause, treatment, and prevention of neurodevelopmental disorders. Customs determines the health-seeking behavior of the individual communities, but some of them continue to victimize and stigmatized the people living with the conditions. In the religious context, Down’s Syndrome is a condition known by God who knew of its existence even before the affected people knew of them. Christian believe that they have a role in protecting and supporting the families and individuals suffering from the condition (Delvin & Scherer,2012). A way to show that you are embracing the role given to you, you can show love and celebrate the people living with Downs Syndrome. Future researches can focus on developing better prevention strategies for the condition and better diagnostic procedures for DS-ASD. Most women in the 21st century prefer giving birth later in life, and the fear of giving birth to a child with Down’s Syndrome may limit their decisions. Also, researches should focus on addressing the problems that arise as a result of the different cultural perspectives on the causes, treatment, and prevention of Down’s Syndrome. The victimization of women and isolation of the families who have a child with Down’s Syndrome needs to be discouraged.
References
Bull, M. J. (2011). Health supervision for children with Down syndrome.
Devlin, B., & Scherer, S. W. (2012). Genetic architecture in autism spectrum disorder. Current opinion in genetics & development, 22(3), 229-237.
Gray, L., Ansell, P., Baird, G., & Parr, J. R. (2011). The continuing challenge of diagnosing autism spectrum disorder in children with Down syndrome. Child: care, health, and development, 37(4), 459-461.
Lott, I. T., & Dierssen, M. (2010). Cognitive deficits and associated neurological complications in individuals with Down’s syndrome. The Lancet Neurology, 9(6), 623-633.
Ogston, P. L., Mackintosh, V. H., & Myers, B. J. (2011). Hope and worry in mothers of children with an autism spectrum disorder or Down syndrome. Research in Autism Spectrum Disorders, 5(4), 1378-1384.
Ram, G., & Chinen, J. (2011). Infections and immunodeficiency in Down syndrome. Clinical & Experimental Immunology, 164(1), 9-16.