Outcomes in Neurodevelopmental and Genetic Disorders
Year: 2005
Type: article
Abstract: Fifty years ago the average life expectancy of someone with Down syndrome was about 12 years. Nowadays it is at least 45 years. The psychiatry of working with children and adults with intellectual disabilities is still virgin territory and this book attempts, fairly successfully, to describe it for the general child psychiatrist. The book is from the Cambridge Child and Adolescent Psychiatry Series, and covers the natural history and outcome of neurodevelopmental and genetic disorders. All these disorders are evident in early childhood, but very little has been written about their outcome in adulthood and similarly, little has been written about associated behavioral difficulties.
The first three chapters are on attention deficit hyperactivity disorder, developmental language disorder and reading and other specific learning difficulties, which are developmental disorders commonly seen by child psychiatrists. They are typically associated with overall average general intellectual abilities. Chapters four and five are on metabolic disorders and hemiplegic cerebral palsy, disorders with clear-cut organic brain impairment associated with a range of intellectual functioning. Finally the last seven chapters outline neurodevelopmental syndromes associated with intellectual disabilities with new information about genetic causes as well as descriptions of typical behaviours in these children, so called behavioural phenotypes.
Once again, as in the previous chapters, the different presentations at different stages in the life span from infancy till adulthood are outlined. This reader found particularly fascinating the chapter on hemiplegic cerebral palsy by Robert Goodman. This static encephalopathy carries with it significant concurrent behavioural and emotional problems, resulting from the combination and interaction of both organic and psychosocial factors. The chapter on Prader-Willi and Angelman’s syndrome by Anthony Holland and colleagues is well worth reading although this information has been fairly widely distributed in the past few years. Both syndromes are associated with a chromosome deletion on a similar part of chromosome 15, yet are phenotypically completely different. The genetic basis for this is discussed and the syndromes are described. Once again particularly with Prader-Willi syndrome significant psychiatric co-morbidity is a serious problem.
This book is written by experts in the field and is highly recommended for all child psychiatrists, not just those working in the field of intellectual disabilities. The usefulness of the book stands out when considering that some of these syndromes may occur in children with average to above average intellectual abilities and may not be recognized by general child psychiatrists, particularly in their milder presentations.
All of the information is research based and well referenced, resulting in a book that is both very readable and highly recommended.
Source: PubMed Central
Author: Robin Friedlander
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W212294291