A succinct definition of neurodevelopmental disorder is a cluster of psychiatric conditions with an early onset during childhood. They usually manifest before entering grade school. These disorders coincide with the developmental period and negatively impacts the social, academic, occupational and personal aspect of functioning in the affected individual (Kilgus, Maxmen & Ward, 2016). Notably, the spectrum of disorders within the neurodevelopmental disorder can co-exist in the same individual. For instance, children with autistic disorder often suffer from intellectual developmental disorder (American Psychiatric Association, 2013).
Teratogens and associated neurodevelopmental disorders
Teratogen is an agent with the potential of causing adverse effects on the fetus following an exposure. Congenital malformation, disturbed postnatal development and behavioral difficulties, intrauterine growth restriction or fetal demise are among the negative implications of teratogens ( Tomson & Battino, 2012). Exposure to antiepileptic drugs in the course of pregnancy has been linked to an increases in neurodevelopmental disorder and congenital malformation. Incidences of autism spectrum disorder including asperser’s disorder and unspecified pervasive disorder has been increased by maternal consumption of valproate (Christensen et al., 2013). Other implicated teratogens with similar effect are lamotrigine and carbamazepine ( Bromley et al., 2013). Antidepressants such as paroxetine and clorimipramine (Kilgus, Maxmen & Ward, 2016) increases the risk of fetal anomalies when used during pregnancy. Lithium, a mood stabilizer (Kilgus, Maxmen & Ward, 2016) has less teratogenic effect than valproate. Valproate exposure via placenta is associated with higher risk of infant neurodevelopmental delay in addition to autism-spectrum disorders (Gentile, 2011). Delays in neurodevelopment with marked alteration in behavior has been linked to heavy maternal consumption of alcohol (Mattson, Crocker & Nguyen, 2011). Underdeveloped motor and cognitive function has been reported in fetal alcohol spectrum disorder (Riley, Infante & Warren, 2011).
Delegate your assignment to our experts and they will do the rest.
In order to prevent exposure to teratogens, the safety profile of antiepileptic drugs to be assessed before instituting optimum doses in pregnant women ( Tomson & Battino, 2012). Alcohol and other teratogens such as antidepressants with toxic effect to the fetus to be avoided by gravid mothers (Gentile, 2011).
Ethical Implications of Incarcerating Pregnant Women
There is justice in liberty deprivation for substance dependent pregnant women so as to protect the fetus from exposure to teratogens. However in many circumstances, the arrest made or other action are taken were not dependent on evidence of actual harm to the fetus or newborn. Usually no adverse effects are documented on pregnancy outcomes. Conviction for criminal charges is pegged on claims of risk of harm or positive toxicology screening but not on the actual prove of harm. In other cases a risk of harm that does not materialize has been witnessed when a medical intervention is order by the court (Paltrow & Flavin, 2013).
What Happened To Asperger’s Disorder?
Asperger’s disorder was initially classified under pervasive developmental disorder in DSM-IV separate from autistic disorder. Clinical symptoms that meet the criteria for Asperger’s disorder in DSM-IV are now given the diagnosis of autism spectrum disorder under the new criteria in DSM-5 (American Psychiatric Association, 2013).
Comparison between Reactive Attachment Disorder (RAD) and Autism
Similarities
There is an overlap in challenges with social relationship between autism spectrum disorder (ASD) and RAD. Both exhibit withdrawn or stereotype pattern of behavior, flattened affect and disinhibition, and a range of intellectual functioning which may reflect intellectual disability (American Psychiatric Association, 2013).
Differences
Negligence and maltreatment in addition to unusual setting of development is responsible for some of the presentation in RAD such as withdrawn behavior and disinhibited emotion and social interaction. This is not true in ASD since neglect or maltreatment are not causal factors. Children with ASD frequently demonstrate attachment behavior typical for their developmental level whereas children with reactive attachment disorder do so only rarely or inconsistently (American Psychiatric Association, 2013).
Differential diagnosis
The differential diagnosis of RAD include autism spectrum disorder, intellectual developmental disorder and depressive disorder (American Psychiatric Association, 2013). Difficulty in social relation and inhibited emotions are usually seen in both RAD and ASD. Delays in attaining social interactions in RAD may be confused with intellectual disability. Children with RAD usually have disinhibited emotions which resembles negative affect seen in depressive disorder.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®) . American Psychiatric Pub.
Bromley, R. L., Mawer, G. E., Briggs, M., Cheyne, C., Clayton-Smith, J., García-Fiñana, M., ... & Liverpool and Manchester Neurodevelopment Group. (2013). The prevalence of neurodevelopmental disorders in children prenatally exposed to antiepileptic drugs. J Neurol Neurosurg Psychiatry , jnnp-2012.
Christensen, J., Grønborg, T. K., Sørensen, M. J., Schendel, D., Parner, E. T., Pedersen, L. H., & Vestergaard, M. (2013). Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. Jama , 309 (16), 1696-1703.
Gentile, S. (2011). Drug treatment for mood disorders in pregnancy. Current opinion in psychiatry , 24 (1), 34-40.
Kilgus, M., Maxmen, J., & Ward, N. (2016). Essential psychopathology and its treatment (4th ed., p. 697). New York : W.W. Norton & Company, [2016].
Mattson, S. N., Crocker, N., & Nguyen, T. T. (2011). Fetal alcohol spectrum disorders: neuropsychological and behavioral features. Neuropsychology review , 21 (2), 81-101.
Paltrow, L. M., & Flavin, J. (2013). Arrests of and forced interventions on pregnant women in the United States, 1973–2005: Implications for women's legal status and public health. Journal of Health Politics, Policy and Law , 38 (2), 299-343.
Riley, E. P., Infante, M. A., & Warren, K. R. (2011). Fetal alcohol spectrum disorders: an overview. Neuropsychology review , 21 (2), 73.
Tomson, T., & Battino, D. (2012). Teratogenic effects of antiepileptic drugs. The Lancet Neurology , 11 (9), 803-813.
