Neurodevelopmental Disorders

Concept First

A child's brain develops rapidly in the early years. When this development is disrupted, it can lead to a group of conditions called neurodevelopmental disorders. The key idea is that these disorders begin early — often before the child starts school — and they affect the child's ability to function in everyday life: at home, with friends, in the classroom, and later at work. The core problem is either a deficit (something missing or delayed, like not speaking at the expected age) or an excess (too much of a behaviour, like constant fidgeting). If these disorders are not addressed in childhood, they can become more serious and chronic as the child grows into an adult.

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Attention-Deficit/Hyperactivity Disorder (ADHD)

ADHD has two main features: inattention and hyperactivity-impulsivity.

Inattention means the child struggles to sustain mental effort. Common signs include:

• Difficulty keeping their mind on one thing
• Not listening when spoken to
• Trouble following instructions
• Being easily distracted and disorganised
• Forgetting things and not finishing assignments
• Losing interest quickly in boring activities

Hyperactivity-impulsivity involves a lack of control. Impulsive children act without thinking. They:

• Cannot wait their turn
• Find it hard to resist immediate temptations
• Have trouble delaying gratification
• Often cause minor mishaps (knocking things over) and sometimes serious accidents

Hyperactivity itself takes many forms. The child is in constant motion — sitting still through a lesson is impossible. They may fidget, squirm, climb, or run around the room aimlessly. Parents and teachers often describe them as "driven by a motor," always on the go, and talking non-stop.

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Autism Spectrum Disorder

This disorder is characterised by three broad areas of difficulty:

1. Widespread impairments in social interaction
2. Impairments in communication skills
3. Stereotyped (repetitive) patterns of behaviour, interests, and activities

Children with autism spectrum disorder have marked difficulties in social interaction and communication across different contexts. They also have a restricted range of interests and a strong desire for routine.

Social difficulties are profound. These children:

• Are unable to initiate social behaviour
• Seem unresponsive to other people's feelings
• Cannot share experiences or emotions with others

Communication and language are seriously abnormal and persist over time. Many never develop speech. Those who do speak have repetitive and deviant speech patterns.

Behaviour patterns are narrow and repetitive. Examples include:

• Lining up objects
• Stereotyped body movements like rocking
• Self-stimulatory motor movements such as hand flapping
• Self-injurious behaviours such as banging their head against the wall

Because of these verbal and non-verbal communication difficulties, individuals with autism spectrum disorder struggle to start, maintain, and even understand relationships.

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Intellectual Disability

Intellectual disability involves two things that must both be present before the age of 18 years:

1. Below average intellectual functioning — an IQ of approximately 70 or below
2. Deficits or impairments in adaptive behaviour — this includes skills in communication, self-care, home living, social/interpersonal skills, functional academic skills, and work

The table below describes the characteristics of intellectually disabled persons.