Hidden impairments

2019 ◽  
pp. 726-745 ◽  
Author(s):  
Marios Adamou ◽  
John Hobson
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Learning Disabilities ◽  
Autism Spectrum Disorders ◽  
Neurodevelopmental Disorders ◽  
Autism Spectrum ◽  
Specific Learning Disabilities ◽  
Hyperactivity Disorder ◽  
Chronic Disorders ◽  
The Individual ◽  
Specific Learning

This chapter on hidden impairments considers the neurodevelopmental disorders including autism spectrum disorders and attention deficit hyperactivity disorder and their impact on employment and how occupational health (OH) professionals can provide appropriate advice on fitness to work. These chronic disorders have a combined prevalence of up to 6%, are highly co-morbid, and commonly present with specific learning disabilities such as dyspraxia, dyslexia, and dyscalculia. As the term implies, they are often missed by clinicians and are costly to society. With equality legislation and increasing diagnosis of neurodevelopmental disorders, OH professionals should be aware of the functional impact of these conditions and the behavioural and cognitive challenges to performance at work so they can best support the individual and advise the employer. The chapter provides guidance on how work can be designed and organized to enable people with neurodevelopmental disorders to obtain and retain suitable employment and to benefit from work.

scholarly journals Association of maternal diabetes with neurodevelopmental disorders: autism spectrum disorders, attention-deficit/hyperactivity disorder and intellectual disability

2020 ◽  
Author(s):  
Shuyun Chen ◽  
Sixian Zhao ◽  
Christina Dalman ◽  
Håkan Karlsson ◽  
Renee Gardner
Keyword(s):  
Diabetes Mellitus ◽  
Attention Deficit Hyperactivity Disorder ◽  
Autism Spectrum Disorders ◽  
Intellectual Disability ◽  
Attention Deficit ◽  
Neurodevelopmental Disorders ◽  
Maternal Diabetes ◽  
Autism Spectrum ◽  
Hyperactivity Disorder ◽  
Spectrum Disorders

Abstract Background Maternal diabetes has been associated with a risk of neurodevelopmental disorders (NDDs) in offspring, though the common co-occurrence of autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) and intellectual disability (ID) is rarely considered, nor is the potential for confounding by shared familial factors (e.g. genetics). Methods This population-based cohort study used data from Psychiatry Sweden, a linkage of Swedish national registers, to follow 2 369 680 individuals born from 1987 to 2010. We used population-averaged logit models to examine the association between exposure to maternal type 1 diabetes mellitus (T1DM), pre-gestational type 2 diabetes mellitus (T2DM) or gestational diabetes mellitus (GDM), and odds of NDDs in offspring. Subgroup analysis was then performed to investigate the timings of GDM diagnosis during pregnancy and its effect on the odds of NDDs in offspring. We compared these results to models considering paternal lifetime T1DM and T2DM as exposures. Results Overall, 45 678 individuals (1.93%) were diagnosed with ASD, 20 823 (0.88%) with ID and 102 018 (4.31%) with ADHD. All types of maternal diabetes were associated with odds of NDDs, with T2DM most strongly associated with any diagnosis of ASD (odds ratioadjusted 1.37, 95% confidence interval 1.03–1.84), ID (2.09, 1.53–2.87) and ADHD (1.43, 1.16–1.77). Considering common co-morbid groups, the associations were strongest between maternal diabetes and diagnostic combinations that included ID. Paternal T1DM and T2DM diagnoses were also associated with offspring NDDs, but these associations were weaker than those with maternal diabetes. Diagnosis of GDM between 27 and 30 weeks of gestation was generally associated with the greatest risk of NDDs in offspring, with the strongest associations for outcomes that included ID. Conclusion The association of maternal diabetes with NDDs in offspring varies depending on the co-morbid presentation of the NDDs, with the greatest odds associated with outcomes that included ID. Results of paternal-comparison studies suggest that the above associations are likely to be partly confounded by shared familial factors, such as genetic liability.

scholarly journals Considering learning disabilities and attention-deficit hyperactivity disorder when assessing for neurodegenerative disease

2019 ◽  
Vol 10 (6) ◽  
pp. 520-526
Author(s):  
Mary K. Colvin ◽  
Janet C. Sherman
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Learning Disabilities ◽  
Neurodegenerative Disease ◽  
Older Adult ◽  
Attention Deficit ◽  
Neurodevelopmental Disorders ◽  
Hyperactivity Disorder ◽  
Increased Risk ◽  
Specific Learning

Purpose of reviewWhen evaluating an older adult for a possible neurodegenerative disease, the role of premorbid specific learning disabilities or attention-deficit hyperactivity disorder (ADHD) should be considered. These neurodevelopmental conditions can manifest as lifelong weaknesses and variability in cognitive functions that complicate assessment of cognitive decline. There is also accumulating evidence that certain neurodevelopmental disorders may entail greater risk for specific neurodegenerative disorders.Recent findingsWe describe clinical cases where diagnosis of neurodegenerative disease was influenced by preexisting neurodevelopmental disorders. We also present a questionnaire to assist with screening for premorbid learning disabilities and ADHD in older adults.SummaryThis article offers clinical guidance for practicing neurologists in the identification and assessment of neurodevelopmental disorders in older adult patients, which informs management and treatment. Consideration of lifetime functioning has become increasingly important with research linking neurodevelopmental disabilities to increased risk of specific neurodegenerative diseases.

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