South African Psychiatry - November 2020

ADHD CONGRESS
1 ST SOUTHERN AFRICAN MULTIDISCIPLINARY ADHD CONGRESS
HOT TOPICS IN ADHD:
NEURODEVELOPMENT
Anusha Lachman
T
he session hosted three leading experts in the
field of Neurodevelopment in South Africa.
The content is a summary of the essential
“take home” messages from each talk.
DR ANDROULA LADIKOS: OVERLAP BETWEEN
ADHD AND AUTISM
This talk highlighted the comorbidity and increased
impairment in children who have both features
of ADHD and Autism Spectrum Disorders. These
frequently co-occur and inadequate treatment as
a result of inaccuracy in identification and diagnosis
often can result in a suboptimal response. There
are no specific diagnostic tests to differentiate the
conditions, as the overlap may be in part explained
by the interplay between genetic factors, the
environment and individual vulnerabilities.
A SUGGESTED APPROACH WOULD BE TO
IDENTIFY WHICH ARE THE MOST OBVIOUS
SYMPTOMS AND WHICH CAUSE THE
MOST FUNCTIONAL IMPAIRMENT AND
THEN DIRECT THE INTERVENTIONS
ACCORDINGLY. THERE ARE RED FLAGS
OR EARLY WARNING SIGNS HOWEVER
NONE ARE SPECIFIC OR DEFINITIVE.
In general look for deficits in Social engagement,
atypical sensory reactivity, stereotypies and poor
communication skills when considering a child with
ASD that has ADHD co-occurring. Motor restlessness
and dysregulation could also be a helpful symptom
cluster to differentiate.
A reference that was suggested
from this talk: Young, S.,
Hollingdale, J., Absoud, M.,
Bolton, P., Branney, P., Colley, W., &
Gudjonsson, G. (2020). Guidance
for identification and treatment of
individuals with attention deficit/
hyperactivity disorder and autism
spectrum disorder based upon
expert consensus. BMC Medicine,
18, 1-29.
Anusha Lachman
PROF KIRSTY DONALD: GENETIC TESTING FOR
NEURODEVELOPMENTAL DISORDERS
This session explored the complexities of genetic
testing in early neurodevelopmental disorders
and highlighted the challenges in the field,
especially since non – European ancestry is under
represented in current GNAS data. Prof Donald
explained the central dogma of genetics including
the difference in genetic inheritances of polygenic
versus mendelian inheritances when it comes to
developmental delays in children.
THE CAUSE OF A CONDITION MAY BE
AN INTERPLAY BETWEEN GENETICS
AND ENVIRONMENTAL FACTORS.
EARLY ADVERSITY ESPECIALLY DURING
SENSITIVE PERIODS OF DEVELOPMENT
WILL IMPACT ON BIOLOGICAL
RESPONSES AND SYSTEMS.
These biological changes include epigenetic and
homeostatic alterations, neuronal disruption and
40 * SOUTH AFRICAN PSYCHIATRY ISSUE 25 2020