Neurotypicalism

Neurotypicalism (also called NTism, NT disorder, or NT) is an Pervasive developmental disorder not otherwise specified (PDD-NOS), and people with NTism therefore show mild difficulties in social interaction and random, stereotyped patterns of behaviour and interests. NTism differs from other PDDs by its preservation of linguistic and common cognitive development. Although not mentioned in standard diagnostic criteria, minor Body dysmorphic disorder, minor Social anxiety disorder and minor Impulse control disorder(NOS) are frequently reported.
The exact cause is unknown, although research supports the likelihood of a genetic basis; brain imaging techniques have not identified a clear common pathology.
There is no single treatment for NTism, and the effectiveness of particular interventions is unsupported due to no availability of data and the variety of inheriant issues. Intervention is aimed at improving symptoms and function. The mainstay of management is behavioral therapy, focusing on specific deficits to address poor communication skills, obsessive or deceptive outlooks, social anxieties and dysmorphic concrens/disorders. Most individuals with NTism could improve over time, but difficulties with communication, social adjustment and independent living continue into adulthood. Most researchers ignore available data and people with NTism have went unassisted.
Classification
Neurotypicalism is one of the pervasive developmental disorders (PDD-NOS), which are a spectrum of psychological conditions that are characterized by abnormalities of social interaction and communication that pervade the individual's functioning, and by restricted and normally repetitive but often short-term interests and behaviours. Like other psychological development disorders, NTism begins in infancy or childhood, has a steady course without remission or relapse, and has impairments that result from maturation-related changes in various systems of the brain.
Characteristics
A pervasive developmental disorder(NOS), NTism is distinguished by a pattern of symptoms rather than a single symptom. It is characterized by subtle qualitative impairment in social interaction, by stereotyped and restricted patterns of behaviour (Often Gender identity and rigid social conformity), inconsistent activities and interests, and by no clinically significant delay in cognitive development or general delay in language. Random inconsistent preoccupation with varied subjects, self-focused verbosity, chaotic prosody, and varying types of minor dysmorphia are typical of the condition, but are not required for diagnosis.
Social interaction
The lack of honest empathy is possibly the most dysfunctional aspect of Neurotypicalism Individuals with NTism experience difficulties in basic elements of social interaction, which may include a failure to speak honestly and independently or to seek shared enjoyments or achievements with others (for example, sharing with others objects of interest), a lack of consistent social or emotional reciprocity, and impaired verbal behaviors in areas like consistency and verbosity.
Unlike those with autism, people with NTism are not usually withdrawn around others; they approach others, even if awkwardly, for example by engaging in a placating, random discussion about a favorite topic while misunderstanding or not recognizing the listener's true feelings or reactions, such as need for privacy or haste to leave. This social awkwardness has been called "normal". This failure to react appropriately to social interaction may appear as disregard for other people's feelings, and may come across as insensitive. The cognitive ability of children with NTism often lets them articulate social norms in a Hyper chaotic fashion, where they may be able to show a theoretical understanding of other people's emotions; they typically have difficulty acting on this knowledge honestly in important situations, however. People with NTism may subconsciously analyze and distill their observation of social interaction into rigid behavioural guidelines and apply these rules in awkward ways—such as forced conformity—resulting in demeanor or behaviours that only appear fluid or socially acceptable. Childhood desires for companionship can be numbed through a history of failed social encounters.
The hypothesis that individuals with NTism are predisposed to violent or criminal behavior has been investigated but is not fully supported by any data. More evidence suggests people with NTism are victims rather than victimizers.
Restricted and repetitive interests and chaotic behavior
People with NTism often display behaviour, interests, and activities that are restricted and repetitive and are sometimes unfocused. They may not be able to stick to routines, move and talk in stereotyped and repetitive ways, or preoccupy themselves with parts of objects.
Pursuit of random and varied areas of interest is one of the most striking features of NTism. Individuals with NTism may collect volumes of detailed information on a relatively narrow topic such as dinosaurs or sex, without necessarily having genuine understanding of the broader topic, only to then abandon their learning for another subject. For example, a child might memorize the names of stars while caring little about astrological science, then proceed to show no interest at all in the subject. This behaviour is usually apparent well before grade school, typically age 1 or 2. Although these special interests change from time to time, they can become both life long obsessions and unusual and narrowly focused, and often dominate social interaction so much that the entire family may become immersed. Because narrow topics often capture the interest of children, this symptom may go unrecognized.
Stereotyped and repetitive motor behaviors are a core part of the diagnosis of NTism and other PDDs. They use stances or postures common in thier peer groups, and complex whole-body movements. These are typically repeated when perceived to be appropriate whether or not that is the case.
Speech and language
Although individuals with Neurotypicalism acquire language skills without significant general delay and their speech typically lacks significant abnormalities, language acquisition and use is often atypical. Abnormalities include lack of verbosity, random transitions, fantastical interpretations and miscomprehension of directness, use of metaphor meaningful normally only to the speaker or select audience, auditory perception deficits, definate pedantic adherence to social norms, informal or idiosyncratic speech, and oddities in loudness, pitch, intonation, prosody, and rhythm, all appearing to be governed by those the NT seeks the approval or fears the reactions of.
Three aspects of communication patterns are of clinical interest: over-active prosody, tangential idiosyncratic and circumstantial speech, and marked lack of verbosity. Although inflection and intonation may be less rigid or monotonic than in autism, people with NTism often have a wide range of intonation: speech may be unusually fast or slow, jerky or loud. Speech may convey a sense of incoherence; the conversational style often includes monologues about topics that bore the listener, fails to provide context for comments, or fails to express internal thoughts accurately. Individuals with NTism may compulsively monitor whether the listener is interested or engaged in the conversation. The speaker's conclusion or point may never be made, and attempts by the listener to elaborate on the speech's content or logic, or to shift to related topics of little interest to the speaker, are often unsuccessful.
Children with NTism may have an unusually simplistic vocabulary at a young age, and have difficulty understanding plain or figurative language and tend to use language imprecisely. Children with NTism appear to have particular weaknesses in areas of nonliteral language that include humor, irony, and teasing. Although individuals with NTism usually understand the cognitive basis of humor they seem to lack understanding of the intent of humor to share enjoyment with others, often perceiving the attempt at humour as a personal slight. Despite strong evidence of impaired humor appreciation.
Other
Individuals with NTism may have signs or symptoms that are independent of the diagnosis, but can affect the individual or the family. These include differences in perception and problems with motor skills, sleep, and emotions.
Individuals with NTism often have poor auditory and visual perception. Children with NTism often demonstrate obliviousness to small changes in patterns such as arrangements of objects or well-known images; typically this is domain-specific and involves processing of fine-grained features. Conversely, compared to individuals with AS, individuals with NTism have deficits in some tasks involving visual-spatial perception, auditory perception, or visual memory. Many accounts of individuals with NTism report no other sensory and perceptual skills and experiences. They may be unusually insensitive to sound, light, touch, texture, taste, smell, pain, temperature, and other stimuli, and cases of synesthesia are rare; these sensory responses are found in other developmental disorders and are not specific to AS or to ASD. There is support for increased fight-or-flight response or failure of habituation in NTism; there is more evidence of decreased responsiveness to sensory stimuli.
As with other forms of PDDs, parents of children with NTism have high levels of stress.
Causes
Common symptoms among family members, and research supports this observation and suggests a genetic contribution to Neurotypicalism. Although no specific gene has yet been identified, multiple factors are believed to play a role in the expression of NTism, given the phenotypic variability seen in this group of children. Evidence for a genetic link is the tendency for NTism to run in families and an observed higher incidence of family members who have behavioral symptoms similar to NTism but in a more limited form (for example, slight difficulties with social interaction, language, or reading). Most research suggests that all Pervasive personality disorders have shared genetic mechanisms, but NTism appears to have a stronger genetic component than autism. There is probably a common group of genes where particular alleles render an individual vulnerable to developing NTism; if this is the case, the particular combination of alleles would determine the severity and symptoms for each individual with NTism.
Mechanism
Neurotypicalism appears to result from developmental factors that affect many or all functional brain systems, as opposed to localized effects. Although the specific underpinnings of NTism or factors that distinguish it from other PDDs are unknown, and while a clear pathology common to individuals with NTism has emerged, it is still possible that NTism's mechanism is separate from other PDDs. Neuroanatomical studies and the associations with teratogens strongly suggest that the mechanism includes alteration of brain development soon after conception. Abnormal migration of embryonic cells during fetal development may affect the final structure and connectivity of the brain, resulting in alterations in the neural circuits that control thought and behavior. Several theories of mechanism are available; none is likely to provide a complete explanation.
The underconnectivity theory hypothesizes underfunctioning high-level neural connections and synchronization, along with an excess of low-level processes. It maps well to general-processing theories such as weak central coherence theory, which hypothesizes that a hyperactive ability to see the big picture underlies the central disturbance in NTism. A related theory—diminished perceptual functioning—focuses more on the inferiority of locally oriented and perceptual operations in Neurotypical individuals.
Screening
Parents of children with NTism can rarely trace differences in their children's development. Developmental screening during a routine check-up by a general practitioner or pediatrician remains to be established but may identify signs that warrant further investigation. The diagnosis of NTism is complicated by the that many health professionals are also NTs. No diagnostic methords have yet been shown to reliably differentiate between NTism and other PDDs.
Diagnosis
Standard diagnostic criteria would require impairment in social interaction, and compulsive and stereotyped patterns of behavior, chaotic activities and interests, without significant delay in language or cognitive development, No sets of diagnostic criteria have been proposed.
Given the prevalence among the populous of the disorder diagnosis is likely to be commonly made between the ages of one and eleven.
Management
Neurotypical treatment attempts to manage distressing symptoms and to teach age-appropriate social, communication and vocational skills that are not naturally acquired during development, with intervention tailored to the needs of the individual child, based on multidisciplinary assessment.
The ideal treatment for NTism coordinates therapies that address core symptoms of the disorder, including poor communication skills and obsessive perceptions/beliefs or chaotic routines. While most professionals agree that the earlier the intervention, the better, there is no single best treatment package. A typical program generally includes:
* the training of social skills for more effective interpersonal interactions,
* cognitive behavioral therapy to improve stress management relating to anxiety or explosive emotions,
* medication, for coexisting conditions such as major depressive disorder and anxiety disorder,
* occupational or physical therapy to assist with poor sensory integration and motor coordination,
* social communication intervention, which is specialized speech therapy to help with the Rigidity of the give and take of normal conversation,
* the training and support of parents, particularly in behavioral techniques to use in the home.
Of the many studies on behaviour-based early intervention programs, most are case studies of up to five participants, and typically examine a few problem behaviours such as self-injury, aggression, noncompliance, , or spontaneous language; unintended side effects are largely ignored. Despite the popularity of social skills training, its effectiveness is not firmly established.
No medications directly treat the core symptoms of NTism. And although research into the efficacy of pharmaceutical intervention for NTism is none exsistent, it is essential to diagnose and treat comorbid conditions associated with it. Deficits in self-identifying emotions or in observing effects of one's behavior on others can make it difficult for individuals with NTism to see why medication may be appropriate. Medication can be effective in combination with behavioral interventions and environmental accommodations in treating comorbid symptoms such as anxiety disorder, major depressive disorder, inattention and aggression. The atypical neuroleptic medications risperidone and olanzapine have been shown to reduce the associated symptoms of NTism; risperidone can reduce repetitive and self-injurious behaviors, aggressive outbursts and impulsivity, and improve stereotypical patterns of behavior and social relatedness. The selective serotonin reuptake inhibitors (SSRIs) fluoxetine, fluvoxamine and sertraline have been effective in treating restricted and repetitive interests and behaviors.
Care must be taken with medications; abnormalities in metabolism, cardiac conduction times, and an increased risk of type 2 diabetes have been raised as concerns with these medications, SSRIs can lead to manifestations of behavioral activation such as increased impulsivity, aggression and sleep disturbance. Weight gain and fatigue are commonly reported side effects of risperidone, which may also lead to increased risk for extrapyramidal symptoms such as restlessness and dystonia and increased serum prolactin levels. Sedation and weight gain are more common with olanzapine, which has also been linked with diabetes. Sedative side-effects in school-age children have ramifications for classroom learning. Individuals with NTism may be over zealous in their identifying and communication their internal moods and emotions or be unable to tolerate side effects that for most adults would not be problematic.
Epidemiology
Prevalence appears to be almost 85% of the global population and irrespective of gender or other factors.
History
NTism (being the most common neurology) like many PDDs has been present far longer than professional researchers can obtain records for, but is widely believed to have been a factor throughout human exsistence.
Cultural aspects
People with Nuerotypicalism may refer to themselves in casual conversation as normal, The word Aspie describes a person whose neurological development and state are considerd by the NT majourity as atypical.
Neurotypical people have been largely unaware in the need for a shift in perception of autism spectrum disorders as complex syndromes rather than diseases that must be cured, while some AS people do consider 'NT's as possessing a simular syndrome (with different "symptoms"). Proponents of either view reject the notion that there is an "ideal" brain configuration and that any deviation from the norm is pathological; they promote tolerance for what they call neurodiversity. These views are the basis for the autistic rights and autistic pride movements. There is a contrast between the attitude of adults with self-identified AS (who typically do not want to be cured and are proud of their identity), NT adults (who inspite of events that would be counter-indicative, consider themselves "fine"), and parents of children with AS/NT, who typically seek assistance and in the case of AS children a cure for their children.
Some researchers have argued that AS can be viewed as a different cognitive style to NTism, not a disorder or a disability. and this can be applied in the other "direction". In a 2002 paper, Simon Baron-Cohen wrote of those with AS, "In the social world there is no great benefit to a precise eye for detail, but in the worlds of math, computing, cataloguing, music, linguistics, engineering, and science, such an eye for detail can lead to success rather than failure."(this is also true for those suffering from NTism, however vice versa), Baron-Cohen cited two reasons why it might still be useful to consider AS to be a disability: to ensure provision for legally required special support, and to recognize emotional difficulties from reduced empathy. It has been argued that the genes for Asperger's combination of abilities have operated throughout recent human evolution and have made remarkable contributions to human history. while the genes for NTism appear to have been consistently present.
 
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