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Chapter 14 Developmental Disorders

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... Learning disorders Autism Mental retardation Attention Deficit Hyperactivity Disorder (ADHD): An Overview Nature of ADHD Inattention, overactivity, ... – PowerPoint PPT presentation

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Title: Chapter 14 Developmental Disorders


1
Chapter 14 Developmental Disorders
2
Nature of Developmental Psychopathology An
Overview
  • Normal vs. Abnormal Development
  • Developmental Psychopathology
  • Disruption of early skills can affect later
    development
  • Developmental Disorders
  • Diagnosed first in infancy, childhood, or
    adolescence
  • Attention deficit hyperactivity disorder (ADHD)
  • Learning disorders
  • Autism
  • Mental retardation

3
Attention Deficit Hyperactivity Disorder (ADHD)
An Overview
  • Nature of ADHD
  • Inattention, overactivity, and impulsivity
  • impairments
  • Behavioral
  • Cognitive
  • Social and academic problems
  • DSM-IV and DSM-IV-TR Symptom Types
  • Inattentive type
  • Hyperactive type
  • Impulsive type

4
ADHD Facts and Statistics
  • Prevalence
  • 6 of school-aged children
  • Symptoms are usually present around age 3 or 4
  • 68 of children with ADHD have problems as adults
  • Gender Differences
  • Boys outnumber girls 4 to 1
  • Cultural Factors
  • Greatest probability of diagnosisin the United
    States

5
The Causes of ADHD Biological Contributions
  • Genetic Contributions
  • ADHD seems to run in families
  • DRD4, DAT1, and DRD5 genes have been implicated
  • Neurobiological Contributions
  • Smaller brain volume
  • Inactivity of the frontal cortex and basal
    ganglia
  • Abnormal frontal lobe development and functioning
  • Precise neurobiological mechanisms remain unclear
  • The Role of Toxins
  • No evidence that allergens and food additives are
    causes
  • Maternal smoking increases risk

6
The Causes of ADHD Psychosocial Contributions
  • Psychosocial Factors
  • Can influence the nature of ADHD
  • ADHD children are often viewed negatively by
    others
  • Constant negative feedback from peers and adults
  • Peer rejection and resulting social isolation
  • Such factors foster low self-esteem

7
Biological Treatment of ADHD
  • Goal of Biological Treatments
  • To reduce impulsivity and hyperactivity
  • To improve attention
  • Stimulant/Non stimulant Medications
  • Reduce core symptoms in 70 of cases
  • Examples include Ritalin, Dexedrine
  • Strattera http//www.baltimorepsych.com/Strattera.
    htm
  • Other Medications With More Limited Efficacy
  • Imipramine and Clonidine (antihypertensive)
  • Effects of Medications
  • Improve compliance decrease negative behaviors
  • Do not affect learning and academic performance
  • Benefits are not lasting following discontinuation

8
Behavioral and Combined Treatment of ADHD
  • Behavioral Treatment
  • Involve reinforcement programs
  • To increase appropriate behaviors
  • Decrease inappropriate behaviors
  • May also involve parent training
  • Combined Bio-Psycho-Social Treatments
  • Are highly recommended
  • Superior to medication or behavioral treatments
    alone

9
Learning Disorders An Overview
  • Scope of Learning Disorders
  • Academic problems in reading, mathematics, and
    writing
  • Performance substantially below expected levels
  • DSM-IV and DSM-IV-TR Reading Disorder
  • Discrepancy between actual and expected
    achievement
  • Performance significantly below age or grade
    level
  • Cannot be caused by sensory deficits
  • DSM-IV and DSM-IV-TR Mathematics Disorder
  • Achievement below expected performance
  • DSM-IV and DSM-IV-TR Disorder of Written
    Expression
  • Achievement below expected performance in writing

10
Learning Disorders Some Facts and Statistics
  • Prevalence of Learning Disorders
  • 5-10 prevalence in the United States
  • Highest in wealthier regions of the United States
  • About 32 of these students drop out of school
  • 5-15 prevalence for reading difficulties
  • School experience tends to be generally negative

11
Growth Area
Figure 14.1 Growth area. More than half of all
schoolchildren classified as disabled have
learning disabilities. Twenty-one years ago, the
proportion was around 25.
12
Uneven Distribution
Figure 14.2 Uneven distribution. The highest
percentages of schoolchildren diagnosed with
learning disabilities are in the wealthiest
states.
13
Biological and Psychosocial Causes of Learning
Disorders
  • Genetic and Neurobiological Contributions
  • Reading disorder runs in families
  • 100 concordance rate for identical twins
  • Evidence for subtle forms of brain damage is
    inconclusive
  • Overall, contributions are unclear
  • Psychosocial Contributions are Largely Unknown

14
Treatment of Learning Disorders
  • Requires Intense Educational Interventions
  • Remediation of basic processing problems
  • Improvement of cognitive skills
  • Targeting skills to compensate for problem areas
  • Data Support Behavioral Educational Interventions

15
Pervasive Developmental Disorders An Overview
  • Nature of Pervasive Developmental Disorders
  • Problems occur in Language, Socialization, and
    Cognition
  • Pervasive Problems span many life areas
  • Examples of Pervasive Developmental Disorders
  • Autistic disorder
  • Aspergers syndrome

16
The Nature of Autistic Disorder An Overview
  • Autism Significant Impairments
  • Social interactions and communication
  • Restricted patterns of behavior, interest, and
    activities
  • Three Central DSM-IV and DSM-IV-TR Features of
    Autism
  • Qualitative impairment of social interaction
  • Problems in communication
  • 50 never acquire useful speech
  • Restricted patterns of behavior, interests, and
    activities

17
Autistic Disorder Facts and Statistics
  • Prevalence and Features of Autism
  • Affects 1 in every 500 births
  • More prevalent in females with IQs below 35
  • More prevalent in males with higher IQs
  • Occurs worldwide
  • Symptoms usually develop before 36 months of age
  • Autism and Intellectual Functioning
  • 50 have IQs in the severe-to-profound range
  • 25 test in the mild-to-moderate IQ range
  • Remaining test in the borderline-to-average IQ
    range
  • Reliable indicators of good prognosis
  • Language ability and IQ

18
Causes of Autism Early and More Recent
Contributions
  • Historical Views
  • Bad parenting
  • Unusual speech patterns
  • Lack of self-awareness
  • Echolalia
  • Current Understanding of Autism
  • Medical conditions Not always related with
    autism
  • Genetic component is largely unclear
  • Neurobiological evidence of brain damage
  • Substantially reduced cerebellum size
  • Psychosocial Contributions Are Unclear

19
Aspergers Disorder Part of the Autistic
Spectrum
  • The Nature of Aspergers Disorder
  • Show significant social impairments
  • Restricted and repetitive stereotyped behaviors
  • May be clumsy
  • Often quite verbal
  • No severe language and/or cognitive delays
  • Prevalence of Aspergers Disorder
  • Often under diagnosed
  • Affects about 1 to 36 persons per 10,000 people
  • Causes of Aspergers Disorder Are Somewhat
    Unclear

20
Treatment of Pervasive Developmental Disorders
Example of Autism
  • Psychosocial Behavioral Treatments
  • Skill building
  • Reduction of problem behaviors
  • Target communication and language problems
  • Address socialization deficits
  • Early intervention is critical
  • Biological and Medical Treatments Are Unavailable
  • Integrated Treatments The Preferred Model
  • Focus on children, their families, schools, and
    home
  • Build in appropriate community and social support

21
Mental Retardation (MR) An Overview
  • Nature of Mental Retardation
  • Disorder of childhood
  • Below-average intellectual and adaptive
    functioning
  • Range of impairment varies greatly across persons
  • DSM-IV and DSM-IV-TR criteria
  • Significantly sub-average intellectual
    functioning
  • Deficits or impairments in present adaptive
    functioning
  • Must be evident before the person is 18 years of
    age

22
DSM-IV and DSM-IV-TR Levels of Mental Retardation
(MR)
  • Mild MR
  • IQ score between 50 or 55 and 70
  • Moderate MR
  • IQ range of 35-40 to 50-55
  • Severe MR
  • IQs ranging from 20-25 up to 35-40
  • Profound MR
  • IQ scores below 20-25

23
Other Classification Systems for Mental
Retardation (MR)
  • American Association of Mental Retardation (AAMR)
  • Defines MR based on levels of assistance required
  • Levels of assistance
  • Intermittent
  • Limited
  • Extensive
  • Pervasive
  • Classification of MR in Educational Systems
  • Educable (IQ of 50 to 70-75)
  • Trainable (IQ of 30 to 50)
  • Severe (IQ below 30)
  • Implications of Different MR Classification
    Systems

24
Mental Retardation (MR) Some Facts and
Statistics
  • Prevalence
  • About 1-3 of the general population
  • 90 are labeled with mild mental retardation
  • Gender Differences
  • MR occurs more often in males
  • Male-to-female ratio of about 1.61
  • Course of MR
  • Tends to be chronic
  • Prognosis varies greatly from person to person

25
Causes of Mental Retardation (MR) Biological
Contributions
  • Hundreds of known causes
  • Environmental Deprivation, abuse
  • Prenatal Exposure to disease or a drug / toxin
  • Perinatal Difficulties during labor
  • Postnatal Head injury
  • Genetic Research
  • Multiple genes, and at times single genes
  • Chromosomal Abnormalities
  • Down syndrome and Fragile X syndrome
  • Maternal Age and Risk of Having a Downs Baby
  • Nearly 75 of Cases
  • Cannot be attributed to any known cause
  • Are thought caused by social and environmental
    factors

26
Rates of Down Syndrome Births
Figure14.3 The increasing likelihood of Down
Syndrome with maternal age (based on data from
Hook, 1982).
27
Causes of Mental Retardation (MR) Psychosocial
Contributions
  • Cultural-Familial Retardation
  • Believed to cause about 75 of MR cases
  • Is the least understood
  • Associated with
  • Mild levels of retardation on IQ tests
  • Good adaptive skills
  • Difference vs. Developmental Views
  • Difference view - Kind and degree of impairment
  • Developmental view Rate of developmental delay

28
Treatment of Mental Retardation (MR)
  • Parallels Treatment of Pervasive Developmental
    Disorders
  • Teach Needed Skills
  • productivity
  • independence
  • Educational and behavioral management
  • Living and self-care skills via task analysis
  • Communication training Often most challenging
  • Community and Supportive Interventions
  • Persons with MR can benefit from such
    interventions

29
Summary of Developmental Disorders
  • Developmental Psychopathology
  • Attention Deficit Hyperactivity Disorder
  • Deficits in attention, hyperactivity, or
    impulsivity
  • Disrupt academic and social functioning
  • Learning Disorders
  • Deficits in performance below expectations
  • Pervasive Developmental Disorder
  • All share deficits in language, socialization,
    and cognition
  • Mental Retardation
  • Sub-average IQ, deficits in adaptive functioning
  • Onset before age 18
  • Prevention and Early Intervention Are Critical
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