Abnormal behavior in childhoodadolescence

1
Abnormal behavior in childhood/adolescence

• Risk factors for disorders
• Gender
• Boys are more likely to develop autism,
  hyperactivity, elimination, anxiety, depression.
• In adolescence, girls are more likely to develop
  anxiety and depression.
• Biological risks
• Prenatal factors, birth complication, premature
  birth, low birth weight, serious illness, genetic
• Psychological
• Stress, cognitive-expectancies, rejection,
  parental abuse

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Pervasive Developmental Disorders

• Previously diagnosed as childhood psychosis
  because of shared features (social/emotional
  impairment, oddities in communication, and
  stereotyped motor behaviors) with schizophrenia
  but research has shown the two disorders are
  distinct.
• Autism is one of the severest of childhood
  disorders

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Cont.

• Means self
• Bleuler first used term but Kanner (1943) applied
  to children who were unable to relate to others.
• See Table 13.1

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Theoretical Perspectives of autism

• Causes remain unknown
• Early view believed it was caused by pathological
  family relationships but there is no research to
  support this.
• Cognitive-learning
• sees autism as a perceptual deficit which allows
  processing one stimulus at a time.
• Difficulty integrating information from various
  senses - presumed malfunction in organization of
  central nervous system that processes
  information. Some suspect neurological damage
  MRI scans show enlarged brain ventricle
  indicative of brain cell loss.
• Genetics plays a role.

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Treatment of autism

• Psychodynamic
• Focuses on providing unconditional support to
  foster attachments.
• Behavioral
• Learning principles can be used to teach more
  adaptive behaviors.
• Most successful treatment programs focus on
  behavioral, educational, and language deficits

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• Autism does continue into adulthood but some
  autistic persons do achieve college degrees and
  live independently.

7
Mental Retardation

• A broad delay in cognitive and social
  development.
• Assessed by formal intelligence tests/
  observation of adaptive function.
• 3 criteria
• Approximately 70 or below in IQ
• Impaired adaptive behavior.
• Before 18 years of age.

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Cont. Mental Retardation

• 4 Classes (See Table 13.3)
• Mild is 50 - 70
• Moderate is 35 - 49
• Severe is 20 - 34
• Profound is below 20

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Causes of MR

• Chromosomal
• Downs syndrome
• An extra chromosome on the 21st gene.
• Characteristics
• Round face, slanted eyes, flat nose, protruding
  tongue, small arms/legs, MR, physical problems
• Klinefelters - Only men
• an extra X sex chromosome
• No secondary sex traits underdeveloped testes,
  enlarged breasts, poor muscle development,
  infertility, MR

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Cont. Causes

• Turners
• only females
• Single X sex chromosome
• Shorter than average, infertility, MR especially
  in math, science.

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Cont. Causes

• Genetic
• Fragile X syndrome
• Mutated gene on X sex chromosome
• Many people carry but show no evidence
• Phenylketonuria (PKU)
• No metabolizing the amino acid phenylalanine
• Tay-Sachs
• Caused by a recessive gene. Results in gradual
  loss of muscle control, deafness, blindness, MR,
  paralysis, die before the age of 5.

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Cont. Causes

• Prenatal factors
• Maternal infections
• Rubella, syphilis
• Drugs the mother ingests
• Fetal alcohol syndrome
• Birth complications
• Oxygen deprivation, prematurity, brain infections
  such as encephalitis, meningitis, traumas
• Cultural-familial (poverty)

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Intervention

• Mild MR may be managed at home with mainstreaming
• May benefit from counseling to adjust to
  life/social skills/self-esteem
• Profound may need institutional care to control
  destructive/aggressive behavior.

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Learning Disorders

• Inadequate development in reading, math, writing
  resulting in impairment in school/ daily
  activities.

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Reading

• Dyslexia
• The most common learning disorder. Difficulty
  recognizing words/comprehending, omitting,
  distorting, substituting words.

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Math and Writing

• Math
• Difficulty understanding terms/operations.
• Written
• Errors in spelling, grammar, composing sentences
  paragraphs

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Theoretical Perspectives

• Focus on cognitive-perceptual/ neurological
• Evidence from autopsies show a brain abnormality
  the relay station for vision, hearing, touch is
  smaller than normals.
• Genetic factors seem to be involved in the brain
  abnormality.

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Interventions

• Psychological
• Emphasizes strengths/preferences. For example, a
  child who learns better verbally than visually
  will be taught verbally.
• Behavioral
• Academic learning built on hierarchy of skills
  reinforce each one.
• Medical model
• biological basis, ie., address visual defect with
  visual tracking exercises.
• Neuropsychological
• combines psychoeducational and medical

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Cont. Interventions

• Linguistic
• Language deficiencies
• Cognitive
• Organize thoughts. They are taught to recognize
  the nature of the learning task, apply
  problem-solving strategies, monitor success.
• Interventions showing the most promise are those
  that provide direct instruction in the academic
  skills the child is deficient. The behavioral
  model has also shown promising results.

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Communication Disorder

• Includes
• Expressive
• Impairment in the use of spoken language (slow
  vocabulary develop, errors in verb tense,
  difficulty recalling words, inappropriate
  length/complexity of sentence)
• Receptive/expressive
• Difficulty understanding/producing speech.
• Articulation
• Difficulty articulating sounds
• Stuttering Disturbance in fluent speech.

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Attention-deficit disorder

• Attention-deficit /hyperactivity disorder
• Some inattention in early childhood is normal.
• This is the most common problem in MHC among
  children.
• Characterized by an inability to sit still,
  bullying temper tantrums, stubborn, no response
  to punishment.
• There is a difference in quality between normal
  overactivity/ADHD. Normal overactivity goal
  directed/exert voluntary control over behavior
  while the ADHD child is hyperactive without
  reason unable to conform behavior to demands.

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Theoretical Perspectives of ADD

• More likely to come from an unstable family.
• Mother had difficulty with pregnancy.
• Mother abused drugs/ETOH.

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Treatment of ADD

• Ritalin/amphetamines
• Hyperactivity reflects inability of cerebral
  cortex to inhibit primitive parts of brain.
  Ritalin facilitates control over lower brain
  centers.
• Stimulants do not foster academic achievement
• Most effective treatment is a combination of
  cognitive-behavioral with medication
• Some children outgrow, others have problems into
  adolescence/adulthood.

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Conduct Disorder

• ADHD unable to control behavior but conduct
  disorder purposefully engages in behavior that
  violates social norms/rights of others. They
  steal, destroy property, rape, kill, cheat, use
  drugs, no remorse.

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Oppositional Defiant Disorder

• Show negative/defiant behavior but not serious
  violation. Develops earlier than conduct may
  lead to conduct disorder.
• Theoretical Perspective
• Genetic
• Processing information, ie., aggressive children
  tend to be biased in their interpretation and see
  people intending to harm them.
• Treatment
• Operant conditioning/cognitive-behavioral
  problem- solving therapy to reconceptualize
  situations

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Anxiety Disorders

• Social Phobias
• Avoid other children/can impede school
  performance.
• GAD/o
• Generally apprehensive/fretful. Report physical
  symptoms
• Separation anxiety disorder
• Persistent, excessive, inappropriate for childs
  level of development. Affects boys/girls
  equally.
• Theoretical Perspectives and Treatment
• Parallels adults use anxiety control techniques
  gradual exposure and relaxation training.

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Depression

• Common among children/adolescence
• Characteristics
• sense of hopelessness, low self-esteem, low
  self-efficacy, expectancies regarding solving
  problems is low, less social activity, less
  emotional expression.
• Adolescents with depression are at a greater risk
  of other psychological problems.

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Cont. Depression

• Correlates
• Negative life events, attributional styles,
  depressed parents.
• Treatment
• Cognitive-behavioral to acquire more social
  skills.
• Family therapy.

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Suicide

• Risk Factors
• Gender girls are more likely to attempt/boys are
  more successful
• Age late adolescence/early adulthood.
• Geography less populated areas.
• Race Native American
• Depression
• Previous suicidal behavior.
• Strained family relationships
• Stress
• Drugs
• Social contagion

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Elimination Disorders

• Enuresis
• Failure to control urination after one has
  reached the normal age for attaining such
  control.
• Encopresis
• Lack of control over bowel movements that is not
  caused by an organic problem.