Childhood Disorders

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Childhood Disorders
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Childhood Disorders

• Disorders that are commonly first diagnosed in
  childhood or that can only be diagnosed in
  childhood
• Variation in presentation of illnesses between
  children and adults
• Behavior that would be seen as abnormal in an
  adult may occur in a normal child
• Not studied at all until the 20th Century

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Mental Retardation

• Significantly subaverage intellectual
  functioning an IQ of approximately 70 or below
• Concurrent deficits or impairments in present
  adaptive functioning in at least two of the
  following areas communication, self-care, home
  living, social/interpersonal skills, use of
  community resources, self-direction, functional
  academic skills, work, leisure, health, and
  safety
• Age of onset is before age 18

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Mental Retardation - Severity

• Mild
• Moderate
• Severe
• Profound

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IQ

• Mean score 100, Standard Deviation 15

68
95
99
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Mental Retardation - Severity

• Mild (50-55 to 70)

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Mental Retardation - Severity

• Moderate (35-40 to 50-55)

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Mental Retardation - Severity

• Severe (20-25 to 35-40)

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Mental Retardation - Severity

• Profound (below 20-25)

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Learning Disorders

• Given a persons chronological age, measured
  intelligence, and age-appropriate education
• Reading Disorder
• Mathematics Disorder
• Disorder of Written Expression

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Pervasive Developmental Disorders

• Autistic Disorder
• Retts Disorder
• Childhood Disintegrative Disorder
• Asbergers Disorder

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Austism

• A total of six (or more) items from 1, 2, and 3,
  with at least two from group 1, and at least one
  each from groups 2 and 3

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Austism

• Group 1 Qualitative impairment in social
  interaction
• Marked impairment in the use of multiple
  nonverbal behaviors
• Failure to develop peer relationships appropriate
  to developmental level
• Lack of spontaneous seeking to share enjoyment,
  interests, or achievements with other people
• Lack or social or emotional reciprocity

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Austism

• Group 2 Qualitative impairments in
  communication
• Delay in, or total lack of, the development of
  spoken language
• In individuals with adequate speech, marked
  impairment in the ability to initiate or sustain
  a conversation with others
• Stereotyped and repetitive use of language
• Lack of varied, spontaneous make-believe play or
  social imitative play appropriate to
  developmental level

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Austism

• Group 3 Restricted repetitive and stereotyped
  patterns of behavior, interests, and activities
• Encompassing preoccupation with one or more
  stereotyped and restricted patterns of interest
  that is abnormal either in intensity or focus
• Apparently inflexible adherence to specific,
  nonfunctional routines
• Stereotyped and repetitive motor mannerisms
• Persistent preoccupation with parts of objects

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Autism

• Delays or abnormal functioning in at least one of
  the following areas, with onset prior to age 3
  years
• Social interaction
• Language as used in social communication
• Symbolic or imaginative play
• The disturbance is not better accounted for by
  Retts Disorder or Childhood Disintegrative
  Disorder
• Essentially, the presence of markedly abnormal
  or impaired development in social interaction and
  communication and a markedly restricted
  repertoire of activity and interests

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Facts about Autism

• Prevalence
• Gender
• Course

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Facts about Autism

• Associated w/
• Splinter Skills
• As a child

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Autism

• Appear to be unaware that other people think,
  feel, and have beliefs
• Sometimes even unable to identify someone elses
  age, gender, emotion
• Can be difficult to diagnose
• Other medical conditions can produce similar
  behaviors
• Autistic symptom profile has been found in kids
  with and without neurological impairments
• Shares several characteristics with other
  disorders that involve social/communication
  impairment
• Symptoms can vary widely

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Autism - Treatment

• Difficult due to social/communication impairments
• Effective programs do the following
• Most promising

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Retts Disorder

• All of the following
• Apparently normal prenatal and perinatal
  development
• Apparently normal psychomotor development through
  the first 5 months after birth
• Normal head circumference at birth

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Retts Disorder

• Onset of all of the following after the period of
  normal development
• Deceleration of head growth between ages 5 and 48
  months
• Loss of previously acquired purposeful hand
  skills between ages 5 and 30 months with the
  subsequent development of hand movements
• Loss of social engagement early in the course
• Appearance of poorly coordinated gait or trunk
  movements
• Severely impaired expressive and receptive
  language development with severe psychomotor
  retardation

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Retts Disorder

• Prevalence
• Gender
• Age of Onset
• Course
• Associated w/
• Cause

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Childhood Disintegrative Disorder

• Apparently normal development for at least the
  first 2 years after birth as manifested by the
  presence of age-appropriate verbal and nonverbal
  communication, social relationships, play, and
  adaptive behavior

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Childhood Disintegrative Disorder

• Clinically significant loss of previously
  acquired between ages 2 and 10 in at least two of
  the following areas
• Expressive or receptive language
• Social skills or adaptive behavior
• Bowel or bladder control
• Play
• Motor skills

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Childhood Disintegrative Disorder

• Abnormalities of functioning in at least two of
  the following areas
• Qualitative impairment in social interaction
  (e.g. impairment in nonverbal behaviors, failure
  to develop peer relationships, lack of varied
  make-believe play, etc.)
• Qualitative impairments in communication (e.g.
  delay or lack of spoken language, inability to
  initiate or sustain conversation, etc.)
• Restricted, repetitive, and stereotyped patterns
  of behavior, interests, and activities
• The disturbance is not better accounted for by
  another mental disorder

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Asbergers

• Qualitative impairment in social interaction,
  manifested by at least two of the following
• Marked impairment in the use of multiple
  nonverbal behaviors
• Failure to develop peer relationships appropriate
  to developmental level
• Lack of spontaneous seeking to share enjoyment,
  interests, or achievements with other people
• Lack or social or emotional reciprocity

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Asbergers

• Restricted repetitive and stereotyped patterns of
  behavior, interests, and activities, manifested
  by at least one of the following
• Encompassing preoccupation with one or more
  stereotyped and restricted patterns of interest
  that is abnormal either in intensity or focus
• Apparently inflexible adherence to specific,
  nonfunctional routines
• Stereotyped and repetitive motor mannerisms
• Persistent preoccupation with parts of objects

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Asbergers

• The disturbance causes significant distress or
  impairment in functioning
• There is no clinically signficant general delay
  in language (e.g. single word use by age 2,
  communicative phrases by age 3)
• There is no clinically significant delay in
  cognitive development or in the development of
  age-appropriate self-help skills and curiosity
  about the environment
• Criteria are not met for another Pervasive
  Developmental Disorder or Schizophrenia

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Asbergers

• Prevalence
• Gender
• Course

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Asbergers

• Communication

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Attention-Deficit/Hyperactivity Disorder

• Either 1 or 2
• 1. Six (or more) of the following symptoms of
  inattention have persisted for at least 6 months
  to a degree that is maladaptive and inconsistent
  with developmental level
• Fails to give close attention to details or makes
  careless mistakes in schoolwork, work, or other
  activities
• Has difficulty sustaining attention in tasks or
  play activities
• Does not seem to listen when spoken to directly
• Does not follow through on instructions and fails
  to finish schoolwork, chores, or duties in the
  workplace
• Has difficulty organizing tasks and activities
• Avoids, dislikes, or is reluctant to engage in
  tasks that require sustained mental effort
• Loses things necessary for tasks or activities
• Is easily distracted by extraneous stimuli
• Is forgetful in daily activities

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ADHD

• 2. Six (or more) of the following symptoms of
  hyperactivity-impulsivity has persisted for at
  least 6 months to a degree that is maladaptive
  and inconsistent with developmental level
• Often fidgets with hands/feet or squirms in seat
• Often leaves seat in classroom or in other
  situations in which remaining seated is expected
• Often runs about or climbs excessively in
  situations in which it is inappropriate
• Often has difficulty playing or engaging in
  leisure activities quietly
• Is often on the go or often acts as if driven
  by a motor
• Often talks excessively
• Often blurts out answers before questions have
  been completed
• Often has difficulty awaiting turn
• Often interrupts or intrudes on others

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ADHD

• Some hyperactive-impulsive or inattentive
  symptoms that caused impairment were present
  before age 7
• Some impairment from the symptoms is present in
  two or more settings
• There must be clear evidence of clinically
  significant impairment in functioning
• Symptoms are not between accounted for by another
  mental disorders

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ADHD

• Prevalence 3-7
• Gender
• Girls
• Boys
• Age of Onset
• Course Over half of cases
• Other cases

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Conduct Disorder

• A. A repetitive and persistent pattern of
  behavior in which the basic rights of others or
  major age-appropriate societal norms or rules are
  violated (see next slides)
• B. The disturbance in behavior causes significant
  impairment in functioning
• C. If the individual is 18 years or older,
  criteria are not met for Antisocial Personality
  Disorder

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Conduct Disorder

• A (continued). Three or more of the following
  criteria in the past 12 months and at least one
  in the past 6 months
• Aggression to people and animals
• Often bullies, threatens, or intimidates others
• Often initiates physical fights
• Has used a weapon that can cause serious physical
  harm to others
• Has been physically cruel to people
• Has been physically cruel to animals
• Has stolen while confronting a victim
• Has forced someone into sexual activity

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Conduct Disorder

• Destruction of property
• Has deliberately engaged in fire setting with the
  intention of causing serious damage
• Has deliberately destroyed others property
  (other than arson)
• Deceitfulness or theft
• Has broken into someone elses house, building,
  or car
• Often lies to obtain goods or favors or to avoid
  obligations
• Has stolen items of nontrivial value without
  confronting a victim

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Conduct Disorder

• Serious violation of rules
• Often stays out at night despite parental
  prohibitions, beginning before age 13
• Has run away from home overnight at least twice
  while living in parental or parental surrogate
  home
• Is often truant from school, beginning before age
  13

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Conduct Disorder

• Prevalence
• Gender
• Males
• Females

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Conduct Disorder

• Age of onset
• Childhood-onset Type
• Adolescent-onset Type
• Unspecified onset Age at onset is not known

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Oppositional Defiant Disorder

• A pattern of negativistic, hostile, and defiant
  behavior lasting at least 6 months, manifested by
  4 or more of the following
• Often loses temper
• Often argues with adults
• Often actively defies or refuses to comply with
  adults requests or rules
• Often deliberately annoys people
• Often blames others for his or her mistakes or
  misbehaviors
• Is often touchy or easily annoyed by others
• Is often angry and resentful
• Is often spiteful or vindictive
• Consider a criterion met only if the
  behavior occurs more frequently than is typically
  observed in individuals of comparable age and
  developmental level

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Oppositional Defiant Disorder

• Prevalence
• Gender Prior to puberty
• After puberty
• Age of Onset
• Course

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Separation Anxiety Disorder

• Developmentally inappropriate and excessive
  anxiety concerning separation from home or from
  those to whom the individual is attached,
  manifested by three or more of the following
• Recurrent excessive distress when separation from
  home or major attachment figures occurs or is
  anticipated
• Persistent and excessive worry about losing, or
  about possible harm befalling, major attachment
  figures
• Persistent and excessive worry that an event will
  lead to separation from a major attachment figure

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Separation Anxiety Disorder

• A (continued). Three or more of the following
• Persistent reluctance or refusal to go to school
  or elsewhere because of fear of separation
• Persistently and excessively fearful or reluctant
  to be alone or without major attachment figures
  at home or in other settings
• Persistent reluctance or refusal to go to sleep
  without being near a major attachment figure or
  to sleep away from home
• Repeated nightmares involving the theme of
  separation
• Repeated complaints of physical symptoms when
  separation occurs or is anticipated

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Separation Anxiety Disorder

• The duration of the disturbance is at least 4
  weeks
• The onset is before age 18
• The disturbance causes clinically significant
  distress or impairment in functioning
• Is not better explained by another mental disorder

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Separation Anxiety Disorder

• Prevalence 4
• Gender In community samples In clinical
  samples
• Age of onset
• Course