Chapter 14 Developmental Disorders

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Chapter 14Developmental Disorders
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Nature of Developmental Psychopathology An
Overview

• Normal vs. Abnormal Development
• Developmental Psychopathology
• Study of how disorders arise and change with time
• 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

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Attention Deficit HyperactivityDisorder (ADHD)
An Overview

• Nature of ADHD
• Central features Inattention, overactivity, and
  impulsivity
• Associated with numerous impairments
• Behavioral
• Cognitive
• Social and academic problems
• DSM-IV and DSM-IV-TR Symptom Types
• Inattentive type
• Hyperactive type
• Impulsive type

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Edward
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ADHD Facts and Statistics

• Prevalence
• Occurs in 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
• Probability of ADHD diagnosis
• Greatest in the United States

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ADHD Sean
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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

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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

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Biological Treatment of ADHD

• Goal of Biological Treatments
• To reduce impulsivity and hyperactivity
• To improve attention
• Stimulant Medications
• Reduce core symptoms in 70 of cases
• Examples include Ritalin, Dexedrine
• Other Medications With More Limited Efficacy
• Imipramine and Clonidine (antihypertensive)
• Effects of Medications
• Improve compliance in many children
• Decrease negative behaviors in many children
• Do not affect learning and academic performance
• Benefits are not lasting following discontinuation

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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

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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

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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

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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.
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Uneven Distribution
Figure 14.2 Uneven distribution. The highest
percentages of schoolchildren diagnosed with
learning disabilities are in the wealthiest
states.
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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

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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

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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

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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

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Autism Christina
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Rebecca
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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

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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

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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

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Treatment of Pervasive DevelopmentalDisorders
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

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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

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Lauren
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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

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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

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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

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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

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Rates of Down Syndrome Births
Figure14.3 The increasing likelihood of Down
Syndrome with maternal age (based on data from
Hook, 1982).
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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

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Treatment of Mental Retardation (MR)

• Parallels Treatment of Pervasive Developmental
  Disorders
• Teach Needed Skills
• To foster productivity
• To foster 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

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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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Exploring Developmental Disorders (ADHD)
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Exploring Developmental Disorders (Learning
Disorders)
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Exploring Developmental Disorders (Pervasive
Developmental Disorders)
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Exploring Developmental Disorders (Mental
Retardation)