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CHAPTER 15
PERVASIVE DEVELOPMENTAL
DISORDERS
AND
MENTAL RETARDATION
PERVASIVE DEVELOPMENTAL
DISORDERS
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Conditions that become apparent early
in a child's development and affect all
major developmental systems (social,
cognitive, and language)
Autistic disorder
Asperser's disorder
Childhood disintegrative disorder
Rett’s disorder
AUTISTIC DISORDER
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Characteristics
Usually noticed by age of 3 years
 Marked difficulty in social interaction
and communication
 Restricted range of interests
 Strong desire for routine
 75% are mentally retarded
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AUTISTIC DISORDER
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Deficits
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Theory of mind – Inability to infer the mental
states of others and to think abstractly
Executive functions – Cognitive operations
involved in planning and flexibility of response
Language – Many never speak and those who
do have stereotypical, repetitive, idiosyncratic
speech patterns
Joint attention behaviors – Inability to maintain
eye contact and social interaction
AUTISTIC DISORDER
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CAUSES
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Brain abnormalities
Genetic factors
Stress or injury may interact with genetic
vulnerability
TREATMENT
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Behavioral – Increase skills, reduce problem
behaviors
Learning techniques to take into account
cognitive strengths and weaknesses
Medications to treat some symptoms
HEREDITARY FACTORS IN AUTISTIC
DISORDER
ASPERGER’S DISORDER
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May be a mild form of autism
Impaired social interaction
Restricted and repetitive patterns of
behavior and interests
Does not include language delays and
absence of autism
Does not include impaired cognitive
development of autism
Usually not diagnosed until school age
CHILDHOOD DISINTEGRATIVE
DISORDER
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Normal development until age 3 or 4,
followed by loss of previously acquired
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Language, social, and motor skills and bowel and
bladder control
Changes thought to be associated with
deterioration in the nervous system
Very rare – One in one million births
More common in boys than girls
Causes unknown
RETT’S DISORDER
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Progressive disorder appearing after normal
development at about 5 months of age
Head stops increasing in size, so becomes
smaller than normal (microcephaly)
Loss of previously acquired developmental skills
(language, social, and motor)
Typically affects only girls
Most become severely retarded
No specific treatment
MENTAL RETARDATION
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Characteristics
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Levels
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Subaverage intellectual function with significant
limitations in adaptive functioning that begins
before age 18
Mild – IQ 50-55 to 70
Moderate – IQ 35-40 to 50-55
Severe – IQ 20-25 to 35-40
Profound – IQ below 20 or 25
Incidence
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One in every 100 individuals in the US
MENTAL RETARDATION
MENTAL RETARDATION
CAUSES OF MENTAL
RETARDATION
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Genetically based
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Dominant genes
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Recessive genes
Genetic mutation
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Phenylketonuria (PKU)
Chromosomal abnormalities
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Tuberous sclerosis
Fragile X syndrome
Down syndrome
Polygenetic
FRAGILE X CHROMOSOME
DOWN SYNDROME
CAUSES OF MENTAL RETARDATION
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The fetal environment
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Maternal infections
Chronic conditions
Blood incompatibilities between mother and
child
Chemicals in fetal environment
 Alcohol- Fetal alcohol syndrome
Radiation
Malnutrition
Factors associated with age and stress of
mother
CAUSES OF MENTAL RETARDATION
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Problems during birth
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Prematurity
Low birth weight
Lack of oxygen during birth process
Too-rapid progress through the birth canal
Damage to the nervous system after birth
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Infections (encephalitis)
Extreme malnutrition
Blows to the head
Tumors
Oxygen deprivation due to accidents (such as near
drowning)
Environmental poisons (lead paint)
CAUSES OF MENTAL RETARDATION
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Psychosocial disadvantage
 Impoverished environment
 30-50% of variation in intelligence
test scores can be attributed to
environmental influences
PREVENTION OF MENTAL RETARDATION
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Primary prevention
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Secondary prevention
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Public education about need for prenatal care,
dangers of pregnant women drinking, and dangers
of exposure of children to lead
Amniocentesis and ultrasound scanning that may
lead to termination of pregnancy
Treatment, as in special diet for PKU children
Tertiary prevention
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Maximizing child’s skills and potential
School- and community-based educational,
vocational, and skills training programs
EARLY INTERVENTION FOR MENTAL
RETARDATION
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Children at psychosocial risk
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Home-based interventions
Special centers with trained staffs,
supplemented by home visits
School-based programs
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Individuals with Disabilities Education Act (IDEA)
guarantees free public education for all disabled
children, including the mentally retarded
Least-restrictive placement
Mainstreaming versus special placement
VOCATIONAL AND SOCIAL SKILLS
TRAINING FOR MENTALLY
RETARDED ADULTS
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Job preparation – Sheltered workshops
Learning how to deal with personal,
financial, and sexual exploitation
Teach social skills and how to say “no”
Training in appropriate sexual behavior
RECOGNITION AND TREATMENTE OF
PSYCHOLOGICAL PROBLEMS
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Forty percent of mentally retarded meet criteria for
some other disorder
Severely and profoundly retarded often have autism
or pervasive developmental disorder
One-fourth have a personality disorder
Many adolescents have temper tantrums, aggressive
and destructive behavior, and alcohol and drug abuse
Children with fragile-X syndrome often have ADHD
Children and adults with Down syndrome often suffer
from depression