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Chapter 13 Childhood Disorders Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Symptoms of Separation Anxiety Disorder Excessive distress when separated from home or caregivers, or is anticipating separation Persistent and excessive worry about losing, or harm coming to, caregivers Excessively fearful about being alone Nightmares about separation Repeated complaints of physical symptoms when separation from caregivers occurs or is anticipated Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Proposed Etiologies for Separation Anxiety Disorder Biological: may be genetic predisposition to anxiety disorders, including separation anxiety and panic attacks. Behavioral inhibition: children are born with an inhibited, fearful temperament. Traumatic and uncontrollable events: traumatic events can cause chronic uncontrollability; parents may encourage fearful behavior or not encourage independence. Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Effects of Cognitive-Behavioral Therapy for Separation Anxiety Disorder 80 70 60 50 40 Intervention group Control Group 30 20 10 0 Pre intervention Chapter 13 6 months 24 months Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Elimination Disorders Enuresis – – – – Chapter 13 Unintended urination at least 2x/week for 3 months Child over 5 years of age Causes may be genetic, or anxiety/conflicts, or inappropriate toilet training Treated with medications, bell and pad method Encopresis – – – – Unintended defecation at least 1x/month for 3 months Child over 4 years of age Usually begins after episodes of severe constipation Treated with medication and behavioral contracting Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Disorders of Cognitive, Motor, and Communication Skills Learning disorders Reading disorder Mathematics disorder Disorder of written expression Deficits in ability to read Deficits in mathematics skills Deficits in the ability to write Motor skills disorders Developmental coordination disorder Deficits in the ability to walk, run, hold on to objects Communication disorders Expressive language disorder Mixed receptive-expressive language disorder Phonological disorder Stuttering Deficits in the ability to express oneself through language Deficits in the ability both to express oneself through language and to understand the language of others Use of speech sounds inappropriate for age or dialect Severe problems in word fluency Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Criteria for Mental Retardation Significantly subaverage intellectual functioning, indicated by an IQ of approximately 70 or below Onset before age 18 Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Criteria for Mental Retardation, continued Significant deficits in at least two of the following areas: 1. Communication 2. Self-care 3. Home living 4. Social or interpersonal skills 5. Use of community resources Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Criteria for Mental Retardation, continued Significant deficits in at least two of the following areas: 6. Self-direction 7. Academic skills 8. Work 9. Leisure 10. Health 11. Personal safety Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Biological Causes of Mental Retardation Genetic contributions to mental retardation Prenatal environment – – Drugs and alcohol Infectious diseases (e.g., rubella, syphilis) Severe head trauma Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Organic Mental Retardation Typically diagnosed in infancy. There is a clear history or indicators of a biological abnormality. The severity of retardation is profound, severe, or moderate. Parents and siblings are likely to have intellectual functioning similar to that of the general population. Socioeconomic status is representative of that of the general population. Physical health is poorer than in the general population.Treatments can improve functioning but not cure the condition. Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Cultural-Familial Mental Retardation • It is typically diagnosed at school age • There may be no history or indicators of biological abnormality • The severity of retardation is often mild • Impairments are specific to certain situations Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Cultural-Familial Mental Retardation, continued • Parents and siblings are more likely to have mild retardation • Occurs often in lower socioeconomic groups • Physical health is about the same as that in the general population • Treatments may cure the condition entirely Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Treatments for Mental Retardation Behavioral Strategies Involvement of parents and caregivers, behavioral modeling, integrated approach Drug Therapy Neuroleptic medications, atypical antipsychotics to reduce aggression, antidepressants to reduce depression Social Programs Early intervention, mainstreaming, institutionalization when necessary, group homes that provide comprehensive care Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Pervasive Developmental Disorders Autism Asperger’s Disorder Rett’s Disorder Pervasive Developmental Disorders Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Tic Disorders Tourette’s disorder Chronic motor or focal tic disorder Transient tic disorder Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Feeding and eating disorders Pica Rumination disorder Feeding disorder of infancy or early childhood Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Other childhood disorders Selective mutism Reactive attachment disorder Stereotypic movement disorder Chapter 13 Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.