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Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Chapter 14
Developmental Disorders
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Attention Deficit Hyperactivity
Disorder (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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Edward
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
ADHD: Sean
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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%.
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Uneven Distribution
Figure 14.2 Uneven distribution. The highest percentages of schoolchildren
diagnosed with learning disabilities are in the wealthiest states.
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
 Asperger’s syndrome
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Autism: Christina
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Rebecca
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Asperger’s Disorder: Part of the Autistic Spectrum
 The Nature of Asperger’s 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 Asperger’s Disorder
 Often under diagnosed
 Affects about 1 to 36 persons per 10,000 people
 Causes of Asperger’s Disorder Are Somewhat Unclear
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Treatment of Pervasive Developmental
Disorders: 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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Lauren
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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 1.6:1
 Course of MR
 Tends to be chronic
 Prognosis varies greatly from person to person
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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 Down’s Baby
 Nearly 75% of Cases
 Cannot be attributed to any known cause
 Are thought caused by social and environmental factors
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Rates of Down Syndrome Births
Figure14.3 The increasing likelihood of Down Syndrome with maternal age (based on
data from Hook, 1982).
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
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
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Exploring Developmental Disorders (ADHD)
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Exploring Developmental Disorders (Learning Disorders)
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Exploring Developmental Disorders (Pervasive
Developmental Disorders)
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow
Chapter 14: Developmental Disorders
Exploring Developmental Disorders (Mental Retardation)