Transcript Developmental and Childhood Disorders

Attention Deficit
Hyperactivity Disorder
Features
 Classification

 Predominantly
Inattentive
 Predominantly Hyperactive-Impulsive
 Combined
ADHD

Gender Differences
 Boys

outnumber girls 4 to 1
Cultural Factors
 Probability
of diagnosis is greatest in the
United States

Toxins as Cause?
 Allergens
and food additives NOT related
 Maternal smoking increases risk
ADHD: Biological Factors

Genetic Factors
 ADHD
seems to run in families
 Three specific genes have been implicated

Neurobiological Factors
 Smaller
brain volume
 Inactivity of the frontal cortex and basal ganglia
 Abnormal frontal lobe development and functioning
Biological Treatment of ADHD

Stimulant Medications
 Ritalin,
Dexedrine, Adderall, others
 Paradoxical Effect
 Reduce the core symptoms of ADHD in 70%
of cases
 Improve compliance and decrease negative
behaviors
 Do not affect learning and academic
performance
 Relapse following discontinuation
Behavioral Treatment of ADHD

Behavioral Treatment
 Increase
appropriate behaviors and decrease
inappropriate behaviors
 May also involve parent training

Combined Biopsychosocial Treatments
 Highly
recommended
 Generally superior to either tx alone
Other Disruptive Behavior
Disorders
Conduct Disorder
 Oppositional Defiant Disorder

Learning Disorders

Academic Performance Lower than IQ
Predicts
 Reading
Disorder
 Arithmetic Disorder
 Disorder of Written Expression

Disorder vs. Disability?
Autism Spectrum Disorders

Autistic Disorder
 Social
and Communication Impairment
 Restricted Behavior

Asperger’s Disorder
 Similar
to Austism without Communication
Impairment
Additional Pervasive
Developmental Disorders

Rett’s Disorder
 Initial
Normal Development
 Increasing Mental Retardation

Childhood Disintegrative Disorder
 Regression
to 4 years
in language and motor skills at 2
Treatment of Autism Spectrum
Disorders


Biological and medical treatments are
unavailable
Behavioral treatments
 Skill
building
 Reduction of problem behaviors
 Target communication and language problems
 Address socialization deficits
 Early intervention is critical

Integrated treatments: The preferred model
 Focus
on children, their families, schools, and home
Mental Retardation

Mild

 IQ
 IQ
from 50-55 to 70
 ~85%

Moderate
 IQ
from 35-40 to 50-55
 ~10%
Severe
from 20-25 to 35-40
 ~3-4%

Profound
 IQ
below 20-25
 ~1-2%
Other Classification Systems

American Association of Mental Retardation
 Levels


of assistance required
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)
Mental Retardation

Biological Factors
 Chromosomal
 Down Syndrome, Fragile X Syndrome
 Neurological




Injury
Prenatal – exposure to disease or a drug/toxin
Perinatal – difficulties during labor
Postnatal – head injury
Cultural-Familial
 Environmental
Deprivation, Abuse
 Considered to be about 75% of Cases
Treatment of Mental Retardation


Parallels treatment of pervasive developmental
disorders
Teach needed skills
 To
foster productivity and independence
 Educational and behavioral management
 Living and self-care skills via task analysis
 Communication training

Community and supportive interventions
Other Childhood Disorders

Tic Disorders
 Tourette’s
Syndrome
Elimination Disorders
 Separation Anxiety
 Selective Mutism
 Others

Cognitive Disorders
 Nature
of Cognitive Disorders
Broad
impairments in memory, attention,
perception, and thinking
Profound changes in behavior and personality
 Three
Classes
Delirium
Dementia
Amnesia
Dementia
 Gradual
deterioration of brain functioning
 Affects judgment, memory, language, and
advanced cognitive processes
 Dementia has many causes and may be
reversible or irreversible
 Impairments have a marked negative
impact on social and occupational
functioning
DSM-IV Classes of Dementia
 Dementia
of the Alzheimer’s type
 Vascular Dementia
 Dementia Due to Other General Medical
Conditions
 Parkinson’s
Disease
 Huntington’s Disease
 Pick’s Disease
 Creutzfeldt-Jakob Disease
 Substance-Induced
Persisting Dementia
 Dementia Due to Multiple Etiologies
 Dementia Not Otherwise Specified
Range of Cognitive Deficits
 Aphasia
 Speech
and word usage deficits

 Apraxia
 Task
and coordination deficits

 Agnosia/Facial Agnosia
 Recognition
deficits

 Executive
 Deficits
Function
in planning, organizing, sequencing, or
abstracting information
Treatment of Dementia

Medical Treatment: Best If Enacted Early
 Few
medical treatments exist for most types of dementia
 Attempt to slow deterioration


Do not actually stop progression of dementia
Psychosocial Treatments
 Focus
on enhancing the lives of dementia patients and their
families/caregivers
 Teach adaptive skills
 Use memory enhancement devices (e.g., memory
notebook)
 Main emphasis of psychosocial interventions is on the
caregivers (help caregivers cope and help them help the
patient)