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Abnormal child psychology: Exam 2
Terms in this set (75)
What are the DSM-V criteria for intellectual disability?
deficits in intellectual functioning, concurrent deficits or impairments in adaptive functioning and need for supports, below-average intellectual and adaptive abilities must be evident prior to age 18.
What are the characteristics of someone with mild mental retardation?
-85% of people with ID
-normal physical development -identification in elementary
-achieve academic skills up to 6th grade level by adolescence.
What are the characteristics of someone with moderate mental retardation?
-10% of those with ID
-applies to many with down syndrome
-identified during preschool
-2nd grade academic skills
-benefit from social and vocational training
What are the characteristics of someone with severe mental retardation?
-3 to 4% of people with ID
-often organic causes
-early identification due to developmental delays or physical abnormalities
-often other health-related complications
-most adapt well to supportive living situations
What are the characteristics of someone with profound mental retardation?
-1 to 2% of people with ID
-Identified in infancy
-often co-occurs with severe medical conditions
-need highly structured environments
How is gender related to prevalence of MR?
More males than females (2:1). Sex difference declines for more severe forms.
How is SES related to prevalence of MR?
Mild ID is more prevalent in lower SES and in minority groups, no difference for more severe levels.
-In high SES, prevalence of mild MR is near 0%
-In lower SES, prevalence is near 2.5%
Describe the organic MR group.
-clear organic cause of ID
-often associated with moderate, severe, and profound MR
-equal rates across SES levels
-causes: prenatal (genetics, accidents in utero), perinatal (prematurity, anoxia), postnatal (head trauma, meningitis).
Describe the cultural-familial MR group.
-no obvious cause
-often associated with mild ID
-more common among low SES families
-few associated disabilities
-causes: polygenetic, environmental deprivation, undetected organic conditions
What problems are associated with having MR?
What are the causes of and causal influences for MR?
-genetic or environmental cause known for 96% of those with mild-profound MR; cause known for only 32% with mild MR
-neurobiological influences: malnutrition, exposure to toxins, infections and diseases, prenatal and postnatal trauma, in utero exposure to alcohol/drugs
-social and psychological influences: deprivation of physical and emotional care, lack of stimulation.
How can MR be prevented?
-Prenatal education and health care. Nutrition, toxins, fetal development.
-Basic child care and infant needs
What did the authors of the Carolina Abecedarian study find?
111 high-risk children randomized to either: enriched treatment group or control group. Both groups received: food assistance, supportive social services, low cost or free primary health care. Txt group also received intensive (5 days/week, 50 weeks/yr, 5 years) "learninggames "curriculum, individualized for each student
-Fewer children in the treatment group met criteria for MR
-Children in the treatment group had higher math and reading scores up to age 20
Which has the most research support: the developmental hypothesis or the difference viewpoint?
What are the features of Down syndrome?
-extra chromosome, not genetic
-incidence increases with age of mother
-mild-moderate ID, facial deformities, low muscle tone, health problems
What are the features of Fragile X syndrome?
-more common in males
-some facial deformities, mild-moderate MR, poor social skills
-33% comorbidity with autism
What are the features of PKU?
-genetically transmitted error of metabolism
-cant metabolize phenylalanine, which turns into phenylpyruvic acid, causing brain damage.
What are the features of Prader-Willi syndrome?
-moderate to severe MR, short stature, incomplete sexual development, low muscle tone, urge to eat constantly.
Similar sequence hypothesis
All children pass through stages of development in the same order at different rates and with different upper levels of development.
Similar structure hypothesis
Children with ID show the same behaviors and underlying processes as children who are of their same developmental age (progress more slowly).
Cognitive development of children with ID is qualitatively different in reasoning/ problem solving.
Fetal alcohol syndrome
Among their symptoms, children with FAS may grow less quickly than other children, have facial abnormalities and have problems with their central nervous systems, including mental retardation.
What are the core areas of deficits for a child with autistic spectrum disorder?
Abnormalities in social behavior, language and communication skills, and unusual behaviors and interests.
What kind of social and communication impairments do children with autism spectrum disorders show?
-Social: profound difficulty relating to other people; lack of interest in social interaction; lack of social and emotional reciprocity; unusual emotional expressiveness & responsiveness; lack of joint attention; impairment in theory of mind.
-Communication: delays in preverbal language development; up to 50% do not develop useful language; monotone voice; lack social chatter; pronoun reversals; difficulty with pragmatics; preservative speech
What are associated characteristics (i.e., intellectual, sensory, physical) of children with autism spectrum disorder?
-Intellectual: 30% have average or above IQs; 70% have intellectual impairment; 25% have splinter skills (above average); 5% have savant abilities (supernormal)
-Sensory: oversensitivity's; under sensitivities; or difficulty perceiving one sense at a time; stimulus over selectivity (focus on bits and pieces rather than whole).
-Physical: 25% develop seizure; 20% have abnormally large heads; digestive problems, sleep disturbances.
What are potential causes of ASD (i.e., biologically based neurodevelopmental disorder)?
-genetic influences: a substantial role
-broader autism phenotype: family members of those with autism display higher rates of social & language deficits
-higher likelihood of chromosomal abnormalities
What are the recommendations for effective treatment of ASD?
-Intensive: 25-40 hours/week, 12 months a year
-Low child: adult ratio
-Peer involvement: interaction with typically developing peers
-Focus on skill acquisition
What was the UCLA Young Autism Project? What were the findings?
-3 groups of children (average age 32 months)
-ABA (40 hours/week of intervention)
-Special education instruction (10 hours/week of individual instruction)
-Special education, no individual instruction
At age 7:
-47% of children in the ABA group were functioning at a normal level academically and educationally
-Average increase in IQ scores of 37 points
-Results maintained at age 13
-Control groups - only 1 child was placed in a normal classroom
What are the positive and negative symptoms of COS?
-Positive: hallucinations (false perceptions), delusions (false beliefs),
disorganized speech (derailment, incoherence, loose associations), disorganized behavior (disheveled appearance)
-Negative: flat affect (lack of emotion), reduction in speech quality, mental confusion, lack of energy/initiative, diagnosis also requires significant decrease in functioning or failure to make expected gains.
When is the average age of onset for COS? How common is schizophrenia in children?
-Average age of onset: 20-25
-Rare in children < age 12
What kind of impairments do children often show prior to a diagnosis of COS?
95% show a clear history of disturbances prior to onset of psychosis.
•speech & language problems
•poor motor development
•social skills deficits
•odd behavior (suspicion/paranoia)
What are the causes of COS?
-strong genetic contribution (80% heritability)
-exposure to a stressful family environment + genetic risk increases risk for developing COS
What are the primary elements of treatment for COS?
-anti-psychotic medications (dopamine antagonists - block dopamine transmission).
-treatment guidelines emphasize the use of antipsychotic medications combined with psychosocial treatments: family intervention, social skills training.
-Impairments in social communication and interaction
-Restricted repetitive and stereotyped patterns of behavior, interests, and activities
-Difficulties in both areas required for diagnosis
-Onset in early developmental period
ability to coordinate attention to a social partner and an object of mutual interest.
Theory of Mind
understanding of what others might know, think or believe.
Protodeclarative (expressive) gestures
Use of joint attention via pointing or showing gestures to engage people in interactions.
Protoimperative (instrumental) gestures
Express needs. Children with autism display these more frequently.
repeat personal pronouns as heard without changing them to suit the situation.
parrot-like repetition of words.
appropriate use of language in social and communicative contexts.
Insistence on sameness
anxious & obsessive insistence on maintenance of routines.
stereotyped as well as repetitive body movements or movements of objects.
skills above average & above their general level of intellect.
interpersonal signs of attentional & thought disturbance. When a speaker fails to effectively communicate meaning to their listener with confusing speech patterns or illogical patterns.
What types of difficulties might a child with a language disorder have?
Persistent difficulties in the acquisition and use of language (spoken, written, sign language) due to deficits in comprehension or production.
-Delayed/slowed speech development; limited vocabulary; and speech marked by short sentences and simple grammatical structure
What is the criteria for a Specific Learning Disorder?
◦Be developmentally inappropriate
◦Interfere with academic achievement or social speech
What types of errors do children with SLD with impairment in reading make? What kinds of difficulties do they have with decoding and how is this related to their ability to read?
-Inability to distinguish separate speech sounds (phonological deficit)
-Slow & incorrect decoding of phonemes
-Makes comprehension difficult
-Difficult to break word into parts rapidly enough to read whole words
◦Reversals (b/d, p/q)
◦transpositions (was/saw, scared/sacred)
◦inversions (m/w, u/n)
◦omissions (place for palace, section for selection)
What kinds of deficits do children with SLD with impairment in Writing and impairment in Math have?
◦ Recognizing numbers and symbols
◦ memorizing math facts (multiplication tables)
◦abstract numerical concepts
◦ Shorter, less interesting, and poorly organized writing products
◦Difficulty with spelling, punctuation, and grammar
What problems are associated with learning disorders?
-Higher rates of behavior and emotional problems
-Social skills deficits in 75% of cases
-School dropout- 40% for adolescents with SLD
-Difficulties may continue into adulthood because of inadequate recognition and services
-Many excel in nonacademic subjects, find his/her niche, or find ways to compensate
What are the possible causes of communication and learning disorders?
◦50-75% of children w/ lang. disorders have a family history of some type of learning disability
◦35-45% of children with learning disorder have a family history
◦Heritability for reading disorder is ~60%
Neurological deficits or differences:
◦Reading and language-based problems associated with left hemisphere brain functions
-Phonological processing- auditory cortex
-Sight word processing - visual cortex
-Verbal expression - frontal cortex
-Amount of language stimulation & exposure to speech (not causal but can exacerbate)
What are the courses of learning and communication disorders?
-5-15% of the population
-Boys diagnosed more often than girls
-Identified usually in 2nd-3rd grade
-Problems likely persist into adulthood without intervention:
◦75% diagnosed w/ reading disorder in elementary school have reading problems in high school
What treatment is effective for SLD with impairment in reading?
-Early intervention leads to better outcomes
-No biological treatments
-Educational & psychosocial interventions may be helpful
-Effective reading instruction focuses on:
◦Phonemic awareness and phonemic decoding skills, fluency in word recognition, construction of meaning, vocabulary, spelling, and writing
Basic sound segments of a language (e.g., "ba", "da", "ee")
Ability to learn phonemes.
◦Rules for combining sounds into meaningful units or words
-e.g., "s" + "ee" = "see"
◦Recognize the relationship between sounds and letters and combinations of letters
-a = "aaaa" (as in "at") and a as in "ate"
Persistent difficulties in the acquisition and use of language (spoken, written, sign language) due to deficits in comprehension or production.
Speech sound disorder
Difficulty producing certain speech sounds & regulating speed of speech.
Child-onset Fluency Disorder
The repeated and prolonged pronunciation of certain syllables that interferes with communication.
◦Gradual onset between ages 2 and 7; peaks at age 5
◦About 3% of children are affected
◦Affects males about three times more often than females
◦80% of those who stutter before age 5 stop after a year in school.
Social Communication Disorder
-Persistent difficulties in pragmatics (social use of language and communication)
-Onset must be early in development
-Added to DSM-V to categorize children who did not meet criteria for ASD but had significant difficulties with social communication
Specific Learning disorder
1) Child's achievement is significantly below (2 SDs) expectations based on age, schooling, and/or intelligence and
2) significant impairment in academics or daily living
-Subtypes: reading, math, writing
-High co-morbidity among learning disorders
Example: Discrepancy in IQ versus achievement
What are the core characteristics of ADHD?
•Difficulty focusing on tasks or following directions
•Deficits in: selective attention, sustained attention.
•Impulsivity and hyperactivity
What additional diagnostic criteria are there?
•Onset prior to age 12
•Symptoms are age-inappropriate & maladaptive
- occur in several settings
-associated with impairments in at least 2 areas
What are the ADHD subtypes?
•Combined Type (ADHD-C): symptoms of inattention & hyperactivity-impulsivity
•Predominantly Hyperactive-Impulsive Type (ADHD-HI): rarest
•Predominantly Inattentive Type (ADHD-PI)
What are the associated characteristics of ADHD?
•Cognitive deficits- executive functions
•Difficulties applying intelligence (IQ usually normal)
•Interpersonal Difficulties: family or peer problems.
•Medical & Physical Characteristics:
-Poor motor coordination
What is the prevalence of ADHD?
•Common referral problem
•5-9% of all school age children in US diagnosed
•Male to female ratio:
-2.5:1 (6:1 in clinical samples)
•Found in many cultures (5% worldwide)
How do ADHD symptoms manifest as children develop (i.e., developmental course of symptoms)?
•Infancy: Difficult temperament
•Preschool: Hyperactivity-impulsivity becomes more visible
•Elementary: Inattention noticed more
-Identification & referral
-Oppositional/defiant behaviors increase
-Symptoms continue for 50% of referred children
What are the causal contributors to ADHD? (i.e., genetic, neurobiological, neurotransmitters, prenatal & early development, family influences)
-Strong evidence for genetic factors
-Runs in families
-Twin studies: concordance rates for MZ (65%) > DZ (33%)
-Symptoms may be related to deficiency in dopamine
•Related to ability to experience reward
•Need for larger and more immediate reinforcers
Prenatal and Early Development:
-Factors that can compromise development of nervous system are related to ADHD
•pregnancy & birth complications
•early neurological trauma
•maternal prenatal smoking or substance use
-Can play a major role in determining the outcome & severity of ADHD
-Poor parenting skills
What types of treatments are used for ADHD?
-Stimulants (e.g.,Methylphenidate/Ritalin, Adderall): most common, most effective
-Effective for ~80% of children
-3% of school-age children take stimulants (more than tripled since 1990)
-Increase dopamine availability
-Non-stimulants (e.g., Strattera)
-increases norepinephrine in brain
-Long acting form
-Parent Management Training:
-Increase positive engagement with child (special time)
-Structure environment, routine
-Use of behavior management strategies:
-Praise for positive behavior
-Rewards and punishments
What were the major results of the MTA study on ADHD treatment?
600, 7-9 yr olds diagnosed with ADHD randomized to
PMT + summer camp
Combined Behavioral + Medication
Results: All had decreased ADHD symptoms
-Combination = best outcomes
Ability to concentrate on relevant stimuli despite distractions.
Ability to maintain persistent focus over time.
Sudden, repetitive, nonrhythmic motor movements or sounds.
Integrate & manage brain functions & underline capacity for self-regulation. They affect:
-Focus & shifting attention
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