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130 Cards in this Set
- Front
- Back
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MR: 3 Criteria
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1. IQ 70 or below
2. Impairment in 2 areas of functioning 3. Onset before 18 |
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MR: 2 Causes
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1. Biological (Downs, PKU, lead)
2. Psychosocial Or both |
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Learning Disorders Definition
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Lower achievement in reading, math, or written expression (2 standard deviation on achievement and intelligence)
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Learning Disorders Subtypes
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1. Reading disorder (dyslexia)
2. Mathematics 3. Written expression |
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Mixed Receptive-Expressive Language Disorder
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Impairment in both receptive and expressive language development
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Phonological Disorder
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Failure to use developmentally expected speech sounds
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Stuttering
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A disturbance in the usual fluency and time patterning of speech, not age appropriate
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Motor Skills Disorder
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Impairment in development of motor coordination not PDD or GMC
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ADHD
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Persistent pattern of developmental;u inappropriate inattention and/or impulsiveness and hyperactivity
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Conduct Disorders
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Persistent pattern of conduct in which the rights of others and societal norms or rules are violated
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Oppositional Defiant Disorders
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Persistent pattern of negativistic, hostile, and defiant behavior without the serious violation of others rights
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Pica
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Persistent eating of nonnutritive substances for at least one month
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Rumination Disorder
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Repeated regurgitation and rechewing of food that begins after a period of normal functioning
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Feeding disorder of normal infancy or early childhood
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Persistent failure to eat adequately, marked failure to put on weight, or marked weight loss over at least one month, beginning by age 6
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Tics
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Sudden involuntary recurrent motor movements or vocalizations
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3 Types of Tic Disorders
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Tourettes, Chronic motor, Vocal Tic
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2 Types of Elimination Disorders
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Encopresis
Enuresis |
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Fetal Alcohol Syndrome
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low birth weight, small size, unusual pattern of facial, limb, ad cardio defects
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SIDS
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May be due to inadequate CNS respiratory control or respiratory blockage in the infants anatomically vulnerable airway
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Childhood Depression
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Similar to adult; masked by oppositionality or delinquency
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Other childhood disorders
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Separation anxiety, Selective Mutism, Reactive Attachment, Stereotypic movement
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MR areas of adaptive functioning
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1. Communication
2. Self-care 3. School/work 4. Social/interpersonal skills |
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Signs of MR in infancy
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1. Less responsive to parents or stimuli
2. Less physically active 3. Less vocally interactive 4. More compliant |
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MR: Areas of adaptive functioning
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1. Communication
2. Self-care 3. School/work 4. Social/interpersonal skills |
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Mild Retardation
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Educable, majority 85%, 6th grade level, semiskilled jobs, live independently, social and communication skills, minimal sensory/motor impairments, noticeable in late childhood
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Moderate Retardation
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Trainable, 10%, 2nd grade, un-semi skilled work, minimally supervised
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Severe Retardation
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3-4%, Poor motor skills, limited speech, learn to talk, trained hygiene skills, simple tasks, close supervision
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Profound MR
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1-2%, severe impairment motor/sensory, constant supervision, simple tasks
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Most common contributing factor of MR
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30% Downs, prenatal use of alcohol or drugs, Early alteration in embyronic development
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Predisposing factors of MR
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1. 15-20% Environment and other mental disorders (deprivation of nurturance, autism)
2. 10% Pregnancy and perinatal problems (fetal malnutrition, HIV, viral, hypoxia, trauma) 3. 5% Heriditary (Tay sachs, fragile X syndrome) 4. 30-40% no clear cause |
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PKU (Phenylketonuria)
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lack of the enzyme necessary to oxidize phenylalanine, an amino acid in protein foods
untreated = excessive phenylpyruvic acid and other metabolites that can damage nervous system need a low phenylalanine diet |
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Fragile X Syndrome
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Occurs in males 2x more, physical and behavioral abnormalities (large head/testes, violence), deficits in cognitive development .
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Down's Syndrome
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47 chromosomes (extra on 21st trisomy 21)
Intellectual impairment, physical disorders, characteristic facial features |
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MR: Causes after birth
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5%: Meningitis, encephalitis, lead poisoning, malnutrition, anoxia
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MR: Psychosocial and other causes
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15-20%: Cultural-familial, deprivation of nurturance, deficiency in health care, deficiant social, cognitive, and other stimulation, and poverty. Autism.
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Childhood psychotic disorders
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Symbiotic psychosis, childhood SCZ)
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Autism: Required Criteria
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6 Signs, two from 1, and one each from 2 and 3
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Autism: Category 1: Social Interaction
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Impairment in nonverbal behaviors, lack of social/emotional reciprocity, absence of peer relationships
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Autism: Category 2: Communication
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Delay or lack of spoken language, impaired ability to initiate or carry on conversations, stereotyped and repetitive use of language or idiosyncratic language, lack of developmentally appropriate play
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Autism: Category 3: Restricted repetitive and stereotyped patterns of behavior, interests, and activities
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Preoccupation with stereotyped and limited patterns of interest, inflexible adherence to purposeless rituals or routines, stereotyped and repetitive motor movements, persistent preoccupation with parts of objects
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Autism: Age limit
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Before age of 3 must be delayed or abnormal functioning in social interactions, language, play,
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Autism: Speech
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Rarely speak (50% none at all), echolalia, reversal in pronouns
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Autism: Social interaction
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Unaware of others, fail to notice needs and distress of others, don't smile, cuddle, eye contact, reach out to others
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Autism: Friendships
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Children have minimal interest.
Adults more interest but lack understanding of social customs |
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Autism: Interests
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Perservative play, react intensely to minor changes in surrounding, more attached to objects
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Autism: Rate
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Rare, 2-5 cases per 10,000
4-5 times more common in males |
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Autism: IQ
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75% MR
Exceptional skills in math, drawing, music, or rote memory |
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Autism v. Scz
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No delusions/hallucinations
Physical unresponsive, early onset, poorer prognosis |
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Autism: Etiology
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Unknown
Occurs equally across all SES and not correlated with personality characteristics, education, occupation, race, or religion |
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Autism: Genetics and Neurological
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Studies have show more in monozygotic twins
High levels of autonomic arousal, ventricular enlargement, frontal lobe dysfunction, cerebellar underdevelopment, abnormal patterns of brain lateralization |
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Autism: Links
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Maternal rubella, complications at birth, and elevated levels of serotonin
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Autism: Pharm TX
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Little effect
Haldol: reduce aggressiveness, emotional lability, withdrawal, stereotyped and self-harm behavior |
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Autism: Behavioral TX
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Operant techniques: Behavior and communication - Reinforced for all efforts not only successful
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Autism: TX
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Most successful beginning when child is very young, active involvement of parents, implemented at home, intensive, structured environment, generalize skills, contracts behavior change and methods to change
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Autism: Prognosis
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Higher level of functioning in beginning = better prognosis (Early language)
Tend to need institutionalization or home care |
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Rhetts Disorder
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1. Deceleration of head growth
2. Loss of hand skills and stereotyped hand movements 4. Uncoordinated gait and trunk movements 5. Deficiencies in expressive and receptive language |
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Rhetts Disorder
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6. Psychomotor retardation
7. Loses interest in social environment 8. Only in females 9. Normal development-5 months then regresses. Before age 4. 10. Genetic mutation |
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Childhood Disintegrative Disorder
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Onset: 2-10 after normal development
2 deficits: expressive/receptive language, motor, bowel/bladder control, social skills |
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Asperger's Disorder
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Deficits in social interaction, interests, and activity patterns
No language delay, self-help skills, cognitive development, curiosity about environment More in males Achieve employment and self-sufficiency |
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Learning Disorders
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2 standard deviation difference between achievement and IQ
Based on age, schooling, and IQ |
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Types of Learning Disorders
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Mathematics
Reading Written Expressing |
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LD: Rule outs
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Must be differ from lack of opportunity, cultural, poor teaching, MR, PDD, sensory deficit
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Types of Reading Disorders or Dyslexia
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Word recognition, reading comprehension, oral reading
Omissions, substituting words, distortions |
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Math Disorder
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Understanding or naming math operations, carrying numbers, learning multiplication tables
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Written expression disorder
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Punctuation, spelling, paragraph organization
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Testing a reading disorder
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WISC and Woodcock Johnson
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Comorbidity and LD
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ADHD: 20-50%
CD, ODD, MDD |
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DYSLEXIA types
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Surface (orthogonal): Inability to read irregularly spelled words Might as mit
Deep: Reading errors Semantic paralexia: Response related to target word in meaning Hot for cold or arm for leg |
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LD: Etiology
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1. Neuro - inattentio, short-term memory deficits, hyperactive, L-R confusion
2. Genetics 3. Toxins, early malnutrition. early iron deficiency, food allergies, hemispheric abnormalitie, cerebellar vestibular dysfunction caused by OME 4. Cognitive processing deficit |
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LD: Treatment
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Behavioral and educational training
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Mixed Receptive/Expressive Language Disorder
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Scores are lower in tests of language versus nonverbal
Problems with language development, understanding words or sentences |
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Phonological Disorder
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Does not use common speech sounds for age and dialect
Substituting sounds or omitting sounds |
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Stuttering
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Abnormalities in fluency and time patterning of speech not age appropriate
Frequent repetitions or prolongations of speech sounds or syllables, interjections or broken words |
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Stuttering
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Begins between 2 and 7
Aggravated by anxiety 60% remits by age 16 Treatment: reduce anxiety, parental pressures |
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Motor Skills Disorder
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Young; Clumsy, delays in milestones
Older: difficulties in puzzle assembly, model building, playing ball, printing, handwriting |
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ADHD Types
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1. Combo
2. Inattentive 3. Hyper/Impulsive 6 or more symptoms in each category |
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ADHD Criteria
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Onset before age 7, durations 6 months, 2 settings
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ADHD: Inattention Signs
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Careless errors, difficulty paying attention, not following through on instructions, being forgetful, losing things, distracted by irrelevant stimuli
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ADHD: Hyperactive SIgns
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Digeting, running excessively, trouble playing quietly, talking too much
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ADHD: Impulsive Signs
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Interrupting others, not waiting turn, blurting answers
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ADHD: Statistics
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3-5% meet criteria
10% show signs Variable IQ Mostly diagnosed school age because of structured environment 4-9 times more in boys |
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ADHD Comorbidity
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50% CD
25% Emotional 20% LD Social maladjustment, motor incoordination, visual/auditory impairment |
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ADHD: Adults
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70% continue to adulthood
Restless, Low frustration tolerance, low self-esteem, emotional lability, impulsivity, difficulty concentrating Sense of underachievement, not meeting goals, chronic procrastination, intolerance to boredom, easy distractibility, worry, insecurity |
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ADHD: Adults Rule Out
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Anxiety disorder, bipolar, MD, OCD, impulse control disorder
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ADHD: Adult personality
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Passive aggressive, Narcissistic
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ADHD: Etiology - Neuro
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1. Diminished glucose metabolism and decreased blood flow in prefrontal cortex and caudate nucleus
2. Smaller caudate nucleus (behavioral inhibition), corpus callosum, and globus pallidus |
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ADHD: Etio
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Food allergy, Perinatal alcohol/nicotine use, high lead levels
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ADHD: Genetics
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Parent has ADHD: 57%
Twin: .80 |
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ADHD: Minimal Brain Dysfunction
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5-10%: normal IQ, mild-severe behavioral problems, impaired perceptual motor, memory, EEG abnormal
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ADHD: Arousal studies
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Mixed finding in arousal studies high/low.
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ADHD: Attention studies
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More likely in dull, repetitive, familiar, structured environment, lack regular reinforcement
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ADHD: Behavioral Disinhibition Hypothesis
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Barkley: Lack of ability to adjust (up/down) activity levels to fit settings
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ADHD: Stimulant Therapy
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Low dose: improve attention
High dose: Reduce activity levels & improve social behaviors Short tern improvements |
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Ritalin (methylphenidate): Somatic SE
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Decreased appetite, insomnia, stomach ache - Mild
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Ritalin (methylphenidate): Movement SE
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30-70% Tics
Increased tic disorder 30-50% OCD SX |
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Ritalin (methylphenidate): Growth Suppression
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Suppress height
Drug holidays can provide time for compensatory growth |
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ADHD: Behavioral TX
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Young: Contingency management
Older: Self-control, self-talk, covert speech, on task skills Best results when parents participate in treatment, set consistent rules, provide structured environment Rewards combined with response cost most effective |
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Conduct Disorder: Signs
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Defy society rules and norms in a variety of settings
1. Aggression to people and animals 2. Destruction of property 3. Deceitfulness or theft 4. Serious violations of rules 5. 3 or more - 12 months. 1 present in last 6 months |
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Conduct Disorder: 2 Types of Onset
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Child: prior to 10. Poor prognosis, overt aggression, violence, comorbidity (ADHD, SA, ASP)
Adolescent: 10-18 Associated with peers |
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Conduct Disorder: Results on Achievement and IQ tests
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Lower on achievement tests, poor abstract thinking, deficits in verbal abilities, no difference on nonverbal
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Conduct Disorder: School
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Lower school achievement, difficult complying with classroom rules, low peer acceptance,
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Conduct Disorder: personality
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Low empathy, low morals, bad judgment, low self-esteem, irritable,
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Conduct Disorder: Causal factors
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BIO: Inability to experience high levels of emotional arousal and genetic predisposition
Family/Env: Poverty, large family size, parental neglect or rejection, family discord, abuse, harsh, inconsistent, lax discipline, and parental psychopathology |
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Conduct Disorder: Treatment
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Combo of behavioral and family
Severe: Child removed from family to residential setting Effective: begin early childhood before adolescence, with parent education, promote family interaction, train parents to monitor child behavior, and use noncoercive methods of punishment and behavioral contracts |
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Oppositional Defiant Disorder: Signs
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Negativistic, argumentative, and defiant to adults - family.
Loss of temper, angry outbursts, resentfulness, and easy annoyance. Rarely accepts responsibility and blames others. 4 signs in last 6 months |
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Pica
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Nonnutritive substances are ingested (paint, cloth, sand, leaves)
At least for one month Between 1-2 years Associated with MR |
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Rumination Disorder
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Recurrent regurgitation and rechewing of food for at least 1 month
3-12 months of age Potentially fatal - malnutrition 25% |
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Feeding Disorder of Infancy or Early Childhood
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"Failure to Thrive"
1 month - not eating enough with weight loss before 6 years |
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Tourette's Disorder
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Onset 2-18 years
Jerky involuntary movements (motor) Vocal sounds such as grunts, clicks, barks (vocal) <10% Copralalia (Obscene) 1 year, daily, asymptomic < 3 months, multiply times a day Chronic |
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Tourette's: Co-occurring
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Most frequent: obsession/compulsion
ADHD, LD, depression, and social problems |
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Tourette's: Treatment
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School intervention, individual/family therapy, meds
Antipsychotics: Haldol, pimoside, clonidine, antidepressants |
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Chronic motor/vocal tic disorder
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Less severe impairment than Tourettes
Single or multiple motor or vocal tics NOT BOTH |
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Encopresis
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Involuntary or intentional passage of feces in inappropriate places. Must be at least 4. Occurs 1x mo for 3 months. Causes shame and avoidance.
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Enuresis: Signs
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Involuntary or intentional passage of urine while awake or asleep. 2 wettings a week for 3 months. At least age 5.
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Enuresis: Treatment
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1. Moisture alarms (most effective), Antidepressant medications (short-term effective 30%), hypnosis, and bladder control exercises
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Separation Anxiety Disorder
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Excessive anxiety (panic) - 4 weeks
Somatic complaints, fantasies of danger |
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School phobia (SX of SAD)
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5-7 yrs. In adolescence may be sign of depression. Somatic complaints. Must return to school.
Causes: Parental overprotective, insecurity as a result of loss or trauma, unresolved dependency issues of parent (psychoanalytic) reinforce dependency issues of child. |
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SAD TX & Prognosis
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Individual, family, behavioral
Can lead into adulthood - ambivalence of leaving home for an independent life |
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Selective Mutism
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Failure to talk in particular social situation (School) for 1 month.
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Reactive Attachment Disorder
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Extremely disturbed ad inappropriate social relatedness before 5 yrs.
1. Inhibited: Failure to respond in an age appropriate manner socially 2. Disinhibited: Indiscriminate sociability with strangers - making requests or affection Associated with extremely pathogenic care - chronic neglect or multiple changes of caregivers failing to provide permanent attachment figures |
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Stereotypic Movement Disorder
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Repetitive nonfunctional motor behaviors (hitting/biting body, body rocking, head banging, teeth grinding). Cause self harm, associated with MR, difficult to resist
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Fetal alcohol syndrome
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Children of alcohol mothers
Failure to thrive, developmental delays, mild to moderate MR, physical abnormalities (short nose, flat midface, small chin, narrow upper lip, very thin |
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Sudden Infant Syndrome
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Respiratory difficulties, low birth weight, shorter body length
5 in 10,000 births. 3rd most frequent cause of death in infants |
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Childhood Depression
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Similar to adult depression, in addition, show separation anxiety, school phobia, antisocial behaviors, aggression, withdrawal, inattention.
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What is true of moderately retarded individuals
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Can be trained to do semiskilled work under supervision
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Rule out LD
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Substandard education experiences for several years. Must exceed any physical deficit.
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Truth about Reading Disabilities
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Persists into adulthood
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Not true about Autism
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Older Autistics are socially withdrawn
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Speaks normally, impaired social interaction, restricted patterns of behavior, interests, activities
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Asperger's disorder
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Most important factor in treating school phobia
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Return to school
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