Disorders Of Childhood- Final Exam

Front 1

• A developmental brain disorder
• Affects social functioning

Back 1

Autism

Front 2

Autism:___increase in pediatric prevalence
between 1991-1997*
why?

Back 2

556%
• A lot of research funded
to help understand it.
• 5-fold increase since 1997!

Front 3

Autism =

Back 3

“within oneself”

Front 4

– Children “withdrew into shells”,
“disregarded people for objects”,
“avoided eye contact”
– “perservation of sameness”
– didn’t speak much

Back 4

Leo Kanner

Front 5

-similar observations to kanner
-similary socially to autism
-but spoke

Back 5

Hans Asperger

Front 6

disruptions in development
• Autism
• Asperger syndrome
• Rett syndrome
• Childhood Disintegrative Disorder
• PDD/NOS

Back 6

pervasive developmental disorder (PDD)/autism spectrum disorder (ASD)

Front 7

more common in boys

Back 7

Autism

Front 8

no language impairment, highly functional

Back 8

Asperger syndrome

Front 9

more common in girls

Back 9

Rett syndrome

Front 10

develop fine, then regress

Back 10

Childhood Disintegrative Disorder

Front 11

don't meet all the criteria

Back 11

PDD/NOS

Front 12

Time Trends: Autism

Back 12

Significant increase in prevalence

Front 13

Now: ~____ per 10,000 (US)

Back 13

30-60

Front 14

1960s: ~___ cases per 10,000

Back 14

4

Front 15

Why the increase?

Back 15

– Improved diagnostic ascertainment
– Broadening of diagnostic concept
– Environmental factors cannot be excluded

Front 16

Autism: A developmental disorder
• Diagnosed between age ___
• Usually because

Back 16

2-5
kids fail to show age-typical
behavior (fail to speak!)

Front 17

• First signs at around ___ months; obvious by
___years.

Back 17

12-24
24mo-6

Front 18

Boys:girls ___

Back 18

4:1

Front 19

Most patients require...
• Some people with autism can

Back 19

..lifelong assistance.
..have productive and somewhat independent lives.

Front 20

most common comorbiditity

Back 20

• Mental Retardation (70%)
• Epilepsy (25%)
– onset adolescence/adulthood

Front 21

Symptoms

Back 21

• DSM -IV-TR: must have at least some impairment in each of areas
a), b) & c).
a) Social interaction
b) Language, communication & imaginative play
c) Range of interests and activities

Front 22

• Associated characteristics:

Back 22

– IQ
– Sensory impairments
– Cognitive deficits

Front 23

Symptoms: social interaction

Back 23

• Difficulties engaging in social interactive behaviors
eye-contact, gestures (pointing), joint attention, peek-a-boo,
little/no social referencing
• little interest in people
• difficulties establishing social relationships
• difficulties sharing (emotional)

Front 24

Some good news…

Back 24

• Even though children with autism may
not like typical affection from their
parents, they do form attachments with
their caregivers.

Front 25

Symptoms: Language,
Communication & Pretend play

Back 25

• Delay or absence of precursors to
language/communication (babbling, communicative
gestures)
• Delay or absence of language production &
comprehension
• Only ~ 50% ever learn “normal” language, but often
stereotypical and devoid of meaning
• Gestures: instrumental but not expressive
• Impairments in speech pragmatics
• Echolalia (parroting)
• Absence of pretend play

Front 26

• Only ~__ ever learn “normal” language, but often
stereotypical and devoid of meaning

Back 26

50%

Front 27

Gestures: _____but not ______

Back 27

instrumental
expressive

Front 28

Symptoms: Range of interest

Back 28

• Preoccupation with one/few types of activities
• Stereotyped & restricted interest
• Stereotyped & restricted motor mannerisms
(hand-flapping,rocking, self-stimulation)
• Inflexible adherence to non-functional
routine

Front 29

Associated characteristics: IQ

Back 29

• Can span the entire range but

Front 30

• ____% mental retardation

Back 30

70%
(IQ < 70)

Front 31

__average or above average IQ

Back 31

30 %

Front 32

• ___have splinter skills

Back 32

25%

Front 33

___autistic savants
– The real “rainman”
• Read by 16 months
• By age 4 memorized 8 encyclopedias!!!

Back 33

5%

Front 34

Associated characteristics:
Sensory processing

Back 34

• Hyper/Hyposensitivity:
Stimulus overselectivity:

Front 35

they really like one type of stimulus

Back 35

Stimulus overselectivity:

Front 36

• Hyper/hypovision (in infancy)*
• Hyper/hypohearing
• Hyper/hyposmell/taste
• Hyper/hypotactility
– Might explain why some
• avoid people
• Don’t like to be touched or cuddled
• Are really picky eaters

Back 36

Hyper/Hyposensitivity:

Front 37

Associated symptoms:
Emotional processing

Back 37

– Problems expressing emotions (facial and vocal)
– Problems processing others’ emotional
expressions (facial and vocal)
– Problems relating to others’ emotions (empathy)

Front 38

Associated symptoms:Processing of faces

Back 38

•More scanning
of inside features
•More focus
on outside features
•More focus on mouth

Front 39

Cognitive deficits: Impairment in ToM

Back 39

• Theory of mind
• People with autism often have trouble in
situations that require “reading others’ minds”
Imagine you see a guy walk into this lecture hall.
He looks around the class, looks at the screen and at me,
then turns around and leaves the room.
What kind of inference do you make?

Front 40

Impairment in ToM: The Sally-Anne Task
is a...

Back 40

• A false-belief task

Front 41

Impairment in ToM: The Sally-Anne Task
• A false-belief task
-Young kids have trouble with this too
-Typical kids can solve this
by the age of ___.
- Older kids and adults with
autism still have trouble with this

Back 41

3-4

Front 42

Cognitive Deficits: Executive Functioning
– Problems with

Back 42

• Higher order planning and regulation of
behaviors
– Problems with
• planning actions
• Ignoring distractions
• Inhibiting inappropriate behaviors
• Flexibly shifting from one task to another

Front 43

Memory and autism

Back 43

Very specific memory problems:
– Few/no organizational strategies
– Visual spatial working memory
– Face memory (local not global)
– Memory for social scenes
– Complexity (sentences)
Main idea: things are less coherent and harder to remember

Front 44

Visual spatial working memory

Back 44

people with autism do worse on this

Front 45

Memory and autism
Central Coherence:

Back 45

processing in bits and
pieces.

Front 46

Causes of autism

Back 46

• Early notion: “refrigerator mom’s”
• Origin is neurobiological
• Genetic and non-genetic
– Twin studies: not always do both have
diagnosis and if, then phenotype can be very
different.

Front 47

Genes & Autism
• single gene?
• As many as ___ genes involved
• Heritability __%
• ___ risk among siblings
• Monozygotic twins: ____
• Dizygotic twins: ~___

Back 47

• Most strongly genetic psychiatric disorder of
childhood!
• Not just a single gene
15
90%
2-6%
36-91%
10%

Front 48

Environmental influences

Back 48

• Pre/perinatal complications
– Infections, teratogens (Alcohol,
Thalidomide), prematurity,problems during
birth
• Diets (Gluten & Casein)
• Vaccines: containing thimoresol (mercury)

Front 49

Where in the brain…

Back 49

• No single region has yet been identified
• Candidates: cerebellum, frontal cortex,
hippocampus, amygdala

Front 50

A brain that grows too fast

Back 50

• Heads small in the
beginning
• Rate of growth very fast -
larger than normal head
size
•The faster the rate,the more
severe the outcome

Front 51

Structural differences

Back 51

• Small cerebellum
• Parietal, Temporal & occipital lobes are
all larger.
• Hippocampus:
– Smaller cells, more
densely packed

Front 52

Face processing

Back 52

• Not much attention to faces
• Faces considered threat ? *
• Activity in amygdala ↑
• ↓ when gaze is averted

Front 53

Chemical imbalances

Back 53

• Serotonin
• Dopamine
• Oxytocin
– Bonding hormone

Front 54

Treatment

Back 54

• Early diagnosis & intervention is KEY.
experience can change the way the brain “wires
up”
• Different treatment for different patients.

Front 55

Treatment Types:

Back 55

– Occupational/physical therapy
– Behavior modification
– Sensory integration therapy
– Diet & medications

Front 56

Treatment Types
Behavior Modification

Back 56

1.Sensory Integration
Therapy (SIT)
2.Listening to sounds,
touching things
3. Play Therapy & Social
stories
4.Behavior & Communication
Therapy:
• DTT
•Speech Therapy
•Picture Exchange
Communication Systems
(PECS)

Front 57

Sensory Integration
Therapy (SIT)

Back 57

involves: Listening to sounds,
touching things
goal: Help individuals deal with
sensory stimulation

Front 58

Play Therapy & Social
stories

Back 58

Involves : Child controlled adult-child interaction
Goal: Improve emotional
development, social skills
and learning

Front 59

Behavior & Communication
Therapy:
• DTT
•Speech Therapy
•Picture Exchange
Communication Systems
(PECS)

Back 59

Involves: •Learning appropriate
behaviors
•Learning how to use
language and symbols to
express needs
Goal:• Helps improve behavior
• Help individuals with
ability to use speech &
gestures to communicate

Front 60

Sensory Integration Therapy

Back 60

Goal: to “understand” sensory stimulation
• Just Right Challenge
• Adaptive Response
• Active Engagement
• Child Directed

Front 61

Social stories™

Back 61

• Write a story/draw a comic strip
- Geared towards an individuals problems
- Help understand “confusing” social
situations.
• Brushing my teeth
• How to have a friend over (turn-taking, sharing)
• Happiness is a good feeling
• How to make someone happy.
• Why do adults forget….

Front 62

Discreet trials training (DTT)

Back 62

• Like “shaping” in OC.
• Reinforcing steps towards right
behavior.
• Using rewards specific to the child

Front 63

PECS

Back 63

-get pic cards
-use cards to express needs, desires, feelings

Front 64

Childhood Onset Schizophrenia (COS)

Back 64

a severe form of schizophrenia with
onset as early as elementary school
(less than 14 years of age)
Schizophrenia (SZ) is a disorder of the brain
that is expressed in abnormal mental function
and disturbed behavior.

Front 65

Schizophrenia (SZ)

Back 65

______ is a disorder of the brain
that is expressed in abnormal mental function
and disturbed behavior.
…”thinking problems”
…”magical” thinking

Front 66

not usually raving maniacs on the rampage more often __________.
in general, lower than _________.
modal onset = _______
not “split” personality
not necessarily _________

Back 66

shy, withdrawn and preoccupied
normal intelligence (IQ 100)
25 years old [COS < 12 years]
chronic or a lifetime affliction

Front 67

Categories of SZ

Back 67

Paranoid
Disorganized
Catatonic
Undifferentiated and Residual

Front 68

delusions of persecution or grandeur
intensely emotional or very formal

Back 68

Paranoid type

Front 69

silliness and incoherence
insensitivity to external cues
hypersensitivity to internal cues

Back 69

Disorganized-

Front 70

enormously excited or strikingly frozen
negativism (oppositional behavior)

Back 70

Catatonic-

Front 71

milder form

Back 71

Undifferentiated and Residual-

Front 72

Symptoms in SZ

Back 72

Disorganized speech- scattered topics, tangential
Memory impairment- poor short-term,
usually normal long-term
Attentional filter- poor separation of relevant from
irrelevant information, thus
nonsensical over-inclusiveness
Perceptual deficits- distorted spatial or auditory percepts
(not! a sensory problem)
Motor deficits- below normal coordination & small motor

Front 73

scattered topics, tangential

Back 73

Disorganized speech-

Front 74

poor short-term,
usually normal long-term

Back 74

Memory impairment-

Front 75

poor separation of relevant from
irrelevant information, thus
nonsensical over-inclusiveness

Back 75

Attentional filter-

Front 76

distorted spatial or auditory percepts
(not! a sensory problem)

Back 76

Perceptual deficits-

Front 77

below normal coordination & small motor

Back 77

Motor deficits-

Front 78

major impairment in the understanding of reality

Back 78

Psychosis

Front 79

bizarre delusions (false beliefs)
hallucinations (false perceptions)
affect ranges from wild agitation ⇒ expressionless

Back 79

psychotic behavior

Front 80

cardinal sign of psychosis

Back 80

bizarre and magical thinking

Front 81

Difficulty of diagnosing children

Back 81

The problem for diagnosis of COS
is that it is really not possible to distinguish between
the rich, unrestrained imagination of normal children
and the hallucinations brought on by psychosis.
Particularly when very young, psychotic children
do not find hallucinations disquieting (as do adults).

Front 82

cardinal sign for COS:

Back 82

gradual, not sudden, onset of
bizarre thinking that has a profound negative impact
on the child’s social and academic development

Front 83

Particular symptoms for COS

Back 83

dysfunction in frontotemporal regions is inversely
correlated with age of onset
neurological soft signsindications
of minor neurological abnormalities
more prevalent in children who are later
diagnosed with COS
withdrawal from social contact

Front 84

COS:
SZ: ~ 1.1 in 100 adults
or 1.1%

Back 84

~ 1.0 in 10,000 children
or ~0.005 % very very rare... probably only 3 in san diego

Front 85

COS onset is

Back 85

2 to 4 years younger and twice
as prevalent in boys

Front 86

SZ is equally prevalent in males and females
!yet !

Back 86

boys develop more slowly than girls
So, is estrogen a protective factor that delays the
course of SZ?

Front 87

Comorbidity in COS

Back 87

depression
ADHD
conduct problems
suicidal tendencies
70% of COS patients have comorbidity
most commonly oppositional behavior or mood disorder
[prevalence of autism in COS cohort is the same
as in the general population]

Front 88

Causes of SZ

Back 88

genetic
developmental
dopamine
stress

Front 89

Genetic correlations

Back 89

Heritability is a significant risk factor
MZ twins: 1:2 pairs where one twin is diagnosed
with SZ, the other twin develops SZ
in pairs where the first diagnosis finds
severe SZ, the other twin develops SZ
77% of the time

Front 90

Developmental disturbances

Back 90

Issues- COS less prevalent in girls
COS predicts the severity of SZ
COS onset predicts severity
motor symptoms and short-term
memory impairment indicate disturbance
of normal developmental in frontal lobes

Front 91

acute
discomfort with social relationships
along with cognitive or perceptual distortions
may be a precursor of COS

Back 91

schizotypal personality disorder

Front 92

Dopamine pathways in SZ

Back 92

neuroleptic medications treat positive symptomschlorpromazine,
haloperidol
regulate hyperactivity in frontal lobes
control psychotic symptoms
reduce dopamine turnover
(m.a.= binding to D2 receptors)
causes Parkinsonian symptoms
(~7 years, 24% of SZ Rx neuroleptics
develop tardive dyskinesia)

Front 93

an external factor that challenges the body’s
normal efforts to maintain homeostasis
(stress is a normal and necessary part of how
the body regulates vital processes)

Back 93

stressor

Front 94

is how the body meets the stressor

Back 94

allostasis

Front 95

demand on the CNS to
activate the HPA axis (adrenal glands) &
retard the immune system

Back 95

allostatic load-

Front 96

-when allostasis is not functioning properly
major causes: chronic anxiety
sleep deprivation
HPA axis increases cortisol level
-chronic increase in cortisol depresses
the immune system and is toxic for
cortical neurons (i.e., cortisol ⇑ PTSD)

Back 96

Allostatic load

Front 97

Treatment for COS

Back 97

pharmacological
psychosocial intervention

Front 98

______ control psychotic symptoms,
but have unacceptable side effects over time

Back 98

neuroleptics

Front 99

_________treat positive symptoms
without apparent negative symptoms
risperidone, olanzapine, clozapine (+risk)

Back 99

atypical antipsychotics

Front 100

_______involves adjustment of
school environment and academic load, training
to manage interpersonal communication,
and psychotherapy for COS and family

Back 100

psychosocial intervention

Front 101

Outcome SZ

Back 101

Treatment for COS includes biological, educational, and social
interventions. Medication is the cornerstone of treatment, but
should be viewed as a means to facilitate psychological
and social interventions. Treatment with only medication is not
as effective as medication combined with other forms of treatment.
The outcome for children with COS varies greatly…some
individuals function well with medication. When symptoms are
recognized early and treated so that school and family life can
continue, some COS patients learn to cope. This positive outcome
can forestall or reduce the longterm cognitive impairments
associated with SZ.

Front 102

transduction of energy

Back 102

sensation

Front 103

how brain organizes sensation

Back 103

perception

Front 104

In the Shining
Tony=
girls=

Back 104

Tony=delusion
girls=hallucination

Front 105

- symptoms

Back 105

catatonic, locked up

Front 106

+ symptoms

Back 106

halucinations, delusions

Front 107

Problems that occur in the absence of other
obvious conditions

Back 107

Communication & Learning Disorders

Front 108

areas of communic. and LD

Back 108

• Listening
• Speaking
• Reading
• Writing
• Reasoning
• Mathematics

Front 109

***_____ have LD and MR***

Back 109

CANNOT bc. normal IQ for LD

Front 110

– Producing speech sounds
– Speech fluency
– Using spoken language to communicate
– Understanding what other people say

Back 110

• Communication Disorders

Front 111

– Reading
– Math
– Writing ability

Back 111

• Learning Disorders

Front 112

– Producing speech sounds

Back 112

phonological

Front 113

– Speech fluency

Back 113

stuttering

Front 114

– Using spoken language to communicate

Back 114

expressive language disorder

Front 115

– Understanding what other people say

Back 115

mised expressive perceptive

Front 116

– Reading

Back 116

dyslexia

Front 117

prob solve and see abstract relationships

Back 117

logical mathematical intelliegence

Front 118

perception and manipulation orientation of objects

Back 118

spacial intelligence

Front 119

hearing and manipulating tones and rythums musical patterns and pitch

Back 119

musical intelligence

Front 120

use the body to coordinate movements

Back 120

bodiliy kinesthetic intelligence

Front 121

how attuned to nature

Back 121

naturalistic intelligence

Front 122

sense moods and felings and actions of others

Back 122

interpersonal

Front 123

recognise define and pursue inner feelings and thoughts

Back 123

intraperosnal

Front 124

meaning function and gramatical rules of words

Back 124

linguistic

Front 125

1. Approach learning in different ways
2. Tailor educational methods
3. Strengthen existing abilities

Back 125

Important Concepts

Front 126

basic sounds building blocks of words (ba, da)

Back 126

phenomes

Front 127

how many phenomes are there

Back 127

44

Front 128

___ is one of the best predictors of school performance in overall intelligence

Back 128

lanugage development

Front 129

– Recognizing the relationship that exists between
sounds & letters, detection of rhyme & alliteration,
and awareness that sounds can be manipulated
within syllables in words

Back 129

Phonological Awareness

Front 130

most intensive period for language development

Back 130

1st 3 yrs of life

Front 131

by ___ kids recoginize basic so8unds of their native language

Back 131

6 months

Front 132

by six months they

Back 132

babble

Front 133

by 9 months

Back 133

10 words

Front 134

Reacts to loud sounds
Turns head toward a sound source
Watches your face when you speak
Vocalizes pleasure and displeasure sounds
Makes noise when talked to

Back 134

birth-5 months

Front 135

Understands "no-no"
Babbles
Tries to communicate by actions or gestures
Tries to repeat your sounds

Back 135

6-11 months

Front 136

Attends to a book or toy for about two minutes
Follows simple directions accompanied by gestures
Answers simple questions nonverbally
Points to objects, pictures, and family members
Says two to three words to label a person or objects
Tries to imitate simple words

Back 136

12-17 months

Front 137

Enjoys being read to
Follows simple commands without gestures
Points to simple body parts such as "nose"
Understands simple verbs such as "eat," "sleep"
Correctly pronounces most vowels and n, m, p, h
Says 8 to 10 words
Asks for common foods by name

Back 137

18-23 months

Front 138

Knows about 50 words at 24 months; says around 40 words at 24
months
Knows some spatial concepts such as "in," "on"
Knows pronouns such as "you," "me," "her"
Knows descriptive words such as "big," "happy"
Begins to use more pronouns such as "you," "I"
Speaks in two to three word phrases
Uses question inflection to ask for something (e.g., "My ball?")

Back 138

2-3 yrs

Front 139

Groups objects such as foods, clothes, etc.
Identifies colors
May distort some of the more difficult sounds: l, r, s, sh,ch, y, v, z, th
Strangers are able to understand much of what is said
Able to describe the use of objects such as "fork," "car," etc.
Has fun with language
Answers simple questions: "What do you do when you are hungry?"
Repeats sentences

Back 139

3-4 yrs

Front 140

Understands spatial concepts such as "behind," "next to."
Understands complex questions
Speech is understandable but makes mistakes
Says about 200 - 300 different words
Uses some irregular past tense verbs such as "ran," "fell."
Describes how to do things such as painting a picture
Lists items that belong in a category
Answers "why" questions

Back 140

4-5 yrs

Front 141

Understands more than 2,000 words
Understands time sequences (what happened first, second, third, etc.)
Carries out a series of three directions
Understands rhyming
Engages in conversation
Sentences can be 8 or more words in length
Uses compound and complex sentences
Describes objects
Uses imagination to create stories

Back 141

5 yrs

Front 142

Communication Disorders

Back 142

• Expressive language disorder
• Mixed receptive-expressive disorder
• Phonological disorder
• Stuttering

Front 143

Mixed receptive-expressive language disorder

Back 143

speaking prob's coupled by difficulty in understanding some aspects of speech

Front 144

Phonological Disorder

Back 144

involves articulation or sound production rather than word kowledge
-1, s, r, z, th, ch

Front 145

Commun. disorders boys __ girls

Back 145

>

Front 146

Commun. disorders what happens with time

Back 146

language probs usually disappear or diminish with time

Front 147

Communication Disorders: Causes

Back 147

• Genetics
• Brain
• Ear infections
• Home environment

Front 148

_______ show a + family history

Back 148

50-70%

Front 149

In communications disorders they have a prob with the ___part of the brain

Back 149

left

Front 150

part of the brain important for language

Back 150

left

Front 151

___ is important for speech comprehension
-prob for receptive

Back 151

wernicke's

Front 152

wernicke's area located in

Back 152

left temp lobe

Front 153

broca's area located in

Back 153

left inf frontal

Front 154

programs for vocalization (speech outlet)

Back 154

Broca's area

Front 155

A problem with Broca's area would be

Back 155

expressive problem

Front 156

connects wernicke's and broca's area

Back 156

arcurate faciculus

Front 157

repeated and prolonged pronuciation of certain syllables

Back 157

stuttering

Front 158

auditory cortex sends info to

Back 158

arcurate faciculus-> wernickes->comprehend-> AF->Broca's->

Front 159

stuttering is

Back 159

strongly inherited (70%)

Front 160

normal speech

Back 160

• Air from lungs pass
through vocal cords
• Vocal cords vibrate &
produce your voice
• Palate, tongue, jaw & lip
modify sound
• Feedback to brain adjusts
movements

Front 161

Stutterers:

Back 161

diff in perslvian region (houses wernicke's area)
-dopamine
-speak slowl to the child

Front 162

word recognition or comprehension

Back 162

reading achievement

Front 163

handwriting spelling

Back 163

writing skill

Front 164

what does it take to read

Back 164

-focus attention on printed marks
-control e movements
-recognize sounds associated with letters
-understand words and grammer
-build ideas and images
-compare new ideas with what u already know

Front 165

word level reconition disability

Back 165

word level reconition disability
-word level reading disability= dyslexia

Front 166

dyslexia aka

Back 166

-word blindness
-visual agnosia for owrds
-specific reading disability

Front 167

__is a specific learning disability that is neurological in
origin. It is characterized by difficulties with accurate and/or
fluent word recognition and by poor spelling and decoding
abilities.These difficulties typically result from a deficit in the
phonological component of language that is often
unexpected in relation to other cognitive abilities and the
provision of effective classroom instruction. Secondary
consequences may include problems in reading
comprehension and reduced reading experience that can
impede the growth of vocabulary and background
knowledge

Back 167

Dyslexia

Front 168

core deficit in reading disorders

Back 168

decoding

Front 169

ID WORDS WITH SPEED AND ACCURACy

Back 169

fluent word reconition

Front 170

breaking wrod into parts

Back 170

decoding abilities

Front 171

3 phonological components

Back 171

1. fluent word recognition
2. poor spelling
3. decoding abilities

Front 172

Typical Errors: dyslexia

Back 172

• Reversals
• Transpositions
• Inversions
• Omissions

Front 173

• Reversals

Back 173

b/d, p/q

Front 174

• Transpositions

Back 174

seqential errors (was/saw)

Front 175

inversions

Back 175

m/w , u/n

Front 176

ommisions

Back 176

place instead of palace

Front 177

constant updating task

Back 177

control group does better than dyslexia , prob w working memory

Front 178

most common learning disorder

Back 178

dyslexia

Front 179

corse of dyslexia

Back 179

not good...why ... diagnostic cirteria discrepanc btw IQ and reading achievement
-efficiacious interventions not used
-motivation diminishes

Front 180

LD: Reading Disorder: Reading Comprehension
Proficient reading comprehension

Back 180

fluent decoding
-can occur in absence of word recognition prob's

Front 181

LD: Reading Disorder: Reading Comprehension
Assessment Issues

Back 181

-read
-response format
-memory demands
-specific aspects of comp
-not alot known

Front 182

mathetmatics disorder have probs with

Back 182

-recognize #'s and symbols
-memorize facts
-aligning #'s
-abstract concepts

Front 183

Verbal dyscalculia

Back 183

naming amts or numbers

Front 184

• Practognostic dyscalculia

Back 184

enumerating, comparing, and manipulating objects

Front 185

• Lexical dyscalculia

Back 185

reading and math symbols

Front 186

• Graphical dyscalculia

Back 186

writing mathematical symbols

Front 187

• Ideognostical dyscalculia

Back 187

understanding concpets and perfoming mentally

Front 188

• Operational dyscalculia

Back 188

??

Front 189

Learning Disorders: Writing Disorder
Problems with visual-motor abilities

Back 189

– Writing
– Figure copying
– Figure rotation

Front 190

finger agnosia

Back 190

can't tell what finger you're touching

Front 191

other factors

Back 191

-low self esteem
-social isolation
-anxiety
-depression
-frustration

Front 192

5 Stages of Sleep:

Back 192

•Non-REM:
Stage 1
Stage 2
Stage 3
Stage 4
•REM

Front 193

REM

Back 193

high frequent brain waves paralysis of large muscles usuall dream in REM brain activity is like you are awak, large muscles are paralized when you are in REM (not want to re-enact dreams might be wh this happens)

Front 194

stage ____ area also as important as REM

Back 194

3 and 4

Front 195

As an ___ we spend more time in REM than we do when we are older

Back 195

infant

Front 196

executive functioning, spending more time in the later part of the night in REM

Back 196

frontal cortex

Front 197

Health Related Disorders: Sleep Disorders
•Dyssomnias

Back 197

•Protodyssomnia
•Hypersomnia
•Narcolepsy
•Breathing-related Sleep Disorder
•Circadian rhythm Sleep Disorder

Front 198

Health Related Disorders: Sleep Disorders
•Parasomnias

Back 198

•Nightmare Disorder
•Sleep Terror Disorder
•Sleepwalking Disorder

Front 199

like insomnia

Back 199

•Protodyssomnia

Front 200

tired alot

Back 200

•Hypersomnia

Front 201

all of sudden fall asleep collapse and fall directly into REM

Back 201

•Narcolepsy

Front 202

Sleep Disorders: Dyssomnias
Protodyssomnia

Back 202

-difficulty initating or maintaining sleep or sleep that is not restorative
-infants repetitive night waking and inability to fall asleep

Front 203

Sleep Disorders: Dyssomnias
Protodyssomnia
prevalence

Back 203

25-50% of 1-3 year olds ...prett common in infants

Front 204

Sleep Disorders: Dyssomnias
Protodyssomnia
treatment

Back 204

behavioral treatment
family guidance

Front 205

Sleep Disorders: Dyssomnias
•Hypersomnia

Back 205

excessive sleepiness

Front 206

Prevalence & Age:
•Hypersomnia

Back 206

Common among young children

Front 207

•Hypersomnia
•Treatment

Back 207

•Behavioral treatment
•Family guidance

Front 208

•Narcolepsy

Back 208

attacks of sleep
-cataplexy-loss of muscle tone...not forever though

Front 209

•Narcolepsy
•Prevalence & Age:

Back 209

•<1%

Front 210

•Treatment•Narcolepsy

Back 210

•Structure
•Support
•Psychostimulants
•SSRIs

Front 211

Sleep Disorders: Dyssomnias
•Circadian Rhythm Sleep Disorder

Back 211

sleep districution leading (circadian means about a day) to excessive sleepiness or insomnia; light is a big one- depresses melatonin which will make you not fall asleep

Front 212

•Prevalence & Age:

Back 212

•Unknown

Front 213

•Treatment

Back 213

•Behavioral treatment
•Chronotherapy

Front 214

Sleep Disorders: Parasomnias
•Nightmare Disorder

Back 214

happens during REM, repeating aweakenings with recall of dreams VERY FRIGHTENING

Front 215

Sleep Disorders: Parasomnias
•Nightmare Disorder
•Prevalence & Age:

Back 215

•Common between ages 3 & 8

Front 216

•Treatment

Back 216

•Provide comfort
•Reduce stress

Front 217

•Sleep Terror Disorder

Back 217

abrupt awakening from sleep
-1st 3rd of sleep wake up screaming bloody murder and still asleep sort of begins with a panicking scream a racing heart, sweating vocalized ditress glassy eyed stare difficult to arouse inconsolable dioriented no memory of episode in the morning

Front 218

•Sleep Terror Disorder
•Prevalence & Age:

Back 218

•3% ages 18 months to 6 years

Front 219

•Treatment

Back 219

•Reduce stress & fatigue
•Add late afternoon nap
helps relieve stress

Front 220

Sleep Disorders: Parasomnias
•Sleepwalking Disorder
•Prevalence & Age:

Back 220

•15% 1 attack
•1-6% 1-4 attacks per week

Front 221

•Treatment

Back 221

•Take safety precautions
•Reduce stress & fatigue
•Add late afternoon nap

Front 222

Can look like other things

Back 222

ADHD
learning difficulties
aggression
cognitive deficits
substance abuse
depression
anxiety

Front 223

Elimination Disorders: Enuresis

Back 223

-involuntary discharge or urine
-over 5 y/o

Front 224

Enuresis
• 3 Subtypes:

Back 224

1. Noctural only
2. Diurnal only
3. Noctural + diurnal

Front 225

• Prevalence:

Back 225

• 13-33% of 5 y.o. wet their beds
• More common

Front 226

enuresis more common

Back 226

in boys than girls
-less educated
-lower SES groups (less structure with this class and need that for potty training and ther is also added stressor as well)

Front 227

course

Back 227

declines rapidly with age

Front 228

Elimination Disorders: Enuresis
1. Limitations imposed on social activities
2. Effects on self-esteem
3. Parental reactions

Back 228

1. Limitations imposed on social activities
-can't sleep away from home
2. Effects on self-esteem
-including degree of social ostracism by peers
3. Parental reactions
-punishment anger rejection

Front 229

Elimination Disorders: Enuresis: Causes

Back 229

• Antidiuretic Hormone (ADH) Deficiency
• Genetics:
• Both parents 77%
• MZ: 68%

Front 230

• Antidiuretic Hormone (ADH) Deficiency

Back 230

helps urine [] so that there is less water and doesnt fill bladder up

Front 231

Elimination Disorders: Enuresis: Treatments

Back 231

• Behavioral:
• Bell & pad
• Dry bed training
• Meds
• Desmopressin(synthetic ADH)
• tricyclics
**meds not very good though bc the bed weting comes back once taken off meds

Front 232

***having them hold it longer will

Back 232

make it stronger...or hourly wakes to strip to the bathroom give a huge reward when one wakes up in dry bed

Front 233

Elimination Disorders: Encopresis

Back 233

passage of feces into inapprotriate places
-clothing
involuntary or intentional
must be 4 y/o

Front 234

Encopresis
• 2 subtypes:

Back 234

• With or without constipation
• Overflow incontinence

Front 235

Elimination Disorders: Encopresis
Prevalence:

Back 235

• 1.5-3%
• 5-6 times

Front 236

Course:

Back 236

• Decreases rapidly with age
• May feel ashamed & try to avoid situations (told public bathrooms are dirty)

Front 237

Elimination Disorders: Encopresis: Causes

Back 237

• Megacolon
• Defecation dynamics

Front 238

• Megacolon

Back 238

avoiding depressing or not recieving signals that have to go to bathroom gets clogged in there if uncleared the feces that stays in there becomes large hard and dry and future bowel movements bery painful

Front 239

Elimination Disorders: Encopresis: Tx
Treatment:

Back 239

• Fiber, enemas, laxatives or lubricants
• Behavioral methods

Front 240

Chronic Illness

Back 240

• Persists longer than 3 months
• Requires a period of continuous
hospitalization of more than 1 month

Front 241

Chronic Illness: 2 Categories

Back 241

1. Somatoform disorders:

2. Psychological factors affecting physical
condition:

Front 242

somatoform disorders

Back 242

• Somatization
• Hypochondriasis
• Pain Disorders

Front 243

Substance Use Disorders

Back 243

•Substance Dependence
•Substance Abuse
•Self-administration
•Alters mood, perception or brain functioning

Front 244

•Substance Dependence

Back 244

addiction

Front 245

•Substance Abuse

Back 245

hazardous use; repeated probs in one yr in 1 or more
1. don't meet obligations
2. use in hazrdous situations
3. legal probs DUI
4. social or interperosnal probs

Front 246

who is drinking the most

Back 246

18-25 y/o and doing the most drugs

Front 247

risk factor for later abuse and dependence is

Back 247

age of 1st use

Front 248

alcohol use before age __ is a strong predictor of subsequent abuse or dependence

Back 248

14

Front 249

girls __ boys to use
mj, alcohol, heroin, roids

Back 249

<

Front 250

girls more likely than boys to use

Back 250

tranquilizers and amphetamines <-weight

Front 251

Substance Abuse: Comorbidities

Back 251

•Polydrug abuse
•Conduct disorder (95%)
•Attention deficits
•Anxiety disorders
•Mood disorders

Front 252

Substance Abuse: Biological Context

Back 252

•Genetics
-hard to parse out
•Prenatal Exposure
-also increases risk of adolecent use of alcohol and tobacco, one hypotheiss brain recpetors become sensitized to substances making child more reactive and crave

Front 253

•Temperament

Back 253

**difficult temperment**

Front 254

Substance Abuse: Family Context

Back 254

•Parental substance abuse
-modeling/social learning
•Parental depression
-maternal dperession, not alcoholism is precdicitive of alcohol use (the - effects of being emotionally unavailable palying a big role in development)
-paternal alcoholism
•Child maltreatment
(kid copes with this by abusing alcohol)
•Parenting style
-authoritative style the best to protect

Front 255

peers are ___ predictor of adolescent drinking

Back 255

most powerful

Front 256

Substance Abuse: Social Context

Back 256

•Peer relationships
-peer influence (normalizes subst. use also model introduce them to drug provide opportunites for continued use)
•Peer influence
•Peer selection
•Early sexual maturation
-esp with girls spend time with older peers that introduce them to violating behaviors such as subst abuse

Front 257

those with low self esteem

Back 257

attracted to drug use to gain status in peer group and make themselves feel better

Front 258

Substance Abuse: Individual Context

Back 258

•Conduct Problems
-early and agressive
•Unconventionality
-deviance, nonreligiousness, independence, critical of society
•Sensation-seeking
•Cognitive Schemas
•Enhancement
•Social
•Coping
•Conformity
•Emotion Regulation

Front 259

protective factors

Back 259

dont use substances likely to value academic achievement be unconcerned with independence from family accpet of social satus quo and involved in religion

Front 260

Substance Abuse: Cultural Context
•Social Class
•Higher rates among ______ youths
•Factors:

Back 260

high class
•Media

Front 261

Substance Abuse: Risk Factors

Back 261

•Personality
-low expectation of success
-poor self esteem
-hopelessness
-alienation
•Environmental
-prob behaviors
-oriented toward peers
•Behavioral
-poor school performance
•Social
-antisocial

Front 262

Substance Abuse: Protective Factors

Back 262

•Personality
-+orientation
-concern about personal health
-intolerance toward deviance
•Environmental
-+ relationships w adults
-regulatory controls
•Behavioral
-prosocial activities
•Social
-positive peer models

Front 263

from use to abuse

Back 263

social intergration
-reduces social support and increasing loneliness
occupation
-impedes successful function
family
-early marriage and child bearing divorce
criminal behavior
-steal DUI selling drugs
mental health
-psycosis increased suicidal ideation depresion

Front 264

culture
school
peer
family
interindividaul
intraindivdual

Back 264

culture: availability of durgs; media
school: academic failure, lack of commitment to school
peer: early peer rejection, peer modeling
family: history of alcoholism
interindividaul: aggressive; conduct probs
intraindivdual:
difficutl temperment, hyperactive

Front 265

eating disorders should not be confused with

Back 265

disorderly eating

Front 266

•Learning to eat is a process

Back 266

•Requires precise coordination

Front 267

•Young children often have troublesome eating habits

Back 267

•Limited food preferences
•More common among girls
•Normal behavior

Front 268

•Girls begin to have weight and appearance concerns at about age

Back 268

9
•Perhaps due to socioculturalfactors
•But, this is normal too

Front 269

Risk Factors

Back 269

•Early Eating Habits
•Disturbed Eating Attitudes
•A person’s belief that cultural standards for attractiveness, body image, and social acceptance are based on one’s ability to control diet and weight gain
–Weight and Body Image Concerns
•Fear of gaining weight
•Distorted body image

Front 270

More Risk Factors

Back 270

•Transition into Adolescence
–Pubertal development
•Dieting and Weight Concerns
–60% of children in grades 5-8 reported having dieted in the past 7 days
–2/3 of mid-adolescent girls reported dieting during the past year
•10% are chronic dieters who remain on diets continuously or were on a diet at least 10 times

Front 271

Biological Regulators

Back 271

Biological processes that influence eating patterns

Front 272

Biological Regulators (2)

Back 272

•Metabolic Rate
–Balance of energy expenditure is established based on genetics and physiological makeup as well as eating and exercise habits
–Self-monitors and self-regulates behavior
•Set Point
–The body’s natural weight range
–Metabolic changes strive to keep weight at this point

Front 273

Feeding Disorder of Infancy or Early Childhood

Back 273

•Sudden or marked deceleration of weight gain in an infant or young child (under age 6) and a slowing or disruption of emotional and social development
•Can affect both physical and mental development and lead to death

Front 274

Feeding Disorder of Infancy or Early ChildhoodPrevalence

Back 274

•Up to 1/3 of young children
•Occurs with equal frequency in boys and girls

Front 275

Feeding Disorder
Development

Back 275

•Onset before age 2
•No medical reason
•Outcome dependent on:
•When disorder is identified
•Degree of malnutrition
•Degree of developmental delay
•Severity of the infant-caregiver relationship

Front 276

Feeding Disorder of Infancy or Early Childhood
Causes

Back 276

•Closely tied to a poor infant-caregiver relationship
•Neglect
•Abuse
•Parental mental illness
•Associated with mothers who have a history of anorexia and disturbed eating habits
•As well as family disadvantage, poverty and unemployment

Front 277

Treatment

Back 277

•Encourage positive interactions between parent and infant
•Smiling, talking and soothing
•Re-evaluation of infant’s feeding behavior

Front 278

Pica

Back 278

•The indigestion of inedible, non-nutritive substances for more than 1 month
•Often seen in very young and those with mental retardation
•Children still interested in eating normal foods
•At risk for developing bulimia as well as lead poisoning or intestinal obstruction

Front 279

Pica
Prevalenc

Back 279

•More prevalent among children in institutions
•Institution: 9-25%
•Community: 0.3-15%

Front 280

Development

Back 280

•The severity of Pica is dependent on the degree of mental retardation and lack of environmental stimulation

Front 281

Pica
Causes

Back 281

•Unclear
•May appear in normally developing infant or toddler
•Often environmentally deprived with poor stimulation and inadequate caregiver interaction
•Perhaps due to vitamin or mineral deficiency
•Ex: clay
•No genetic role with exception of cases of mental retardatio

Front 282

Treatment

Back 282

•Emphasis on caregiver reinforcing appropriate behavior
•Encourage positive attention and interaction with child
•Vitamin supplements

Front 283

•Food avoidance
–Marked anxiety of swallowing or choking
•May be triggered by incident of choking or witnessing someone choking
•No distorted image or preoccupation with weight and/or shape
•Equally affects males and females

Back 283

Functional Dysphagia

Front 284

•Profound refusal to eat or drink
–Will also not talk, walk or care for self
•Underweight and dehydrated. Life-threatening.
•May be diagnosed as anorexia nervosa
–But, appears to have more symptoms
–Possibly an extreme form of post-traumatic stress disorder or learned helplessness

Back 284

Pervasive Refusal Syndrome

Front 285

Both disorders have good prognoses if treated appropriately with multidisciplinary approach

Back 285

Functional Dysphagia &Pervasive Refusal Syndrome

Front 286

Our Culture obesity

Back 286

•The conflict: Mass media powerfully promotes the thin ideal in a land where fast food is widely available and accessible
•In a comparison of 15 developed countries, the US had the highest percentage of obese children
•Child obesity increase of 3%-5% in 1990s
–10% increase among minority population

Front 287

•Children whose BMI falls between the 85thand 95thpercentile are at risk for obesity
•15% of 6-11 year olds
•A child is considered obese if above the ___ percentile

Back 287

95%

Front 288

Obesity
Prevalence

Back 288

•1960s: 5%
•1990s: 15%
•10% toddlers

Front 289

Development

Back 289

•Meal portions
•Accessibility of fast food
•Convenience of junk food

Front 290

Obesity
Causes

Back 290

Causes
•Genetics
•3 times more likely if both parents are obese
•40% if one sibling is obese
•Deficiency of Leptin
•Family factors
•Parenting
•Lack of limits, communication and support
•Diet
•Poor eating habits
•Lifestyle
•Lack of exercise

Front 291

Treatment

Back 291

•Changes in family functioning
•Increase parental knowledge
•Role models
•Encouragement
•Teach self-control and monitoring

Front 292

Anorexia Nervosa

Back 292

“loss of appetite”

Front 293

Subtypes of AN

Back 293

Restricting Type
–Weight loss due to severe restriction of diet, fasting or excessive exercise
Binge-Eating/Purging Type
–Binge and purge on small amounts of food, unlike bulimia nervosa

Front 294

Signs of AN

Back 294

•Weight loss in a short amount time without known medical illness
•Ritualistic eating behavior
•Severe and selective restriction of food intake
•Active maintenance of low body weight
•Obsessive exercising
•Socially withdrawn, impaired concentration, irritability

Front 295

Anorexia Nervosa
Prevalence

Back 295

–Among adolescents: 0.3%
–Disproportionatelyfemale
•11:1

Front 296

Development

Back 296

–Onset between 14-18 years old
–Often preceded by dieting

Front 297

Subsequent Course

Back 297

–Rate of mortality: 5%
–Less than ½ of survivors fully recover
–1/3 show some improvement
–In 1/5, the disorder is chronic and lifelong

Front 298

Subtypes of BN 2

Back 298

Purging Type
–Regular self-induced vomiting or laxative and diuretic misuse
•Majority of people with BN practice purging
•Induced vomiting most common among those seeking treatment
Non-Purging Type
–Excessive exercise or fasting
•The most common compensatory behavior among those not in treatment
Signs of BN
•Regular bingeing
–Episode of uncontrolled, rapid eating
•Regular purging
•Mood swings
•Weight not changing despite frequent exercise or consumption of large amounts of food
•Use of bathroom for long periods of time after meals

Front 299

Signs of BN

Back 299

Regular bingeing
–Episode of uncontrolled, rapid eating
•Regular purging
•Mood swings
•Weight not changing despite frequent exercise or consumption of large amounts of food
•Use of bathroom for long periods of time after meals

Front 300

Bulimia Nervosa
Prevalence

Back 300

–1-2% in 16-35 year olds
–Disproportionately female
•30:1

Front 301

Development

Back 301

–Onset usually late adolescence and young adulthood
•Slightly later than AN
–Usually starts in same way as AN

Front 302

Subsequent Course

Back 302

–50%-75% fully recover

Front 303

Causes of AN and BN

Back 303

–Genetics
•4-5 times more likely if a relative has AN or BN
•If identical twin has AN, 58%-88% chance of developing also
•Inherited personality traits
–Neurobiological
•Serotonin imbalance
Social
–Physical appearance is key to:
•Happiness
•Self-worth
•Femininity
•Success
–Cultural ideals
Psychological
•Characteristics
–Need to feel in control
–BN
»Rigid, “all-or-nothing” , black and white attitude.
–AN
»Restricting Type:highly controlled, rigid with obsessive tendencies
»Binge-Eating/Purging Type:impulsive behaviors, self-injuryand substance misuse.

Front 304

•Comorbidity

Back 304

–90% also have depression, anxiety disorders or OCD

Front 305

Treatment of AN and BN

Back 305

•Bulimia Nervosa
–Cognitive behavioral therapy
–Antidepressants
•Anorexia Nervosa
1.Help patient realize she/he needs help
2.Weight restoration
3.Family therapy and cognitive behavioral therapy

Front 306

•Bingeing without compensatory behavior
•Coping mechanism for stress
•No need to be physically hungry
•In youth, 25% of those that meet ...criteria report attempted suicide

Back 306

Binge Eating Disorder

Front 307

Eating Disorders Not Otherwise Specified

Back 307

•Partial Anorexia Nervosa
–Menstrual cycle is normal
–Body weight normal weight for age and height
•Partial Bulimia Nervosa
–The binge eating and compensatory behaviors occurs less than twice a week for 3 months
May be more appropriate for adolescents since are still not yet physically, cognitively and emotionally mature

Front 308

• Child maltreatment

Back 308

– Physical abuse
– Neglect
– Sexual abuse
– Emotional abuse

Front 309

• Non-accidental trauma

Back 309

– Wide ranging effects of maltreatment

Front 310

Victimization

Back 310

Abuse or mistreatment of someone whose
ability to protect self is limited

Front 311

Considerations

Back 311

• Victim wants to stop the violence, but longs
to belong to a family
• Affection & attention may coexist with
violence & abuse
• Intensity of violence increases over time

Front 312

Types of Maltreatment: Physical Abuse

Back 312

• Multiple acts of aggression
– Includes punching, beating, kicking, biting,
burning, shaking, or otherwise physically
harming a child

Front 313

•Physical neglect

Back 313

– Refusal or delay in seeking health care, expulsion from
the home or refusal to allow runway to return home,
abandonment, & inadequate supervision

Front 314

•Educational neglect

Back 314

– Allowing chronic truancy, failing to enroll a child in
school & failing to attend to a child’s special educational
need

Front 315

•Emotional neglect

Back 315

Inattention to needs for affection, refusal or failure to
provide needed psychological care, spousal abuse in
the child’s presence, & permission of drug or alcohol
use by the child

Front 316

Maltreatment: Brain

Back 316

•HPA axis
•Hippocampus
•Prefrontal cortex
•Amygdala
•NT: Norepinephrine

Front 317

Maltreatment: Resiliency & Adaptation

Back 317

•Positive relationships with 1 important &
consistent person
•Positive self-esteem
•Positive sense of self

Front 318

•Repeated acts or omissions by the parents or
caregivers that have caused, or could cause,
serious behavioral, cognitive, emotional or mental
disorders

Back 318

Types of Maltreatment: Emotional Abuse