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135 Cards in this Set

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What are the three hallmarks of mental retardation?
1. Significantly subaverage intellectual functioning (below 70 IQ)
2. Deficits in adaptve functioning in at least two areas
3. Onset before age 18
What are eleven important areas of adaptive functioning?
1. Communication
2. Self-care
3. Home living
4. Social/interpersonal skills
5. Use of community resources
6. Self-directions
7. Academics
8. Work
9. Leisure
10. Health
11. Safety
What percentage of cases of mental retardation are prenatal in origin?
75%
Alterations at what stage of development are most likely to lead to mental retardation?
Embryonic-- conception to eight weeks.
What is the most common cause of prenatal mental retardation?
Environmental factors.
What are four environmental factors which can cause prenatal mental retardation?
1. Poor maternal nutrition
2. Poor maternal health
3. Limited access to health care
4. Exposure to pollutants, chemicals and toxins (e.g., maternal alcohol consumption)
What percentage of cases of prenatal mental retardation are caused by genetic factors?
5%
What is the perinatal period?
one pound in utero to one month after birth
What percentage of cases of mental retardation are perinatal in origin?
10%
What are five perinatal causes of mental retardation?
1. Fetal malnutrition
2. Hypoxia (oxygen deprivation)
3. Prematurity
4. Trauma
5. Viral infection
What is hypoxia?
Oxygen deprivation

(can be a perinatal cause of mental retardation)
What percentage of cases of mental retardation are postnatal in origin?
10%
What are three postnatal causes of mental retardation?
1. Brain tumors
2.Trauma
3. Infection
What is the relationship between mental retardation and other mental disorders?
People with mental retardation have three to four times more mental disorders than the general population.
What are the four disorders most commonly associated with mental retardation?
1. ADHD
2. Mood disorders
3. Pervasive developmental disorders
4. Stereotypic movement disorders
What is the male to female ratio of people with mental retardation?
1.5 : 1
What is the IQ range for mild mental retardation?
55 to 70
What is the IQ range for moderate mental retardation?
40 to 55
What is the IQ range for severe mental retardation?
25 to 40
What is the IQ range for profound mental retardation?
Below 25
What are the five types of mental retardation?
1. Mild (55-70 IQ)
2. Moderate (40 to 55)
3. Severe (25 to 40)
4. Profound (Below 25)
5. Severity Unspecified (standard tests cannot be used)
What is the most common form of mental retardation?
Mild (85% of the population)
What percentage of people with mental retardation have mild mr?
85%
Describe mild mental retardation. (four aspects)
Can develop social and communication skills.

Minimal sensorimotor impairment.

Up to 6th grade level.

Can be somewhat self-supporting.
Describe moderate mental retardation.
Develop communication skills.

Up to 2nd grade level.

Can attend to personal care, and do unskilled or semiskilled work under supervision.
Describe severe mental retardation.
Impaired in communication in childhood; can learn to talk during school-age years.

Can be trained in elementary self-care skills.
Describe profound mental retardation.
Significant impairment in sensorimotor functioning, need a highly structured environment.
What type of people with mental retardation are most likely to have an underlying neurological basis for the disorder?
Profound mental retardation.
What is the definition of a learning disorder?
1. Significant discrepancy between IQ and expected academic achievement (reading, math, written expression) based on life circumstances
2. Interferes in academic achievement or activities of daily living
What are four disorders and two problems associated with learning disabilities?
1. Conduct Disorder
2. ADHD
3. Oppositional Defiant Disorder
4. Depressive Disorder

1. low self-esteem
2. deficits in social skills
What are four types of Learning Disorders?
1. Reading Disorder
2. Mathematics Disorder
3. DIsorder of Written Expression
4. LD NOS
When is Reading Disorder usually diagnosed?
Rarely before the end of kindergarten.
What are ten disorders usually diagnosed in childhood or adolescence?
1. Mental Retardation
2. Learning Disorders
3. Motor Skills Disorders
4. Communication Disorders
5. Pervasive Developmental Disorders
6. Attention Deficit and Disruptive Behavior Disorders
7. Feeding and Eating Disorders of Infancy or Early Childhood
8. Tic Disorders
9. Elimination Disorders
10. Other.
What is Developmental Coordination Disorder? What are four ways it can manifest?
Deficits in daily activities which require motor coordination.

1. Delays in achieving motor milestones
2. Clumsiness
3. Poor performance in sports
4. Poor handwriting
What are five types of communication disorders?
1. Expressive Language Disorder
2. Mixed Receptive-Expressive Language Disorder
3. Phonological Disorder (errors in sound production and use)
4. Stuttering
5. Communication Disorder NOS
What are four symptoms of the communication disorder Expressive Language Disorder?
1. Limited vocabulary
2. Errors in tense
3. Difficulty recalling words
4. Difficulty producing sentences
What are seven symptoms of the communication disorder Mixed Receptive-Expressive Language Disorder?
1. Limited vocabulary
2. Errors in tense
3. Difficulty recalling words
4. Difficulty producing sentences
5. Difficulty understanding words
6. Difficulty understanding sentences
7. Difficulty understanding particular statements (e.g., "if-then" statements)
What is Phonological Disorder? What are two possible manifestations?
A communication disorder involving errors in sound production and use.

1. Substituting one sound for another
2. Omitting sounds such as final consonants
What is stuttering? What are seven types of stuttering?
A communication disorder involving a disturbance in the normal fluency and time patterning of speech.

1. Sound repetitions
2. Syllable repetitions
3. Interjections ("um," "like")
4. Broken words (pause in the word)
5. Blocking (involuntary silent pauses)
6. Circumlocutions (avoiding certain words)
7. Monosyllabic whole-word repetitions
What percentage of children with expressive language disorder outgrow it?
Approximately 50%.
Until what age is stuttering considered normal, and so not warranting a diagnosis?
Two or three.
What is the definition of pervasive developmental disorders?
Severe and pervasive problems in several areas of development including

1. Reciprocal social interactions
2. Communication
3. The presence of stereotyped behaviors, interests and activities
What are five pervasive developmental disorders?
1. Autistic disorder
2. Rett's disorder
3. Childhood disintegrative disorder
4. Asperger's disorder
5. Pervasive developmental disorder NOS
What are the four diagnostic criteria of Autistic disorder?
1. Impairment in social interaction (e.g., failure to develop peer relationships, not seeking to share enjoyment with others)
2. Impairment in communication (delay or lack of spoken language, inability to initiate or sustain a conversation)
3. A restricted repertoire of activities (e.g., inflexible adherence to routines and rituals, stereotyped and repetitive motor mannerisms).
4. Onset before age three
What is Rett's disorder? What are seven of its symptoms?
A type of pervasive developmental disorder.

1. Totally normal development until somewhere between age five and forty-eight months
2. Sudden deceleration of head growth
3. Acquisition of stereotyped hand movements
4. Loss of social engagement
5. Appearance of poorly coordinated movements
6. Severely impaired language development
7. Psychomotor retardation
In what population does Rett's Disorder appear?
Only in females.
What percentage of children with Autistic Disorder are diagnosed with mental retardation?
75%
What are the three characteristics of the best onset for Autistic Disorder?
1. Later onset
2. Higher IQ
3. Child speaks before age five
What is savantism?
An individual who generally has lower intelligence, but has striking and unusual abilities (e.g, math, perfect pitch).
What disorder is associated with savantism (although savantism is also found in people without this disorder)?
Autism
What are three characteristics of Childhood Disintegrative Disorder?
1. Normal development for two years, followed by:
2. Clinically significant loss of previously acquired skills before age ten in at least two areas (language, social skills, play, motor skills, bowel/bladder control)
3. Abnormalities in at least two areas (social interaction, communication and restriction of behaviors, interests and activities)
In what population is Childhood Disintegrative Disorder found?
More common among males.
What are three characteristics of Asperger's Disorder in children?
1. Qualitative impairment in social interaction
2. Restricted repertoire of behavior
3. No language delays or delays in cognitive development or adaptive behavior beyond social interaction

Onset is later than autism.
In what population is Asperger's Disorder found?
More common in males.
Describe Asperger's Disorder in adulthood. (2 ways)
Difficulties with empathy and modulating social interactions.
Define ADHD
1. Some symptoms must have been presen since before age seven.
2. Symptoms must be severe enough to interfere with functioning in a least two areas.
3. Occurs for at least six months.
4. Six or more symptoms of inattention and/or hyperactivity
What are nine possible symptoms of inattention?
1) Failure to pay attention to details resulting in careless errors
2) Difficulty sustaining attention to tasks
3) Does not seem to listen when spoken to directly
4) Does not follow through or fails to finish assignments
5) Has difficulty organizing tasks
6) Avoids tasks requiring sustained attention
7) Frequently loses things
8) Is easily distracted
9) Is forgetful
What are nine possible symptoms of hyperactivity/impulsivity?
1) Frequently fidgets or squirms
2) Stands up when remaining seated is expected
3) Runs or climbs excessively in inappropriate situations
4) Has difficulty playing quietly
5) Is constantly "on the go."
6) Talks excessively
7) Blurts out answers before questions are completed
8) Has difficulty waiting for their turn
9) Interrupts or intrudes on others
In what population is ADHD found?
Six to nine times more common in males than in females.
What five medications are used to treat ADHD?
1. Rialin (methylphenidate)
2. Cylert (pemoline)
3. Dexedrine (dextroamphetamine)
4. Adderall (amphetamine)
5. Concerta (methylphenidate)
What are four non-pharmacological interventions for ADHD?
1. Behavior therapy
2. Social skills training
3. Parenting education
4. EEG biofeedback
How old does a child have to be before ADHD can be easily distinguished from normal behavior?
Four or five
What is the lifetime course of ADHD?
Usually attenuates during late adolescence or adulthood, though some people have it for life.
What are three characteristics of ADHD commonly experienced in adulthood?
1. Difficulty focusing
2. Difficulty finishing tasks
3. Procrastination
What are ten features often associated with ADHD?
1. Low frustration tolerance
2. Temper outbursts
3. Bossiness
4. Mood lability
5. Demoralization
6. Dysphoria
7. Rejection by peers
8. Poor self-esteem
9. Impaired academic achievement
10. Strained family relationships
What is the relationship between ADHD and IQ?
Children with ADHD often have lower IQ.
What are two frequent concomitant diagnoses with ADHD?
1. Oppositional Defiant Disorder
2. Conduct Disorder
What are three diagnoses which may be associated with ADHD?
1. Mood Disorders
2. Anxiety Disorders
3. Learning Disorders
What is the definition of Conduct Disorder?
A persistent pattern of behavior in which the basic rights of others or major age-appropriate social norms or rules are violated.

Must feature: Three criteria within a one-year period, and at least one criterion in the past six months.
What are the four categories of problem behavior displayed in conduct disorder?
1. Aggression to people and animals
2. Destruction of property
3. Deceitfulness or theft
4. Serious violation of rules
What are thirteen criteria of Conduct Disorder? (5; 2; 3; 3)
1. Bullying and threatening others
2. Initiating physical fights
3. Use of a weapon
4. Physical cruelty to people or animals
5. Forcing someone into sexual activity

6. Deliberate fire setting
7. Deliberate destruction of property

8. Breaking into someone's house or car
9. Lying to obtain favors
10. Stealing

11. Staying out late
12. Running away from home
13. Being truant from school
What are five criteria of Conduct Disorder which fall into the category of aggression to people and animals?
1. Bullying and threatening others
2. Initiating physical fights
3. Use of a weapon
4. Physical cruelty to people or animals
5. Forcing someone into sexual activity
What are two criteria of Conduct Disorder which fall into the category of destruction of property?
6. Deliberate fire setting
7. Deliberate destruction of property
What are three criteria of Conduct Disorder which fall into the category of deceitfulness or theft?
8. Breaking into someone's house or car
9. Lying to obtain favors
10. Stealing
What are three criteria of Conduct Disorder which fall into the category of serious violation of rules?
11. Staying out late
12. Running away from home
13. Being truant from school
What are the two subtypes of Conduct Disorder?
1. Childhood-Onset (before age 10)
2. Adolescent-Onset (after age 10)
What are three major associated features of Conduct Disorder?
1. Lack of empathy for others
2. The tendency to misperceive others' intentions as hostile and threatening and thereby feel justified in responding aggressively
3. Lack of guilt or remorse
Describe people with conduct disorder.
Self-esteem is usually low, and poor frustration tolerance, irritability, temper outbursts and recklessness are common. Often associated with precocious sexual behavior, drinking, smoking, use of illegal substances and risk-taking acts. More suicidal than the average population.

Also, if there's not a high correlation with a history of trauma, I will eat my hat.
What six problems for the person are often associated with conduct disorder?
1. School suspension or expulsion
2. Legal problems
3. Work problems
4. Sexually-transmitted diseases
5. Unplanned pregnancy
6. Physical injury from fights and accidents
What five disorders are often concomitant with conduct disorder?
1. ADHD
2. Learning Disorders
3. Mood Disorders
4. Anxiety Disorders
5. Substance-Related Disorders

(Also PTSD, but PsychPrep didn't mention that.)
What is associated with a poor prognosis in Conduct Disorder?
Early onset.
What is the lifetime course of Conduct Disorder?
Usually remits by adulthood, though a minority of people continue to exhibit symptoms that meet criteria for Antisocial Personality Disorder in adulthood.
What are nine predisposing factors to the development of Conduct Disorder?
1. Parental rejection and neglect
2. Inconsistent child-rearing with harsh discipline
3. Physical or sexual abuse
4. Lack of supervision
5. Change in caregivers or institutional living
6. Difficult infant temperament
7. Large family size
8. Absent father
9. Association with a delinquent peer group
What are the five modes of treatment used together to treat Conduct Disorder?
1. Behavior modification
2. Family therapy
3. Individual therapy
4. Social skills therapy
5. Medication
What is the essential feature of Oppositional Defiant Disorder?
A recurrent pattern of negativistic, defiant, disobedient and hostile behavior toward authority figures, which persists for at least six months.
Define Oppositional Defiant Disorder.
Must include a recurrent pattern of negativistic, defiant, disobedient and hostile behavior toward authority figures, which persists for at least six months.

Four criteria.
What are eight criteria of Oppositional Defiant Disorder?
1. Frequent loss of temper
2. Frequent arguments with adults
3. Deliberate defiance of rules
4. Deliberate annoyance of others
5. Blaming others for one's mistakes
6. Being easily annoyed and touchy
7. Frequently being angry and resentful
8. Frequently being spiteful and vindictive
Where does Oppositional Defiant Disorder most frequently appear?
At home-- may not appear at school, in the community, or in an interview.
What three disorders are often associated with Oppositional Defiant Disorder?
1. ADHD
2. Communication Disorder
3. Learning Disorder
When does Oppositional Defiant Disorder usually manifest?
By age eight.
What are three feeding and eating disorders of infancy or early childhood?
1. Pica
2. Rumination disorder
3. Feeding disorder of infancy or early childhood
What is Pica?
Essential feature: the persistent eating of nonnutritive substances for a period of at least one month (e.g, paint, plaster, insects, leaves, soil.)
When does pica appear?
Infancy or young children, sometimes in pregnant women.
With what disorder is pica associated?
Mental retardation.
What is rumination disorder?
Repeated regurgitation and rechewing of food for a minimum one month period, following a period of normal functioning.

(Ew.)
What are three complications of rumination disorder?
1. Weight loss
2. Failure to make weight gain
3. Malnutrition
What is the age of onset of rumination disorder?
Between three and twelve months.
What is Feeding disorder of infancy or early childhood?
Failure to eat adequately with significant failure to gain weight, or weight loss by one month. Made only when there is no general medical condition that accounts for the symptoms.
What is the age of onset of Feeding disorder of infancy or early childhood?
Before age six.
With what disorder is Feeding disorder of infancy or early childhood most closely associated?
"Failure-to-thrive" syndrome
What are four types of tic disorders?
1. Tourette's Disorder
2. Chronic Motor or Vocal Tic
3. Transient Tic Disorder
4. Tic Disorder NOS
What is a tic?
A sudden, rapid, recurrent, non-rhythmic, stereotyped motor movement or vocalization.

Can be repressed for a time, but eventually become irresistible.
What affects the appearance of tic?
Can increase under stress, and decrease during absorbing activities.
What are seven motor tics?
1. Eye blinking
2. Neck jerking
3. Shoulder shrugging
4. Facial grimacing
5. Jumping
6. Touching
7. Grooming behaviors
What are six vocal tics?
1. Throat clearing
2. Grunting
3. Sniffing
4. Barking
5. Coprolalia (swearing)
6. Echolalia (automatic repetition of vocalizations made by another person)
What is coprolalia?
Swearing
What is echolalia?
Automatic repetition of vocalizations made by another person.
What are three treatments for tics? What is the most common?
1. Haldol (halperidol, antipsychotic)-- most common.
2. Catapres (clonidine, antihypertensive)
3. Prozac (fluoxetine, SSRI)
Describe Tourette's Disorder
Multiple motor and one or more vocal tics, which occur many times a day, nearly every day, throughout a period of one year or more. Onset is before age eighteen.
What disorder is most commonly comorbid with Tourette's?
ADHD.

Some theoreticians say that what appear to be Learning Disorder in kids with Tourette's can be better explained by ADHD.
Describe Chronic Motor or Vocal Tic.
Single or multiple motor OR vocal tics, not both, for one year or more.

Onset before age eighteen.
Describe Transient Tic Disorder.
Single or multiple motor and/or vocal tics which occur many times a day for a minimum of four weeks, but not longer than one year.

Onset before age eighteen.
What are two elimination disorders?
1. Eneuresis
2. Encopresis
Describe encopresis.
Repeated passage of feces into inappropriate places, whether intentionally or involuntarily.

At least once a month for a minimum of three months.

Must have achieved the chronological or mental age of four.
What are the four subtypes of encopresis?
1. With Constipation and Overflow Incontinence
2. Without Constipation and Overflow Incontinence

1. Primary (person has never achieved continence)
2. Secondary (develops after a period of continence)
What disorders are often comorbid with deliberate Encopresis?
1. Oppositional Defiant Disorder
2. Conduct Disorder
What are two ways to treat Encopresis?
1. Behavioral treatment
2. Family therapy
Describe eneuresis.
Repeated voiding of urine into the bed or clothes, whether intentionally or involuntarily.

Occurs twice a week for at least three months OR results in significant distress or impairment in functioning.

Must be at least five years old chronologically/mentally.

Not diagnosed when due to a physical disorder.
What are three subtypes of eneuresis?
1. Nocturnal only
2. Diurnal only
3. Nocturnal and Diurnal
What are two characterizations of Eneuresis?
1. Primary (person has never developed continence)
2. Secondary (problem appears after a period of continence)
What is the course of eneuresis?
Remits by adulthood for 99% of people.
How is it treated? (three ways)
1. Medication (imipramine and DDAVP, a nasal spray)
2. The bell and pad (a behavioral approach, more effective than meds)
3. Family and individual therapy (if associated with a stressor)
What are five "Other" disorders of infancy or childhood?
1. Separation Anxiety Disorder
2. Selective Mutism
3. Reactive Attachment Disorder
4. Stereotypic Movement Disorder
5. Disorder of Infancy, Childhood or Adolescence NOS
What is separation anxiety disorder?
Developmentally appropriate and excessive anxiety concerning being away from the home or the person(s) to whom the individual is attached.

Three or more criteria.

At least four weeks, onset before age eighteen.
What are seven criteria of separation anxiety disorder?
1. Distress when separation occurs or is anticipated
2. Worry about harm befalling one of one's major attachment figures
3. Worry about getting lost or kidnapped
4. School refusal because of fear of separation
5. Reluctance/refusal to go asleep without being near an important person
6. Repeated nightmares about separation
7. Repeated physical complaints when separation occurs or is anticipated
What is the lifetime course of separation anxiety disorder?
May precede development of Panic Disorder with Agoraphobia
How is separation anxiety disorder treated?
Examination of family dynamics that may be contributing to separation anxiety, such as excessive parental anxiety or enmeshment.
What is selective mutism?
A consistent failure to speak in specific social situations when speaking is expected, in spite of speaking in other situations.

Disturbance interferes with educational or occupational achievement, or with social communication.

Minimum one month's duration, onset usually before age five.
With what is selective mutism related?
Other childhood anxiety disorders (social anxiety, social phobia). Considered a sign of fear, not of willfulness or disobedience.
Is selective mutism related to trauma?
Current research says no.
How is selective mutism treated?
Combination of behavioral therapy, CBT, individual therapy, family therapy, medication (usually SSRIs).
What does behavioral therapy for selective mutism involve?
Desensitization and relaxation protocols, sometimes including guided imagery.
What is reactive attachment disorder?
Significant disturbance in social relatedness in most contexts, beginning before age five, due to grossly pathological care.
What are the two subtypes of Reactive Attachment Disorder?
1. Inhibited Type (child shows a pattern of excessively inhibited, hypervigilant, or highly ambivalent responses)
2. Disinhibited Type (exhibits indiscriminate sociability and lack of selectivity in attachment figures)
What is Stereotypic Movement Disorder?
Motor behavior that is repetitive and nonfunctional (e.g., body rocking, head banging, self-biting) that interferes with normal activities or results in self-inflicted injury.

Must last for four weeks or more.

Does not count if the behaviors are symptoms of another disorder, such as OCD or a PDD.