Chapter 15 Mental Retardation and Pervasive Developmental Disorders Copyright © 2006 Pearson Education Canada Inc.

2 Brief Overview Mental retardation – pejorative overtones – changing societal views Pervasive developmental disorders – severe communication & social deficits – much less common

Copyright © 2006 Pearson Education Canada Inc. 3 Overview: Mental Retardation diverse category & wide range of symptoms early intervention important  CASE STUDY: “A Mother With Mild Mental Retardation” – generally happy life – depression – does Karen have a “disorder”?

Copyright © 2006 Pearson Education Canada Inc. 4 Mental Retardation: definition AAMR:  “Mental retardation is a disability characterized by significant limitations both in intellectual functioning and in adaptive behaviour as expressed in conceptual, social, and practical skills…”

Copyright © 2006 Pearson Education Canada Inc. 5 Symptoms & Features  significant intellectual limitations  significant limitations in adaptation  onset before age 18

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8 The Controversial IQ Test cultural fairness validity issues what is it measuring?

Copyright © 2006 Pearson Education Canada Inc. 9 Limits in Adaptive Skills conceptual – level of self-sufficiency social – level of interpersonal skills practical – daily living

Copyright © 2006 Pearson Education Canada Inc. 10 Historical Perspective Pejorative terms idiot, moron, imbecile entered the psychiatric lexicon 1866: Langdon Down describes “mongolism” 1872: “asylum for idiots” in Ontario IQ test development

Copyright © 2006 Pearson Education Canada Inc. 11 Contemporary Perspective classification based on: – IQ score – etiology sub-types based on IQ score

Copyright © 2006 Pearson Education Canada Inc. 12 DSM-IV-TR: Severity of Mental Retardation Mild – IQ to 70 Moderate – IQ to – e.g., Down syndrome Severe – IQ to Profound – IQ below 20-25

Copyright © 2006 Pearson Education Canada Inc. 13 Epidemiology 1% of general population differs according to “population” being examined disproportionate among low SES

Copyright © 2006 Pearson Education Canada Inc. 14 Etiology: Biological Factors chromosomal disorders (e.g., Down Syndrome) genetic disorders (e.g., phenylketonuria) infectious diseases (e.g., Rubella, syphilis) Toxins (e.g., FAS) normal genetic variation

Copyright © 2006 Pearson Education Canada Inc. 15 Copyright © 2006 Pearson Education Canada Inc.

16 Etiology: Psychological Factors early sensory deprivation early abuse/neglect

Copyright © 2006 Pearson Education Canada Inc. 17 Etiology: Social Factors poverty and related under- stimulation

Copyright © 2006 Pearson Education Canada Inc. 18 Treatment: Prevention Efforts A.Primary Prevention  health care promotion  pregnancy testing: amniocentesis & ultrasound

Copyright © 2006 Pearson Education Canada Inc. 19 Canadian Focus: Eugenics Movement forced sterilization program ( ) – often done surreptitiously – Alberta & BC lawsuits in the 1990s Alberta government apology  Discussion Point: How could this happen in Canada?

Copyright © 2006 Pearson Education Canada Inc. 20 Treatment: Prevention Efforts B. Secondary Prevention  early intervention programs (e.g., Aboriginal Head Start in Canada)

Copyright © 2006 Pearson Education Canada Inc. 21 Treatment: Prevention Efforts C. Tertiary Prevention  early assessment  early education/skill development

Copyright © 2006 Pearson Education Canada Inc. 22 Treatment: Normalization Efforts Mainstreaming Deinstitutionalization

Copyright © 2006 Pearson Education Canada Inc. 23 Overview: Autistic Disorder & Pervasive Developmental Disorders (PDDs) unusual problems emerging early in life profound interpersonal disturbances unusual behaviours communication problems autism example: Rain Man

Copyright © 2006 Pearson Education Canada Inc. 24 Case Study: John’s Autism apathetic to others negative reactions to affection intensive behavioural intervention planned

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27 Symptoms & Associated Features  impaired social interaction – lacking theory of mind/perspective-taking – social isolation communication deficits – echolalia – pronoun reversal – often mute stereotyped behaviour – self-stimulation self-injury

Copyright © 2006 Pearson Education Canada Inc. 28 Savant performance some children with Autism/PDD show exceptional ability in 1 domain – music, mathematics rare & poorly understood

Copyright © 2006 Pearson Education Canada Inc. 29 Historical Perspective “early infantile autism” (Kanner, 1943) Asperger’s Syndrome childhood schizophrenia

Copyright © 2006 Pearson Education Canada Inc. 30 Epidemiology Prevalence: 10/10,000 kids may have Autism (Bryson, 1996) SES: little relation gender: 3-4X more common in boys

Copyright © 2006 Pearson Education Canada Inc. 31 Etiology Psychological/Social – little support despite traditional “blame the parents” notion Biological – consequence of other conditions (e.g., rubella) – genetics: Concordance rates in twin study: MZ: 60%, DZ: 0% – neurophysiology: endorphins

Copyright © 2006 Pearson Education Canada Inc. 32 Treatment medication – disappointing results overall psychotherapy – intensive behavioural modification