1. Disorders of Childhood and Adolescence
Chapter 12

2. Chapter Outline Intellectual Disability Learning Disorders
Pervasive Developmental Disorders
Attention Deficit and Disruptive Behavior Disorders
Childhood Disorders of Eating and Elimination

3. Pervasive Developmental Disorders
Serious impairment in social interaction and communication
Autism spectrum disorders
Autistic disorder
Asperger’s disorder
Pervasive developmental disorder NOS
An estimated 60 to 75% of children with autistic disorder or PDD-NOS have IQs below 70.

4. Functional Impairment of Autistic Disorder
Life-long impairment
Socially isolated
Victims of bullying, teasing, or often ignored by classmates
Prevalence 1 out of every 152 children
More common in boys (4.7 boys for every 1 girl diagnosed)
Onset before the age of three
Parents are able to usually recognize that something is wrong around 12 to 18 months of age.

5. Do Vaccines Produce Autism?
Fact: Until recently a child with intellectual disability was not given a second diagnosis even if the autistic behaviors were present and the diagnostic criteria has changed (autism spectrum disorder) leading to a rise in children with the disorder. Conclusion: Both environmental and biological factors contribute to autism, but current data do not support a causal role for MMR vaccine.
Let’s examine the evidence
1. Initial research was correlational not causal. In one city, rates of autism continued to rise even when the vaccine was discontinued.

6. Etiology of Autistic Disorders
Genetic syndromes and chromosomal abnormalities
Unusually accelerated head and brain growth
Structural and organizational abnormalities in the brains
Under-activated fusiform gyrus

7. Ethics and Responsibility
“Refrigerator mothers” in the 1950s and 1960s
1970s roots in neurobiology
Discredited theories around vaccines and gluten-free diets
Environmental factors such as medical technology, toxins, lifestyle, and technology

8. Treatment of Autistic Disorders
Medication
-Are not found to be effective for social or communication deficits
-Atypical antipsychotics (help manage aggressive behavior and self-injury)
-Stimulants (reduce hyperactivity)
-SSRIs
Behavioral interventions
-Positive reinforcement and shaping
-Applied behavior analysis (ABA)
For self-injury
-Aversive procedures

9. Attention-Deficit and Disruptive Behavior Disorders
Childhood disorder characterized by inattentiveness, hyperactivity, and impulsivity
Deficit in executive functioning
Diagnosed in early elementary school
Comorbidity with other psychological disorders

10. Functional Impairment and Etiology of ADHD
More accidents and injuries
Psychosocial difficulties
3 to 5% of children have ADHD
More likely to have automobile accidents
More likely to engage in criminal behavior
Genetic factors
Substance use during pregnancy
Pregnancy complications
Between 20 to 25% of children with ADHD have a family member with ADHD as well.

11. Figure 12.5 ADHD and Childhood Injuries

12. Treatment of ADHD A child’s age as a factor
Level of functional impairment
Behavioral
parent training,
classroom modification,
social skills training,
daily report card, and
summer programs
Medication
-Stimulants (enhance the neurotransmitters of dopamine and norepinephrine)
-Decrease core symptoms
MTA

13. Conduct disorder and ODD is more common in boys than females.
Fact or Fiction?
Children diagnosed with conduct disorder or ODD are least likely to engage in serious violations of rules.
Fact or fiction?
No, these disorders are among the most difficult to treat and one of the common reasons a child is brought to seek mental health treatment. Both of the disorders engage in violating the rights of others and breaking societal rules.
Conduct disorder and ODD is more common in boys than females.
Fact or fiction?
Technically yes, boys are more likely to be diagnosed at 13.4% versus girls at 9.1% with ODD and conduct disorder is also more common in boys at 2% to 16% versus 1% to 10% in girls. However, girls engage in what is called “relational aggression.”

14. Conduct Disorder and Oppositional Defiant Disorder
Conduct disorder (continuous and repeated pattern of violating the basic rights of others or breaking societal rules with aggression toward people or animals, destruction of property, deceitfulness or theft, and serious rule violations)
Oppositional defiant disorder (negative, hostile, or defiant behaviors that are less severe than those with conduct disorder)

15. Etiology of ODD and Conduct Disorder
Higher among children from lower SES (worst inner city neighborhoods)
Little known about cause of ODD
Influence of family
Psychological
-Psychological disorders in parents
-Poor parenting
-Child abuse
-SES
Antisocial personality disorder as adults

16. Treatment of ODD and Conduct disorder
Psychosocial interventions
Level of functional impairment
Behavioral (parent management training, classroom modification, social skills training, and summer programs)
Medication
-Unsuccessful when used alone
-Atypical antipsychotic (Risperidone reduce symptoms of aggression)
MST