1. Chapter 14 Developmental Disorders

2. Nature of Developmental Psychopathology: An Overview
Normal vs. Abnormal Development
Developmental Psychopathology
Study of how disorders arise and change with time
Disruption of early skills can affect later development
Developmental Disorders
Diagnosed first in infancy, childhood, or adolescence
Attention deficit hyperactivity disorder (ADHD)
Learning disorders
Autism
Mental retardation

3. Attention Deficit Hyperactivity Disorder (ADHD): An Overview
Nature of ADHD
Central features – Inattention, overactivity, and impulsivity
Associated with numerous impairments
Behavioral
Cognitive
Social and academic problems
DSM-IV and DSM-IV-TR Symptom Types
Inattentive type
Hyperactive type
Impulsive type

4. Edward

5. ADHD: Facts and Statistics
Prevalence
Occurs in 6% of school-aged children
Symptoms are usually present around age 3 or 4
68% of children with ADHD have problems as adults
Gender Differences
Boys outnumber girls 4 to 1
Cultural Factors
Probability of ADHD diagnosis
Greatest in the United States

6. ADHD: Sean

7. The Causes of ADHD: Biological Contributions
Genetic Contributions
ADHD seems to run in families
DRD4, DAT1, and DRD5 genes have been implicated
Neurobiological Contributions
Smaller brain volume
Inactivity of the frontal cortex and basal ganglia
Abnormal frontal lobe development and functioning
Precise neurobiological mechanisms remain unclear
The Role of Toxins
No evidence that allergens and food additives are causes
Maternal smoking increases risk

8. The Causes of ADHD: Psychosocial Contributions
Psychosocial Factors
Can influence the nature of ADHD
ADHD children are often viewed negatively by others
Constant negative feedback from peers and adults
Peer rejection and resulting social isolation
Such factors foster low self-esteem

9. Biological Treatment of ADHD
Goal of Biological Treatments
To reduce impulsivity and hyperactivity
To improve attention
Stimulant Medications
Reduce core symptoms in 70% of cases
Examples include Ritalin, Dexedrine
Other Medications With More Limited Efficacy
Imipramine and Clonidine (antihypertensive)
Effects of Medications
Improve compliance in many children
Decrease negative behaviors in many children
Do not affect learning and academic performance
Benefits are not lasting following discontinuation

10. Behavioral and Combined Treatment of ADHD
Behavioral Treatment
Involve reinforcement programs
To increase appropriate behaviors
Decrease inappropriate behaviors
May also involve parent training
Combined Bio-Psycho-Social Treatments
Are highly recommended
Superior to medication or behavioral treatments alone

11. Learning Disorders: An Overview
Scope of Learning Disorders
Academic problems in reading, mathematics, and writing
Performance substantially below expected levels
DSM-IV and DSM-IV-TR Reading Disorder
Discrepancy between actual and expected achievement
Performance significantly below age or grade level
Cannot be caused by sensory deficits
DSM-IV and DSM-IV-TR Mathematics Disorder
Achievement below expected performance
DSM-IV and DSM-IV-TR Disorder of Written Expression
Achievement below expected performance in writing

12. Learning Disorders: Some Facts and Statistics
Prevalence of Learning Disorders
5-10% prevalence in the United States
Highest in wealthier regions of the United States
About 32% of these students drop out of school
5-15% prevalence for reading difficulties
School experience tends to be generally negative

13. Growth Area
Figure 14.1 Growth area. More than half of all schoolchildren classified as disabled have learning disabilities. Twenty-one years ago, the proportion was around 25%.

14. Uneven Distribution
Figure Uneven distribution. The highest percentages of schoolchildren diagnosed with learning disabilities are in the wealthiest states.

15. Biological and Psychosocial Causes of Learning Disorders
Genetic and Neurobiological Contributions
Reading disorder runs in families
100% concordance rate for identical twins
Evidence for subtle forms of brain damage is inconclusive
Overall, contributions are unclear
Psychosocial Contributions are Largely Unknown

16. Treatment of Learning Disorders
Requires Intense Educational Interventions
Remediation of basic processing problems
Improvement of cognitive skills
Targeting skills to compensate for problem areas
Data Support Behavioral Educational Interventions

17. Pervasive Developmental Disorders: An Overview
Nature of Pervasive Developmental Disorders
Problems occur in Language, Socialization, and Cognition
Pervasive – Problems span many life areas
Examples of Pervasive Developmental Disorders
Autistic disorder
Asperger’s syndrome

18. The Nature of Autistic Disorder: An Overview
Autism – Significant Impairments
Social interactions and communication
Restricted patterns of behavior, interest, and activities
Three Central DSM-IV and DSM-IV-TR Features of Autism
Qualitative impairment of social interaction
Problems in communication
50% never acquire useful speech
Restricted patterns of behavior, interests, and activities

19. Autism: Christina

20. Rebecca

21. Autistic Disorder: Facts and Statistics
Prevalence and Features of Autism
Affects 1 in every 500 births
More prevalent in females with IQs below 35
More prevalent in males with higher IQs
Occurs worldwide
Symptoms usually develop before 36 months of age
Autism and Intellectual Functioning
50% have IQs in the severe-to-profound range
25% test in the mild-to-moderate IQ range
Remaining test in the borderline-to-average IQ range
Reliable indicators of good prognosis
Language ability and IQ

22. Causes of Autism: Early and More Recent Contributions
Historical Views
Bad parenting
Unusual speech patterns
Lack of self-awareness
Echolalia
Current Understanding of Autism
Medical conditions – Not always related with autism
Genetic component is largely unclear
Neurobiological evidence of brain damage
Substantially reduced cerebellum size
Psychosocial Contributions Are Unclear

23. Asperger’s Disorder: Part of the Autistic Spectrum
The Nature of Asperger’s Disorder
Show significant social impairments
Restricted and repetitive stereotyped behaviors
May be clumsy
Often quite verbal
No severe language and/or cognitive delays
Prevalence of Asperger’s Disorder
Often under diagnosed
Affects about 1 to 36 persons per 10,000 people
Causes of Asperger’s Disorder Are Somewhat Unclear

24. Treatment of Pervasive Developmental Disorders: Example of Autism
Psychosocial “Behavioral” Treatments
Skill building
Reduction of problem behaviors
Target communication and language problems
Address socialization deficits
Early intervention is critical
Biological and Medical Treatments Are Unavailable
Integrated Treatments: The Preferred Model
Focus on children, their families, schools, and home
Build in appropriate community and social support

25. Mental Retardation (MR): An Overview
Nature of Mental Retardation
Disorder of childhood
Below-average intellectual and adaptive functioning
Range of impairment varies greatly across persons
DSM-IV and DSM-IV-TR criteria
Significantly sub-average intellectual functioning
Deficits or impairments in present adaptive functioning
Must be evident before the person is 18 years of age

26. Lauren

27. DSM-IV and DSM-IV-TR Levels of Mental Retardation (MR)
Mild MR
IQ score between 50 or 55 and 70
Moderate MR
IQ range of to 50-55
Severe MR
IQs ranging from up to 35-40
Profound MR
IQ scores below 20-25

28. Other Classification Systems for Mental Retardation (MR)
American Association of Mental Retardation (AAMR)
Defines MR based on levels of assistance required
Levels of assistance
Intermittent
Limited
Extensive
Pervasive
Classification of MR in Educational Systems
Educable (IQ of 50 to 70-75)
Trainable (IQ of 30 to 50)
Severe (IQ below 30)
Implications of Different MR Classification Systems

29. Mental Retardation (MR): Some Facts and Statistics
Prevalence
About 1-3% of the general population
90% are labeled with mild mental retardation
Gender Differences
MR occurs more often in males
Male-to-female ratio of about 1.6:1
Course of MR
Tends to be chronic
Prognosis varies greatly from person to person

30. Causes of Mental Retardation (MR): Biological Contributions
Hundreds of known causes
Environmental – Deprivation, abuse
Prenatal – Exposure to disease or a drug / toxin
Perinatal – Difficulties during labor
Postnatal – Head injury
Genetic Research
Multiple genes, and at times single genes
Chromosomal Abnormalities
Down syndrome and Fragile X syndrome
Maternal Age and Risk of Having a Down’s Baby
Nearly 75% of Cases
Cannot be attributed to any known cause
Are thought caused by social and environmental factors

31. Rates of Down Syndrome Births
Figure14.3 The increasing likelihood of Down Syndrome with maternal age (based on data from Hook, 1982).

32. Causes of Mental Retardation (MR): Psychosocial Contributions
Cultural-Familial Retardation
Believed to cause about 75% of MR cases
Is the least understood
Associated with
Mild levels of retardation on IQ tests
Good adaptive skills
Difference vs. Developmental Views
Difference view - Kind and degree of impairment
Developmental view – Rate of developmental delay

33. Treatment of Mental Retardation (MR)
Parallels Treatment of Pervasive Developmental Disorders
Teach Needed Skills
To foster productivity
To foster independence
Educational and behavioral management
Living and self-care skills via task analysis
Communication training – Often most challenging
Community and Supportive Interventions
Persons with MR can benefit from such interventions

34. Summary of Developmental Disorders
Developmental Psychopathology
Attention Deficit Hyperactivity Disorder
Deficits in attention, hyperactivity, or impulsivity
Disrupt academic and social functioning
Learning Disorders
Deficits in performance below expectations
Pervasive Developmental Disorder
All share deficits in language, socialization, and cognition
Mental Retardation
Sub-average IQ, deficits in adaptive functioning
Onset before age 18
Prevention and Early Intervention Are Critical

35. Exploring Developmental Disorders (ADHD)

36. Exploring Developmental Disorders (Learning Disorders)

37. Exploring Developmental Disorders (Pervasive Developmental Disorders)

38. Exploring Developmental Disorders (Mental Retardation)