6/12- Cognitive Development Flashcards
1
Q
Current views on intelligence:
- Multifaceted and ______ organized
- Some ______ impacts global functioning on cognitive tasks as well as special abilities
- A person’s __ is a general estimate of the sum of many different abilities
A
Current views on intelligence:
- Multifaceted and hierarchically organized
- Some general factor (g) impacts global functioning on cognitive tasks as well as special abilities
- A person’s IQ is a general estimate of the sum of many different abilities
2
Q
T/F: the max IQ score is 100
A
False; 100 is the average IQ
3
Q
Normal curve characteristics:
__% of population with scores within __ standard deviations of the mean ()
__ of the population have IQ scores within 1 SD of the mean ()
A
Normal curve characteristics:
- 95% of population with scores withNextin 2 standard deviations of the mean (70-130)
- 2/3 of the population have IQ scores within 1 SD of the mean (85-115)
4
Q
What is intellectual giftedness (“superior” range)?
A
Starts 2 SDs above the mean (> 130)
(Mental retardation less than 2 SDs below)
5
Q
What is the Flynn Effect?
A
- When a new version of an IQ test is normed, the standard scoring is set so that performance at the population median results in a score of IQ 100
- If test-takers are scored by a constant standard scoring rule, IQ test scores have been rising at an average rate of around three IQ points per decade.
6
Q
What are the Wechsler Scales?
A
7
Q
What are some nonverbal measures?
A
Wechsler Nonverbal Scale of Ability (WNV)
- Ages 4 yrs - 21 yrs 11 mo
Test of nonverbal intelligence- 3rd ed
- Ages 5-85
Universal Nonverbal Intelligence Test (UNIT)
- Ages 5 - 17 rs 11 mo
8
Q
Additional Assessments
A
9
Q
What is Stanford-Binet Intelligence Scale good for?
A
- Ages 2-5
- Good for assessing low end and very high end of intellectual functioning range
10
Q
What is Woodcock-Johnson II tests of Cognitive used for?
A
- Ages 2-90+
- Used most often by school districts
11
Q
What is Kaufman Brief Intelligence Test used for?
A
- Ages 4-90
- A quick measure of verbal and nonverbal intelligence
12
Q
What are the Differential Ability Scales used for?
A
- Ages 2.5 yrs - 17 yrs 11 mo
- More culturally unbiased measure
- Good for assessing African American, Asian, Hispanic, and non-White/Non-Hispanic children equally
13
Q
What are causes/risk factors for mental retardation/intellectual disability: Biomedical?
A
Bomedical:
- Chromosomal/genetic disorders: Down’s, William’s, Fragile X, Prader-WIlli
- Maternal risk factors: age, illness
- Premature birth or birth injury
- Traumatic brain injury
- Degenerative disorders
- Seizure disorders
14
Q
What are causes/risk factors for mental retardation/intellectual disability: Social?
A
Social:
- Poverty
- Domestic violence
- Lack of prenatal care
- Traumatic exposure: neglect, poverty, impaired caregivers
15
Q
What are causes/risk factors for mental retardation/intellectual disability: Behavioral?
A
Behavioral:
- Parental drug, alcohol, tobacco use
- Parental rejection or abandonment
- Trauma: abuse, neglect, domestic violence, danger
16
Q
What are causes/risk factors for mental retardation/intellectual disability: Educational?
A
Educational:
- Parental cognitive disability
- Lack of medical referrals for intervention
- Impaired parenting
- Inadequate special education/early intervention
17
Q
Characteristics/Diagnosis of Mental Retardation/Intellectual Disability in DSM5?
A
- Deficits in intellectual functions (e.g. problem-solving, planning, learning, etc.); generally full scale IQ < 70 (not enough alone!)
- Accompanied by significant limitations in adaptive functioning in at least 2 of the adaptive skill areas
- Onset prior to age 18- must have evidence of deficits in childhood and adolescence (unless talking about a traumatic brain injury)
18
Q
What are some of the adaptive behavior skill areas (2 required with deficits in intellectual functions for Dx of intellectual disability)?
A
- Communication
- Self-care
- Home-living
- Social/interpersonal skills
- Use of community resources
- Self-direction
- Functional academic skills
- Work
- Leisure
- Health
- Safety
19
Q
Levels of severity of Mental Retardation/Intellectual Disability? How determined?
A
(formerly based on range of IQ scores)
Now by level of adaptive functioning:
- Mild
- Moderate
- Severe
- Profound
20
Q
Level of severity: Mild?
A
- There may be no obvious differences in young children
- Differences often appear in academic settings for children and teens
- May be able to have a job with special training and supervision and may be able to live partially independently
21
Q
Level of severity: Moderate?
A
- Skills lag behind same-age peers throughout development
- May need help acquiring basic skills for daily living (e.g. hygiene, safety, household chore)
– may need supervised housing
- May work in sheltered environment or with extensive support and supervision
22
Q
Level of severity: Severe?
A
- Little or no communication skills;
- Sensory impairments
- Need extensive supports throughout life in most domains
23
Q
Level of severity: Profound?
A
- Minimal functioning; limited understanding of others/world
- No independence; usually need supervision and nursing care
24
Q
How does American Association on Intellectual and Developmental Disabilities (AAIDD) classify Mental Retardation/Intellectual Disability? (and 5 assumptions)
A
Significant limitations both in intellectual functioning and adaptive behavior as expressed in conceptual, social, and practical skills which are apparent prior to the age of 18;
Definition applied within context based on 5 assumptions:
1. Limitations are considered within the context of the person’s environment and culture
2. Assessment should consider cultural and linguistic diversity as well as differences in communications, sensory, motor, and behavioral factors
3. Limitations often coexist with strengths
4. You must develop a profile of needed supports
5. With appropriate personalized supports, the functioning of the person with the intellectual disability will generally improve
25
How is academic achievement affected by learning disabilities?
- Individual's achievement on individually administered standardized tests of academic performance are substantially **below (2 SDs)** that are expected for age, schooling, and level of intelligence
- **Smaller discrepency (between 1-2 SDs) between IQ and achievement** can also be used especially if IQ performance may have been compromised by a **comorbid** disorder, medical condition, or other factor
26
What are some assessments for academic achievement and learning disabilities?
- Woodcock-Johnson IV Tests of Achievement
- Wechsler Individual Achievement Test- II ed
- Wide Range Achievement Test- 4th ed
27
What is the **Individuals with Disabilities Education Act (IDEA**)? Problems?
Federal law that requires school districts to provide a **free and appropriate education** to students with disabilities
- Not based on discrepancy model of DSM
- **Based on "educational need"**
(School use **Response to Intervention (RTI)** method to determine if the student has received high quality instruction prior to a label of "learning disability")
28
What does **Section 504 of the Rehabilitation Act** of 1973 say?
Specifies that **no program that receives federal money can discriminate** against a person with a disability
- Requires that students have an **equal opportunity to participate** in all school activities
- Some children who do not qualify for Special Education under IDEA may still receive accommodations and modifications under Section 504
29
Populations encompassed by IDEA and Section 504?
IDEA children are a smaller subset of 504 children
30
IDEA = ____ education
S504 = ____ education Process
(flowchart)
**IDEA** = **Special** education
**S504** = **Regular** education
31
Assessment for guiding treatment involves what categories?
- Medical Hx
- Psychosocial Evaluation
- Physical Examination
- Laboratory Examination
32
Coordination of care needs to involve what?
- Parents/guardians and extended family
- Pediatricians/primary care physicians
- Daycare providers/babysitters/teachers
- Mental health professionals
- Community supports (church, neighbors, after-school programs, etc.)
33
DDx for mental retardation/intellectual disability?
- Autism/Pervasive Developmental Disorders
- Communication disorders
- Attention-Deficit/Hyperactivity Disorders
- Trauma Related Disorders
- Sensory deficits
- Hearing and vision impairments
- Physical mobility limitations
- Environmental deprivation
34
Characteristics of Autism/Pervasive Developmental Disorders?
**Autism/Pervasive Developmental Disorders**
(Old name = Asperger's)
- May have intellectual and cognitive deficits too
- Language delays
- Social delays/impairments (poor eye contact, few or no friendships)
- Fixed/perseverative interests
- Stereotyped behaviors and motor movements
- Sensory sensitivities
- Emotional understanding of self and others
- Ruled-out through comprehensive history and evaluation of adaptive and developmental functioning
35
Characteristics of Communication Disorders?
- Delays restricted to expressive and/or receptive language
- Ruled out through testing (speech/language pathologists; psychologists- use of nonverbal IQ measures)
36
Characteristics of Attention-Deficit/Hyperactivity Disorders?
- Often comorbid with learning disabilities
- Age inappropriate problems with attention, impulsivity, hyperactivity
- Often have problems with peers and adults
- May seem to lack common sense and good problem-solving/decision-making skills
- Comprehensive evaluation needed to rule-out medical causes and better evaluate cognitive abilities
37
Characteristics of Trauma-Related Disorders?
- Fear and worry about the safety of self, family, friends
- Anxiety related to future possible trauma
- Increased activity level - Decreased concentration and attention
- Increased irritability - Changes in sleep or appetite
- Withdrawal
- Angry outbursts
- Aggression
- Aches and pains
- Decline in grades
- Problems with peers
- Substance abuse, dangerous behaviors, unhealthy sexual behaviors
**TRAUMA HAS A HUGE IMPACT!!!**
38
**Case: Jose, 8 yo Hispanic male**
- CC: referred for psychological testing by his therapist to aid in diagnostic clarification
- Mother had concerns about academic performance
- **Developmental** Hx: exposed to drugs and alcohol in utero, hx of neglect and physical abuse by biological mother, CPS custody at age 3, adopted at 4
- Speech and motor delayed at time of placement, but rapid improvements with services through ECl-- all within expected range by age 5
- No significant Hx of illness, LOC, etc.
- **Social/emotional** Hx: easily frustrated, threatened his mother with a knife last year and was briefly hospitalized, Hx of nightmares (decreased over past 3 yrs), seen weekly in outpt therapy, previously Dx'd with PTSD and Oppositional Defiant Disorder
- **Educational**: Hx of aggression during kindergarten towards other students, always an A/B student; performs better in smaller classroom
- **Medical**: no current health concerns per pediatrician What Psychological/cognitive tests can be done?
**Results: Individual Achievement Tests**
- Reading: 37%
- Math: 615
- Written language: 70%
- Oral language: 94%
**- Total Composite: 66%**
**Results: Intelligence Scale for Children:**
- Verbal comprehension: 50%
- Perceptual reasoning: 66%
- Working memory: 47%
- Processing Speed: 79%
**- Full Scale: 66%**
**_Diagnosis?_**
**_Recommendations?_**
IQ test (WISC-IV) Academic achievement (WIAT-II)
**Emotional functioning:**
- General behavioral/emotional screeners
----Achenbach Child Behavior Checklist (CBCL) and Teach Report Form (TRF)
---- Beck Youth Inventories: depression, anxiety, anger, disruptive behavior, self-esteem - Continuous Performance Test (children)
- Trauma Symptom Checklist for Children
**Diagnosis: Depressive Disorder; Not Otherwise Specified**
**Recommendations:**
- Continue individual and family therapy
- Work w/ a child psychiatrist regarding possible medication options
- School evaluation to determine if he meets criteria for Special Education under the Emotional Disturbance label
39
**Case: John, 4 yo Caucasian male**
- Referred by family doctor
- Kicked out of preschool due to aggression
- Cannot identify colors, letters, or numbers (a little concerning, but not awful for this age)
- Calls people by the wrong name
- **Developmental** Hx: pre-term labor during 4th mo of gestation, carried to full-term with steroid tx, fine motor and toileting delays
- **Emotional/social** hx: aggression towards siblings and peers, easily upset and difficult to soothe, Hx of flapping, spinning, poor eye contact, preservative interests
- **Medical** Hx: good health, Hx of sleep disturbance and some tremors in hands- sleep study found no clinical result; examiner noted possible muscle weakness in R side of face
**- Psychological/cognitive**: IQ test (WPPSI-III), Adaptive Behaviors (ABAS-II), General Behavior/emotional screener (CBCL), Autism-specific screens (ASDS, CARS2)
**Results: IQ Test**
- Verbal: 4%
- Performance: 0.2%
- Processing Speed: 5%
- **Full Scale IQ: 2% (68 composite)**
**Results: Adaptive Behavior Assessment:** composite: 0.2%
**Diagnosis?**
**Recommendations?**
**Diagnosis: Autistic Disorder; Mild Mental Retardation**
- Had markers of autism as well as impaired intellectual functioning (so **both** diagnoses)
**Recommendation:**
- Further medical evaluation regarding possible neurological concerns
- Autism-specific supports for family
- Evaluation by school for PPCD program
- Occupational therapy
- Individual and family therapy
- Re-evaluation of functioning in 1-2 yrs
40
**Case: Beth, 17 yo African American female**
- Referred for testing by psychiatrist and parents to aid in determining current level of functioning
- Previously diagnosed with ADHD and has been treated with Vyvanse
- Parents concerned about her apparent lack of age-typical social interactions and cognitive functioning; concerned about her ability to go to college
- Developmental Hx: pregnancy and delivery without complication, good attachment with parents, devo milestone all within normal limits, no significant medical Hx
- School/education: 12th grade, receives accommodations based on previous ADHD diagnosis, involved in extracurricular activities
- **Social/emotional** Hx; parents perceive her as emotionally immature and socially isolated (does not ask to go out on weekends); Beth says she has friends and communicates mostly online and through texting, generally positive mood, no behavior problems, no sleep or appetite problems, no trauma history
- **Medical** Hx: in good health per recent physical exam from pediatrician
- **Psychological/Cognitive**: (picture)
Results**: Adult Intelligence composite** = 14%
Results**: Woodcock-Johnson Test of Achievement total** = 7%
**Diagnosis?**
**Intervention?**
**Diagnosis:**
**- Mathematics Disorder** (no evidence of ADHD present)
**Recommendations:**
- Educational modifications and accommodations for mathematics disability
- Assistance from school in determining appropriate options for secondary education and/or vocational training
- Family therapy to work on communication difficulties between Beth and her parents
