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Abnormal Psych > Ch 13 (lesson 16): childhood disorders > Flashcards

Ch 13 (lesson 16): childhood disorders Flashcards

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1
Q

disorders of Childhood

A
  • attention deficit disorder
  • conduct disorder
  • depression and anxiety disorders
  • learning disability
  • communication disorders
  • motor disorders
  • intellectual development disorder
  • autism spectrum disorder
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2
Q

Developmental psychopathology

A

area of psychopathology that studies disorders within context of normal child development

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3
Q

relationship btwn child and adult psychopathology

A
  • some disorders are unique to children
    • eg: separation anxiety disorder
  • some disorders are primarily childhood disorders, but may continue into adulthood
    • eg: adhd
  • some disorders are present in children and adults
    • eg: depression

symptoms can be quite different in adulthood than in childhood

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4
Q

DSM-5 childhood disorders- 2 chapters

A
  • Neurodevelopmental disorders
  • Disruptive, Impulse Control, and Conduct disorder
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5
Q

changes in DSM-5 from DSM-IV-TR

A
  • name changes
    • eg: mental retardation –> intellectual developmental disorder
  • DSM-5 combined some disorders
    • eg: autistic disorder, aspergers, childhood disintegrative disorder, and pervasive developmental disorder —> combined into autism spectrum disorder
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6
Q

the more prevalent childhood disorders are often divided into two domains:

A
  • Externalizing disorders (outward-directed behavior such as aggressive, noncompliant, over-active, impulsive)
  • Internalizing disorders (inward focused experiences/ behavior like depression, social withdrawel, anxiety)
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7
Q

Externalizing disorders

A

contains:

  • ADHD
  • conduct disorder
  • oppositional defiant disorder

characterized by:

  • outward-directed
    • aggressiveness
    • noncompliance
    • over-activity
    • impulsiveness
  • more common in boys
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8
Q

internalizing disorders

A

contains

  • childhood anxiety
  • mood disorders

characterized by

  • inward behaviors and experiences
    • depression
    • anxiety
    • social withdrawal
  • more common in girls
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9
Q

Attention Deficit/Hyperactivity Disorder

A

can include:

  • Excessive levels of activity (Hyperactivity)
    • fidgeting, squirming, running around when inappropriate, incessant talking
  • Distractibility + difficulty concentration
    • careless mistakes, cannot follow instructions, forgetful
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10
Q

DSM-5 criteria of AD/HD

A

either A or B:

  • A. 6+ manifestations of inattention at least 6 mo
    • eg: careless mistakes, not listening well, not following instructions, distraction, forgetful
  • B. 6+ manifestations of hyperactivity-impulsivity at least 6 mo
    • eg fidgeting, running about, “driven by a motor”, interrupting/intruding, incessant talking
  • some of the above present b4 age 12
  • present in 2+ settings
  • sig impairment
  • 17+, only 5 signs
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11
Q

ADHD presentation specifiers

A
  • predominantly inattentive
  • predominantly hyperactive-impulsive
  • combination of both presentations
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12
Q

ADHD or Conduct Disorder? (differential diagnosis)

A

adhd:

  • more off-task behavior, cog and achievement deficits

conduct disorder:

  • more aggressive, act out in most settings, antisocial parents, family hostility

if have both:

  • worst features of each manifest
  • most serious antisocial behavior
  • most likely rejected by peers
  • poorest academic acheivement
  • poorest prognosis
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13
Q

prevalence, gender differences, comorbidity, beyond childhood

A
  • comorbidity: anxiety + depression (30% adhd have)
  • prevalence- 3-7%, now 8-11%
  • more common in boys (maybe due to boys more externalized/ aggressive)
  • persistence beyond childhood:
    • 65%- 85% still exhibit symptoms
    • 60% adults continue to meet criteria in remission
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14
Q

girls w ADHD

A

Hinshaw et al- large diverse study on girls w adhd

  • girls tended to be combined or inattentive type

combined type had:

  • more disruptive behavior than inattentive type
  • more comorbid diagnoses of conduct disorder or oppositional defiant disorder than w/out ADHD
  • viewed more neg by peers than inattentive or w/out ADHD

Inattentive type:

  • viewed more neg than girls w/out ADHD
  • exhibit neurological deficits (poor planning, prob solving)
  • have symptoms of EDs and Substance abuse by adolescence
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15
Q

Etiology of ADHD- Genetic factors

A
  • adoption and twin studies
    • heritability estimates 70-80%
  • two dopamine genes implicated *
    • DRD4 (dopamine receptor gene)
    • DAT1 (dopamine transporter gene)
    • *either gene assoc. w/ increased risk ONLY when prenatal maternal nicotine or alc use is present

not one single gene, many genes interacting w eachother and enviro

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16
Q

Etiology of ADHD- Neurobiological factors

A
  • Dopaminergic areas smaller in kids w ADHD
    • frontal lobes, caudate neucleus, globus pallidus
  • Poor performance on tests of frontal lobe function (exec functioning, impulsivity)
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17
Q

Etiology ADHD- Prenatal + Perinatal factors

A
  • Low birth weight
    • can be mitigated by later maternal warmth
  • maternal tobacco and alc use
    • exposure to tobacco in utero
    • may damage dopaminergic system resulting in behavioral disinhibition
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18
Q

etiology of ADHD- Enviornmental toxins

A
  • Limited evidence that food additives/ coloring may have small impact on hyperactive behavior
  • no evidence that refined sugar causes ADHD
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19
Q

Etiology of ADHD- parent-child relationships

A
  • parents give more commands/ have more neg interactions
  • family factors-
    • interact w genetic and neurobiological factors
    • contribute to or maintain ADHD behaviors, not cause them
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20
Q

treatment of ADHD- meds

A

Stimulants (ritalin, adderall, concerta, strattera)

  • reduce disruptive behavior
  • improve interactions
  • improve goal-directed behavior/ concentration
  • reduce aggression

side effects:

  • loss of appetite
  • weight
  • sleep probs
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21
Q

Treatment ADHD- meds plus behavioral treatment

A
  • slightly better than meds alone
  • improved social skills, meds alone don’t
  • 3 year followup found superior benefits of meds by themselves didn’t persist
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22
Q

treatment of ADHD- behavioral/ psych treatment

A

psych treatment:

  • parental training
  • change in classroom mgmt
  • behavior monitoring and reinforcement of approp. behavior
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23
Q

treatment of adhd- behavior treatment- classroom structure

A

supportive classroom structure:

  • brief assignments
  • immediate feedback
  • task-focused style
  • breaks for exercise
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24
Q

Conduct Disorder (CD)

A
  • pattern of engaging in behaviors that violate social norms/ rights of others/ often illegal
    • aggression
    • cruelty towards ppl/animals
    • damaging property
    • lying
    • stealing
    • vandalism
  • oft w viciousness, callousness, lack of remourse
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25
Q

Oppositional Defiant Disorder (ODD)

A
  • ODD behaviors don’t meet criteria for CD (esp extreme physical aggressiveness) but displays pattern of defiant behavior
    • argumentative
    • loses temper
    • lack of compliance
    • deliberately aggravates others
    • Hostile, vindictive, spiteful, or touchy
    • blames thers
  • comorbid w ADHD, learning and communication disorders
    • disruptive behavior of ODD more deliberate than ADHD
  • Most often diagnosed in boys, but may be as prevalent in girls
  • 8.3% prevalence
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26
Q

Intermittent explosive disorder (IED)

A
  • recurrent verbal or physical aggressive outbursts that are fare out of proportion
  • diff from conduct disorder, because the outburts are impulsive, not preplanned
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27
Q

DSM-5 criteria for Conduct disorder

A
  • repetitive and persistent behavior pattern that violates basic rights of others/ social norms
  • 3+ in the last 12 mo, atleast 1 in last 6 mo
    • A. aggression to ppl or animals
    • B. destruction of property
    • C. deceitfulness or theft
    • D. serious violation of rules
  • significant impairment is social, academic, occupational func.
  • includes a “limited prosocial emotions” diagnostic specifier for kids w callous, unemotional traits
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28
Q

Conduct disorder, comorbidity

A
  • substance abuse common
    • unclear whether in precedes or is concomitant
  • Comorbid w anxiety and depression
    • 14-45%
    • CD precedes anxiety and depression (but phobias and social anxiety precedes it)
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29
Q

Prevalence of conduct disorder

A
  • 7% preschool children exhibit symptoms
  • boys 4-16%
  • girls 1.2-9%
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30
Q

Conduct disorder-2 types

A
    1. Life-course-persistent pattern of antisocial behavior
      - 10-15x more likely in boys
    1. Adolescence-limited
      - maturity gap btwn physical maturation and rewarding adult behaviors

follow up longitudinal studies of life-course-persistent type show more severe probs into adulthood including:

  • academic underacheivement
  • neurophyscological
  • ADHD
  • family psychopathology
  • poorer physical health
  • lower SES
  • violent behaviors
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31
Q

Etiology of Conduct disorder- factors

A
  • social factors
  • psychological factors
  • neurobiological factors

interaction between all three to develop conduct disorder

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32
Q

Etiology of CD- Genetic factors

A
  • Heritability likely plays a part
  • twin study mixed results
    • genetics played role in rule-breaking behavior in wealthy areas, not as much in poor areas
  • adoption studies focused on criminal behavior, not conduct disorder
  • meta-analysis of twin + adopt studies suggest 40-50% heritability of antisocial behavior
    • genetics stronger influence when behaviors begin in childhood (rather than adolescence)
  • genetics and environment-
    • abuse as child PLUS low MAOA activity most likely to develop CD
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33
Q

Etiology of CD- Neurobiological factors

A
  • poor verbal skills
  • difficulty w executive functioning
  • Low IQ
  • Lower levels of resting skin conductance and heart rate– suggests lower arousal levels (less anxious of doing bad/getting caught)

txtbook adds

  • those w callous/ unemotional traits: deficits in regions that support emotion, especially empathy
    • amygdala, ventral striatum, prefrontal cortex
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34
Q

Etiology of CD- Psych factors

A
  • deficient moral development, lack of remorse
  • modeling and reinforcement of aggressive behavior
  • harsh and inconsistent parenting
  • lack of parental monitoring
  • Cognitive bias: neutral acts by others perceived as hostile
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35
Q

dodge’s cognitive theory of aggression- CD

A

—> ambiguous act interp. as hostile –>

aggression toward others –>

retaliation from others –>

further angry aggression towards others –>

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36
Q

Etiology of CD: Peers, Sociocultural

A
  • Peer influences associated w CD
    • Rejection by peers
    • Affiliation w deviant peers

-Sociocultural factors
- poverty
- urban enviro

  • higher rates of delinq. acts among PoC males linked to living in poorer neighborhoods rather than race

txtbook adds-

  • social selection view: kids w CD choose to be assoc. w likeminded peers, thus cont. antisocial behavior
  • social influence view: being around devient peers helps initiate antisocial behavior

both correct

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37
Q

treatment of Conduct disorder- Family Interventions

A

Family Interventions

  • Family check-ups (FCU) assoc. w less disruptive behavior
  • Parental mgmt training (PMT)
    • teach parents to reward prosocial behavior
    • positive reinforcement for pos behaviors, time-out and loss of privileges for aggressive or antisocial behavior
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38
Q

treatment of Conduct disorder- Multisystemic therapy (MST)

A

Multisystemic therapy (MST)

  • Deliver intensive community-based services
  • incorporates behavioral, cog, family-systems, and case-mgmt techniques
  • emphasizes individual and family strenghs
  • identifying social context for the conduct prob
  • using present-focused and action-oriented interventions
  • interventions that require daily/weekly efforts by family members

treatment is provided in homes, schools, local recreational centers to maximize chances that improvement will carry into the daily lives of children/their familiies

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39
Q

treatment of Conduct disorder- prevention program

A

types- Head start, Fast Track

goal: to prevent conduct disorder before it develops

  • Fast track- impressive reductions in later psychopathology w brief intervention
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40
Q

Depression and Anxiety in children/adolescents- Comorbidity

A
  • often co-occur w ADHD and CD
  • also co-occur w eachother
  • early research suggested depression and anxiety can be distinguished from each other the same way as in adults
    • depression: high neg affect, low pos affect
    • anxiety: high neg affect but not low levels of pos affect
    • more recent research calls this into question
41
Q

Symptoms of Depression shared by children, adolescents, and adults

A
  • depressed mood
  • inability to experience pleasure
  • fatigue
  • probs concentrating
  • suicidal ideation
42
Q

Symptoms of Depression specific to children and adolescents

A
  • higher rates of suicide attempts
  • higher rates of guilt
  • lower rates of
    • early morning awakening
    • early morning depression
    • loss of appetite
    • weight loss
43
Q

prevalence of depression in children/ adolescents

A
  • 1% preschoolers
  • 2-3% under 12
  • 15.9% adolescent girls, 7.7% adolescent boys
44
Q

Etiology of Depression- Genetic factors

A
  • Having depressed parents = 4x increase in risk of developing depression in childhood
    • there are risks of this involving genes and the environment
  • gene-enviro interaction- ppl w short allele of serotonin transporter gene AND sig interpersonal stressful life events more likely to have depressive episode
    -interpersonal factor esp. important in adolescent girls
45
Q

Etiology of Depression- Early adversity/ life events

A

kids w depression (15-20) more likely to have experienced early adversity and neg life events

46
Q

Etiology of Depression- Family and relationship factors

A
  • a parent who is depressed
  • parental rejection modestly assoc. w depression
  • children w depression and their parents interact in negative ways
    • less warmth
    • more hostility
47
Q

Etiology of depression- Cog distortions and neg attributional style

A
  • cog distortions and neg attributional style, hopelessness theory
  • stable attributional style
    • develops by early adolescence
    • by 8th/9th grade attributional style serves as cog diathesis for depression
48
Q

Etiology of Depression- Brain factors

A
  • HPA axis and release of cortisol
    • cortisol levels on awakening predicted onset of of MDD
  • cortisol in depressed ppl assoc. w smaller hippocampus volume
    • grew more slowly btwn early + mid adolescents for those who developed depression
49
Q

treatment of depression- meds

A
  • SSRIs more effective than tricyclics
  • Meta-analysis show medications most effective for anxiety other than OCD
    • less effective for depression and OCD

Concerns abt meds:

  • side effects including diarrhea, nausea, sleep probs, agitation
  • possibility of increased risk of suicide attempts
50
Q

treatment of depression- psychotherapy

A
  • IPT (interpersonal therapy)
    • Focuses on peer pressures, transition to adulthood, and issues related to independence
  • CBT
    • More effective for white adolescents, those w good coping skills already, and those w recurrent depression

-Psychotherapy generally only modestly effective w kids and adolescents
- CBT no better than other therapies

51
Q

treatment of depression- two types of preventative interventions

A
  • selective prevention programs
    • target kids based on family and enviro risk factors
  • universal prevention programs
    • targeted towards large groups, provide info about depression
52
Q

Anxiety in Children and Adolescents

A
  • Anxiety disorder
    • more severe and persistent worry
    • must interfere w functioning
  • most childhood fears disappear but adults w anxiety disorders report feeling anxious as children
  • unlike adults, kids don’t need to regard their anxiety/ fear as unreasonablw
  • 3-5% prevalence
53
Q

Separation Anxiety Disorder

A
  • worry about parental or personal safety when away from parents
  • typically observed when child begins school
  • associated w development of other internalizing and externalizing disorders later
54
Q

social anxiety disorder

A
  • extremely shy and quiet
  • selective mutism
    • refusal to speak in unfamiliar social setting
  • 1% prevalence
  • Etiology
    • often overestimation of threat
    • underestimation of coping ability
    • poor social skills
55
Q

PTSD

A
  • Exposure to trauma
    • chronic physical or sexual abuse
    • community violence
    • natural disasters
  • symptom categories
    • flashbacks, nightmares, intrusice thoughts
    • avoidance
    • neg cognitions and moods
    • hyperarousal and vigilance

differ from adults:

  • may exhibit agitation instead of fear/hopelessness
56
Q

OCD

A
  • prevalence 1-4%, more common in boys
  • symptoms similar to those in adults
  • most common obsessions:
    • contamination from dirt/germs
    • aggression
    • thoughts about sex/religion (more common in adolescence)
57
Q

Etiology of anxiety disorders- Genetics

A
  • Heritability 29-50%
  • Genetics play stronger role in separation anxiety in context of more neg life events
58
Q

Etiology of anxiety disorder- parenting, attachment, etc

A
  • parenting plays small role
    • 4% variance
    • parental control and overprotectiveness more so than parental rejection
  • emotion regulation and attachment probs also play a role
    • overestimate danger, underestimate ability to cope
  • perception of lack of acceptance/ being bullied risk factor in anxiety and social phobia
59
Q

etiology of anxiety disorders- PTSD

A
  • family stress and coping style
  • past experience w trauma
  • parent reactions to trauma can help lessen child’s distress
60
Q

treatment of Anxiety Disorders - Exposure

A
  • Exposure to feared object
    • reward approach behavior

CBT Kendall’s Coping Cat
- shows to be effective in two randomized clinical trials
- 7-13
- Cognitive restructuring
- develop new ways to think about fears
- Psychoeducation
- Modeling and exposure
- skills training and practice
- relapse prevention
- family involved in treatment

txtbook:
Coping Cat focuses on:
- confrontation of fears
- development of new ways to think about fears
- exposure to feared situations
- relapse prevention

61
Q

treatment of anxiety- OCD

A
  • CBT + Zoloft
62
Q

Specific Learning Disorder (Learning Disability?- slide show)

A
  • Evidence of inadequate development in specific area of academic, language, speech, or motor skills
  • not due to intellectual disability, autism, physical disorder, or deficient educational opportunities
  • usually average or above avg intelligence
  • often identified and treated in school
  • reading disorders more common in boys
63
Q

DSM-5 criteria for Specific learning disorder

A
  • Difficulties in learning basic academic skills (reading, math, or writing) inconsistent w age/ schooling/intelligence
  • persists atleast 6 mo
  • sig intereference w academic achievement or activities
64
Q

specifiers of Specific Learning Disorder

A
  • Reading impairment (Dyslexia) (5-15%)
  • written expression impairment
  • math impairment (dyscalculia)
65
Q

Communication DIsorders

A
  • Speech Sound disorder (formerly phonological disorder)
  • Childhood-onset Fluency Disorder (formerly stuttering)
  • Social (pragmatic) communication Disordr
    -Language Disorder
66
Q

Speech Sound Disorder

A

formerly phonological disorder

  • correct comprehension and sufficient vocabulary use
  • unclear speech and improper articulation
67
Q

Childhood-onset fluency Disorder (stuttering)

A

Disturbance in verbal fluency characterized by one or more of the following speech patterns:

  • frequent repetitions or prolongation of sounds
  • long pauses btwn words
  • substituting easy words for thos that are difficult to articulate
  • repeating whole words
68
Q

Social (pragmatic) communication disorder

A
  • persistent difficulty with verbal + non-verbal communication
  • limits effective communication, social relationships, academic achievement, or occupational performance
  • not explained by low cog ability
  • must be present in early childhood
69
Q

language disorder

A
  • Persistent deficits in comprehension production of language
  • substantially below age level
  • beginning in early development period, not due to other disorders/ conditions
70
Q

Motor Disoders

A
  • Developmental Coordination Disorder (fka motor skills disorder
    • Marked impairment in dev. of motor coord
71
Q
  • repetitive, seemingly purposeless, oftem rhythimical motor behavior
  • interferes w normal activities
  • onset in “early dev. periods”
A

Sterotypic Movement Disorder

72
Q

Involves one or more vocal and multiple motor tics (sudden rapid movement/vocalization)

  • onset before 18
A

tourrette’s Disorder

73
Q

at least on motor or vocal tic, not both

  • must be present for > 1 year
  • onset before 18
A

Persistent (chronic) motor or vocal tic disorder

74
Q

one or more motor and or vocal tics, present < 1 year

  • onset before 18
A

provisional tic disorder

75
Q

tic disorder symptoms causeing distress/ impairment but not meeting other criteria

A

Other Specified tic disorder

or “Unspecified tic disorder”, if reason is unspecified

76
Q

Etiology of Dyslexia- Genetic Factors

A
  • Evidence from family and twin studies show heritable component
  • genes for dyslexia are genes associated w typical reading abilities (generalist genes)
77
Q

Etiology of Dyslexia- Problems in language processing

A
  • deficient PHONOLOGICAL AWARENESS
    • inadequate left temporal, parietal, occipital activation
    • phonological awareness : includes perceiving spoken language and its relation to printed words, detedcting syllables, recognizing rhyme
  • difficulties in speech perception
  • difficulties in analysis of sounds and their relationship to printed words
  • difficulty recognizing rhyme and alliteration
  • problems naming familiar objects rapidly
  • delays learning syntactic rules
78
Q

Parts of brain implicated in dyslexia

A
  • frontal lobe
  • temporal lobe
  • parietal
  • sometimes occipital too
79
Q

Etiology of Dyscalculia- Genetic and biological

A
  • Evidence from twin studies suggest common genetic factors underlie both reading and math defecits
  • intraparietal sulcus implicated
  • has different cog deficits from dyslexia
  • kids w only dyscalculia don’t have deficits in phonological awareness
80
Q

treatment of reading/writing disorder

A
  • mulitsensory instruction in listening, speaking, writing skills
  • readiness skills in younger kids in preparation for learning to read
  • phonics instruction
81
Q

treatment of communication disorders

A
  • fast forWard
    • computer games and audiotapes that slow speech sounds
82
Q

Intellectual Disability (Intellectual Developmental Disorder?)

A
  • fka mental retardation in DSM-IV-TR
    • not preferred due to stigma
    • followed the guidelines of American Association on Intellectual and Developmental Disabilities

AAIDD definition of Intellectual Disability:

  • characterized by sig limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual , social and practical adaptive skills
  • began before 18
  • Five assumptions Essential to the App. of the definition
      1. limitations in func considered w/in context of community enviro typical of person’s age/peers/culture
    1. valid assess. considers cult. and linguistic diversity as well as differences in communication/sensory/motor/ behavioral factors
    1. w/in indvl limitations coexist w strengths
    1. purpose of describing limitations is to develop profile of needed supports
    1. w aprop. personalized supoorts over sustained period, life func of person w intellec. disability generally will improve
83
Q

Intellectual Disability- DSM-5

A
  • Intellectual deficit of 2 or more std deviation in IQ below the avg score for age + culture- typically below 70
  • sig deficits in adaptive func relative to age + culture in 1+ area:
    • communication
    • social participation
    • work or school
    • independence and home/community
    • requiring need for support at school/work/ind. life
  • onset during development
84
Q

Intellectual disability- Dsm-5 changes

A
  • explicit recog that IQ score consirdered w/in cultural context
  • adaptive func also assessed/ considered w/in age/culture
  • no longer distinguish mild, mod, severe ID based on IQ scores alone
85
Q

Etiology of Intellectual Disability- neurobiological factors

A
  • Down syndrome
    • chromosomal trisomy 21- extra copy of chromosome 21 ( 47 instead of 46)
  • Fragile-X syndrome
    • mutation in fMR1 gene on X chromosome
  • Recessive-gene disease
    • Phenylketonuria (PKU)
  • Maternal infectious disease, esp during 1st trimester
    • cytomegalovirus, toxoplasmosis, rubella, herpes simplex, HIV, syphilis
  • lead/mercury poisoning
86
Q

Treatment of Intellectual Disability- residential, behavioral

A
  • Residential treatment
    • small- med sized community residences
  • Behavioral treatments
    • language, social, motor skills training
    • method of successive approximation (shaping) to teach basic self-care skills for severe cases (holding a spoon, toilet)
    • applied behavioral analysis- applying behavioral learning theory to learn new skills
  • Cognitive treatments
    • problem-solving strategies
  • computer-assisted instruction
87
Q

Autism Spectrum Disorder- DSM-5 vs IV-TR

A
  • DSM-5 combines multiple diagnoses into Autism Spectrum disorder:
    • Autistic disorder
    • Aspergers Disorder
    • pervasive developmental disorder not otherwise specified
    • childhood disintegrative disorder
  • research didn’t support distinctive categories
  • share similar clinical features- vary only in severity
  • DSM_5 includes clinical specifiers relating to severity and extent of language impairment
88
Q

`DSM-5 criteria for Autism spectrum disorder

A

total of 6+ items from A, B, and C below w at least 2 from A, 1 each from B and C

A. Deficits in Social communication/interactions:

  • deficits in nonverbal behavior (eye contact, facial expression, body lang)
  • deficits in dev of peer relationships
  • deficits in social/emotional reciprocity (not approaching others, not having back-and-forth, reduced sharing of interests/emotions)

B. Restricted, repetitive behavior patterns/interests/activities

  • stereotyped or repetitive speech motor movements, use of objects
  • excessive adherence to routines, rituals in verbal/nonverbal behavior, resistance to change
  • v restricted interests abnormal in focus, such as parts of objects
  • hyper or hypo-reactivity to sensory input or unusual interest in sensory enviro

C. onset in early childhood
D. symptoms limit and impair functioning

89
Q

characteristics of autism

A
  • profound problems w social world
  • theory of mind
  • communication deficits
  • repetitive and ritualistic acts
90
Q

autism - profound problems w social world

A
  • rarely approached by others, may look through people
  • problems in joint attention
  • pay attention to different parts of face- neglect eye contact
  • this likely contributes to difficulties in perceiving emotion in other people
91
Q

autism- theory of mind

A

theory of mind

  • understanding that other people have different desires, beliefs, intentions, emotions
  • crucial for understanding and successfully engaging in social interaction
  • typically develops btwn 2.5-5 yrs
  • children w ASD seem not to achieve this developmental milestone- atleast to same degree
92
Q

autism-communication deficits

A
  • kids w ASD have evidence of early language disturbances
  • Echolalia: immediate or delayed repetition of what was heard
  • pronoun reversal
  • literal use of words
93
Q

ASD- repetitive and ritualistic acts

A
  • extremely upset when routine altered
  • engage in obsessional play
  • engage in ritualistic body movements
  • become attached to inanimate objects
94
Q

ASD- comorbidity, prevalence, prognosis

A

Comorbidity:

  • IQ> 70 common
    • kids w intellectual disability score poorly on all parts of IQ test, ASD score poorly on subtests related to language, tasks requiring abstract thought, symbolism, sequential logic
  • anxiety
  • specific learning disorder

prevalence

  • 1/110 kids
  • found in all SES, ethnic, racial groups
  • diagnosis of ASD remarkably stable

prognosis

  • kids w higher IQ who learn to speak b4 6 have best outcomes
95
Q

Etiology of ASD- genetic

A
  • heritability: .80
  • twin studies: 47-90% for MZ twins, 0-20% for DZ
  • genetic flaw- deletion of chromosome 16
96
Q

Etiology ASD- Neurobiological factors

A
  • Brain size
    • although normal size at birth, brains of autistic adults/kids are bigger than normal
    • pruning of neurons not occurring
      -“overgrown” areas include frontal, temporal, cerebellar - linked to language, social, emotional func.
      -abnormally sized amygdalae predicted more difficulty in social behavior/communication
97
Q

Treatment of ASD

A
  • Psych treatments more promising than drugs
  • Earlier treatment = better outcomes

Behavioral treatments:

  • Intensive Operant Conditioning (dramatic, encouraging results)
    • using reinforces to teach kids appropriate responses, motor behavior etc.
  • Parent training and education
  • Pivotal Response Treatment
    • focus on increasing motivation and responsiveness rather than on discrete behaviors
  • Joint Attention Intervention and symbolic play used to improve attention and expressive skills
98
Q

treatment for ASD- meds

A

Haloperidol (Haldol)
- antipsychotic
- reduces aggression and motor behavior
- doesn’t improve language and interpersonal relationships

Abnormal Psych (16 decks)

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