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PSY240 > Chapter 14 & 15: Developmental and Childhood Disorders > Flashcards

Chapter 14 & 15: Developmental and Childhood Disorders Flashcards

1
Q

What are neurodevelopmental disorders?

A
  • disorders that begin generally before, during, or soon after birth, though they may not be detected for some time depending on severity
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2
Q

What are disorders of childhood and adolescence?

A
  • emergent as a child develops, perhaps more due to environment than a gestational disorder
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3
Q

What is intellectual disability?

A
  • refers to significantly subaverage intellectual functioning beginning before the age of 18, and accompanied by limitations in two or more areas of adaptive skill
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4
Q

What is autism?

A
  • best known of the neurodevelopmental disorders
  • characterized by a lack of responsiveness, unusual responses to the environment, and absent or unusual expressive language
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5
Q

What are the DSM-V changes concerning developmental disorders?

A
  • “mental retardation” replaced with “intellectual disability”
  • more emphasis placed on cultural issues and adaptive functioning
  • manifested in several diagnostic categories:
    →unusual physical features,
    → deficits in language,
    → motor ability, and other skills,
    → and patterns of behaviour such as hyperactivity, aggressiveness, or stereotypy (the repetition of meaningless gestures or movements)
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6
Q

What is the prevelance of intellectual disability in Canada?

A
  • 8 per 1000 in general

- children aged 7-10 is ~3.65 per 1000

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7
Q

What are the diagnostic issues for intellectual disability?

A
  • level of IQ
    → may have average/high IQ but deficits in adaptive behaviour
  • American Association on Mental Retardation (AAMR) has strongly influenced definition and classification of “intellectual disabiliity”
    → *
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8
Q

How is adaptive behaviour measured?

A
  • Vineland Adaptive Behaviour Scales
    → completed during interviews with parents, teachers, or caregivers
  • Scales of Independent Behaviour
    → evaluates level of support needed in each domanin of functioning
  • Adaptive Behaviour Assessment System
    → norms for adaptive behaviour and related skills from 5-89 years of age
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9
Q

What are the genetic causes of developmental disorders?

A
  • dominant inheritance
    → rare, but seen in tuberous sclerosis and neurofibromatosis
  • recessive inheritance
    → phenylketonuria, Tay-Sachs disease, galactosemia
  • sex-linked
    → Fragile X syndrome, Lesch-Nyah syndrome
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10
Q

What is an example of chromosomal abnormalities in developmental disorders?

A
  • Down Syndrome
    → extra chromosome on pair 21 (Trisomy 21)
    → translocation
    → mosaicism

*

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11
Q

What is amniocentesis?

A

*

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12
Q

What is chorionic villus sampling (CVS)?

A

*

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13
Q

What is phenylketonuriea (PKU)?

A
  • best known of several rare metabolic disorders that can cause Intellectual Disability
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14
Q

How is PKU treated?

A
  • dietary treatment beginning early in infancy typically results in intellectual functioning within the normal range
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15
Q

What are examples of other metabolic disorders?

A

→ congenital hypothyroidism
→ hyperammonemia
→ Gaucher’s disease
→ Hurler’s syndrome

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16
Q

What is congenital hypothyroidism?

A

*

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17
Q

What is hyperammonemia?

A

*

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18
Q

What is Gaucher’s disease?

A

*

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19
Q

What is Hurler’s syndrome?

A

*

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20
Q

What are environmental causes of developmental disorders?

A
  • fetus exposed to toxins (e.g., drugs or alcohol) or infections (e.g., rubella or HIV)
  • blood supply lacks nutrients or oxygen
  • birth-related trauma, though rare
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21
Q

What is the psychosocial disadvantage model of intellectual disability?

A
  • psychological and social deprivation, due to lack of stimulation and care
  • poverty, poor nutrition, large family size, lack of structure in the home, and low academic expectations
  • approx. 75% of people diagnosed as having a neurodevelopmental disorder, no organic cause or brain dysfunction has been identified
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22
Q

What studies support genetic effects of developmental disorders?

A
  • he IQ scores of monozygotic twins are significantly more concordant than those of dizygotic twins
  • adoption studies suggest that intelligence scores are affected more by the genetic makeup of the biological parents and possibly prenatal environmental factors than by environmental input provided by adoptive parents.
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23
Q

What are early intervention methods that can reduce developmental disorder symptoms?

A
  • encouragement of exploration
  • assistance in basic skills
  • guided rehearsal and extension of new skills
  • protection from inappropriate disapproval, teasing, or punishment
  • rich and responsive language environment
  • supportive and predictable environment in terms of opportunities for learning and patterns of interaction
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24
Q

What is Fragile X syndrome?

A
  • characterized by a weakened or “fragile” site on the X chromosome
  • second most frequently occurring chromosomal abnormality causing intellectual disability
    → most common hereditary cause
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25
Q

What are the common symptoms of Fragile X syndrome?

A

*

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26
Q

What does social inclusion strategy for developmental disorders entail?

A
  • active process that can enhance participation and development of individuals with neurodevelopmental disorders
  • preparation for community living
    → educational programs for people with neurodevelopmental disorders have focused on developing social skills and independent living skills
    → reducing or managing maladaptive behaviours
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27
Q

What is the normalization principle?

A
  • lives of individuals with disabilities should be as normal as possible
  • contributed to the deinstitutionalization of thousands of people with disabilities and the provision of community-based accommodation and services
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28
Q

What is dual diagnosis?

A
  • co-occurrence of serious behavioural or psychiatric disorders (like emotional and behavioural problems) in people with neurodevelopmental disorders
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29
Q

How is dual diagnosis treated?

A
  • behavioural approach

→ intervention of choice for maladaptive behaviours such as aggression, destructiveness, and self-injury

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30
Q

Who is Leo Kanner?

A
  • identified autism as a childhood disorderr in 1943
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31
Q

What is the prevalence of autism spectrum disorder in Canada?

A
  • 1 to 3 per 1000 births

- higher IQ variant occurs three times more often in men than women

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32
Q

What are the two features of autism spectrum disorder?

A
  • social dysfunction

- unusual responses to the environment

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33
Q

How is communication affected in those with autism spectrum disorder?

A
  • approx. 50% of children with autism spectrum disorder are mute
    → often do not communicate meaningfully even with speech
34
Q

What is echolalia?

A
  • automatic repetition of vocalizations made by another person
  • common characteristic of speech in children with autism spectrum disorder
35
Q

What is pronoun reversal?

A
  • common characteristic of speech in children with autism spectrum disorder
  • often refer to themselves as “he” or “she” rather than “I,” perhaps because they have trouble shifting reference between speaker and listener or a third party
36
Q

How is social dysfunction manifested in those with autism spectrum disorder?

A
  • avoid eye contact

- disinterest in faces

37
Q

How is abnormal response to environment manifested in those with autism spectrum disorder?

A
  • difficulty orienting, focusing, controlling, and maintaining attention
38
Q

How is autism spectrum disorder assessed?

A 
- carried out by multidisciplinary team, like a psychology Power Rangers
→ psychologist & psychiatrist
→ speech and language specialist
→ occupational and physical therapist
→ teacher
39
Q

Which disorders now fall under autism spectrum disorders in the new DSM-V?

A
  • Asperger’s
  • Childhood Disintegrative Disorder
  • Pervasive Developmental Disorder Not Otherwise Specified
40
Q

What is the biological etiology of autism spectrum disorders?

A
  • impairment not limited to single area of brain
    → variability within different functional domains (e.g., attention, memory, language)
  • genetic factors
41
Q

How are autism spectrum disorders treated?

A
  • medications & nutritional supplements
  • drugs used to regulate levels of neurotransmitters (e.g., serotonin, dopamine, norepinephrine) thought to contribute to abnormal behaviours frequently associated with autism spectrum disorder
  • not been effective overall
42
Q

What do behavioural interventions seek to develop in treating autism spectrum disorders?

A
  • self-help skills,
  • language
  • appropriate social interactions
  • academic skills
43
Q

What social skills are taught to people with autism spectrum disorder?

A
  • initiating contact,
  • responding appropriately
  • reciprocal interchange
44
Q

Where do reading disorders stem from according to neuroimaging?

A
  • core deficit in phonological processing
45
Q

What is a learning disability?

A
  • define a subset of students with exceptionalities that required special education programming
    → as defined by Education Act (1990)
46
Q

What are the DSM-V criteria for neurodevelopmental disorder?

A

A – persistent difficulties learning and using key academic skills despite the provision of interventions that target those difficulties

B – performance of academic skills that are well below average for chronological age

C – appearance of the learning difficulties in the school years

D – recognition that learning difficulties are not attributable to other neurological conditions or intellectual disabilities

47
Q

Which academic skills does the DSM-V focus on in terms of impairment in learning?

A
  • reading single words accurately and fluently,
  • reading comprehension, written expression and spelling
  • arithmetic calculation
  • mathematical reasoning
48
Q

What is dyslexia?

A
  • impairment in reading
  • involves difficulties not only in the recognition but also in the comprehension of words
  • 2-8% of children
  • accounts for ~80% of learning disorders
49
Q

What is dyscalculia?

A
  • impairment in mathematics
  • problems with recognizing and understanding numerical symbols, sequencing problems, and attention deficits
  • 6% of children
50
Q

What are nonverbal learning disaabilities (NLD)?

A
  • characterized by average verbal intelligence yet show impairments in reading facial expressions and body language, interpreting maps, and learning to tell time
  • controversial since there may or may not be link between NLD and Asperger disorder
51
Q

What does neuroimaging show in the brains of people with dyslexia?

A
  • altered patterns of asymmetry in the language areas of the brain
  • minor malformations of the cortex
52
Q

What are the three major behavioural/emotional disorders of childhood and adolescence?

A
  • attention deficit/hyperactivity disorder (ADHD)
  • oppositional defiant disorder (ODD)
  • disruptive mood dysregulation disorder (DMDD)
53
Q

What is ADHD?

A
  • childhood disorder characterized by disruptive behaviour, an inability to control activity levels or impulses, or difficulty concentrating
  • best studied; co-morbid with conduct disorder (CD)
  • best treated with stimulant medication
54
Q

What is conduct disorder (CD)?

A
  • childhood disorder
  • children show pattern of violating the rights of others and major age-appropriate societal norms or rules in a variety of settings
55
Q

What is oppositional defiant disorder (ODD)?

A
  • childhood disorder
  • more frequently than usual:
    → refuse to follow instructions
    → argue for the sake of arguing
    → show hostility toward parents and teachers
  • often have problems with substance abuse
56
Q

What environmental factors contribute to oppositional defiant disorder?

A
  • criminality
  • family violence
  • substance abuse
  • other psychiatric disorders
57
Q

What is separation anxiety disorder?

A
  • only anxiety disorder exclusive to children
  • characterized by severe/excessive anxiety or panic at the prospect of separation from parents or others they’re emotionally attached to
  • diagnosed before puberty and onset before age 6
  • 1/3 later develop other anxiety or mood disorders
58
Q

What is disruptive mood dysregulation disorder?

A
  • new category in DSM-V

- focuses on impulsive, angry outbursts, non-destructive/non-physical aggression and verbal aggression

59
Q

What is the difficulty in diagnosing childhood disorders?

A
  • children generally do not self-refer for help
    → parents/teachers must report for assessment
  • children generally do not have insight into their problems or the verbal capacity to describe them
60
Q

What are externalizing and internalizing problems in childhood?

A
  • externalizing
    → behaviour problems
    → problems of undercontrol
  • internalizing
    → depression
    → anxiety
61
Q

What are the most common psychiatric disorders among children in North America?

A
  • anxiety disorders
  • conduct disorder
  • ADHD
62
Q

What are the three subtypes of ADHD?

A

– ADHD inattentive type (ADHD-I),
– ADHD hyperactive type (ADHD-H) or
– ADHD hyperactive-inattentive or combined type (ADHD-HI).

63
Q

What is the developmental trajectory of ADHD?

A
  • most children with ADHD continue to have symptoms that require a chronic approach to management through adolescence and adulthood
  • most important long-term issue for youth with ADHD is increased risk for developing another psychiatric disorder
  • 50% of adults with ADHD also have a mood or anxiety disorder
64
Q

What is the biological etiology of ADHD?

A
  • multiple risk factors
  • reduced brain size (3-8% reduction)
  • abnormalities in the metabolism of dopamine and noradrenergic neurotransmitters, and their regulatory genes
65
Q

Which parts of the brain are implicated in ADHD?

A
  • abnormalities of the prefrontal cortex
    → associated with executive functioning
  • abnormalities of the basal ganglia
    → associated with higher motor control, learning, memory and cognition, and emotional regulation
66
Q

How heritable is ADHD?

A
  • 77% heritability
67
Q

What prenatal factors are related to ADHD?

A
  • prenatal toxin exposure, including poor diet, mercury, and lead exposure
  • pregnancy and delivery complications
  • exposure to alcohol and maternal smoking
68
Q

What is prescribed to children with ADHD?

A
  • Ritalin (methylphenidate)

- Dexedrine (dextroamphetamine)

69
Q

Which ADHD symptoms respond to medication?

A
  • hyperactivity
  • restlessness
  • impulsivity
  • disruptiveness and aggression
  • socially inappropriate behaviour
70
Q

What is the prevalence of CD and ODD?

A
  • ODD: 5 to 10% of children
    → minority develop CD
  • CD: 3 to 6% of children
    → minority develop antisocial personality disorder as adults
71
Q

What is heterotypic continuity?

A
  • underlying (developmental) process or impairment stays the same, but how it is manifested may be different
  • e.g. CD, ODD, and APD are the same disorder manifesting itself differently over time
72
Q

What is the heritability for antisocial and aggressive behaviour in childhood?

A
  • 44 to 72% heritability

- shown intergenerational patterns of criminal behaviour

73
Q

What child-rearing patterns predict later conduct problems?

A
  • poor parental supervision and lack of parental involvement

- lack warmth, acceptance, affection, and emotional support

74
Q

How does problem-solving skills training treat children with CD and ODD?

A
  • multiple strategies.
  • modelling and practice, role-play, and reinforcement contingencies
  • data show that problem-solving skills can lead to significant improvements in children’s behaviour; but not back to a normal level
75
Q

What medications are used to treat CD and ODD?

A
  • mood stabilizers
  • neuroleptics → antipsychotic medication
  • stimulants
76
Q

How do parent training programs treat children with CD and ODD?

A
  • based on a social learning causal model
    → interactions between the parent and the child are considered to maintain and promote conduct problems inadvertently (coercive process, aversive reactions used to control behaviour of another person)
  • goals include developing specific parental skills to promote prosocial behaviours in children using proper discipline to minimize undesirable behaviours
77
Q

What differentiates separation anxiety disorder from generalized anxiety disorder?

A
  • in GAD distress and uncertainty that the child feels becomes directed outward to the world
78
Q

What is homotypic continuity?

A
  • underlying (developmental) process or impairment may change but is manifested the same
  • e.g., separation anxiety disorder developing int agoraphobia and panic disorder in adulthood
79
Q

What is behavioural inhibition?

A
  • temperament in early childhood that may be related to anxiety disorders later in life
  • characterized by profound avoidance of others in preschool, and atypical autonomic nervous system response to novelty
80
Q

What is the biological etiology of anxiety disorders in children?

A
  • elevated levels of cortisol (stress hormone) during pregnancy
  • amygdala dysfunction (predisposition) combined with conditioned fear experience
81
Q

How does cognitive-behavioural therapy treat anxiety disorders in children?

A
  • behavioural therapy attempts to enhance self-efficacy
    → also exposure therapy
  • cognitive techniques help children reframe anxious thoughts
    → cope and develop adaptive behaviours
  • overall successful treatment
  • by the way medications generally unsuccessful

PSY240 (16 decks)

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