Chapter 14 Flashcards
Intellectual Disability
- A generalized delay or impairment in the development of intellectual and adaptive abilities.
- Two standard deviations below the mean
- IQ 70 or less
- Significantly sub-average intellectual functioning and deficits or impairment in at least two areas of life functioning
The four levels of mental retardation according to the DSM-IV-TR
- Mild mental retardation includes the IQ range from 50–55 to approximately 70
- Moderate mental retardation includes the IQ range from 35–40 to 50–55
- Severe mental retardation includes the IQ range from 20–25 to 35–40
- Profound mental retardation includes the IQ range below 20–25
Intellectual Disability changes from DSM 4 to 5
Not referred to as ‘mental retardation’ in DSM 5
DSM 5 made a movement to 1 diagnosis rather than the 4
Biological causes of intellectual disabilities
chromosomal and genetic disorders, infectious diseases, and maternal alcohol use during pregnancy.
Psychosocial causes of intellectual disabilities
exposure to an impoverished home environment marked by the lack of intellectually stimulating activities during childhood.
Down syndrome
– A condition caused by the presence of an extra chromosome on the 21st pair and characterized by intellectual disability and various physical anomalies.
- It usually occurs when the 21st pair of chromosomes in either the egg or the sperm fails to divide normally, resulting in an extra chromosome.
- Down syndrome occurs in about 1 in 700 births.
Odds increase with age of birth mother
Fragile X syndrome
- An inherited form of intellectual disability caused by a mutated FMR-1 gene on the X chromosome.
- The second most commonly occurring chromosomal abnormality causing intellectual disability
- The disorder is caused by a defective gene in an area of the X sex chromosome that appears fragile
- Affects 1 out of 1,000 to 1,500 males and 1 out of 2,000 to 2,500 females and more women are carriers
- Males show a particular pattern of cognitive functioning
(Weaknesses in sequential processing of words in a particular order and Strengths in simultaneous processing of information in a holistic fashion) - Only approx. 1/3 of females are mildly mentally retarded
Most display only learning difficulties involving attention, short-term memory, planning, problem solving, and understanding mathematical concepts - High comorbidity rates with autism spectrum disorder
Phenylketonuria (PKU)
- A genetic disorder that prevents the metabolization of phenylpyruvic acid, leading to intellectual disability unless the diet is strictly controlled.
- It is caused by a recessive gene that inactivates a liver enzyme, which prevents the child from metabolizing the amino acid phenylalanine, found in many foods.
- occurs in 1 in 10,000-15,000 live births in North America.
- If treated with a low-phenylalanine diet before three months of age, individuals will usually function intellectually within the normal IQ range
- Untreated: often moderate-severe intellectual disability
Prenatal environment causing intellectual disability
Rubella (German measles), HIV, Fetal Alcohol Spectrum, syphilis, drug use, cytomegalovirus, and genital herpes.
Cultural-Familial Causes of intellectual disabilities
Children in impoverished families may lack toys, books, or opportunities to interact with adults in intellectually stimulating ways
“Essential daily ingredients” for development of young childrenPly time, interaction with adults
Learning disorder
- A deficiency in a specific learning ability in the context of normal intelligence and exposure to learning opportunities. (large discrepancy between overall intelligence and academic ability)
- Typically chronic disorders that affect development well into adulthood.
- Children with learning disorders tend to perform poorly in school.
Specific Learning Disorder
in DSM-5 encompass various types of learning disorders or disabilities involving significant deficits in skills related to reading, writing, arithmetic and math, and executive functions.
Specifies used to distinguish features and level of severity
Problems with Reading (dyslexia)
- characterizes children who have poorly developed skills in recognizing words and comprehending written text.
- Boys are more likely to show disruptive behavior in class and to be referred for evaluation.
- Impairment in phonological processing/ Lack of awareness that words can be broken down
Problems with Writing
refers to children with grossly deficient writing skills
deficiency may be characterized by errors in spelling, grammar, or punctuation, or by difficulty in composing sentences and paragraphs
severe writing difficulties generally become apparent by age 7; milder cases may not be recognized until the age of 10 or later (is this when it shows or when we test it?)
Problems with Arithmetical and Mathematic Reasoning Skills
may have problems understanding basic mathematical terms or operations, such as addition or subtraction; decoding mathematical symbols (+, =, etc.); or learning multiplication tables.
problem may become apparent as early as the first grade (age 6) but is not generally recognized until about the second or third grade
Nonverbal Learning Disability
Average verbal intelligence yet impairments in many nonverbal aspects of daily living
E.g., reading facial expressions and body language, interpreting maps, learning to tell time
The difference between NLD and Asperger disorder
Similar: difficulties in processing nonverbal social cues, impairments in executive function
NLD: visual-spatial cognitive deficits
Asperger: restricted repetitive and stereotypic movements
diagnosis of learning disorder
There is clear impairment in school performance or in daily living activities
The impairment is not due to mental retardation or to a pervasive developmental disorder such as autism
Causes of Learning disabilities
unknown but possibly the products of subtle central nervous system impairments
The word autism derives from the Greek word
autos, meaning “self.”
Autistic thinking
is the tendency to view oneself as the center of the universe, to believe that external events somehow refer to oneself.
Autism Stats
- Estimates suggest 1 to 3 per 1000 live births in Canada
- More common in boys than in girls, about four times as common.
- The disorder generally becomes evident in toddlers between 18 and 30 months of age, but the average child is not diagnosed until about age 6.
- The earlier children with autism are diagnosed and treated, the better they generally are.
Autism spectrum disorders are characterized by deficits in three major areas:
Social Interaction
Verbal and Non-Verbal Communication
Behavior and Interests
Autism - Social Interaction
- Marked impairment in the use of multiple nonverbal behaviors e.g., eye contact, facial expression, body postures, gestures to regulate social interaction
- Failure to develop peer relationships appropriate to developmental level
- Lack of spontaneous seeking to share enjoyment, interests, or achievement with others
- Lack of social or emotional reciprocity
Autism - Communication
- half of children with autism are mute
- Those who develop speech often do not communicate meaningfully
- Development of functional speech by age 5 is the strongest single predictor of functional outcome among those with autism
- Speech may be peculiar
peculiar speech in autism
echolalia = parroting back what the child has heard in a high-pitched monotone)
pronoun reversals = using “you” or “he” instead of “I”; trouble shifting reference
use of words that have meaning only to those who have intimate knowledge of the child
Autism - behaviour and interests
- Often have restricted, repetitive, and unusual behaviors and interests
- Repetitive movements often seen as a form of self-stimulation
- Focus on particular aspects of their environment to the exclusion of others
- Preoccupation with objects or patterns
Intelligence of autistic children
- Approximately 25 percent of those with autism function in the normal range of intelligence
- Some meaningful speech and can function somewhat more independently
- Small proportion of the remaining 75 percent are often called savants - Islets of exceptional ability in a particular area
Asperger Disorder characteristics
- Viewed as a mild form of autism or ‘high-functioning’ autism - high on the spectrum
- No significantly delayed cognitive development
- Difficulties with social skills
- Adaptive behavior and interest in the environment are age appropriate and may have particular interest in social interaction
Most common social deficits of Asperger Disorder
May begin speaking seemingly in mid-thought
Failure to observe social norms
Failure to show awareness of listener feelings
Use of stereotyped phrases
Child Disintegrative Disorder
- Has later onset and occurs after a period of several years of normal development
- Behaviors and deficits in social skill and communication similar to those in autism
Autism Spectrum Disorder
- communication deficits include responding inappropriately in conversations, misreading nonverbal interactions, or having difficulty building friendships appropriate to their age.
- may be overly dependent on routines, highly sensitive to changes in their environment, or intensely focused on inappropriate items.
- Symptoms fall on a continuum, with some individuals showing mild symptoms and others having much more severe symptoms.
How common is ASD
In 2013, researchers estimated that 2% of children (more than 1 million children in total) in the U.S. were affected by some form of autism spectrum disorder.
Causes of ASD
- Executive functioning as controlled by frontal lobe
- Abnormal levels of serotonin in 30-50% of children with autism
- Prenatal infections during pregnancy and delivery fairly common among mothers
- Frequent occurrence of autistic features in individuals with Fragile X and PKU
- Investigators have linked increased risk of autism to children with older fathers
- Early and now discredited belief held that the autistic child’s aloofness was a reaction to parents who were cold and detached—“emotional refrigerators” who lacked the ability to establish warm relationships with their children.
- Suggestion that children with autism have perceptual deficits that limit them to processing only one stimulus at a time
Vaccinations and Autism
- Researchers have consistently failed to find links between autism and use of childhood vaccines
- Original study cited was by Wakefield (1998) and published in Lancet was later retracted because the data was found to be falsified
Treatment of Autism
- Drugs (70 percent of children with autism over age 8 receive)
- Nutritional Supplements
- Operant conditioning methods, using rewards and mild punishments to increase the child’s ability to attend to others, to play with other children, and to develop academic skills.
- Highly intensive and structured behavioral treatment programs offering a great deal of individual, one-to-one instruction (impressive gains in autistic children who received more than 40 hours/week for 2 years)
- Programs focus on developing self-help skills, language, appropriate social interactions,academic skills, and reducing maladaptive behaviors like self-stimulation, stereotyped actions, self-injury, and aggression
- Reductions in challenging behaviors occurring in 80 to 90 percent of positive interventions
echolalia
in autism, a speech pattern in which the child will repeat another’s words or phrases, using the same or similar intonation
LA
What are the symptoms and features of mental retardation? What is the difference in the way it is defined by the DSM-IV-TR and the AAMR?
Compare and contrast autism with Asperger’s disorder.
Discuss the biological causes of mental retardation.
Discuss two important factors or areas of research with regard to the etiology of developmental disorders.
Compare and contrast the psychopharmacological treatment of autism with behavioural treatments.
Discuss the evidence supporting an organic-based etiology of autism.
Describe the concept of normalization and give examples of its application to individuals with developmental disorders.
