LESSON 3 Flashcards
Often before the child enters school, and are characterized by developmental deficits or differences in brain processes that produce impairments of personal, social, academic or occupational functioning
Developmental period
Under of developmental disorders (3)
Intellectual dissability
Global developmental delay
Unspecified intellectual disability
Also known as “ Intellectual developmental disorder”
Intellectual disability
Law that changes “Mental retardation” to “Intellectual disability”
Rosa’s Law
Intellectual disability includes both ___ and ___ deficits in conceptual, social, and practical domains.
Intellectual
Adaptive functioning
Onset of intellectual and adaptive deficits during the developmental period ___ the age of ___
Before
18
Reasoning, problem solving, planning, abstract thinking, judgement, learning and other processes involving intelligence
Intellectual functioning
❏Conceptual – difficulties in learning academic skills;
abstract thinking, executive function and short-term
memory (in adults).
❏Social – immaturity in social interactions, difficulties in
regulating emotion and behavior, gullible.
❏Practical – needs some support in complex daily living
tasks, decision for well-being, legal matters, family raising,
etc.
Mild intellectual disability
❏Conceptual – significant delay in learning academic skills,
ongoing assistance to conceptual tasks; development of
academic skills in elementary level (in adults).
❏Social - marked difference in social interactions, less
complex spoken language, etc.
❏Practical – extended period of teaching for practical skills,
ongoing support, sometimes maladaptive behavior.
Moderate intellectual disability
❏Conceptual – limited attainment of academic skills, little
understanding on written language and numbers, extensive
support for problem solving.
❏Social - spoken language is limited, used more for
communication, understands simple gestures and speech.
❏Practical – support for daily living, supervision at all times,
inability to make decisions, sometimes maladaptive
behavior.
Severe intellectual disability
❏Conceptual – academic skills heavily rely on senses.
❏Social - very limited understanding on symbolic
communication and speech, largely communicate via
nonverbal.
❏Practical – depends on others for daily living tasks,
sometimes maladaptive behavior.
Profound intellectual disability
depends on others for daily living tasks, sometimes maladaptive behavior.
Practical (PROFOUND INTELLECTUAL DISABILITY)
very limited understanding on symbolic communication and speech, largely communicate via
nonverbal.
Social (PROFOUND INTELLECTUAL DISABILITY)
academic skills heavily rely on senses.
Conceptual (PROFOUND INTELLECTUAL DISABILITY)
support for daily living, supervision at all times, inability to make decisions, sometimes maladaptive
behavior.
Practical (SEVERE INTELLECTUAL DISABILITY)
spoken language is limited, used more for communication, understands simple gestures and speech.
Social (SEVERE INTELLECTUAL DISABILITY)
limited attainment of academic skills, little understanding on written language and numbers, extensive
support for problem solving.
Conceptual (SEVERE INTELLECTUAL DISABILITY)
– extended period of teaching for practical skills, ongoing support, sometimes maladaptive behavior.
Practical (MODERATE INTELLECTUAL)
marked difference in social interactions, less complex spoken language, etc.
Social (MODERATE INTELLECTUAL)
– significant delay in learning academic skills, ongoing assistance to conceptual tasks; development of
academic skills in elementary level (in adults).
Conceptual (MODERATE INTELLECTUAL)
needs some support in complex daily living tasks, decision for well-being, legal matters, family raising,
etc.
Practical (MILD INTELLECTUAL )
immaturity in social interactions, difficulties in regulating emotion and behavior, gullible.
Social (MILD INTELLECTUAL DISABILITY)
difficulties in learning academic skills; abstract thinking, executive function and short-term
memory (in adults).
Conceptual (MILD INTELLECTUAL)
❏At least ___ impairment of the three domains is needed to say that person
has deficit in adaptive functioning.
❏Deficit(s) must be related to ____
One
Intellectual impairments
learning and self-management across life settings.
Adapvie functioning
Practical domain
awareness of others’ thoughts, feelings and experiences; empathy; communications, etc.
Adaptive functioning
Social domain
competence in memory, language, reading, writing, math reasoning, acquisition of knowledge, problem solving and
judgment.
Adaptive functioning
Conceptual domain
❏Refers to how well a person meets community standards of personal independence and social responsibility.
Adaptive functioning
❏A person needs to have a score of ___ or below on an IQ test to say that they have intellectual deficits
- Measuring IQ is not always enough as an indicator of ID
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cognitive impairments that
result from a combination of psychosocial and biological influences.
Cultural-Familial intellectual disability
Psychosocial influences (3)
❏Abuse
❏Neglect
❏Social Deprivation
moderate-to-severe levels of ID and have higher rates of hyperactivity, short attention spans, gaze
avoidance, and perseverative speech.
Fragile X syndrome
caused by an extra 21st chromosome, it is characterized with ID, noticeable facial features,
tendency to have heart malformations, and increased risk
for Alzheimer’s disease.
Down syndrome
X-linked disorder affecting males
that causes ID, cerebral palsy, and self-injurious behavior.
Lesch-Nyhan syndrome
genetic disorder characterized by inability to break down phenylalanine which results to ID, seizures and behavioral problems.
Phenylketonuria (PKU)
genetic disorder characterized by ID, seizures, and bumps on skin that resemble acnes.
Tuberous Sclerosis
a condition that can lead to severe learning disabilities.
❏Infections, malnutrition, and head injury
Fetal alcohol syndrome
❏Exposure to disease and/or substances (e.g., drugs, lead, mercury) while still on
the womb.
❏Difficulties in labor and delivery.
Biological influences
❏Men are more likely to have intellectual disabilities compared
to women.
- Sex-linked genetic factors and vulnerability to brain injury are
the possible reasons.
Sex Ratio of intellectual disability
Diagnosis is given for individuals OVER the age of 5 when the
person cannot participate properly in assessment.
unspecified intellectual disability
❏Diagnosis is given for individuals UNDER the age of 5 when the
person cannot participate properly in assessment.
Global developmental delay
❏Behavioral approach for problem behaviors
❏Constructive feedback
❏Social skills training
❏Administration of stimulants and norepinephrine-reuptake
inhibitors
Treatments of ADHD
❏Child abuse, neglect, frequent foster placements (very little
contribution to causes but can worsen the living)
❏Traits such as reduced behavioral inhibition, effortful
control, or constraint; negative emotionality; and/or
elevated novelty seeking may predispose some children to
ADHD.
Psychosocial influence of ADHD
❏Highly heritable
❏Dysfunction in dopamine, serotonin, GABA, and norepinephrine
❏Fetal exposure to certain drugs, especially tobacco
❏Low birth weight and prematurity
❏Slightly smaller brain volume
❏Artificial food coloring and additives increase hyperactivity
❏Pesticides found in foods
Biological influence of ADHD
❏Males have higher cases of ADHD compared to females.
❏Higher male prevalence might be due to higher tolerance to
female hyperactivity.
Sex ratio of ADHD
❏Symptoms do not meet the full criteria of ADHD and the
clinician specifies the reason.
❏Symptoms do not meet the full criteria of ADHD and the
clinician does not specify the reason.
Other specified ADHD
Unspecified ADHD
If criteria for hyperactivity-impulsivity is met but inattention is not met for the past 6 months.
Predominantly hyperactive/impulsive presentation (ADHD)
If criteria for inattention is met but hyperactivity-impulsivity is not met for the past 6 months.
Predominantly inattentive presentation (ADHD)
If criteria for both inattention and
hyperactivity-impulsivity are met for the past 6 months.
Combined presentation (ADHD)
❏There is clear evidence that the symptoms interfere with, or
reduce the quality of, social, academic, or occupational
functioning.
❏The symptoms do not occur exclusively during the course of
schizophrenia or another psychotic disorder and are not better
explained by another mental disorder
ADHD diagnostic criteria
❏Symptoms must be present ___ the age of ___
❏Several inattentive or hyperactive-impulsive symptoms are
present in ___ or more settings.
ADHD diagnostic criteria
Before
12
Two
❏runs about or climbs in situations where it is inappropriate (for adolescents above: restlessness)
❏unable to play or engage in leisure activities quietly
❏often “on the go,” acting as if “driven by a motor”
❏talks excessively
❏blurts out an answer before a question has been
completed
❏difficulty waiting his or her turn
❏interrupts or intrudes on others
Hyperactivity and impulsivity criteria of ADHD
❏fidgets with or taps hands or feet or squirms in seat
❏leaves seat in situations when remaining seated is
expected
Hyperactivity and impulsivity criteria of ADHD
___or more (at least 5 for 17
years old above) of the following symptoms have persisted
for at least ___ months to a degree that is inconsistent with
developmental level and that negatively impacts directly on
social and academic/occupational activities
Hyperactivity and impulsivity
Six
6
❏does not follow through on instructions and fails to finish
schoolwork, chores, or duties in the workplace
❏difficulty organizing tasks and activities
❏avoids, dislikes, or is reluctant to engage in tasks that
require sustained mental effort
❏loses things necessary for tasks or activities
❏easily distracted by extraneous stimuli (may include
unrelated thoughts for adolescents above)
❏forgetful in daily activities
Inattention criteria of ADHD
❏fails to give close attention to details or makes careless
mistakes
❏difficulty sustaining attention in tasks or play activities
❏does not seem to listen when spoken to directly
Inattention criteria of ADHD
Six or more (at least 5 for 17 years old above) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities
Inattention
❏Persistent pattern of inattention and/or hyperactivity-
impulsivity that interferes with functioning or development, as
characterized by inattention and/or hyperactivity.
Attention deficit/Hyperactivity disorder
❏Behavioral approaches to skill building and problem behaviors
❏Naturalistic teaching strategies
❏Pharmacological treatments (e.g., tranquilizers and SSRI).
Treatment of ASD
❏Historically proposed reasons are lack of self-awareness,
having cold and perfectionist parents.
Psychosocial influence of ASD
❏Low birth weight
❏Fetal exposure to valproate
❏Late parental age
❏Heredity
❏Low level of oxytocin
❏Large amygdala at childhood
Biological influence of ASD.
❏Approximately ___% of individuals with ASD have intellectual
disabilities
❏ASD has high occurrence for ___ compared to ___
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Males
Females
❏Adults with ASD especially without additional impairment can
suppress difficulties and repetitive behaviors in public.
❏Symptoms are typically recognized during the second year of
life (age 12–24 months)
Autism spectrum disorder
❏Symptoms must be present in the early developmental
period.
❏Symptoms cause clinically significant impairment in important
areas of current functioning.
❏Disturbances are not better explained by intellectual
developmental disorder (intellectual disability) or global
developmental delay.
ASD diagnostic criteria
❏Repetitive and restricted patterns of behavior, interest or
activities (at least 2):
➔Stereotyped or repetitive behavior. use of objects and
speech
➔Extreme rigidity and inflexibility.
➔Highly restrictive and fixated interests.
➔Hypo-, hypersensitivity or unusual interest to sensory
inputs.
ASD diagnostic criteria
❏Before are in separated diagnoses under pervasive developmental
disorders (i.e., autistic disorder, Asperger’s disorder, childhood
disintegrative disorder, Rett’s disorder, PDD-NOS)
ASD
❏Teaching skills to become productive and independent (via
task analysis).
❏Augmentative communication strategies for severe cases.
• Biological interventions are not possible
Treatment of intellectual disability
