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3Chapter 14 Textbook Notes - Developmental Disorders

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PSYC 235
Christopher Bowie

Chapter 14 Developmental Disorders In this chapter we cover those disorders that are revealed in a clinically significant way during a childs developing years and that are of concern to families and educational systems. For the most part: A child develops one skill before acquiring the next. This pattern of change implies that any disruptions in the development of early skills will, by the very nature of this sequential process, disrupt the development of latter skills. Knowing what processes are disrupted will help us understand the disorder better and may lead to more appropriate intervention strategies. - Attention Deficit/hyperactivity Disorder (ADHD) - Involves characteristics of inattention or hyperactivity and impulsivity, and learning disorders, which are characterized by one or more difficulties in areas such as reading and writing. - Autism A more severe disability, in which a child shows significant impairment in social interactions and communication and restricted patterns of behaviour, interest, and activities. - Mental Retardation - Involves significant deficits in cognitive abilities ATTENTION DEFICIT/HYPERACTIVITY DISORDER CLINICAL DESCRIPTION - Primary characteristics of people include a pattern of inattention, such as not paying attention to school or work-related tasks, or of hyperactivity and impulsivity. Many have a great deal of difficulty sustaining their attention on a task or activity. Some also display motor hyperactivity, as well as impulsivity (acting without thinking shouting out responses to questions before the prof is done) - DSM differentiates two types of symptoms (one of them must be present to be diagnosed with ADHD) o Problems of inattention Appear not to listen to others They may lose necessary assignments or books May not pay attention to details, making careless mistakes o Hyperactivity Fidgeting Having trouble sitting for any length of time Always being on the go Impulsivity (blurting out answers before questions have been completed/ waiting turns) - Academic performance tends to suffer and they engage in more frequent dangers & risky behaviours. Children with ADHD are also likely to be unpopular and rejected by their peers, mostly because inattention, hyperactivity and impulsivity get in the way of establishing & maintaining friendships. Thus, creating low self-esteem. Statistics - Some ADHD symptoms should be present in childhood, before 7. They are identified as being different from their peers around 3 or 4; their parents describe them as very active, mischievous, slow to toilet train, and oppositional. - 68% of children with ADHD have ongoing difficulties through adulthood (Less impulsive, but driving difficulties due to inattention, speeding, or license suspended) - Frequently comorbid with other disruptive behaviour disorders (Ex. ODD & conduct disorder) Chapter 14 Developmental Disorders CAUSES Genetics - ADHD is common in families in which one person has the disorder. Families display an increase in psychopathology in general, including conduct disorder, mood & anxiety disorders, and substance abuse. - Most attention is focused on genes associated with the neurochemical dopamine (and also serotonin). Evidence shows ADAD is associated with the dopamine D4 receptor gene (the dopamine transporter gene) and the dopamine D5 receptor gene. - The overall size (volume) of the brain is smaller in children with ADHD, including smaller areas of the frontal cortex, the basal ganglia and the cerebellar vermis (part of the back of the cerebellum). ADHD is associated with maternal smoking. 3 times more likely to have a child with ADHD. Negative response by parents or peers to the childs impulsivity and hyperactivity may contribute to low self-esteem. TREATMENTS Biological and Psychosocial Interventions - The goal of biological treatments is to reduce the childrens impulsivity and hyperactivity and to improve their attention skills. Psychosocial treatments focus on broader issues such as improving academic performance, decreasing disruptive behaviour, and improving social skills. Psychostimulants include: Methylphenidate (Ritalin, Concerta), D-amphetamine & pemoline (works 70%) - Stimulant medications appear to reinforce brains ability to focus attention during problem-solving tasks Two main concerns regarding the use of stimulant medication: Potential stimulant drug abuse Methylphenidate are sometimes abused for their ability to create elation and reduce fatigue. Medications may be overprescribed & long-term effects not well understood Over-prescription effects might include insomnia, irritability and appetite suppression - Most children who dont respond to medications do not show gains in the important areas of academic and social skills. The programs set such goals as increasing the amount of time the child remains seated, increasing the number of math papers completed, or engaging in appropriate play with peers. Reinforcement programs reward the children. LEARNING DISORDERS Reading Disorder A significant discrepancy between a persons reading achievement and what would be expected for someone of the same age (Ex. Dyslexia). It is required that the person read at a level significantly below that of a typical person of the same age, cognitive ability (IQ test) and educational background. Mathematics Disorder achievement below expected performance in mathematics Disorder of written Expression achievement below expected performance in writing Interfere with the students academic achievement and disrupts their daily activitiesChapter 14 Developmental Disorders CAUSES - Learning disability is one of the two most common disabilities suffered by children up to 14 years of age. Biological Cause (genetic basis) Parents and siblings of people with reading disorders are more likely to display these disorders. Chromosomes 2, 3, 6, 15 and 18 seem to be linked. - Psychological and motivational factors that have been reinforced by others seem to play an important role in the eventual outcome for those with learning disorders. People with learning disabilities display very different types of cognitive problems and therefore probably represent a number of etiological subgroups. TREATMENT - Two common methods of assessing learning disorders is through two types of tests: Intellectual tests (Ex. Wechsler intelligence Scales) Achievement tests and comparing the results of both. - Biological treatment is typically restricted to those individuals who may also have ADHD, which we have seen involves impulsivity and an inability to sustain attention, and which can be helped with certain stimulant medications such as methylphenidate (Ritalin). - Educational efforts can be categorized into: 1) Basic processing of problems (ex. by teaching students visual & auditory perception skills 2) Improve cognitive skills through general instruction in listening, comprehension and memory 3) Targeting behavioural skills needed to compensate for specific problems that student may have Communication and Related Disorders STUTTER
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