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Developmental Disorders Lecture and textbook notes (chapter 14) detailing developmental disorders such as attention deficit hyperactivity disorder, learning disorders, pervasive developmental disorders, mental retardation and prevention methods.

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Uzma Rehman

Developmental Disorders March-24-11 2:31 PM Disorders revealed in a clinically significant way during a child's developing years and are a concern to families and the educational system Difficulties often persist into adulthood and are typically lifelong Overview Developmental psychopathology o Study of how disorders arise and change with time o Childhood is associated with significant developmental changes o Disruption of early skills will likely disrupt development of later skills Developmental Disorders o Diagnosed first in infancy, childhood or adolescence o Tend to be more severe o Attention deficit hyperactivity disorder, autism, learning disorders, mental retardation o Autism spectrum includes low levels of autism, extreme levels of autism, Asperger's o Symptoms of ADHD: impulsive disorganised behaviour, restlessness, average intelligence. Video: fidgety, talking, can't pay attention, repetitive Perspectives Brain changes significantly for several years after birth, time when critical developments occur in social, emotional, cognitive and other important competency areas Child develops one skill before acquiring the next. Any disruption in the development of early skills will disrupt the development of later skills o Ex. Believed that those with autism suffer from disruption in early social development Absence of early and meaningful social relationships has serious consequences; may have difficulty learning to communicate Knowing what processes are disrupted will help to understand the disorder better, may lead to more appropriate intervention strategies Echolalia: involves repeating the speech of others. Once thought to be a sign of autism, but is actually an intermediate step in language development Attention Deficit Hyperactivity Disorder March-24-11 2:57 PM Attention deficit hyperactivity disorder (ADHD): developmental disorder featuring maladaptive levels of inattention, excessive activity and impulsiveness One of the most common reasons children are referred to mental health professionals Clinical Description Difficulty sustaining attention May display motor hyperactivity ADHD symptoms clustering into two categories o Lack of attention o Hyperactive and impulsive behaviour Either cluster 1 or 2 must be present for a diagnosis Inattention, hyperactivity and impulsivity often cause secondary problems: academic performance tends to suffer, increased risk for minor injuries Symptoms get in the way of establishing and maintaining friendships Problems with peers combined with frequent negative feedback from parents and teachers often results in low self esteem. Nature of ADHD o Central features - inattention, over activity, and impulsivity o Associated with behavioural, cognitive, social and academic problems Symptoms show up in more than one place; home and school Symptoms more severe in an unorganised home Statistics 6% of school aged children Some ADHD symptoms can be present before the age of 7 Gender differences in ADHD is 4:1 for males o Unsure of why we get the gender difference o Possible that symptoms don't show up as severely or manifests differently 68% of children with ADHD have ongoing difficulties in adulthood Less impulsive over time, but inattention persists Adults with ADHD more likely to have driving accidents More likely to receive label of ADHD in North America compared to anywhere else o Concerns about over diagnosis, efforts to develop more objective measures Frequently comorbid with other disruptive disorders: oppositional defiant disorder and conduct disorder Risk factor for antisocial behaviour in boys but not girls Also frequently comorbid with learning disorders Causes More common in families in which one person has the disorder Some shared genetic deficits may contribute to the problem More than one gene probably responsible Most attention so far has focused on genes associated with dopamine; serotonin also implicated Strong evidence that ADHD is associated with dopamine D4 receptor gene, the transporter gene, and the D5 receptor gene o Serotonin genes also important risk factors - not surprising, serotonin contributes to regulation of dopamine transmission in the brain No major brain damage found in those with ADHD, but there are subtle differences o Overall size of the brain is smaller in children with ADHD; the frontal cortex, the basal ganglia, and the cerebellar vermis are all smaller o Smaller volume occurs early in development, meaning general progressive damage is not occurring o Inactivity of the right frontal cortex (implicated in organisation, inhibition) and basal ganglia o Right hemisphere malfunction o Abnormal frontal lobe development and functioning Little evidence supports accusations of diet being implicated Mothers who smoke during pregnancy are up to three times more likely to have a child with ADHD. Not clear if it's the toxic effect of smoking or an associated process Negative responses by parents, teachers and peers contribute to feelings of low self esteem Treatment Biological and psychological interventions Goal of biological treatments is to reduce impulsivity and hyperactivity and improve attention o Stimulant medication (methylphenidate , D-amphetamine, pemoline) reduces core symptoms of ADHD in 70% of cases o Cyclert greater likelihood of negative side effects o Certain antidepressants may have similar effects o Drugs seem to improve compliance and reduce negative behaviour, but no improvement in learning or academic performance o Stimulants reinforce brain's ability to focus o Concern for potential abuse, over prescription and long term effects which are not well understood o Behavioural programs implemented to help with academics o Controversy around prescribing stimulants to children o Beneficial effects are not long lasting following drug discontinuation Multimodal Treatment of Attention Deficit Hyperactivity Disorder o
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