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Lecture 10

Psy 345-lecture 10.doc

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Department
Psychology
Course
PSY345H5
Professor
Stuart Kamenetsky
Semester
Fall

Description
Psy 345 Lecture 10 Autism Acquired Brain injury continued -brain injuries caused by stroke or aneurysm can be due to the type of lifestyle a person lives. People who live unhealthy lifestyles may be more prone to these types of brain injuries -It is not always possible due to the extent of brain injury for a person to resume their life prior to the injury -There are various living options available for people after a brain injury -Difficulties -self concept-adjusting goals and expectations of oneself to reduced abilities (career, family etc...). A person who has a PhD in psychology and lectures at a university may not be able to do so if they sustain a brain injury. Rationality-people become less rational after a brain injury. This can be due to pain or frustration or the fact that they have cognitive deficits as a result of their injury. -Frontal brain injury often results in lack of impulse control. There are times when you will see a man who can’t control his sexual urges. Damage to the frontal lobe affects the personality -Dynamic of care and control in group homes. A 50 year old man who is forced to live in a group home against his wishes, can have a very difficult time understanding. Furthermore, the man has young adults telling him what to do (get up, get dressed, eat, shower etc...). People with brain injuries lose the ability to follow a clear pattern of what to do. People lives are micro managed and it becomes very hard. -Result- often what we see is severe behavioral problems. Usually when a person gets out of hand they are restrained or the police are called. -Intervention -Combination of medication and applied behavioral analysis (focus on ABCs of behaviour-antecedents, behavior and consequences). We are not looking for a cure we are looking to ease the symptoms. People usually require some type of medication to bring them down and help control depression, anxiety and aggression. These medications help to bring the person under control but can give them flat affect. Behavior modification is used to change the behavior. Rewards and punishments are used to encourage or discourage certain behavior (old model). In applied behaviour analysis you start off by collecting data on the antecedents of the behaviour. This looks at what happened prior to the behaviour occurring. If we can pinpoint the antecedents then we don’t need to focus on the consequences (problem with consequences and rewards and punishments is that the person may come satiated and they will not work). A person will follow a person around to see what antecedents occurred prior to their explosive behaviour and write it down. The goal is to remove the antecedents to stop the behaviour. They are also looking at the consequences to understand what is keeping the behaviour going. There is less focus on us providing consequences through rewards and punishments. This approach is much more long lasting. -Compared to other methods, ABA is quite successful, but critics claim that it is based upon bribery and intimidation. -Alternative options: Sedation in psychiatric wards of hospitals and institutions Video -Ashley -born like any other normal child -18 months old she was in a car accident -she was in the hospital for 24 days, then into rehab for 4 months. -she had 2 internal and external shunts to relieve the pressure from the fluid in her head -she goes to physical and speech therapy 2 times a week. They focus on gross motor skills to help her to learn to crawl and eventually walk. She works on visual attention, verbalization and protective extension of arms. She doesn’t eat well so they are working on that. The blind institute comes to the house. -her mother tries to take her out in the community for her benefit -she is in a wheelchair -Matt -at 4 years old he crossed the street and was hit by a car -he is in school in kindergarten, and after he will go to a special ed class. -He walks with a walker and wears a helmet -the skills that are focused on are speech and fine motor skills so he can use a pencil again, counting, alphabet. He receives speech therapy 2 times a week, once in a group and once individually. He speaks in sentences but it is not always understandable. -He is progressing and the hope is eventually he will be able to go back into the regular classroom. -Dan -dan’s friend Joey shot him in the head with his dad’s gun -dan had to relearn everything all over again. He had to learn to walk, talk, eat, go to the bathroom, speak etc... -he is currently in high school -he works well with his hands in shop and auto class -he meets with a tracker to track him throughout the school day. -his mother has been a good advocate for Dan in regards to his school and therapy Autism -autism is from the greek word auto which refers to the self. It relates to external aloneness and detachment from society. It results in various degrees of limitations. These include language, interpersonal skills, emotion and affective behaviour and intellectual functioning. This is a spectrum disorder so some individuals have high functioning and intellect and low functioning and intellect. -there is somewhat of an autism culture. Some people believe that normal behaviour has no meaning and there is no need to be fixed. -definition of IDEA, 1992-a developmental disability significantly affecting verbal and nonverbal communication(eye contact, how close we stand to each other) and social interaction, generally evident before age 3, that adversely affects a child’s performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. The term does not apply if a child’s educational performance is adversely affected primarily because the child has a serious emotional disturbance (being abused, learned helplessness where they don’t trust people). If there is a good environmental explanation for these consequences then it is not autism. Not every child with autism will have all of these points mentioned -Prevalence: 4-14 out of 10,000. The exact number is never clear due to variance in diagnostic criteria and definition. Autism is on the increase. Environmentalist say that due to the environment becoming more toxic we have more children with autism. The evidence however is not all that clear. In the 70s they got rid of leaded gas and harmful gases. We have got better over the years with these things but
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