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Lecture 10

PS280-Z Lecture 10 – Thursday August 8th, 2013.docx

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Kathy Foxall

PS280-Z Lecture 10 – Thursday August 8 , 2013h Developmental Disorders Intellectual Developmental Disorder/Intellectual Disability - Criteria o 3 conditions  IQ below 75 (change from DSM-IV)  AND impaired adaptive functioning  AND onset of condition before age 18 Classification of Intellectual Disability (lots of overlap) - Mild (IQ 55-75) o 85% in thisthategory o Obtain 6 grade level academic skills by age 18 or so - Moderate (IQ 35-55) o Often have physical handicaps, difficulty in coordination, etc. o Would not be able to live in unsupervised setting - Severe (IQ 20-40) o Most have physical and sensory handicaps o Very little independent activity o Decreased lifespan - Profound (IQ below 25) o Total supervision and total or near total personal care o Sensory & physical handicaps  Prone to pneumonia o Decreased lifespan Adaptive Behaviour is considered in 4 Domains - Communication o Expressive, receptive, written language - Daily living or personal living skills o Eating, dressing, hygiene - Social interaction skills o Interpersonal skills, coping, leisure skills - Motor skills o Movement, coordination, ability to manipulation objects Etiology of Developmental Disability - Genetic - Brain injuries before age 18 - Toxins - Infections - Environmental factors - Interactions of causes Genetic Causes - Down syndrome & trisomy 21 rd o 3 chromosome or part of a chromosome o Usually occurs during egg or sperm division  Fathers over the age of 40 o 1/350 with mother ages 35-39 o 1/100 mothers 40+ - Fragile X o Range of cognitive difficulties o Different physical appearance Testing for Genetic Disorders - Prenatal Genetic Diagnosis before fertilization in IVF - MSS (maternal serum screening) weeks 15-20 detects alpha feto-protein (AFP) & hormones from the placenta … assesses risk of Down syndrome & spina bifida - Nuchal translucency (NT) at 10-14 weeks o Uses ultrasound to measure amount of fluid at the back of the fetus’s neck - Amniocentesis week 11-18 o Highly accurate (99.4%), but .5% risk of infections and miscarriage - Chorionic villus sampling (CVS) weeks 10-12 o Takes cells from the placenta PKU - Recessive genetic disorder - 1/70 may be carriers - 2 parents need to be carriers for this to be a possibility - 1/14,000 births - Liver enzyme deficiency o Unable to metabolize amino acid phenylalanine o Build of neurotoxin o Interferes with development of myelin sheath - Some recommend staying on diet throughout lifespan o Also recommend that known carriers go on special diet in pregnancy Infectious Diseases in Utero - Infectious diseases in utero o HIV, rubella (German measles), herpes, CMV (cytomegalovirus), toxoplasmosis, syphilis, HIV o testing to determine immunity to rubella more than 6 months before getting pregnant - Infectious diseases after birth o encephalitis, meningitis, Reye’s syndrome FASD/FAS/FAE/ARBD (alcohol related birth defects) - In Seattle, 9.1/1000 births - Binge drinking (5 or more drinks) is especially problematic in pregnancy Institutionalization and Neglect Infectious Diseases after Birth - Encephalitis o An infection of the brain - Meningitis o Infection of the lining of the brain - Reye’s syndrome o A disorder caused by an intereaction o When a child has a virus (such as chicken pox) and is given an aspirin  The interaction of the virus and the aspirin leads to brain damage and organ failure (in many cases) and sometimes death Malnutrition - Severe malnutrition damages CNS; fewer brain cells, 35% lower brain weight - Also associated with schizophrenia and other mental disorders - 3 variable, which is poverty and less adequate medical care Autism and other Developmental Disorders - Disorders that have profound implications - First diagnosed in childhood, continue to affect in adult years - Affect functioning in all areas - cognitive, social, language - Includes autism, Asperger's disorder, Rett's disorder, childhood disintegrative disorder, & pervasive developmental disorder NOS) Prevalence of Autism - 1-3/1000 births in Canada - Other estimates of 1/150/births - Changes in criteria, greater awareness - 3-4 x more in males than in females at higher IQ levels Autism - From Greek autos (self), aloneness - About 25% normal intelligence - Savantism in some with below average intelligence - Girls more likely to have severe intellectual disability - About 50% non-verbal - Usually symptoms within first year of life, but not always possible to diagnose until age 2, onset by 3 years - About 1/3 some degree of partial independence in adulthood - What are these children like? o Children are aware of people, but do not seem to see them as any different from inanimate objects o Communication very limited in many o Usually do not want to be touched or held o Restricted activities - do not play like typical children; repetitive movements, self stimulation, rocking, flailing hands, etc. - Very upset about changes in routine; e.g., extremely upset over changes in furnishings in house, or in Rainman, dinner menu, etc. - May engage in self-harm, head banging, hand biting - May be lack of fear of real dangers, excessive fear of harmless objects - They do have emotions, e.g. they get upset, cry, smile, but they do not need validation or confirmation from adults in the same way as normal children Attention, Perception, and Cognition - Odd responses to sensory stimuli, such as high pain threshold, over-sensitivity to pain, being touched, light, odours - Problems with attention – focusing attention, maintaining attention - Yet may over-focus on some things o e.g. may be fascinated with movement, e.g. fans, opening and closing of doors, spinning movements of wheels - Engage in repetitive, sustained odd play Communication - 50% do not develo
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