PSYC330 Exam 3 Study Guide.docx

12 Pages

Course Code
PSYC 330
Andrea Chronis- Tuscano

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Child Maltreatment Child maltreatment often occurs w/in ongoing Child Victim Characteristics relationships that are assumed to be protective, Younger children more at risk for abuse/ neglect supportive, and nurturing Sexual abuse more common in children >12 - Abused children want to stop violence as long as - More common among poor/ disadvantaged belong to family - Children from single- parent homes w/ live in - Affection/ attention can coexist w/ abuse partner and large families at highest risk (confusing) - 80% sexual abuse victims are female (BUT boys - Intension of violence increases over time, but and girls victims of maltreatment almost equally) child is hopeful it will stop - -Boys more likely to be sexually abused by male HISTORY: children were viewed as property to parents, nonfamily members, Girls more likely to be by male child abuse only recognized as problem in early 1970s family members US Child Abuse Prevention and Treatment Act Perpetrators (CAPTA) - 80% victims are abused by parent but ~50% - Acts resulting in death, serious harm, sexual sexually abused by person other than parents abuse - Mother perpetrator of neglect 90% of time - Require people in contact with children to report known/ suspected cases of abuse - Males offendors in 90% sexual abuse, about half Prevalence- CPS states 3.5 million suspected cases of are child’s father - Most common perpetrator for child abuse (except abuse/ neglect in US each year SA) is female parent acting alone 90% • Relatively rare- 4-5 children per 10,000 • Non-autistic relatives of individuals with autism display higher than normal rates of social, • Prevalence is on the rise language, and cognitive deficits that are similar in • Occurs in all social classes and cultures quality to those found in autism, but less severe • 3-4 times more common in boys (but girls more Brain Abnormalities severely affected) • elevated rates of epilepsy & EEG abnormalities in Early Identification ~50% of individuals with autism suggest abnormal brain functioning Difficult to make a diagnosis before age 2 • involvement of multiple brain regions at both • Around 18 months cortical and subcortical levels – Joint attention • structural abnormalities in frontal lobe cortex, – Protodeclarative pointing cerebellum, medial temporal lobe, & related limbic system structures – Showing objects – Pretend play • decreased blood flow in frontal & temporal lobes • elevated blood serotonin in 1/3 of cases Asperger’s Disorder Associated Characteristics - difficulties in social interaction and unusual Intellectual Deficits and Strengths- about 80% of autistic children are mentally retarded w/ weakness in verbal IQ patterns of interest/ behavior - relatively intact cognitive and communication skills - About 25% have splinter skills and 5% have savant -  BUT higher verbal mental age, less language abilities delay, greater interest in social contact Sensory & Perceptual Impairments o More likely to affect boys - Oversensitivities/ undersensitivities - Stimulus overselectivity o Better long term outcome than for autism Cognitive Deficits: - Brain abnormalitie sin cerebellum and limbic system similar to those for autism, less severe Difficulty understanding social situations and impairments in ability to understand others and own mental state Rett’s Disorder- Severe neurological development - Deficit in executive fx disorder - Lack of drive for central coherence - Theory of Mind - Deceleration of head growth, hand skills, social engagement, coordinated movement Physical Characteristics: development of epilepsy in 20- - Severely impaired language development, 30% in late adolescence psychomotor retardation, develop stereotyped - Abnormally large head circumference in 25% hand movements Family Stress - raising an autistic child is stressful - A female disorder - parents may be socially ostracized by friends and - Poor long term prognosis strangers Accompanying Disorders & Symptoms - Childhood Disintegrative Disorder - most often associated with MR and epilepsy - Significant loss of previously acquired language, - other common co-occurring symptoms include social skills and adaptive behavior prior to age 10 hyperactivity, anxieties, mood problems, self- - Following period of apparently normal injurious behavior development DSM-IV Criteria for Autism DSM- 5 Criteria 1. Persistent deficits in social communication and social • Impairment in social interaction and communication interaction across multiple contexts • Restricted repetitive and stereotyped patterns of 2. Restricted, repetitive patterns of behavior, interests or behavior, interests, and activities activities • Delays or abnormal fxing in social interaction, - All one category now w/ severity and specifiers communication or symbolic/ imaginative play prior - Current severity based on critera 1 and 2 to age 3 Specifiers: Social Impairments: deficit in 1. Social imitations - w/ or w/o accompanying intellectual impairment or 2. Make believe play language impairment 3. Social expressiveness - associated w/ known medical or genetic condition or environmental factor 4. Processing of emotional information - associated w/ another neuro- developmental, 5. Joint social attention mental or behavior disorder 6. Ability to see others as social agents Communication deficits: - w/ catatonia 1. Use of protodeclarative or expressive gestures 2. Development of any useful language (~50%) 3. Use of qualitatively appropriate forms of communication 4. Understanding language pragmatics 5. Communicate emotion and engage in narrative discourse - Assessment/ Tx of Autism Spectrum Disorders Assessment Treatment Overview parent interview & observation - Parents have tried an average of 7-9 treatments, Child Assessment currently using btwn 4-6 different therapies - Autism Diagnostic Interview (ADI) - NO CURE - Autism Diagnostic Observation Scale (ADOS) Goals of Tx Intelligence Testing 1. Minimize core deficits Adaptive Behavior- to what extent are they able to do 2. Maximize child’s independence basic, daily activities (dressing yourself, brush teeth, feed yourself) 3. Help parents cope Identify autism as early as possible! Early intervention is VERY important Language developed by age 5 is positive outcome - Plasticity of neural treatment - Intensive, comprehensive, individualized tx is key o At least 25 hrs/ week for 12 months o Helps to generalize skills to other settings 5 Randomized controlled trials from 1998- 2006 - Some plasticity in early development in response to interventions Applied Behavioral Analysis Key Components of Effective Tx • ↓ harmful behaviors (head banging) 1. Early- as soon as the dx is seriously considered (before • ↑ self-help skills age 3) • ↑ compliance with simple commands 2. Intensive- at least 15 hrs per week (up to 40 hrs), 12 months • ↑ communication of needs 3. Low student- teacher ratio • ↑ appropriate play 4. High Structure- predictable routines, visual activity For Higher functioning children: schedules, clear physical boundaries to minimize - Language fluency distractions 5. Family inclusion w/ parent training - Age appropriate social interactions 6. Peer Interactions- opportunities for interactions w/ - Behaviors and skills expected in typical classroom typically developing peers 7. Generalization to new settings and situations Lovaas Method 8. Ongoing assessment to monitor progress and adjust tx - Intensive behavioral tx for children <46 months if needed - Based on principles of reinforcement + shaping - 40 hrs 1:1 tx weekly for up to 6 yrs Applied Behavioral Analysis (Sallows and Graupner - Parents trained extensively 2005) 47% recovery rate for tx group compared to 2% of control - replication of Lovaas tx w/ additional modifications - 2-3 groups: clinic directed and parent directed group (educational placement - provided evidence for lack of spontaneous - 23 children age 35-37 months old recovery in control groups No group differences but almost 50% of children had 1. Discrete Trial Learning- presenting a stimulus and normal IQ range at 3-4 yrs after Tx requiring a specific response to be rewarded - Poor outcomes associated w/ initial low IQ (<44), - given instruction to say something, and if perform lack of language (no words at 36 months) response then get verbal/ tangible reinforcement - Best outcomes associated w/ rapid acquisition of 2. Incidental (Pivotal Response) Training- capitalizes on new skills and change in IQ after 1 yr of tx naturally occurring opportunities - child wants juice, make them say juice before giving it to them Current Directions in Neuroscience Research  Autism 1. Autism is heterogenous Baby Sibs Approach- study infants at high risk to be autistic  Behaviorally- severly mentally retarded to  Risk greater in infants w/ autistic sibling (general intelligent 1/88 risk, w/ autism in family 1/20)  Genetically- highly heritable, polygenic disorder  Longitudinal study assesses early markers and o No clear gene that causes autism identifies critical social behaviors early  Neurologically- between- subject differences are Joint Attention critical for social/ linguistic learning [left large posterior superior temporal sulcus involved in JA) 2. Autism is characterized by enhanced + impaired abilities  Two people coordinating attention on same object  Emphasis on deficits in social and language  IJA- initiating joint attention domains  RJA – responding to joint attention  But also enhances perceptual processing  Normally emerges in age 2, but autism have 3. Autism is a developmental disorder difficulty  Autism emerges early  Examine precursors as early as 4m- gaze following  Early warning signs: failure to orient to name, less eye contact, less looking at objects held by others, lack of sharing, lack of coordination of gaze/ facial Gaze following hypotheses- comparison of time to looka t expression, repetitive movements, difficulty keys in in/ congruent gaze cue condition provides index of calming when distress attention orienting  Atypical patterns of brain development seen early - Predict that infants at risk will be less likely to (brain size differences maximal in first few years) follow gaze (no diff in reaction time to get keys for in/ congruent conditions) o brain growth in autism is too fast too early and typical child undergoes protracted Brain overgrowth- protracted period of refining brain growth connections squished into short time window 4. Brain in autism is noisier - Lose experience dependent pruning and noisy brain w/ non optimal connections  brain regions typically selective for social processing but autistic people show less - Functions require integration among multiple brain selectivity to social conditions in certain brain systems suffer the most regions  Frontal cortex- social/ executive fx/ language  selective- shows strong response to one condition (social condition) and weak response to control  Temporal cortex- social and language condition  Cerebellum- attention  Amygdala- social, emotion, novelty 5. Can vs Do o Amygdala volume changes by age  real world impairment sin social interaction  implicit (passive) studies reveal differences in social brain areas Future Directions - Early ages and developmental change o explicit studies often do not - Connectivity between regions  salient in social domains (face perception, self- reflection, irony comprehension, theory of mind) - More naturalistic experiments Explicit- where will Sally look? Asp and Con give correct - Effect of treatments on neural processing answer on where she thinks it is - Links between genes, brain and behavior Implicit- spontaneous looking differs  engaging in social cognition is automatic for normals  spontaneous engagement is widely absent in ASD  explicit social cognition can be elicited  appropriate brain regions supporting these fx are recruited
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