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Chapter 7

PSYC 3505 Chapter Notes - Chapter 7: Brain Injury, Teratology, Putamen


Department
Psychology
Course Code
PSYC 3505
Professor
Monique Senechal
Chapter
7

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Ch.7 Learners with Attention Deficit Hyperactivity Disorder Pg. 169-197 PSYC 3505
* Key Terms are highlighted and defined at the end of notes*
Definition- “characterized by a pattern of behaviour, present in multiple settings (eg. school and home) that can result in performance
issues in social, education or work setting. As in DSM-IV, symptoms will be divided into 2 categories of inattention and hyperactivity
and impulsivity that include behaviours like: failure to pay close attention to details, difficulty organizing tasks and activities,
excessive talking, or an inability to remain seated in appropriate situations.” (DSM5 official definition
http://www.dsm5.org/documents/adhd%20fact%20sheet.pdf)
There are three subgroups of ADHD:
1) ADHD Predominately Inattentive Type
2) ADHD Predominately Hyperactive Type
3) ADHD Combined Type
- Diagnostic table is located on page 173 Table 7.1
History of ADHD-
- Dr. George F. Still was one of the pioneering forces in bringing the condition of ADHD to the attention of the medical community in
1902. He was a physician from London who observed cases of children who displayed behaviour such as: -spitefulness
-cruelty
-disobedience
-impulsivity
-problems with attention/hyperactivity
- Still’s views on ADHD still coincide with some of today’s beliefs as well as those of Barkley who proposed the theory of ADHD
being a deficit involving behavioural inhibition
- Five of these beliefs are:
1. Still speculated that many of these children had mild brain pathology
2. Many of the children hand normal intelligence
3. The condition was more prevalent in males than females
4. There was evidence that the condition had a hereditary basis
5. Many of these children and their relatives also had other physical problems such as depression and tics
- Still didn’t refer to ADHD as such (the name came later) but referred to individuals having ‘defective moral control’, today this
would be referred to a conduct disorder
- Kurt Goldstein observed soldiers after World War I who had suffered major head injuries among other symptoms, Goldstein noticed
that patients showed disorganized behavior, hyperactivity and perseveration
- Perseveration is one of the behaviours now used today to characterize individuals with ADHD
- The Strauss Syndrome- Alfred Strauss and Heinz Werner (1930-1940) teamed up to try to replicate Goldstein’s findings and
observed that children hyperactivity and distractibility were behaviours that some children with intellectual disabilities
- Strauss & Werner devised an experimental task using background /figure slides (eg. figure=hat, background= wavy lines)
- Findings: children with supposed brain injuries were more likely to report the background slide vs. normal children who
reported the figure
Cruickshank’s Work-
- William Cruickshank used Strauss and Werners background/figure test and found that children with cerebral palsy were more likely
to respond to the background vs. figure
- these findings extended on Strauss & Werners work in two ways:
1) all of Cruickshank’s subjects had cerebral palsy which affects the brain, but only in terms of motor control whereas Strauss
& Werners patients were intellectually impaired.
2) children who were studied were largely of normal intelligence
- these findings demonstrated that children without intellectual disabilities could also show signs of hyperactivity and distractibility
- Minimal Brain injury & Hyperactive Child Syndrome

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- after birth complications renewed Still’s suggestion that subtle brain pathology could result in behaviour problems eg. hyperactivity
and distractibility
- ‘minimal brain injury’ was the label that professional began to give children who were of normal intelligence but who were
inattentive, impulsive and hyperactive
- the ‘minimal brain injury label’ evolved to be the ‘hyperactive child syndrome’ because it was descriptive of behaviour that did not
rely on vague and unreliable diagnosis of subtle brain damage
- Eventually ADHD came to be after revision
Controversial Causes of ADHD-
- it has been suggested that an overload of sugar in things such as candies and soft drinks lead to hyperactivity and ADHD- may lead
to hyperactive behaviour but no direct link to ADHD
- watching too much tv leads to hyperactivity/inattention and supposedly ADHD, no direct link found
- foods that contain artificial dies and coloring, not direct link found
Prevalence-
- one of the most frequent reasons that kids are referred to guidance services due to behavioural problems
- 1/3 to ½ of cases that are referred to guidance clinics are for ADHD
- 3-5% of school aged kids have ADHD
- more frequent in boys, 5:1 ratio
- argued that it is more frequent in boys because they display a more hyperactive kind of ADHD vs. girls who are argued to be
underdiagnosed, it is suggested though that girls may have a more inattentive way of showing signs and this is why they may not be
detected as much as boys
- some critics have suggested that ADHD is a result of the pressures of achievement and conformity, but this theory does not hold true
Assessment-
There are 4 important components to a diagnosis:
1. medical exam- to rule out other medical causes eg. tumors, thyroid problems etc.
2. clinical interview- includes parents and child and is about learning the child’s physical and psychological state….it is important to
keep in mind that this is subjective and the child might not seem to show signs of ADHD due to it’s unfamiliar surroundings
3. teacher and parent (sometime child) rating scales- most popular are the Conners Scale and the ADHD Rating Scale IV, scale are
based on DSM5 criteria which are a list of 18 (eg. fails to pay close attention to details and makes careless mistakes in his/her own
work: 1) sometimes 2) often 3)very often etc.)
4. behavioural observations- clinician will try to naturally or structurally observe the child in a classroom or a lab, sometimes giving
them tasks such as the CPT Continuous Performance Test
Causes-
- difficult to pinpoint exact causes, not as easy as taking a bloodtest to reach a diagnosis
- there is strong evidence linking neurological abnormalities to ADHD, with the use of brain imaging, ADHD most likely stems from
neurological dysfunction rather than actual brain damage
- heredity can also play a huge role
- teratogenic and other medical influences play a lower role
- through imaging techniques 3 areas of the brain that were shown to be linked to ADHD were:
1) the frontal lobes: located at the front of the brain the frontal lobe or at the very front the pre-frontal lobes are responsible
for executive functioning eg: regulating one’s own behaviour
2) basal ganglia (specifically the caudate and the globus pallidus): responsible for the coordination and control of motor
behaviour
3) cerebellum: also responsible for control of motor behaviour
- Neurotransmitters dopamine and norepinephrine are also shown to play a role in ADHD
Heredity Factors- important ways to identify if and how heredity plays a role in ADHD:
- Family Studies: show that if a child has ADHD his/her sibling is 32% likely to also have it, children of adults with ADHD
are 57% likely
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