Abnormal Psych- Ch. 14 Notes PDF

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Chapter 14: Neurodevelopmental Disorder Notes● Overview of Neurodevelopmental Disorders ○ These disorders change over time ○ Usually originate in childhood but can persist over time ○ Are of concern to educators and families ○ What is Normal? What is Abnormal? ■ Development is about gaining one skil...

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Chapter 14: Neurodevelopmental Disorder Notes ● Overview of Neurodevelopmental Disorders ○ These disorders change over time ○ Usually originate in childhood but can persist over time ○ Are of concern to educators and families ○ What is Normal? What is Abnormal? ■ Development is about gaining one skill after another ■ Children often develop social skills and want to interact with others ■ **Table to common communication and motor disorders page 522** ● Attention-Deficit/Hyperactivity Disorder ○ Attention-deficit/hyperactivity Disorder (ADHD): primary characteristics include a pattern of inattention, such as being disorganized or forgetful about school or work related tasks, or hyperactivity and impulsivity ○ One of the most common reasons children are referred for mental health services in the United States ○ This can disrupt academics and social relations ■ Clinical Description ● Has a difficulty keeping their attention on an activity or task ● Their tasks are unfinished and they may seem to be not listening ● Motor hyperactivity ○ Fidgety ● Impulsivity ● Two categories of symptoms- one must be present to be diagnosed ○ Inattention ○ Hyperactivity and impulsivity ● Academic performance often suffers ■ Statistics ● 5.2% of all children ● Children who are more active may be misdiagnosed ● May be a western idea ○ May just be a part of development ● Symptoms of adhd in girls and boys may be different ● Children with adhd are usually noticed between the ages of 3 and 4 ● Many other disorders overlap with this disorder ■ Causes ● Common in families where one person has the disorder ○ Also higher risk of conduct disorder, mood disorder, anxiety disorders, and substance abuse

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● Environmental influence plays a small role ● Multiple genes are responsible ● Copy number variants: mutations occur that either create extra copies of a gene on one chromosome or result in the deletion of genes ○ Results in disrupted development ○ Gene associated with dopamine D receptor gene ● Environment- if mother smoked during pregnancy children with a mutation involving the dopamine system was more likely to be shown ○ More prenatal conditions may affect ● Brian volume is slightly smaller (3%-4%) ○ Areas of the brain that deal with self organization are affected ● Allergens and food additives may play a role- this is controversial ● Negative responses to child’s behavior- low self esteem Treatment of ADHD ● Psychosocial interventions- focus on broader issues such as improving academic performance, decreasing disruptive behavior, and improving social skills ● Biological treatment- reduce impulsivity and hyperactivity and improve attention skills Psychological Interventions ● Behavioral interventions to help children at home and school ● Reinforcement programs reward child for improvements ● Parent education programs- teach parents how to deal with the behavior ● Social skills- training children to interact appropriately with peers ● Cognitive-behavioral intervention- used for adults with ADHD ○ Reduce distractibility and improve organizational skills ○ Want results to be short term and long term Biological Interventions ● Stimulants- 1st type of medication used for ADHD ○ Should be used temporarily with psychosocial interventions ● Methylphenidate and non stimulants have also been used ● Genetic screening may be used to identify problems ● May not help everyone and may cause side effects such as insomnia, drowsiness, or irritability Combined Approach to Treatment

● Medication was more helpful than treatment alone of community involvement ● There is controversy over whether behavioral interventions combined with medication is better than medication alone ● Behavioral interventions do have added benefits that medication can not do ● This is always a challenge for their families and education systems ● Specific Learning Disorder ○ Specific learning disorder: characterized by performance that is substantially below what would be expected based on their age, intelligence quotient (IQ) score ■ Clinical Description ● A significant discrepancy between a person’s academic achievement and what would be expected for someone that age ● Disorders of reading, written expression, or mathematics ● 2 standard deviations below the average IQ ■ Statistics ● 5% to 15% across youth ○ Reading difficulties being most common (7% of general population) ● Diagnosis increases in wealthier regions of the US ● Blacks were reported to have more learning disabilities than whites ● Students with learning disorders are more likely to drop out of school, more likely to be unemployed, and more likely to have suicidal thoughts ○ These can be mitigated with good relationships with trusting adults and programs in postsecondary and employment settings ● Communication disorders are closely related ○ Presence in early life can lead to wide ranging problems later in life ● Childhood-onset fluency disorder: also known as stuttering ● Language disorder: combines expressive and mixed receptive-expressive language disorder ■ Causes ● Genetic, neurobiological, and environmental factors are responsible ● Genetic studies- Learning disorders run in families ○ There are not specific genes responsible for reading, math, or writing disorders

○ There are genes that affect learning though ○ Problems with work identification can be seen in genes ○ Other problems develop through environmental influences (such as at home reading) ● There seems to be structural and functional differences in the brains of those with a learning disorder ○ Left hemisphere- Broca’s area, left parietotemporal area, and left occipitotemporal area ○ Imtrapariental sulcus is critical for the development of math skills ○ No specific areas known to affect writing disorders ● Disorders of reading are more diagnosed in english speaking countries- the english language may be more difficult to read ○ All people with reading disorders tend to have less activity in the left temporal lobe ● Psychological and motivational factors play a big role in the outcome ● Other factors- socioeconomic status, cultural expectancies, parental interactions and expectations, and child management practices ■ Treatment of Learning Disorders ● Educational intervention ○ Specific skills instruction ○ Strategy instruction ● Direct Instruction ○ Teaching students in small groups and teaching until mastery ● For reading disabilities- auditory and language processing skills ● Behavioral interventions- can change the way the brain works ● Drug (biological) treatment is usually limited ● Autism Spectrum Disorder ○ Autism Spectrum Disorder: a neurodevelopmental disorder that affects how one perceives and socializes with others ■ Includes pervasive developmental disorders (autistic disorder, Asperger’s disorder, and childhood disintegrative disorder) ■ Rett disorder: a genetic condition that affects mostly females and is characterized by hand wringing and poor coordination ● MeCP2 mutation

■ Social (pragmatic) communication disorder- the difficulty in social communication as seen in ASD, but without restricted, repetitive patterns of behavior ■ Clinical Description ● There are 2 major characteristics ○ Impairments in social communication and social interactions ○ Restricted, repetitive patterns of behavior, interests, or activities ● Impairments are present in early childhood ● Could affect daily living ● There are 3 levels of severity for both of the main characteristics ○ Level 1- requiring support ○ Level 2- requiring substantial support ○ Level 3- requiring very substantial support ■ Impairment in Social Communication and Social Interaction ● They fail to develop age appropriate social relationships ● Three things that must be present to be diagnosed with ASDProblems with social reciprocity (failure to engage in back-and-forth social interactions), nonverbal communication, and initiating and maintaining social relationships ● Main component of social reciprocity- joint attention ● Eye tracking technology is also used ● Prosody: the lack of appropriate facial expressions or tone of voice ■ Restricted, Repetitive Patterns of Behavior, Interests, or Activities ● Maintenance of sameness ● Doing the same motion or activity over and over ■ Statistics ● Prevalence has risen due to increased awareness ● Male to female ratio is 4.5 to 1 ● Appears to be worldwide ● 31% of the individuals with ASD also have intellectual disorders ● The better language skills and IQ test performance= better the prognosis ■ Causes: Psychological and Social Dimensions ● Biological contributions and psychosocial influences ● Used to be seen as the fault of the parent ■ Causes: Biological Dimensions

● Social communication and restricted and repetitive behaviors are caused from biological influences ■ Genetic Influences ● Moderate genetic heritability ● Many genes are involved with ASD ○ Genes responsible for the brain chemical oxytocin (has a role with how we bond with others and social memory) ● Increased chance of having a child with ASD with older parents ○ Maturation may occur in the sperm or egg that causes ASD ■ Neurobiological Influences ● Amygdala- the area of the brain that is involved in emotions such as anxiety and fear ○ children with ASD have a larger one- causing excessive anxiety and fear ● Neuropeptide oxytocin- influences bonding, and is found to increase trust and reduce fear ○ Children with ASD had lower levels of this in their blood ● Very controversial theory- Mercury, specifically present in child vaccines, may cause ASD ○ But studies have proven this is false ○ Some parents are not vaccinating their children which leads to the spread of serious diseases ○ Treatment of Autism Spectrum Disorder ■ Focused on children with severe forms ■ Focuses on teaching social skills ■ Enhancing their communication and daily living skills ■ Psychological Treatments ● Early psychodynamic theory- focused on ego development because they believed bad parenting caused ASD ● Behavioral approaches- skill building and behavioral treatment of problem behaviors ● Shaping and discriminating theories were used to teach speech ● Naturalistic teaching strategies: a teaching strategy that involved arranging an environment so that the child initiates interest and this is used as a teaching opportunity ● Use of peers as trainers ● Early interventions are best ■ Biological Treatments

● Medical intervention has had little positive impact on social and language difficulties ● Tranquilizers and serotonin-specific reuptake are used to decrease agitation ● One drug will most likely not help everyone ■ Integrating Treatments ● Early intervention holds the most hope ● School education and special psychological supports- help with communication and socialization problems ● Behavioral approaches ● Pharmacological treatments can help temporarily ● Other children focus on integrating them in the community ● Intellectual Disability (Intellectual Developmental Disorder) ○ Intellectual Disability: a disorder evident in childhood as significantly below average intellectual and adaptive functioning ○ Three domains ■ Conceptual- language, reasoning, knowledge, and memory ■ Social- problems with social judgement and friendships ■ Practical- difficulties managing personal care or job responsibilities ■ Clinical Description ● Display a broad range of abilities and personalities ● Some may have a disability that affects their functioning ● Tend to be more chronic and less helped by treatment ● Criteria- Significant low IQ scores, impairments in adaptive functioning, and seen before the age of 18 ● Classification system ○ Mild- IQ 50 to 55 and 70 ○ Moderate- IQ 35 to 40 and 50 to 55 ○ Severe- IQ 20 to 25 and 35 to 40 ○ Profound- IQ scores below 20 to 25 ■ Statistics ● 90% of the people with ID have a mild form ● 1% to 3% of total population ● This is chronic ● Flynn Effect- IQ scores have risen ○ Causes ■ Environmental- deprivation, abuse, and neglect ■ Prenatal- exposure to disease or drugs while in the womb ■ Perinatal- difficulties during labor and delivery

■ Postnatal- infections and head injury ■ Fetal alcohol syndrome- heavy use of alcohol of pregnant women, leads to severe learning disabilities ■ Biological Dimensions ● Most research of ID focuses on biological causes ■ Genetic Influences ● Down syndrome- extra 21st chromosome ● Single gene disorder, mitochondrial disorders, and multiple genetic mutations ○ Single genes- dominant gene, recessive gene, or x-linked gene ● Phenylketonuria (PKU): a disorder that involves an inability to break down the phenylalanine chemical ● Lesch-Nyhan Syndrome: an x-linked disorder, is characterized by ID, signs of cerebral palsy, and self injurious behavior ○ Women with this disease are carriers ■ Chromosomal Influences ● Down syndrome- extra 21st chromosome (trisomy 21) ● Amniocentesis: a procedure that involves removing and testing a sample of fluid that surrounds the fetus in the amniotic sac with CVS ● Chorionic villus sampling (CVS): a small piece of placental tissue is removed and tested ● Fragile X Syndrome: a second common chromosomally related cause of ID ○ Mutation on X chromosome ■ Psychological and Social Dimensions ● Cultural influences- abuse, neglect, and social deprivation (sometimes referred to as cultural-familial  intellectual disability) ○ Are now rare because of better childcare and early identification ■ Treatment of Intellectual Disabilities ● Similar to severe forms to ASD and learning disorders ● Behavioral innovations ● Communication training ○ Augmentative communication strategies- Ex: sign language ● Prevention of Neurodevelopmental Disorders ○ Early intervention (Ex: head start programs) ○ Correct genetic and chromosomal abnormalities

○ Behavioral intervention for safety training ○ Substance use treatment and prevention...