Cheatsheet 2 - Cheat sheet for child abnormal. Professor Tiede-Koszuta PDF

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Cheat sheet for child abnormal. Professor Tiede-Koszuta...

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1-3% of population has ID: Onset during developmental period. IQ 70 or below. Includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. 3 CRITERIA must be met: deficits in intellectual functions— reasoning, problem solving, abstract thinking, judgment, academic learning, and learning from experience. Deficits in adaptive functioning that results in failure to meet developmental and socio-cultural standards for personal independence and responsibility. w/o ongoing support, adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and independent living across multiple environments. Onset during developmental period BEFORE AGE 18. 

MILD: not identified until early elem years. Preschool children: no obvious diffs. For school-aged children and adults: learning difficulties in academic skills involving reading, writing, arithmetic, time, or money, the support needed in one or more areas to meet age-related expectations. In adults: impaired abstract thinking, executive function, short-term memory, and functional use of academic skills. Immature social interactions, difficulty perceiving peers’ social cues, immature or more concrete communication, conversation and language. Difficulty regulating ageinappropriate emotion and behavior, limited understanding of risk in social situations, immature judgment for age. At risk for being manipulated by others. Children may function age appropriately and maintain personal care, may need some support with complex daily living tasks. Adults need support with shopping, transportation, home and child care, organizing, cooking, and money management, may participate in recreational skills similar to age-mates, but need support with well-being and organization, may hold jobs that do not emphasize conceptual skills, need support with health care and legal decisions. Over represented in minority groups. CAN develop social and communication skills. Appropriate support.

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MODERATE: Identified in preschool years. Applies to many w down syndrome. Conceptual skills lag. Preschoolers: language and pre-academic skills develop slowly. School-aged: skills develop slowly and are limited. Adults: academic skill development is typically at elem level, support req for all use of academic skills and work. Show diff in communicative behavior, less complex spoken language as primary tool for social communication, capacity for relationships in life long toes to family and friends, limited social judgment and decision making abilities, needs caretaker, has friendships w typically developing peers that are affected by communication or social limitations. They can eat, dress, eliminate, and practice hygiene age-appropriately after being taught and practicing with reminders. May achieve independent employment in jobs that req limited conceptual communication skills, but need support from coworkers. Develop variety of recreational skills but need additional support, maladaptive behaviors present in some. Can perform unskilled or semiskilled work with guidance.

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SEVERE: identified at young age b/c organic causes. Few conceptual skills, little understanding of written language or concepts involving numbers, needs caretaker throughout life. Limited spoken language in terms of vocab and grammar, speaks using single words or phrases, exhibits speech & communication focused on present, understands simple speech and gestural communication, & has relationships w fam members for pleasure and help. Needs support for daily living, supervision at all times, unable to make responsible decisions regarding well-being of self or others. Some may exhibit maladaptive behavior—self-injury. Mobility or health problems. Live in group homes or with family.

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PROFOUND: Seen in infancy b/c of marked delay in development or anomalies. Uses visuospatial skills like matching and sorting based on physical characteristics, may have motor and sensory impairments. Limited understanding of symbolic communication or gestures, but may understand some simple instructions or gestures, nonverbally, nonsymbollically expresses desires and emotions, enjoys relationships with wellknown family members, initiates response to social interactions through gestural and emotional cues, may have co-occurring sensory and physical impairments. Dependent on others for all aspects of daily life. May be able to assist with daily work tasks at home. Perform simple actions w objects w extended support. Enjoys recreational activities w support, and may exhibit maladaptive behaviors. Life-long care.

DOWN SYNDROME: Most common single disorder. Mod-sev ID. 3 number 21 chromosomes. Higher risk with maternal age. Delayed speech, verbal, STM, and auditory processing deficits. Have social understanding, empathy, and social interactions. Facial features: small skull, large tongue protruding from small mouth, almond shaped eyes/sloping eyebrows, flat nasal bridge, short crooked fifth finger, and broad, square shaped hands with monkey-like crease across the palm. FRAGILE-X: Most common INHERITED form of ID. Due to a fractured X chromosome. More common and severe in boys. Facial features: long faces, prominent jaws, large ears, and large foreheads. Deficits in visual spatial skills, sequential processing, motor coordination and executive functioning. Males: unusual social and communication patterns—shyness, poor eye contact, delays in cognitive and communication development. Autismlike behaviors—flapping, biting selves, walking on toes, and repetitious actions. Females: social anxiety/avoidance. MORE related to social phobia—not necessarily autism because they want to connect to others. These children are affectionate towards family. PRADER-WILLI: short stature, ID or learning disability, incomplete sexual development, low muscle tone, urge to eat constantly. OCD like behavior w/ overeating, foraging, and hoarding. Have almond eyes, downturned mouth, and small hands and feet. ANGELMAN: moderate too severe ID. Characterized by awkward gait (axtaxia), jerky movements, hand flapping, seizures, and absence of speech. Large jaw and open-mouthed expression. Prader & angelman are associated w abnormality of chromosome 15. WILLIAMS SYNDROME: deletions on chromosome 7. Elfin like appearance—overly friendly/social w poor social judgment, sound sensitive but love music, with no fear of strangers. Mild-mod ID, age quickly, and have no social inhibition. FETAL ALCOHOL SYNDROME: folds at corners of eyes, low nasal bridge, short nose, smooth area between nose and upper lip, small head circumference, small eye opening, small mid-face, and thin upper lip.

Childhood Onset Schizophrenia: RARE BEFORE AGE 18. neurodevelopmental disorder of the brain. Characterized by severe psychotic symptoms, bizarre delusions, hallucinations, thought disturbances, grossly disorganized behavior, or catatonic behavior, extremely inappropriate or flat affect, and significant deterioration or impairment in functioning. GRADUAL not sudden onset. Positive symptoms: delusions, hallucinations=most common for children is Auditory. Occur in 80% of cases with onset prior to age 11. Negative symptoms: slowed thinking, speech, movement, emotional apathy, anhedonia, and lack of drive. CRITERIA: severe disturbance in sensory functioning/and or behavior. TWO or more of the following—at least one has to be 1,2,or3. 1-delusions, 2-hallucinations, 3-disorganized speech, 4-grossly disorganized or catatonic behavior, 5-negative symptoms. Social/occupational dysfunction in work, interpersonal relations, or self-care markedly below the level of achieved prior to onset. Duration: continuous signs of disturbance persist for at least 6 months. Schizoaffective and mood disorder, substance/medical condition exclusion. Relationship to autism spectrum or communication disorder: if there’s a history of autism spectrum disorder, diagnosis is only made if hallucinations or delusions are present for at least 1 month, Specify if catatonic and what the severity level is. Delusions of influence someone else is controlling my body/mind like the gov’t, aliens, neighbor, etc. Delusions of self significance I’m famous/more talented, God, God-like powers. Persecutory delusions child feels they’re being tricked, sabotaged, or poisoned. May exhibit rocking or arm flapping. ASD: early belief that parents wish that the child didn’t exist led to autism. Onset: soon after birth or up to a year later or longer they will start to show regression. Symptoms can improve with time and some have shown to improve over time. It is a neurodevelopmental disorder characterized by abnormalities in social behavior, language & communication skills, and unusual behaviors and interests. CRITERIA: Persistent deficits in social communication, social interaction across multiple contexts: 1. Deficits in social-emotional reciprocity, from abnormal social approach and failure of normal back-and-forth conversation, to reduced sharing of interests, emotions, or affect, to failure to initiate or respond to social interactions. 2. Deficits in nonverbal communicative behaviors used for social interaction, ranging from: abnormalities in eye contact and body language, deficits in understanding and use of gestures, total lack of facial expressions and nonverbal communication. Restricted, repetitive behavior, interests, or activities in at least 2 of the following: 1. Stereotyped or repetitive motor movements, use of objects, or speech (lining up toys or flipping objects, echolalia, idiosyncratic phrases). 2. Insistence of sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take some route or eat same food every day). 3. Highly restricted, fixated interests that are abnormal in intensity and focus (strong attachment to or preoccupation with unusual objects). 4. Hyper-or hypo activity to sensory input or unusual interest in sensory aspects of environment (apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement). Over selective or impaired shifting of attention to sensory input, impairment in mixing across sensory modalities, sensory dominance-prefer one sense over the other. Symptoms present in early developmental period. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning. Disturbances are not better explained by ID or global developmental delay. ID and autism freq co-occur, social communication should be below that expected for general developmental level for them to both be diagnosed. CAN RANGE FROM PROFOUND ID TO GENIUS INTELLECTUAL ABILITY. Behavior of child with autism can change with age. Language impairments: use protoimperative gestures = I want something. No joint attention. Those who begin to speak may regress btwn 12-30 months. Children with asd who do pick up lang do before age 5. Pronoun reversals, echolalia, and preservative speech— focus on same topic, go on and on about same topic or thing. Impairments in pragmatics, or the social aspect of language and social conventions. One of most specific to ASD is lack of Theory of Mind, the ability to understand that other people’s thoughts and beliefs differ from your own. Some higher level functioning children with ASD may be able to pass the ToM test, so they know what SHOULD happen, but they don’t show this in every day life. Abt 70% have intellectual impairments—they tend to have lower verbal abilities compared to visual. They could possibly score a 70 on a verbal exam but 130 on a visual-spatial for an avg IQ of 100. They don’t engage in pretend play. Due to motivational deficits? Maybe it isn’t rewarding for them to have social interaction. Splinter skills—can read, recite word for word, do all these things like math but may not quite grasp the relatedness or understanding of them to the real world. Savant skills —remarkable talents. ASD may be detailoriented…highly focused on detail, not the big picture. Social (Pragmatic) communication disorder: persistent difficulties with pragmatics—social use of language and communication. They are culturally specific practices and skills related to social uses of language, conversational norms, and use of nonverbal communication. Pragmatic difficulties in: expressive and receptive skills, being able to adapt one’s communication to the social context, & being able to understand social meanings expressed by others. CRITERIA: Persistent difficulties in social use of verbal and nonverbal communication by all of following: 1. Deficits in using communication for social purposes, in appropriate manner. 2. Impairment of ability to change communication to match context or needs of listener, speaking differently in a classroom than on a playground, talking diff to a child than to an adult, etc. 3. Difficulties following rules of language and storytelling, taking turns in conversation, rephrasing when misunderstood, knowing how to use verbal and nonverbal signals. 4. Difficulties understanding what is not explicitly stated and nonliteral or ambiguous meanings of language. Deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance. Onset is early in developmental period (4 or 5). TERMS: Neurodevelopmental: brain impairments that develop through time. Flynn effect: Scores rising since the beginning of IQ testing, about 3 points per decade. Joint attention is the ability to coordinate attention to a social partner and an object or event of mutual interest. Lacking in ASD. Sensory overselectivityis the tendency to focus on one feature of an object or event in the environment while ignoring other equally important features.Stereotypy: stimming. No purpose? Figurative speech: holds meaning different form its literal meaning. Adaptive skills: effective way of coping with life demands, how capable someone is living independently and abiding by community. Adaptive behavior skills include—conceptual skills: Receptive and expressive language, Reading and writing,Money concepts,Self-directions. Social skills: Interpersonal, Responsibility, Self-esteem, Gullibility (likelihood of being tricked or manipulated), Naiveté, Follows rules, Obeys laws, Avoids victimization. Practical skills: Personal activities of daily living such as eating, dressing, mobility, and toileting, Instrumental activities of daily living such as preparing meals, taking medication, using the telephone, managing money, using transportation and doing housekeeping activities. Occupational skills: maintaining safe environment. Cultural familial group Intellectual disability (ID) in which there is no evidence of organic brain damage (usually associated with mild ID). Organic causes of ID : biological. Central coherence: which refers to the strong tendency of humans to interpret stimuli in a relatively global way that takes the broader context into account. Those w ASD have low central coherence. INCR ASD due to ? vaccines, mercury, diet, acetaminophen, caffeine, antibiotics, allergies, environmental pollutants, and electromagnetic radiation—not scientific. Prob due to greater awareness among parents and professionals; a broadening of the concept and its definition over the years; greater recognition and diagnosis of milder forms of asd; changes in diagnostic criteria and categories. People with low SES and are in poverty, improper prenatal care, unenriched environment effect IQ score....