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Childhood Disorders. Behavior disorders - ADHD, CD, ODD Separation anxiety disorder Elimination disorders - eneuresis, encopresis Disorders of cognitive, motor, communication skills - learning disorders Mental retardation Pervasive developmental disorders - autism, Asperger’s disorder.

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childhood disorders
Childhood Disorders
  • Behavior disorders - ADHD, CD, ODD
  • Separation anxiety disorder
  • Elimination disorders - eneuresis, encopresis
  • Disorders of cognitive, motor, communication skills - learning disorders
  • Mental retardation
  • Pervasive developmental disorders - autism, Asperger’s disorder
attention deficit hyperactivity disorder categories of symptoms
Attention-Deficit/Hyperactivity Disorder - Categories of Symptoms
  • Inattention
  • Hyperactivity
  • Impulsivity
symptoms of inattention
Symptoms of Inattention
  • Neglects details, makes careless errors
  • Difficulty w/ sustaining attention
  • Doesn’t seem to listen when others talk
  • Difficulty w/ organizing
more symptoms of inattention
More Symptoms of Inattention
  • Avoids activities requiring sustained effort & attn.
  • Loses things frequently
  • Easily distracted
  • Forgetful
hyperactivity symptoms
Hyperactivity Symptoms
  • Fidgets, squirms
  • Leaves seat when inappropriate
  • Runs about or climbs excessively
  • Trouble engaging in quiet activities
  • Often acts as if “driven by motor
  • Often talks excessively
impulsivity symptoms
Impulsivity Symptoms
  • Blurts out responses while others talking
  • Difficulty waiting turn
  • Often interrupts or intrudes
adhd theories
ADHD Theories
  • Neurological immaturity - slowed brain development (consistent w/ fact that sx’s decline w/ age)
  • Dopamine
  • Runs in families, antisocial fathers
  • Prenatal, birth complications
  • Maybe food allergies in some, not sugar
adhd tx
  • Stimulants (Ritalin, etc.) decrease demanding, disruptive behavior, improve mood & goal-directedness
  • (Stimulants) work by increasing dopamine levels
  • No. of children prescribed stimulants increased 2 1/2 X in recent yrs.
behavior therapy w adhd
Behavior Therapy w/ ADHD
  • Best results when meds accompanied by tx
  • Reinforcing positive behaviors
  • Extinguishing negative behaviors
conduct disorder
Conduct Disorder
  • Bullies, threatens, or intimidates
  • Initiates physical fights
  • Uses weapons in fights
  • Engages in theft, burglary
  • Physically abuses people, animals
  • Lies, breaks promises
more on conduct disorder
More on Conduct Disorder
  • Violates rules about staying out all night
  • Runs away from home
  • Set fires deliberately
  • Vandalizes, destroys others’ property
  • Often skips school
more on conduct disorder1
More on Conduct Disorder
  • As adolescents, half engage in drug abuse, criminal behavior
  • 34-40% dx’d as antisocial personality disorder as adults
  • As adults, 75-85% chronically unemployed
gender conduct disorder
Gender & Conduct Disorder
  • Boys 3X more likely to be dx’d
  • Boys w/ CD more aggressive than girls w/ it
  • Antisocial behavior may take different form in girls
    • Verbal aggression, character defamation
    • Ostracism, alienation
  • Girls w/ CD equally likely to lie, steal, abuse substances
oppositional defiant disorder
Oppositional Defiant Disorder
  • Often loses temper
  • Often argues w/ adults
  • Often refuses to comply w/ requests, rules
  • Deliberately tries to annoy others
  • Blames others for mistakes, misbehavior
more odd criteria
More ODD Criteria
  • Touchy or easily annoyed
  • Angry, resentful
  • Spiteful, vindictive
  • Disorder often starts very early but some outgrow by late childhood, early adolescence
  • Arguably is early form of CD, same or separate disorder?
biological contributors to cd odd
Biological Contributors to CD, ODD
  • Problems often start in infancy, difficult babies (irritable, demanding, non-compliant, impulsive, respond to frustration w/ aggression)
  • Both are heritable, antisocial behavior runs in families
other biological contributors
Other Biological Contributors
  • Possible neurological deficits (corr. w/ ADHD)
  • Low arousal, testosterone, serotonin (as w/ ____)
tx of cd odd
Tx of CD, ODD
  • SSRI’s, antipsychotics, lithium
  • Cognitive-behavioral tx
    • Identify situational triggers for anger
    • Keep diaries of emotions, behaviors
    • Teach empathy
    • Learn to see others’ motives as benign
    • Calming self-talk
    • Teach problem solving, behavioral alternatives
childhood disorders1
Childhood Disorders
  • Behavior disorders - ADHD, CD, ODD
  • Separation anxiety disorder
  • Elimination disorders - eneuresis, encopresis
  • Cognitive, motor, communication skill disorders (learning disorders/disabilities)
  • Mental retardation
  • Pervasive developmental disorders - autism, Asperger’s
  • Formerly dx’d in 1 child in 10,000
  • Now dx’d in 1 in 166
  • More often occurs in boys (1 in 114)
  • Usually accompanied by mental retardation, exception is autistic savant (Rainman)
  • One of the pervasive developmental disorders - these involve severe, lasting impairment in several areas of development
  • Autism - deficits in
    • Social interaction
    • Communication
    • Activities & interests
deficits in social interactions
Deficits in Social Interactions
  • Little nonverbal indicating connection - eye contact, facial expression, posture, gestures
  • Failure to develop normal peer relationships
  • Little pleasure when others are happy
  • Little reciprocity in social interactions
deficits in communication
Deficits in Communication
  • Delayed or absent speech
  • Significant trouble in initiating, maintaining conversation
  • Unusual language, echolalia, phrase repetition, pronoun reversal
  • Lack of make-believe play or imitation of others
deficits in activities interests
Deficits in Activities, Interests
  • Preoccupation w/ certain activities or toys
  • Compulsive adherence to routine, rituals
  • Stereotyped, repetitive movements, e.g., hand flapping, head banging
  • Echopraxia
  • Preoccupation w/ parts of objects, unusual uses of objects
etiology of autism
Etiology of Autism
  • Earlier thought to be due to cold mothers
  • Deficits in theory of mind - inability to understand that people have mental states which can be used to connect w/ others
more on autism etiology
More on Autism Etiology
  • Disruption in normal development & organization of brain:
  • Larger heads & brains
  • Structural, functional deficits
  • Different brain activation in response to faces
  • Possible serotonin, norepinephrine imbalances
autism treatment
Autism Treatment
  • Meds help overactivity, stereotyped behavior, sleep disturbance, tension
  • SSRI’s reduce repetitive & aggressive behavior, improve interaction
  • Behavioral techniques & structured education key - 47% of those given this for 40 hrs./wk. for 2 yrs. achieved normal intellectual/educational level
asperger s disorder
Asperger’s Disorder
  • Harder to dx than autism
  • Cognitively normal
  • Deficits in social interaction, activities, interests