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Developmental Disorders

Developmental Disorders. Chapter 13. Pervasive Developmental Disorders: An Overview. Nature of Pervasive Developmental Disorders Problems occur in language, socialization, and cognition Pervasive – Means the problems span the person’s entire life

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Developmental Disorders

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  1. Developmental Disorders Chapter 13

  2. Pervasive Developmental Disorders: An Overview • Nature of Pervasive Developmental Disorders • Problems occur in language, socialization, and cognition • Pervasive – Means the problems span the person’s entire life • Examples of Pervasive Developmental Disorders • Autistic disorder • Asperger’s syndrome • Treatment of Autism and other PDD’s focuses upon: • Acquisition of language skills • Improving quality of social interactions • Acquiring greatest possible functional skills

  3. The Nature of Autistic Disorder: An Overview • Autism • Significant impairment in social interactions and communication • Restricted patterns of behavior, interest, and activities • Three Central DSM-IV and DSM-IV-TR Features of Autism • Problems in socialization and social function • Problems in communication – 50% never acquire useful speech • Restricted patterns of behavior, interests, and activities

  4. Autistic Disorder: Facts and Statistics • Prevalence and Features of Autism • Rare condition – Affecting 2 to 20 persons for every 10,000 people; but prevalence is increasing considerably • Autism occurs worldwide • Symptoms develop before 36 months of age • Autism and Intellectual Functioning • 50% have IQs in the severe-to-profound range of mental retardation • 25% test in the mild-to-moderate IQ range (i.e., IQ of 50 to 70) • Remaining people display abilities in the borderline-to-average IQ range • Better language skills and IQ test performance predict better lifetime prognosis

  5. Increasing Prevalence? • 1966 epidemiological study (Lotter, 1966) • 4-5/10,000 (.05%) • 2002 review of recent studies • 60 per 10,000 autism spectrum disorders (.6%) • 8 to 30 per 10,000 for autistic disorder (.3%) • Probably reasons for increase • Identification of children with higher and lower intelligence • Broadening and refining of criteria • General awareness of the disorder • Diagnosing disorder in children with other difficulties

  6. Asperger’s Disorder: Part of the Autistic Spectrum • The Nature of Asperger’s Disorder • Such persons show significant social impairments • Restricted and repetitive stereotyped behaviors • May be clumsy, and are often quite verbal (i.e., pedantic or overly formal speech) • Do not show severe delays in language and other cognitive skills • Prevalence of Asperger’s Disorder • Often under diagnosed • Affects about 1 to 36 persons per 10,000 people

  7. CAUSES OF AUTISM-SPECTRUM DISORDERS • Significant genetic component • Families with 1 autistic child have 3-5% risk of having a second child with autism (rate in general pop. Is .02-.05%) • Possible/probably neurological dysfunction • High rate of MR, clumsiness, abnormal posture or gait • Abnormally small cerebellum • No evidence for psychosocial causes • Poor parenting does not lead to autism or related disorders (no “refrigerator mothers”)

  8. TREATMENT • Specialized behavioral techniques using shaping, discrimination training, reinforcement to teach small steps • Communication – speech, sign language, use of picture board • Socialization – eye contact, some limited social behavior; does not usually result in “normal” relationships (e.g., friends) • Intensive, early intervention shows significant and in some cases, dramatic treatment • 20-40 hrs/wk, beginning before age 6, 2+ years • This is the most important and best treatment for the disorder • Support for family

  9. Mental Retardation (MR): An Overview • Nature of Mental Retardation • Below-average intellectual and adaptive functioning • Range of impairment varies greatly across persons • Mental Retardation and the DSM-IV and DSM-IV-TR • Significantly sub-average intellectual functioning (IQ below 70) • Concurrent deficits or impairments in two or more areas of adaptive functioning • MR must be evident before the person is 18 years of age

  10. DSM-IV and DSM-IV-TR Levels of Mental Retardation (MR) • Mild MR (85%) • Includes persons with an IQ score between 50 or 55 and 70 • Moderate MR (10%) • Includes persons in the IQ range of 35-40 to 50-55 • Severe MR (3-4%) • Includes people with IQs ranging from 20-25 up to 35-40 • Profound MR (1-2%) • Includes people with IQ scores below 20-25

  11. Other Classification Systems for Mental Retardation (MR) • American Association of Mental Retardation (AAMR) • Defines MR based on levels of assistance required • Examples of levels include intermittent, limited, extensive, or pervasive assistance • Classification of MR in Educational Systems • Educable mental retardation (i.e., IQ of 50 to approximately 70-75) • Trainable mental retardation (i.e., IQ of 30 to 50) • Severe mental retardation (i.e., IQ below 30) • Implications of Different MR Classification Systems

  12. Mental Retardation (MR): Some Facts and Statistics • Prevalence • About 1% to 3% of the general population • 90% of MR persons are labeled with mild mental retardation • Gender Differences • MR occurs more often in males, male-to-female ratio of about 6:1 • Course of MR • Tends to be chronic, but prognosis varies greatly from person to person

  13. BIOLOGICAL CAUSES • Genetic (only about 30% cases of MR) • Tuberous sclerosis (rare, but 60% have MR); PKU (restricted diet till age 7 since unable to break down phenylalanine); Lesch-Nyhan syndrome • Chromosomal abnormalities • Down Syndrome – trisomy 21 (extra 21st chromosome) • Fragile X syndrome

  14. PSYCHOLOGICAL & SOCIAL CAUSES • Cultural-familial retardation (70% cases of MR) – mild to moderate MR • combination of biological and psychological factors? • abuse, neglect, social deprivation

  15. TREATMENT OF MR • Goal of maximizing functioning • Select reasonable goals for areas of functioning • Self-care (dressing, feeding self) • Communication • Social skills • Tasks of daily living (transportation, buying groceries) • Cognitive skills developed as appropriate (read, write, make change) • Use behavioral techniques to teach skills, shaping, repeated trials, reinforcement • Individuals with MR have higher rate of other psychological disorders (depression, psychosis)

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