Selected Childhood Disorders

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Selected Childhood Disorders

• Jeff Baker, Ph.D.Wendi M. Hirsch, Ph.D.Jennifer
  Yates, M.A.

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Overview

• Mental Retardation
• Pervasive Developmental Disorders
• Learning Disabilities
• Attention Deficit Hyperactivity Disorder

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Definition of Mental Retardation

• Significantly subaverage intellectual functioning
  before age 18
• Existing concurrently with related limitations in
  2 or more of the following adaptive skill areas

• communication
• self-care
• home living
• social skills
• community use
• self-direction
• health and safety
• functional academics
• leisure
• work

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Prevalence of Mental Retardation

• 2-3 of the population
• 1.2-2 of all newborns are potentially MR, but
  the severe usually die
• .37 of the adult population is severely mentally
  retarded
• more males than females
• Down Syndrome about 1/3 of MR
• 4/5 (80) of all MR persons function in the mild
  to moderate range

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What is intellectual functioning?

• ability to take and maintain a definite direction
• capacity to make adaptations to attain a desired
  end
• global capacity of the individual to act
  purposefully, to think rationally, and to deal
  effectively with the environment

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IQ is something measured by an intelligence test

• Scores lower than 2 standard deviations from the
  mean
• Verbal and Nonverbal (Performance) IQ
• Full Scale IQ

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Measures of Intelligence

• Wechsler Scales
• for preschoolers Wechsler Preschool and Primary
  Scales of Intelligence (WPPSI)
• for ages 6-16 Wechsler Intelligence Scales for
  Children (WISC)
• for adults Wechsler Adult Intelligence Scale
  (WAIS)
• Stanford-Binet
• Kaufman Assessment Battery for Children (K-ABC)
• Tests of Nonverbal Intelligence (TONI)

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Measures of Adaptive Behavior

• Vineland Adaptive Behavior Scales
• Adaptive Behavior Scales of the American
  Association of Mental Deficiency

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Classification of Intelligence

• 130-160 Very superior
• 120-129 Superior
• 110-119 High Average
• 90-109 Average
• 80-89 Low Average
• 70-79 Borderline MR
• 55-70 Mild MR
• 35-55 Moderate MR
• 25-35 Severe MR
• Below 25 Profound MR

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Etiology of Mental Retardation

• Infections and Intoxication
• Trauma or Physical Agent
• Metabolism or Nutrition
• Chromosomal Abnormality/Syndrome
• Environmental Influences
• Unknown

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What will make you suspect MR?

• not doing well in school
• often overactive and inattentive
• often uncoordinated
• social problems
• compliant child not following directions
• delays in developmental milestones

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Pervasive Developmental Disorders

• Severe and pervasive disturbances in several
  areas of development
• reciprocal social interaction skills
• communication skills
• stereotyped interests and/or behaviors
• impairments are distinctly deviant compared to
  the individuals developmental and mental age
• generally evident in first three years of life

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Types of PDD

• Autism
• marked impairments in social interactions (no
  reciprocity)
• marked impairments in communication (receptive
  and expressive)
• repetitive patterns of stereotyped movements,
  interests, behaviors
• delays have onset before 3 years
• usually mentally retarded, but some have normal
  intelligence
• Asperger Syndrome
• social impairments (including restricted
  interests and behaviors)
• stereotyped movements, behaviors, and interests
• no significant language or cognitive delay

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PDD-contd

• Rett Syndrome
• normal development before 6 months
• steady decline of functioning consistent with
  encephalopathy
• loss of speech
• apraxic gait
• psychomotor retardation
• only known to occur in girls
• shortened life span
• progressive muscle deterioration
• probably a metabolism disorder - genetic basis
• PDD-NOS or PDD-other

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Learning Disabilities

• A marked deficit in ability to learn in a
  specific area
• Discrepancy between the individuals intellect
  and performance in specific area(s) (ability gt
  achievement)

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Type of Learning Disability

• Dyslexia reading, spelling, written language,
  oral communication
• Nonverbal learning disability
• visual perceptual deficits
• developmental coordination disorder

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Attention Deficit Hyperactivity Disorder (ADHD)

• A disorder of behavior regulation
• starting
• maintaining
• stopping

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Typical ADHD presentation

• difficulties sustaining attention, easily
  distracted
• poor impulse control
• hyperactive behavior (may or may not be present)
• symptoms must be present prior to the age of 7
• more common in boys