Child Psychopathology

1
Child Psychopathology

• Different views of mental retardation
• Developmental course and etiology
• Issues in intervention
• Case
• Reading for today Chapter 9

2
Social Quiz

• Why do we have unleaded gasoline?
• How did plumbing bring down the Roman Empire?
• Why was the Mad Hatter mad?
• Why is it frowned upon to consume large
  quantities of alcohol when pregnant?
• What color do we want newborn babies to be and
  why?
• Why does the dentist put an apron over your body
  when X-raying your teeth?

3
History of assessment

• Binet Simon hired to develop a test to
  determine if individuals could be educated
• Concept of mental age developed, which when
  expressed as a ratio MA/CA IQ
• Test became widely used, revised at Stanford
  University, became Stanford-Binet Intelligence
  Test
• IQ designed to predict success in school

4
DSM-IV Criteria

• Significantly subaverage IQ (less than 70)
• Concurrent deficits or impairments in adaptive
  functioning
• Characteristics evident prior to age 18
• Ranges (and Educational Classifications)
• Mild 50/55 to 70 (Educable)
• Moderate 35/40 to 50/55 (Trainable)
• Severe 20/25 to 35/40 (Severe)

5
Prevalence

• 1-3 of population, depending on cutoff used
• those with mild mental retardation are 85 of
  population, majority have idiopathic origin
  (cultural-familial)
• Those with organic MR are more likely to have
  genetic causes
• Slightly more males than females
• Low SES and minority groups at higher risk

6
Other characteristics

• Cultural-familial MR has global delays
• organic MR has less sequential organized delays,
  medical problems such as heart malformation
• Figure 8.3 signs of other CNS problems
• Mild MR may be associated with failure, lowering
  goals, and minimal success (learned helplessness)
• Comorbid developmental disabilities including
  epilepsy, speech, language, behavior, sensory
• attachments develop, but signals, proximity
  seeking, and even distress may be lower
• 10-40 have emotional or behavior problems (e.g.,
  pica)

7
Biological Causes

• Heritability of IQ 50 Polygenes
• Chromosomal anomalies most common cause of more
  severe forms
• Meiosis Downs, Turners Crossover
• Fragile X syndrome (inherited)
• Metabolism problems (PKU)
• Neurobiology malnutrition, teratogens (lead,
  mercury), fetal alcohol, perinatal stress leading
  to physical damage (e.g., IVH)

8
Social and psychological causes

• Deprived physical care
• Poor emotional care
• Poor social stimulation
• Victor DAvyron (feral child) was MR by
  environmental causes
• These interact with biology, e.g., poor housing
  may have paint chips, chips may have leaded
  paint, children may eat paint chips as they do
  not have toys to play with

9
Interventions for mental retardation

• Medications rarely, if ever, used
• Prenatal postnatal education screening
• Vitamins, alcohol, PKU
• Community-based placements/ living situations
  What are you aware of?
• Answers Residential, Community-based, supported
  work environment, mainstreaming
• Variety of psychosocial interventions

10
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11
Psychosocial interventions

• infant stimulation, developmental surveillance
• behavioral approaches include shaping, modeling,
  graduated guidance, both /- beh.
• Self-regulation and metacognitive training
• Camp, other special programs (e.g., SMILE)
• family support coping with parenting demands,
  stress

12
Case Review

• What is the diagnosis?
• Intervention Planning?