11/20/14 11:32 AMDefining Disorders of Childhood and
AdolescenceChallengesChildren are developing and changing
rapidlyChildren may not communicate directlyOften rely on parent
reportMust consider family contextDevelopmental Psychopathology -
view abnormal behavior within the context of normal development
Deviates from what is expected for a child at that age and in that
sociocultural contextPersistent and severeImpairs child or
othersMore severe events---earlier in life; less severe
events---later in lifeChildhood and AdolescenceSome disorders of
children childhood anxiety disorders and childhood depression have
adult counterpartsOther childhood disorders elimination disorders,
for example usually disappear or radically change form by
adulthoodThere also are disorders that begin in birth or childhood
and persist in stable forms into adult lifeThese include autism
spectrum disorder and intellectual disability (previously called
mental retardation)Disorders Usually First Diagnosed in Infancy,
Childhood, or AdolescenceAll of these chapters are gone. They are
in different chapters. A lot of chapters are integrated in other
chaptersA separate chapter in DSM-IVMental RetardationPervasive
Developmental DisordersAttention Deficit and Disruptive Behavior
DisordersElimination DisordersTic DisordersETCDSM 5
ChangesDisorders Usually Diagnosed in Infancy, Childhood, or
Adolescence is no longer be a separate groupingMany disorders that
were in this chapter are now integrated throughout manual Others
are in the two chapters on the next slide ..Disruptive, Impulse
Control, and Conduct DisordersNeurodevelopmental disorders Autism
spectrum disorders Aspergers syndrome is GONE! They rank them in
autism spectrum disorder intellectual disability (intellectual
developmental disorder)New label to mental retardationADHDTic
disordersEtc. Externalizing Versus InternalizingAlternate way of
conceptualizing childhood disorders often used in research
Externalizing create difficulties for external world, failure to
conform to rules or expectations of othersCreating problems for
other people Conduct disordersOppositional defiant disorder ADHD
Internalizing - affect the childs internal world, sadness or
anxietyAnxietyDepressionDisruptive Mood Dysregulation Disorder
(Temper Dandrums) A new mood disorder in DSM-5 so not a lot of
researchChildhood disorder (6-18 years) Severe recurrent temper
outbursts three times a week for at least a year Persistent
irritable or angry mood between outburstsAn alternative to
diagnosing bipolar disorder in childrenAttention-Deficit/
Hyperactivity DisorderMaybe it is a neurological problems
Persistent pattern of inattention and/or hyperactivity see handout
Symptoms present before age 12Symptoms present in two or more
settings Symptoms reduce quality of functioning Conduct DisorderThe
patterns must be present for 12 monthsThe earlier these outcomes
occur, the more severe the issues Persistent pattern of behavior in
which basic rights of others or major societal norms are
violatedMust meet 3 of 15 criteria that fall into the following
areas: aggression to people or animals, destruction of property,
deceitfulness or theft, serious violations of rulesPhysical
fightsWeapons Physically violenceForced to sexual thingsDestroying
other peoples propertyRunning away from home or school Causes of
Externalizing Disorders Biological Temperament Some kids are born
with this temperament Genetics Maybe inherited Neuropsychological
abnormalities ADHD may represent minimal brain dsyfunction Food
additives and sugar Social Parenting styles Influences of media,
peers Psychological Self control Moral reasoning
InterventionsEmpathy buildingDiscriminate anothers emotional
stateAssume the perspective and role of anotherRespond emotionally
to anotherAnger managementAttend to internal statePractice adaptive
self statementsPractice competing responseCounter with empathyThink
through nonviolent solutionsReward self for nonviolent
solutionsImpulse controlBiological goal is to reduce impulsivity
and hyperactivity and improve attention RitalinAdderallEffective in
about 70% of cases of ADHD at least temporarilyControversies and
concernsAutism Spectrum DisorderIn DSM 4, there were 2
categories:Autistic DisorderDefined in 1943 by KannerAspergers
DisorderDefined in 1944 by AspergerDSM 5 both have been combined in
autism spectrum disorderAutism Spectrum Disorder: Key
FeaturesImpairment in social communication and interaction
Echolalia echoing everything you say to them You: Hey johnThe
child: (Repeats) Hey JohnRestrictive, repetitive, and stereotyped
patterns of behavior, interests, or activitiesNo variability in
kidsLack of imagination They do not engage in things other kids
doThey are rocking back and forthSymptoms must be present from
early childhoodThe symptoms had to be present before age 3Sometimes
from birth Response as a kid is weird (no responsive) Symptoms
cause impairment in functioningAutism spectrum disorder:
severitySpecify severity for both A and BLevel 1 Requiring
supportLevel 2 Requiring substantial supportLevel 3 requiring very
substantial supportAlso specify: With or without accompanying
intellectual impairment, with or without accompanying language
impairmentTreatment = Behavior intervention Reinforcement for good
behaviorsIgnorance for bad behaviorsAutism Spectrum Disorder: Some
FactsPrevalence on rise in recent yearsRise to theories regarding
environmental causes e.g., vaccinesDo poorly on IQ tests29%- mild
to moderate impairment42%- severe impairmentBest predictor of
outcome IQ and language development before age 6Video of Ricky: As
a child, he was more spontaneous and activeLong term, as an adult,
he is robotic, and lost most of his skills Autism Spectrum
Disorder: Causal FactorsBettleheim: refrigerator
parentsPsychological disorder caused by the parentsCanner
identified autism (signs of symptoms) and described the parents as
being cold, distant people who could not respond to their
expectationsNo research for this theory so it can be wrongTheory of
the Mind: Sally Ann TaskThe kids with autism cannot get the
perspective of another person. They will say that the marble is in
Anns box rather than in Sallys basket. They cannot understand
another persons perspective. Biological factorsGenetic factors:
families with one child with autism have a 3%-5% chance of having
another child with that disorderNeurological abnormalities: e.g.,
cerebellum They might have smaller cerebellum Not really biological
factors and it is not consistentTreatment ApproachesBehavioral
modification LovaasMaterial cue (food) with social cue (smile and
kiss)Will these reinforcement work at home and in school? Emphasis
on teaching adaptive behavior and communication skills
ShapingReinforcementIntellectual Disability (Intellectual
Developmental Disorder) Deficits in intellectual functioning (must
be confirmed by clinical assessment and individualized,
standardized intelligence testing) Deficits in adaptive functioning
Onset during developmental period (before age 18)Intellectual
DisabilityLevels of severityMild 50-70 85%Moderate35-49 10%Severe
20-34 3-4%Profound below 20 1-2%CausesChromosomal abnormality:
Downs syndromeGenetic: Fragile X syndrome, PKUPrenatal
factorsCultural-familialEducation: mainstreaming Keep the kids in
mainstream of lifeSome kids need to be in special classes, they
need extra help because you need to the kid in mainstream. They
need to be interacting with reality and normal people.
Disorders of Childhood and Adolescences 11/20/14 11:32 AM
11/20/14 11:32 AM
