Chapter 15 Mental Retardation and Pervasive Developmental Disorders Copyright © 2006 Pearson...

Chapter 15Mental Retardation and Pervasive

Developmental Disorders

Copyright © 2006 Pearson Education Canada Inc.

Copyright © 2006 Pearson Education Canada Inc. 2

Brief Overview

Mental retardation– pejorative overtones– changing societal views

Pervasive developmental disorders– severe communication & social deficits – much less common


Overview: Mental Retardation

diverse category & wide range of symptoms

early intervention important

CASE STUDY: “A Mother With Mild Mental Retardation”– generally happy life– depression– does Karen have a “disorder”?


Mental Retardation: definition

AAMR:

“Mental retardation is a disability characterized by significant limitations both in intellectual functioning and in adaptive behaviour as expressed in conceptual, social, and practical skills…”


Symptoms & Features

significant intellectual limitations

significant limitations in adaptation

onset before age 18


The Controversial IQ Test

cultural fairness

validity issues

what is it measuring?


Limits in Adaptive Skills

conceptual– level of self-sufficiency

social– level of interpersonal skills

practical– daily living


Historical Perspective

Pejorative terms idiot, moron, imbecile entered the psychiatric lexicon

1866: Langdon Down describes “mongolism”

1872: “asylum for idiots” in Ontario IQ test development


Contemporary Perspective

classification based on:– IQ score– etiology

sub-types based on IQ score


DSM-IV-TR: Severity of Mental Retardation

Mild – IQ 50-55 to 70

Moderate– IQ 35-40 to 50-55– e.g., Down syndrome

Severe– IQ 20-25 to 35-40

Profound– IQ below 20-25


Epidemiology

1% of general populationdiffers according to “population” being

examineddisproportionate among low SES


Etiology: Biological Factors

chromosomal disorders (e.g., Down Syndrome)

genetic disorders (e.g., phenylketonuria) infectious diseases (e.g., Rubella,

syphilis) Toxins (e.g., FAS) normal genetic variation


Etiology: Psychological Factors

early sensory deprivationearly abuse/neglect


Etiology: Social Factors

poverty and related under-stimulation


Treatment: Prevention Efforts

A. Primary Prevention

health care promotion pregnancy testing: amniocentesis &

ultrasound


Canadian Focus:Eugenics Movement

forced sterilization program (1928-72)– often done surreptitiously– Alberta & BC

lawsuits in the 1990s Alberta government apology

Discussion Point: How could this happen in Canada?



B. Secondary Prevention

early intervention programs (e.g., Aboriginal Head Start in Canada)



C. Tertiary Prevention

early assessment early education/skill development


Treatment: Normalization Efforts

Mainstreaming

Deinstitutionalization


Overview: Autistic Disorder & Pervasive Developmental Disorders (PDDs)

unusual problems emerging early in lifeprofound interpersonal disturbancesunusual behaviourscommunication problemsautism example: Rain Man


Case Study: John’s Autism

apathetic to othersnegative reactions to affectionintensive behavioural intervention

planned


Symptoms & Associated Features

impaired social interaction– lacking theory of mind/perspective-taking– social isolation

communication deficits– echolalia– pronoun reversal– often mute

stereotyped behaviour– self-stimulation

self-injury


Savant performance

some children with Autism/PDD show exceptional ability in 1 domain– music, mathematics

rare & poorly understood


Historical Perspective

“early infantile autism” (Kanner, 1943)

Asperger’s Syndrome childhood schizophrenia


Epidemiology

Prevalence: 10/10,000 kids may have Autism (Bryson, 1996)

SES: little relation

gender: 3-4X more common in boys


Etiology

Psychological/Social– little support despite traditional “blame the

parents” notion

Biological– consequence of other conditions (e.g., rubella)– genetics:

Concordance rates in twin study: MZ: 60%, DZ: 0%

– neurophysiology: endorphins


Treatment

medication– disappointing results overall

psychotherapy– intensive behavioural modification

Chapter 15 Mental Retardation and Pervasive Developmental Disorders Copyright © 2006 Pearson...

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