CHAPTER 15

PERVASIVE DEVELOPMENTAL DISORDERS

ANDMENTAL RETARDATION

PERVASIVE DEVELOPMENTAL DISORDERS

Conditions that become apparent early in a child's development and affect all major developmental systems (social, cognitive, and language)

Autistic disorder Asperser's disorder Childhood disintegrative disorder Rett’s disorder

AUTISTIC DISORDER

Characteristics Usually noticed by age of 3 years Marked difficulty in social

interaction and communication Restricted range of interests Strong desire for routine 75% are mentally retarded

AUTISTIC DISORDER

Deficits Theory of mind – Inability to infer the

mental states of others and to think abstractly

Executive functions – Cognitive operations involved in planning and flexibility of response

Language – Many never speak and those who do have stereotypical, repetitive, idiosyncratic speech patterns

Joint attention behaviors – Inability to maintain eye contact and social interaction

AUTISTIC DISORDER

CAUSES Brain abnormalities Genetic factors Stress or injury may interact with genetic

vulnerability TREATMENT

Behavioral – Increase skills, reduce problem behaviors

Learning techniques to take into account cognitive strengths and weaknesses

Medications to treat some symptoms

HEREDITARY FACTORS IN AUTISTIC DISORDER

ASPERGER’S DISORDER

May be a mild form of autism Impaired social interaction Restricted and repetitive patterns of

behavior and interests Does not include language delays and

absence of autism Does not include impaired cognitive

development of autism Usually not diagnosed until school

age

CHILDHOOD DISINTEGRATIVE DISORDER

Normal development until age 3 or 4, followed by loss of previously acquired Language, social, and motor skills and

bowel and bladder control Changes thought to be associated with

deterioration in the nervous system Very rare – One in one million births More common in boys than girls Causes unknown

RETT’S DISORDER

Progressive disorder appearing after normal development at about 5 months of age

Head stops increasing in size, so becomes smaller than normal (microcephaly)

Loss of previously acquired developmental skills (language, social, and motor)

Typically affects only girls Most become severely retarded No specific treatment

MENTAL RETARDATION Characteristics

Subaverage intellectual function with significant limitations in adaptive functioning that begins before age 18

Levels Mild – IQ 50-55 to 70 Moderate – IQ 35-40 to 50-55 Severe – IQ 20-25 to 35-40 Profound – IQ below 20 or 25

Incidence One in every 100 individuals in the US

MENTAL RETARDATION

MENTAL RETARDATION

CAUSES OF MENTAL RETARDATION

Genetically based Dominant genes

Tuberous sclerosis Recessive genes Genetic mutation

Phenylketonuria (PKU) Chromosomal abnormalities

Fragile X syndrome Down syndrome

Polygenetic

FRAGILE X CHROMOSOME

DOWN SYNDROME

CAUSES OF MENTAL RETARDATION

The fetal environment Maternal infections Chronic conditions Blood incompatibilities between

mother and child Chemicals in fetal environment

Alcohol- Fetal alcohol syndrome Radiation Malnutrition Factors associated with age and stress

of mother

CAUSES OF MENTAL RETARDATION

Problems during birth Prematurity Low birth weight Lack of oxygen during birth process Too-rapid progress through the birth canal

Damage to the nervous system after birth

Infections (encephalitis) Extreme malnutrition Blows to the head Tumors Oxygen deprivation due to accidents (such as

near drowning) Environmental poisons (lead paint)

CAUSES OF MENTAL RETARDATION

Psychosocial disadvantage Impoverished environment 30-50% of variation in

intelligence test scores can be attributed to environmental influences

PREVENTION OF MENTAL RETARDATION

Primary prevention Public education about need for prenatal

care, dangers of pregnant women drinking, and dangers of exposure of children to lead

Amniocentesis and ultrasound scanning that may lead to termination of pregnancy

Secondary prevention Treatment, as in special diet for PKU children

Tertiary prevention Maximizing child’s skills and potential School- and community-based educational,

vocational, and skills training programs

EARLY INTERVENTION FOR MENTAL RETARDATION

Children at psychosocial risk Home-based interventions Special centers with trained staffs,

supplemented by home visits School-based programs

Individuals with Disabilities Education Act (IDEA) guarantees free public education for all disabled children, including the mentally retarded

Least-restrictive placement Mainstreaming versus special placement

VOCATIONAL AND SOCIAL SKILLS TRAINING FOR MENTALLY

RETARDED ADULTS Job preparation – Sheltered

workshops Learning how to deal with

personal, financial, and sexual exploitation

Teach social skills and how to say “no”

Training in appropriate sexual behavior

RECOGNITION AND TREATMENTE OF PSYCHOLOGICAL PROBLEMS

Forty percent of mentally retarded meet criteria for some other disorder

Severely and profoundly retarded often have autism or pervasive developmental disorder

One-fourth have a personality disorder Many adolescents have temper tantrums,

aggressive and destructive behavior, and alcohol and drug abuse

Children with fragile-X syndrome often have ADHD

Children and adults with Down syndrome often suffer from depression