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CHAPTER 15

CHAPTER 15. PERVASIVE DEVELOPMENTAL DISORDERS AND MENTAL 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

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CHAPTER 15

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  1. CHAPTER 15 PERVASIVE DEVELOPMENTAL DISORDERS ANDMENTAL RETARDATION

  2. 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

  3. 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

  4. 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

  5. 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

  6. HEREDITARY FACTORS IN AUTISTIC DISORDER

  7. 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

  8. 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

  9. 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

  10. 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

  11. MENTAL RETARDATION

  12. MENTAL RETARDATION

  13. CAUSES OF MENTAL RETARDATION • Genetically based • Dominant genes • Tuberous sclerosis • Recessive genes • Genetic mutation • Phenylketonuria (PKU) • Chromosomal abnormalities • Fragile X syndrome • Down syndrome • Polygenetic

  14. FRAGILE X CHROMOSOME

  15. DOWN SYNDROME

  16. 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

  17. 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)

  18. CAUSES OF MENTAL RETARDATION • Psychosocial disadvantage • Impoverished environment • 30-50% of variation in intelligence test scores can be attributed to environmental influences

  19. 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

  20. 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

  21. 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

  22. 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

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