Disorders of childhood

1. Disorders of childhood Disorders usually first diagnosed in infancy, childhood, or adolescence

2. Mental Retardation (Axis II) • Sub-average intelligence • Measured with a standardized, individually-administered IQ test • Limited abilities in 2 or more of • Communication • Self-care • Home living • Social skills • Use of resources • Self-direction • Academic skills • Work • Leisure • Health & safety

3. Severity of Mental Retardation • Mild: IQ 50-55 to 70 -- Educable • Moderate: IQ 35-40 to 50-55 -- Trainable • Severe: IQ 20-25 to 35-40 -- Self-care, simple tasks under supervision • Profound: IQ below 20-25 -- Some self-care

4. Other classification systems • AAMR (American Association on Mental Retardation) • Uses the same criteria as DSM-IV • Rates low intellectual ability at 70-75 or below • Specifies levels of support required, rather than level of severity • Intermittent, Limited, Persistent, Pervasive • P.L. 95-602 (1978): Developmental disabilities include Mental Retardation

5. Causes of Mental Retardation • Genetics (5%): Tay-Sachs disease, fragile X, Down syndrome due to translocation • Early alterations of development (30%): • Down syndrome due to trisomy 21 • Prenatal toxins (Alcohol, infections) • Pregnancy and perinatal problems (10%) • Malnutrition, prematurity, hypoxia, trauma • Childhood illness, trauma, or poison (5%) • Environmental deprivation, autism(15-20%)

6. Prognosis • Intellectual abilities, as measured by IQ, tend to remain stable through life. • Specific adaptive abilities improve with remediation. • Measures of adaptive ability may be inaccurate or impossible to obtain.

7. Learning Disorders • More than 2 standard deviations between achievement and IQ • Not due to mental retardation, lack of opportunity, culture, or poor teaching • Reading Disorder • Mathematics Disorder • Disorder of Written Expression • Developmental Coordination Disorder (Motor Skills Disorder)

8. Communication Disorders • More than 2 standard deviations between communication skill and non-verbal IQ measure • Expressive Language Disorder • Mixed Expressive-Receptive Language Disorder • Phonological Disorder • Stuttering

9. Pervasive Developmental Disorders • Autistic Disorder • Social communication and interaction deficit • Restricted range of interests and activities • Rett’s Disorder • Normal functioning, followed after 5 mo. by: • Decelerated head growth • Loss of purposeful hand skills • Lowered social interest • Severe language impairment

10. Additional pervasive developmental disorders • Childhood Disintegrative Disorder • Significant regression after 2 years of normal development in 2 or more of: • language skills • social skills • bowel or bladder control • play • motor skills • Asperger’s Disorder: Autistic symptoms but with normal language skills

11. Behavioral disorders • Attention-Deficit/Hyperactivity Disorder • Conduct Disorder • Oppositional Defiant Disorder

12. Feeding, eating, and elimination disorders • Pica • Rumination Disorder • Feeding Disorder of Infancy or Early Childhood • Enuresis • Encopresis

13. Tic disorders • Tourette’s Disorder • Chronic Motor or Vocal Tic Disorder • Transient Tic Disorder

14. Other disorders of childhood • Separation Anxiety Disorder • Selective Mutism • Reactive Attachment Disorder • Stereotypic Movement Disorder