CHAPTER 15 PERVASIVE DEVELOPMENTAL DISORDERS AND MENTAL RETARDATION
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