Exam 2 review

What is iq

• Looking a the knowledge that children “should know” grouping children by age

IQ= mental age/ chronological age *100

• Flynn effect

• Norms become otudated quickly

Who made IQ

Alfred binet

Intellectual disabiltiy Mild

IQ 70-50 – 85% of ID cases

Moderate iq diability

- IQ 49-35 – 10% of ID cases

Severe iq diability

– IQ 34-20 – 4% of ID cases

Profound iq diability

– IQ <20 – 1-2% of ID cases

Intellectual Disability: Clinical Classification Serverity

Severity Specifier Function

Mild –Can live independently with little help

Moderate –Can live independently or semi-

independently with higher levels of support

Severe and Profound – Likely to require significant

support and round the clock care

Creidtera for diangoses Intellectual Disability

Deficits in adaptive function must fail to meet

developmental and socio-cultural norms for personal

independence and social responsibility and must limit

functioning in multiple domains of life (home, school,

work)

Deficits in intellectual function in conceptual, social, and

practical domains that must be confirmed by

individualized clinical assessment and standardized

intelligence testing

• 1975

• education for all handicapped children act - provides free and appropriate eduationf or all children

Language disorder

problems in the acquisition and use of language occur across different language modalities

Social (pragmatic) Communication Disorder

problems in social use of language

Speech Sound Disorder

disorder in the literal production of speech

Child-Onset Fluency Disorder (stutter) Average state

language production are present and often worsened by anxiety

Specific language disorder: Overview

Very common; often two per class. Have issues with understanding, learning, and producing words. Specific cognitive problems with working memory. Normal intellect

Communication Disorders Classifications

Can occur in isolation, but often co-occur with other developmental disorders

10-15 % of children will experience some speech delay,

50-80% will resolve by age 3

After age 4, clinical evaluation is recommended

3-5 times more common in males

Stuttering 1% of all folks - most resolve by adulthood

Learning Disability: History

Early definitions lumped these individuals with ID with early intentions of services for schools and too generic of testing

However, these are not disorders of aptitude or intellectual ability, but acquisition/learning

Individuals vary substantially in their cognition and optimal learning

Do not reflect an intellectual limit but difficulties with

“academic skills”

Learning Disability:

History/ Clinical Classification

DSM 5 TR

Must persist for 6 months and rule out schooling issues

Includes three major categories:

Dyslexia – reading difficulties

Dyscalculia – mathematics difficulties

Dysgraphia – writing difficulties

Prevalence learning disability

5-6% of all students, reduced to 1-2% estimatedwhen accounting for teaching and school quality

Accounts for 50% of all Special Education Services

Dyslexia (reading problems) – 75-80% of LD

Risk factors Learning disability

Specific Associated risks: Single candidate genes, prenatal environment, ACES (deprivation, poverty, neglect-centered stress), and altered neurodevelopment

Thought to precede skill acquisition and reflect an increased difficulty with skill acquisition

dyslexia paradox

Atypical neurodevelopment and optimal window for early interventions precede the learning environment when the diability in skill can be discovered. This phenomenon is referred to as: 

Learning diasbility: Current reasearch in dyslexia

recruited 100s of kids with parents who have _____ and followed them over early childhood with nueroimaging scans and cognitve testing

Turesky et al 2025

Learning Disability:

Important Factors for Resilience

Services to teach skills and techniques to manage

skill acquisition and difficulty

Minor to complete academic setting modifications

Typically, minor accommodations are needed, and

full independence is achieved

History: Autism Spectrum Disorder

As early as 1800s case studies and clinical of unusual orunique patients exist that would nowdescriptions be classified as autism

1943 Leo Kanner, a two-part disorder: “autism” – in one’s own world (linked conceptually with schism of schizophrenia) and “insistence on sameness” in repetitive behaviors

1944 Hans Asperger described autism as a personality issue that occurred in boys with distinct and specialized interests that interfered with social development
1970s established the validity of this category and noted:

It is distinct from child-onset schizophrenia

Autism is a “brain-based” neurodevelopmental disorder

Children respond better to structured teaching rather than psychotherapy

Included in the DSM in 1980

In DSM IV – autism a dimensional approach and included subtypes of Asperger’s Disorder and Rhett’s Disorder – 2,200 ways to receive an autism diagnos

Autism Spectrum Disorder - DSM 5 TR

Diagnostic Criteria:

Persistent deficits in social communication and social interaction across multiple contexts

Restricted, repetitive behaviors, interests, or activities

Symptoms must be present in early development (but  may not become fully manifest until social demands exceed capacities) masking

Symptoms cause clinically significant impairment in social, occupational, or other important areas.

These disturbances are not better explained by ID or global delay

Autism Spectrum Disorder - DSM 5 TR Deficets criterian

Persistent deficits in social communication and social interaction across multiple contexts, as manifested by all of the following, currently or by history:

Deficits in social-emotional reciprocity

Deficits in non-verbal communication

Deficits in developing, maintaining, and understanding relationships

Austin specturm disorder DSM 5 criterians behaviros

B. Restricted, repetitive behaviors, interests, or activities as manifested by at least two of the following:

Stereotyped or repetitive motor movements, use of objects, or speech

Insistence on sameness, inflexible adherence to routines or behavioral patterns

Highly restricted, fixated interests that are abnormal in intensity or focus

Hypo or hyperreactivity to sensory input or unusual interest in sensory aspects of the environment

Autism Spectrum Disorder - Specifiers –
DSM 5 TR

Support

Requiring very substantial support

Requiring substantial support

Requiring support

Impairment

  with or without intellectual impairment

  with or without language impairment

Genetic/medical/environmental Factor

   with {insert factor here}

Neurodevelopmental, mental, or behavioral problem

   with {insert problem here}

With Catatonia

Autism Spectrum Disorder - Prevalence

1-2% of the population

Typically diagnosed before age 3

12-24 months if sufficiently severely specified

later diagnosis tend to be related to effective masking

It is not degenerative (though some features may resolve in Rhett’s Syndrome) – typically stable in terms of support needed
Full range of IQ possible

Autism has higher prevalence among ID individuals

Autism Spectrum Disorder –Risk factors

Prentatal/obstetric environment risk factors:

Advanced paternal age

Extreme prematurity

In utero exposure to toxins

Genes

37-90% genetic contribution

twin studies with shared prenatal environment

15% of cases of Autism are associated with known genetics

polygenetic

ADHD: General Info

Prevalence 7.2-15.5% estimated prevalence in the US

2-3 times more likely to be diagnosed in males in

childhood

Sex differences diminish by adulthood

Sex differences in clinical presentation

Males tend to have more hyperactivity

Females tend to have more inattention

ADHD Two dimensions

inattention, which is identified by nine behaviors.

hyperactivity and impulsivity, also assessed by nine behaviors.

ADHD: Clinical Classification –DSM-5 TR

First core feature represents the two primary dimensions: inattention

and hyperactivity/impulsivity

Second core feature is the age of onset, which, in DSM‐5 must be

prior to 12 years.

Third core feature is pervasiveness (present in two or more settings,

like home, school, daycare, and different social and vocational

settings).

Fourth criterion is evidence of problems with adaptation that interfere

with social, academic, or vocational functioning.

Fifth core feature is that the behavioral pattern associated with ADHD

is not better explained by another disorder but neurological disorder is

not exclusionary and ADHD is commonly seen in relation to

prematurity, congenital brain injuries, and traumatic brain injury.

Inattention ADHD

Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is

inconsistent with developmental level and that negatively impacts directly on social and

academic/occupational activities:

Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during

other activities (e.g., overlooks or misses details, work is inaccurate).

Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused

during lectures, conversations, or lengthy reading).

Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the

absence of any obvious distraction).

Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the

workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).

Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty

keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to

meet deadlines).

Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g.,

schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing

lengthy papers).

Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools,

wallets, keys, paperwork, eyeglasses, mobile telephones).

Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include

unrelated thoughts). Is often forgetful in daily activities (e.g., doing chores, running errands; for older

adolescents and adults, returning calls, paying bills, keeping appointments)

ADHD Hyper activity

Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental

level and that negatively impacts directly on social and academic/occupational activities:

Often fidgets with or taps hands or feet or squirms in seat.

Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in

other situations that require remaining in place).

Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless.)

Often unable to play or engage in leisure activities quietly.

Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings;

may be experienced by others as being restless or difficult to keep up with).

Often talks excessively.

Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for turn in conversation).

Often has difficulty waiting his or her turn (e.g., while waiting in line).

Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or

receiving permission; for adolescents and adults, may intrude into or take over what others are doing).

Several inattentive or hyperactive‐impulsive symptoms were present prior to age 12 years.

Several inattentive or hyperactive‐impulsive symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in

other activities).

There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.

The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another

mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).

ADHD: Clinical Classification Features

Features consistent over time (homotypic continuity):

Concentration difficulties, struggles to sit still

Developmental Disorder (heterotypic continuity)

1.5-5 years old

Clumsy, quickly shifts activities, wanders, can’t wait their turn,

demanding, gets into things

6-18 years old

Acts young for their age, confused, daydreams, impulsive, poor

school performance, inattentive, stares, talks too much, loud

ADHD:

Important Factors for Risk

Genes related to Dopamine regulation

Distinct brain structural and functional patterns related to

the development of control function

Adhd current research higlights

Distinict nuerodevelopmental trjectories of the cortex

• Shorter life expectancies 6.8 for men and 8.6 for women

• ADHD is 9 times higer among individuals with another mental health diagnosis

ASD gender differences

3-4 times more likely to be diagnosed in males

Sex differences in presentation

Females tend to show more ID and epilepsy when diagnosed early

Females may be better at masking symptoms of ASD

ASD females tend to have better reciprocal conversations and fewer social difficulties, fewe