CP Exam 2

Intellectual disability

significant limitations in cognitive ability, interfere with adaptive functioning (everyday activities: cook, manage bills), low IQ

Early onset

from birth, neurodevelopmental disorders (ex. autism, ADHD)

Eugenics

Francis Galton, strengthen human gene pool by discouraging people w/ disorders from reproducing, marrying, and forced sterilization

IQ

mental age/chronological age x 100

Modern intelligence tests are…

standardized (norms), reliable (consistent across administrators), and valid (measure what is intended to measure)

adaptive functioning

daily living skills (occupational, practical, social, conceptual), live independently?, assessed through questionnaire with family member

Flynn effect

IQ scores have raised on average 3 points per decade

DSM criteria for ID

deficits in intellectual functions (IQ), adaptive functions, and early onset

4 levels of severity

mild (55-70), moderate (40-55), severe (25-55), profound (<25)

mild ID

85% of ID population

typically not identified until elementary school, academic skills up to 6th grade, usually achieve some sort of independence but may need supervision

moderate ID

10% of ID population

identified during preschool, academic skills up to 2nd grade, can adapt to living in community and can usually do some kind of skill work but often need supervision in sheltered workshops

severe ID

4% of ID pop.

identified at very young age, organic cause (ex. cerebral palsey), academic skills up to preschool/kindergarten, may be able to perform tasks closely supervised, not living independently

profound ID

2% of ID pop.

infancy due to biological abnormalities, only rudimentary communication skills and basic self care (if that), life long care and assistance in supervised group homes or specialized facilities

developmental hypothesis

kids w/ IDs progress through same milestones in a similar sequence, but slower (similar structure & similar sequence hypotheses)

difference hypothesis

kids w/ IDs develop in a different, less sequential, and less organized fashion

social functioning - social isolation

emotional and behavioral problems, self injurious behavior, and pica

autism spectrum disorder (ASD)

neurodevelopmental disorder characterized by abnormalities in social communication and unusual behavior and interests, Kanner 1943 —> first described, infantile autism (within oneself), refridgerator parents (ASD caused by “cold” parents)

DSM 5 features of ASD

a) deficits in social communication and interaction (need all three) → deficits in reciprocity, nonverbal communication, and developing and understanding relationships

b) restrictive and repetitive behaviors (need 2) → repetitive motor movements/use of objects/speech, insistence on sameness (routines), fixated interests, and sensory processing differences

core deficits - social interaction

atypical processing of faces and facial expressions, difficulty maintaining eye contact, poor joint attention, more response to caregiver than others

core deficits - social communication

protoimperative (using gestures to get what you want) vs. protodeclarative (direct someones attention to object of interest) gestures

ASD kids use protoimperative more, 30-40% develop no functional language, pronoun reversal, poor pragmatic language

restricted and repetitive interests

explosive reactions to minor changes in routines, preoccupation with unusual objects/parts of objects, echolalia (immediate vs delayed), self stimulator behaviors, sensory over-responsitivity

associated characteristics

70% have IDs, limited pretend play, Sally Anne test (theory of mind), most have comorbid disorders

communication disorders

deficits in language, speech, and communication

includes language disorder, speech sound disorder, childhood onset fluency disorder, pragmatic language disorder

specific learning disorder

achievement test results that are substantially below whats expected for age and schooling

phonemes

elementary vowel and consanant sounds

morphemes

smallest units that stand for objects, events, ideas, characteristics, or relationships

phonology

learning and storing phonemes and rules for combining them, deficits strongly linked to comm and learning disorders

phonological awareness

recognizing relationship between sounds and letters, detecting rhyme and alliteration, an awareness that sounds can be manipulated within syllables in words

causes of IDs

organic (biological), cultural familial(no clear cause, overrepresented by low SES)

4 major risk factors

biological (chromosomal abnormalities, parent age, prematurity, maternal infection), social (poverty, malnutrition, lack of prenatal care), behavioral (parental substance use, abuse/neglect), educational (lack of early intervention, parents disability, lack of preparation for parenthood)

down syndrome

most common disorder resulting from chromosomal abnormality, incidence increases with maternal age

fragile x syndrome

most commonly inherited, large forehead, prominent jaw, low portruding ears, many also meet criteria for autism

prader willi syndrome

involuntary urge to eat, incomplete sexual development, low muscle tone

angelmann syndrome

ataxia, hand falpping, seizuers, large jaw, open mouthed posture

phenylketonuria

lack liver enzymes to convert phynylalanine into tyrosine, accumulates in body and converted into phenypyruvic acid, causes brain damage

fetal alcohol spectrum disorder and syndrome

FAS most severe type, teratogen, brain damage, characterized by CNS dysfunction, typically mild ID

treated for IDs

prenatal education and screening, early intervention, behavioral treatment, family strategies

causes of autism

risk factors - preterm birth, bleeding during pregnancy, preeclampsia, older parents, materal substance use, maternal fever

genetics

brain abnormalities

treatment for ASD

no known cure, therapy

discrete trial training: stimulus → response → consequence

early intervention

childhood onset schizophrenia

progressive neurodevelopmental disorder, gradual onset, symptoms persist into adolescence and adulthood, more severe adult form

DSM definition of COS

psychotic disorder involving disturbances in thinking, perceptions, speech, emotions, and behavior

a) core symptoms (2 or more for one month) - delusions, hallucinations, disorganized thinking (speech) (must be one of first three), grossly disorganized behavior, negative symptoms (absence of something typical)

b) causes impairment in work, school, firendships, and self care

c) continuous signs for 6+ months

defining features of COS

affect flattening, alogia (not much talking), avolition (lack motivation)

causes of COS

strong genetic contribution, enlarged ventricles and gray matter shrinkage, maternal diabetes, low birth weight, communication deviance, longer duration of untreted psychosis associated with poorer outcomes

treatment for COS

antipsychotic medications, education of person about their illness, support groups and social skills training, CBT, token economy

language disorder DSM criteria

a) persistent difficulties in acquiring and using language to communication (reduced vocab, limited sentence structure, impairments in discolsure)

b) abilities must be substantially below those of peers and result in functional limitiations

c) onset in developmental period

d) not due to sensory, motor, medical problems, or ID

speech sound disorder DSM criteria

a) difficulty with speech sound production that interferes with intelligibility

b) functional limitations

c) onset during developmental period

50-70% have hiswtory of LD

risk factors of speech sound dis.

deficits in phonological awareness related to problems in functional connections between brain regions, less activity in left temporal region, parental speech and language stimulation may affect pace and range of language development

treatment for speech sound dis.

promote language competencies, adjust environment to accommdate childs needs, therapy (SLP)

childhood onset fluency disorder (stutter) DSM criteria

disturbances in fluency and time patterning of speech that are developmentally inappropraite and characterized by:

repetition, prolonged sounds, broken words/pauses, blocking, circumllocutions, excess physical tension, early onset, anxiety

treatment for stutter

teach patients to slow down and use short simple sentences, contingency management, breathing regulation

social (pragmatic) comm. disorder DSM criteria

persistent difficulties in using language for social purpose, changing communication to match situation, problems following rules of language, difficulties making inferences, functional limitations, early onset

specific learning disorder

diagnosed when math, reading, writing fall below peers, 1.5 SD below peers, associated with emotional/behavioral problems, misdiagnosed as ADHD, ID, or ODD

reading LD

inability to distinguish or separate sounds in words spoken, phonics (slower) vs. whole word (faster) teaching, reversals, transpositions, inversions, omissions, dyslexia

writing LD

problems in spelling, grammar, punctuation, organization, shorter, less interesting, and poorly organized essays, also called dysgraphia

math LD

difficulties in number sense, memorization, fluency calculation, reasoning, also called dyscalculia

treatment for SLDs - rearly, comprehensive, ongoing, RTI (response to intervention), CBT

successful reading progrmas- direct instruction, teach reading and spelling in coordination, intensive (3+ yers), teach for automaticity to increase fluency