Atypical Development Lecture Notes

Typical vs. Atypical Development

Typical development refers to the normal sequence and milestones of growth across various domains such as motor, fine motor, cognitive, communication, self-help, and interactional skills.

• Motor Skills: Sitting independently (typically achieved around 5-9 months).
• Fine Motor Skills: Passing an object from hand to hand (typically developed around 4-9 months).
• Cognitive Skills: Object permanence (understanding that objects continue to exist even when out of sight), typically developed from 6-9 months.
• Communication Skills: Babbling (typically develops from 5-14 months).
• Self-Help Skills: Drinking from a cup (typically develops from 9-17 months).
• Interactional Skills: Collaborating during a game.

Development is a product of both nature and nurture, and milestones can vary depending on context. For example, children in countries with conflict may reach milestones later than those in stable environments.

Atypical development refers to developments that significantly deviate from typical developmental norms. These deviations are assumed to be harmful to the individual.

Factors Contributing to Atypical Development

Multiple factors contribute to atypical development:

• Genetics
• Developmental Norms
• Cultural Norms
• Gender Norms
• Situational Norms
• Role of Adults
• Changing Views of Atypicality

Genetics

Mutations or deletions in a child's genetic material can lead to developmental abnormalities. Examples include:

• Down Syndrome: An extra copy of chromosome 21 (Trisomy 21).
• Williams Syndrome: Deletion of genes.

Culture and Ethnocentrism

Cultural beliefs and judgments influence perceptions of behavior. For example, research has shown that:

• Thai children tend to exhibit more internalizing problems (e.g., anxiety, depression).
• U.S. children tend to exhibit more externalizing problems (e.g., aggression).

Culture can mediate the identification of disorders. A study comparing Thai and U.S. teachers found that Thai teachers are stricter in identifying behavioral problems.

Role of Adults

Parents play a significant role in establishing typicality and atypicality. A study comparing European American and Asian American parents evaluating children with Down Syndrome showed:

• European American parents tended to give higher scores for success, future success, ability, effort, and sympathy.
• Asian American parents were stricter and showed a higher tendency to feel anger and blame toward their children.

Gender

Gender norms influence development by affecting emotions, behaviors, opportunities, and choices. Gender stereotypes can bias the judgment of certain behaviors. For instance:

• Males are often expected to be more aggressive, dominant, and active.
• Females are often expected to be more sensitive, emotional, and shy.

Gender norms can impact the diagnosis of conditions like autism, which is more frequently diagnosed in males.

Situational Norms

Atypicality is also considered based on the context. A behavior acceptable in one setting may not be acceptable in another (e.g., laughing in a playground vs. during a lecture).

Role of Others

Identification and living with a problem often occur when others become concerned. Teachers and parents are often the first to signal disruptions in a child's behavior. Teacher-parent disagreement can occur due to varying behaviors in different contexts or parental denial of atypical behavior, which may be correlated with parental anxiety, depression, or stress.

Changing Views of Atypicality

Perceptions of what is atypical can change over time with new data and evolving perspectives. For example:

• Nail-biting: Once viewed as an expression of a maladaptive personality or associated with OCD, it is now often considered a behavior for relaxation or a temporary disruption, connected with perfectionism.

Summary of Factors

Atypical development is complex and involves genetic influences, knowledge about development, cultural/ethnic influences, and the individuals making judgments.

Theoretical Views on Atypical and Typical Development

Freudian Theory

The perception of atypical and typical development starts with Freud's psychosexual stages. Failure to achieve certain aspects in each stage may lead to atypicality.

• Oral Stage (Birth to 1 year): Focus on biting, eating, chewing, sucking. Atypical development occurs with too much or too little gratification.
• Anal Stage (1-3 years): Related to toilet training. Harsh or rigid toilet training can lead to anxiety that generalizes to other aspects of life.
• Phallic Stage (3-5 years): Involves the Oedipus complex. Issues in relationships at this stage may have consequences on future relationships.

A key distinction is that Freud posited that individuals might regress to a previous stage during stressful moments, whereas Piaget argued that once a stage is surpassed, there’s no regression.

Behaviorism and Social Learning Theory

The distinction between typical and atypical depends on the stimuli or context to which a child is exposed. Key concepts include:

• Classical Conditioning: As demonstrated in the Little Albert experiment where fear was conditioned by associating a neutral stimulus (white rat) with an aversive sound.
• Operant Conditioning: Behavior can be reinforced positively or negatively.
• Social Learning Theory (Bandura): Children learn by observing others. The Bobo doll experiment demonstrated that children imitate aggressive behaviors they observe.

The ability of children to learn by observing others depends on attention, ability to reproduce the behavior, and motivation.

Developmental Delay, Developmental Disorder, and Learning Disability

• Developmental Delay: A greater-than-expected rate of experiencing developmental milestones. The milestone is eventually reached, but later than typical.
• Developmental Disorder: A gap in experiencing developmental milestones. The sequential pattern may differ from typical development.
• Learning Disability: Problems with receiving, processing, analyzing, and storing information. According to a 2015 statistic, 1.1 million people in England have a learning disability. Research from 2002-2003 estimates that 2-3 children in every 100 have a learning disability.

Specific Learning Difficulties

• Dyslexia: Difficulty with processing words, reading, writing, spelling, and speaking. It is estimated to affect up to 1 in 10 people in the UK.
• Dysgraphia: Difficulty with writing, handwriting, spelling, and organizing ideas.
• Dyscalculia: Difficulty with numbers.
• Dyspraxia: Difficulty with fine motor skills, hand-eye coordination, balance, and manual dexterity.

Dyslexia

Problems in word-level reading, difficulty in writing letters in the correct order, and discriminating similar letters.

Dysgraphia

Problems in writing and transcribing letters and words slowly. In children, it is related to the mechanics of writing, while in adults, it involves difficulty in grammar and syntax.

Dyscalculia

Problems in arithmetic, deficits in understanding counting, and delays in memory-based retrieval. Children may struggle with the flexibility and magnitude of numbers. They might not understand that $6 = 4 + 2 = 3 \times 2$.

Etiology of Learning Difficulties

Genetic and environmental factors contribute to learning difficulties. Studies on monozygotic twins and biological vs. adoptive families are used to understand these factors.

Interventions are often effective. One study showed that intense training improved word recognition and altered brain activation in children with word recognition disabilities.

Autism

Primary Features

• Impaired Social Interaction
• Disturbed Communication
• Restricted, Repetitive Behaviors and Interests

Secondary Features

• Problems in Adaptive Behavior
• Poor Executive Function
• Poor Social Cognition

Impaired Social Interaction

Deficits include a lack of joint attention, difficulty understanding emotions, collaborating with others, and interpreting facial expressions.

Disturbed Communication

Deficits in spoken language, gesture, facial expressions, and pragmatic use of language.

Restrictive Repetitive Behaviors and Interests

Tendency to engage in repetitive behaviors.

Triad of Impairment

The primary features are organized into the Triad of Impairment:

• Social Interaction
• Communication
• Activities and Interests

Atypical Autism

Atypical autism may present impairments in only two out of the three areas within the Triad of Impairment.

Secondary Features of Autism

• Prevalence in adaptive behaviors: Difficulties performing tasks in everyday life.
• Poor executive function: Deficits in working memory, cognitive flexibility, and inhibitory control.
• Impairment in theory of mind: Inability to understand others' beliefs and emotions.

Children with autism can struggle with emotion recognition tasks. They may struggle to assign the correct emotion to the context of the story. For example, a story about winning a math competition should be linked with the emotion of happiness.

Etiology of Autism

Autism is behaviorally defined, but genetic influences are significant. Studies show that monozygotic twins have a high chance of both having autism. Advanced paternal and maternal age, maternal medication, maternal bleeding, and gestational diabetes are also associated with autism.

Interventions for Autism

Three types of intervention exist:

• Behavioral Interventions
• Educational Interventions
• Pharmacological Interventions

Behavioral Interventions

Some focus on improving specific behaviors, while others provide comprehensive treatment. The pivotal response treatment focuses on multiple aspects to have an overall impact.

Pivotal Response Treatment

Areas targeted include motivation, self-confession, self-management, and responding to multiple cues.

The Project

A multi-stage project with different durations and goals. For example, the first stage (2-4 weeks) aims to improve following directions and reduce behaviors like tantrums.

Effective interventions are intensive and start at a young age. Controlled learning situations and generalization techniques are essential. Parental involvement is crucial.

Educational Interventions

Offer individual assessments, training for parents, family support, employment support, and collaboration with other agencies. Social stories are a tool used within educational interventions.

Social Stories

These stories help children understand and respond to a range of situations by showing a setting for the kids that they have to imitate in the future. They act as guidelines for them.

Pharmacological Interventions

Mostly involve using antipsychotic medication (e.g., Risperidone) and Ritalin to decrease aggression, self-injury, temper tantrums, or stereotypic behavior. However, use is controversial due to side effects and the absence of specific medical reasons.

Genetic Disorders Associated with Learning Disabilities

• Down Syndrome
• Fragile X Syndrome
• Williams Syndrome

Down Syndrome

Trisomy 21: Chromosome 21 appears in triplicate instead of a pair. Advanced maternal age is a risk factor. Common physical features include:

• Epicanthic folds
• Flat facial features
• Heart issues
• Vision and hearing problems

Cognitive and Behavioral Profile

Rate of intellectual growth slows through childhood and adolescence. Deficits occur in verbal short-term memory and auditory processing, which can compromise language. Mild behavior problems such as stubbornness and inattention can occur. An increased risk of developing dementia is also present.

Executive Function

From meta reviews, it can be seen that children with Down Syndrome prefer the lower executive function compared to children who are physically developing. And working memory and cognitive flexibility are the least effective while human inhibitory control was the least effective executive function.

Fragile X Syndrome

Inhibition in the FMR1 gene, leading to a lack of a specific protein. More prevalent in males than females. Some telltale physical features include:

• Long face
• Large ears

Cognitive and Behavioral Profile

Moderate to severe intellectual disability. Difficulties with numbers and behavioral problems. Struggles with coordination and understanding of visuospatial information. Strengths in daily living activities, but struggles in communication and executive functions.

Williams Syndrome

Small deletion of about 25-28 genes from chromosome 7. Specific physical features include elfin-like face, small lower jaw. Around 1 in 20,000 children are affected. They can experience hypercalcemia, which is a very high production of calcium levels in the blood and can lead to kidney stones.

Cognitive and Behavioral Profile

Moderate to severe learning disability with linguistic strengths, but significant visuospatial skill weaknesses. They may often come off as very chatty, but at the same time struggle in great relationship.

Interventions for Genetic Disorders

• Behavioral Interventions: Aim to improve adaptive behavior and reduce challenging behaviors. Discrete trial learning is used in a structured setting.
• Family Support: Courses and materials to help understand and behave with the children.
• Pharmacological Intervention: Medications are mostly used to control symptoms of ADHD, but use remains controversial.