Abnormal Psychology Chapter 13

Attention-Deficit/Hyperactivity Disorder

(ADHD) children display impulsivity, inattention, and hyperactivity that are inappropriate to their development levels. Affects 7-9% of children and adolescent in the U.S. diagnosis have been rising rapidly over the years. today mroe than 6 million children ages 4-17 in the US are diagnosed w/ ADHD. 2/3rds of children take ADHD medication, stimulants to help focus attention. ADHD diagnosed to 9x more biys than girls. Black and Hispanic less likely than Euro-American. disorder is usually diganised in elementary school where symtpms become apparent, but can happen any time before the age of 12. comorbidity with other disorders like learning diabilites, conduct disorder, anxiety and depressive disorders and communication disorders. in addition to inattention, ADHD children include inability to sit still for more than a few minutes, bullying , temper tantrums, stubbornness, and failure to respond to punishment. sometimes only attention problems other times only hypeactivity or impulsiveness. critics say it just labels kids who are hard to control as mentally sick. hyperactive children cannot control themselves or listen to goal oriented behavior, unlike normal children who are said to be hyper. They have average intelligence bu perform poorly at school, disrupt class, repeat grades ect. Children w/ this are more likely to have mood disorders, anxiety disorders, and problems getting along w/ family members. lack empathy, tend to be less liked by kids in the class. problems w/ drugs, holding a job, achieving higher education levels; show more delinquent and antisocial behavior. ADHD symptoms decline w/ age, disorder often persists into a milder form into adulthood. affects about 4% of US adults at some point in their lives. usually takes the form of inattention, problems w/ working memory, and distractibiity rather than hyperactivity. 3 subtypes: a) a predominantly inattentive type b) a predominantly hyperactive type c) a combination type characterized by high levels of both inattention and hyperactivity-impulsivity.

speech sound disorder

(Phonological disorder) there is a persistent difficulty articulating the sound of speech in the absence of defects in the oral speech mechanism or neurological impairments. children w/ the disorder may omit or substitute or mispronounce certain sounds-especially ch, f, l, r, sh, and th, which most children articulate properly by the time they reach school years. It may sound as if they are uttering "baby talk". children w/more severe forms have trouble articulating sounds usually mastered during preschool yrs b, m, t, d, n, and h. speech therapy is helpful and mild cases may resolve themselves by age 8.

Intellectual disability

1% of the pop is affected by this AKA ID (AKA intellectual development disorder or IDD) primary feature of ID is a general deficit in intellectual development. formerly called mental retardation, intellectual disability is the diagnostic term applying to individuals who have significant and broad-ranging limitations or deficits in intellectual functioning and adaptive behaviors (lack of basic conceptual, social, and practical skills of daily living) Children w/ ID trend to have deficits of reasoning and problem-solving ability, abstract thinking skills, judgement, and school performance. Intellectual disability begins before the age of 18 during child development and follows a lifelong course. However many children w/ ID improve over time, especially w/ support guidance, and enriched educational opportunities. those who are reared in impoverished environments may fail to improve or may deteriorate. Diagnosed on basis of low IQ score and impaired adaptive functioning occurring before the age of 18 that results in significant impairments in meting expected standards of independent functioning and social responsibility. these impairments involve difficulty performing common tasks of daily life expected of someone of the same age in a given cultural setting in three domains: 1) Conceptual (skills relating to use of lang., reading, writing, math, reasoning, memory, and problem solving) 2) Social (skills relating to awareness of other people's experiences, ability to communicate effectively w/ others, and ability to form friendships. 3) Practical (ability to meet personal care needs, fulfill job repsonsibilites, manage money, and organize school and work tasks) Earlier versions of the DSM require an IQ score of less than 70 (100= avg.) for a diagnosis of mental retardation, DSM-5 doesn't set a particular IQ score for the diagnosis of ID.

How common is Autism Spectrum Disorder

2% of children (more than 1 million children in total) in US were affected by some form of autism spectrum disorder Investors have linked increased risk of autism to children w/ older fathers researchers have consistently failed to find links between autism and use of childhood vaccines like the MMR (measles, mumps, rubella) vaccine. nearly 5x more common in boys than girls 1st sign of disorder (nonverbal communication) 12-18 month old. "good babies" but begin to reject reject physical affectation, like cuddling, hugging, and kissing. speech falls behind the norm sign's of detachment, failure to look at other's faces Disorder can be diagnosed around 2 or 3, bu avg child is diagnosed at 6. the earlier the treatment the better.

prevalence of mental health problems in children and adolescents

4 of 10 adolescents (40.3%) have experienced a diagnosed mental health disorder in the past year. 1 in 4 (23.4%) are presently affected. 1 in 10 children suffer from a mental disorder severe enough to impair development. In children 6-17 are the most commonly diagnosed psychological disorders are learning disorders (11.5%) and attention-deficit/hyperactivity disorder (8.8%).Depression too common in American youth ages 12-17 yrs old. 7% of boys and 14% of girls had suffered from major depressive disorder in the preceding 6 month period of time. Majority of children w/ psychological disorders fail to get treated, only about 1/3 get treated. children w/ internal problems like anxiety and depression are less likely to get treated than children w/ external problems (acting out or aggressive behavior) that are disruptive or annoying to others.

Learning disorders

AKA learning disability, chronic disorders that affect development well into adulthood. children w/ this tend to perform poorly school in relation to their level of intelligence and age. children w/ these have often have other psychological problems, such as low self-esteem(teachers and parents see them as failures). also have higher risk of developing ADHD

Diagnostics criteria for CD

Aggression to people or animals includes: -engaging in frwuently.. Property destruction lying or theft Serious rule violations Childood criteria prior to age 10 Mild-severity would mean there are few problems w/ conducy beyond those needed to make a diagnosis and all.. MOdertae Severe

Autism and Autism spectrum Disorder

Autism is one of the most severe behavioral disorders of childhood, it is chronic, life-long condition. Swiss psychiatrist Eugen Bleuler coined the word autism derives from the Greek autos, meaning "self". Autistic thinking is the tendency to view oneself as the center of the universe , to believe that external events somehow refer to oneself. (old version of what we thought) 1943 Leo Kanner, applied "early infantile autism"..

Treatment approaches

Behavioral based parent-training programs are often used to help parents reduce children's aggressive, disruptive behavior and increase adaptive behavior. Treatments target several goals, including helping parents use more consistent and clearer rules and effective discipline strategies, increase positive reinforcement (use of rewards and praise for desirable behaviors of the child), and increase positive interactions w/ the child. Parents must alter disruptive behavior and reward them when they act appropriately. Anger control challenging training may also be of value in treating children w. anger problems and aggressive behavior. CD children are sometimes placed in residual treatment programs that establish explicit rules w/ clear rewards and mild punishments (ex withdrawal of privileges). Boys especially display aggressive behavior and have problems controlling their anger. Cognitive behavioral therapy (CBT) -used to teach aggressive children to reconceptualize social provocational (action or speech that makes someone angry)problems to be solved rather than as challenges to answer w/ violence. these children learn to use calming self-talk to inhibit impulsive behavior and control anger and to find and use nonviolent solutions to social conflicts. ODD resident treatment facilities *[arent traiing for ODD to decrease aggresive and oppositional behavior; increase adaptive behavior.

Causes of Intellectual Disability

Biological causes- chromosomes and genetic disorders, infectious diseases, and maternal alcohol use during pregnancy. Psychosocial causes include stimulating activities during childhood.

Treating depression in children

CBT in treating depression and children and adolescents. 755 of depressed youths treated w/ CBT no longer showed signs of depression by the end of treatment involves social skills training (learning how to start a conversation and make friends) training in problem-solving skills, increasing frequency of rewarding activities, and countering depressive thoughts. In addition family therapy may help families resolve underlying conflicts and reorganize their relationships so that members can become more supportive of eachother.

Additionally

Children w/ disruptive behavior disorder like CD or ODD also tend to show biased ways of processing social info . EX: may think other see them as ill. quick to blame others for conflicts they get into. tend to view other treating them unfairly regardless of evidence. may also show cognitive deficits such as inability to generate non violent social conflicts

Specific learning disorder

DSM-5 applies a single diagnosis of this to encompass various types of learning disorders or disabilities involving significant deficits in skills involved in reading, writing, arithmetic and math, and executive functions. these deficits significantly significantly impact academic performance. They emerge during the grade-school years, but may not be recognized until academic demands exceed the individual's abilities such as when timed tests are introduced. Diagnosis- can't be better explained by delay in intellectual development or by underlying neurological or other medical conditions. the examiner needs to specify the particular learning deficits that interferes w/ academic, social or occupational functioning or by combination of specific deficits.

Problems w/ reading

DSM-5 doesn't use the term dyslexia, even though it's common among teachers and parents, and clinicians to describe reading deficits.

autism spectrum disorder(ASD)

DSM-5 places autism (prev called autistic disorder) in a broader diagnostic category called this or ASD, that includes a range of autism related disorders that vary in severity. DSM-5 identifies ASD on the basis of a common set of behaviors representing persistent deceits in communication and social interactions and restricted or fixated interests and repetitive behaviors. Clinicians need to rate the severity of ASD as severe, moderate, or mild. more severe the disorder the greater the level of support that is needed. A calss of developmental disorders characterized by significantly impaired behavior or functioning in multiple areas of evelopment -includes a range of autism-related disorders that vary in sevreity develop early and often associated w/ ID and.or language impairment Generaly show social/emotional impairment, communication deficits, stereotyped intersts/motor behaviors Asperger's disordres and childhood disinegrative disorder (listed as distinct disorders within the autism spectrum in previous DSM-IV TR) are now calssified as autism spectrum disorder.

Treatment Enuresis

Enuresis usually resolves itself as children mature . Generally involve the urine alarm technique or drug therapy.

separation anxiety disorder

Mary Ainsworth- development of attachment behaviors and found that separation anxiety normally begins during the first year. Having strong attachment early age gives the child confidence to explore new environments later in life. those who show insecure attachments are more prone to develop problem behaviors, such as anxiety, in later childhood in the face of negative life events experienced by the family. This in children is diagnosed when the level of fear or anxiety associated w/ separation from a caregiver or attachment figure is persistent and excessive or inappropriate for the child's development level. 3-year old should be able to go to preschool w/o vomiting and nausea brought by anxiety. 6 yr olds should be able to attend 1st grade w/o persistent dread that something awful will happen to them or their parents. Children w/ this cling to their parents and follow them around the house. insist someone stay w/ them while falling asleep. nightmares, stomach aches, nausea and vomiting when separation is anticipated (school days) pleading w/ parents not to leave, or throwing tantrums when parents are about to depart. children may refuse to attend school for fear that something will happen to their parents whole they are away. Affects an estimated 4% to 5% of children and is the most common anxiety disorder affecting children under the age of 12. The disorder occurs most often in girls and is associated w/ school refusal. Disorder may persist into adulthood, leading to an exaggerated concern about the well-being of one' children and spouse and difficulty tolerating any separation from them. Used to be called "school phobia". for adolescents refusal to attend school is connected w/ academic and social concerns, so the label of separation anxiety disorder would not apply. Development- follows stressful life events, like illness, death, or change in school or home.

Cultural-Familial Causes

Most cases of ID are mild and aren't distinguished by biological causes or distinguished physical features.these have this kind of roots, such as being raised in an impoverished home or social or cultural environment lacking in intellectually stimulating activities or neglect and abuse. children Impoverished families- may lack toys, books, or opportunities to interact w/ adults in intellectually stimulating ways. may not develop appropriate lang skills or have any motivation to learn. economic burdens-the need to hold multiple jobs, may prevent parents from spending time reading to them, talking to them at length, and exposing them to creative play or activities. the children may spend most of their time glued to a TV. these parents who were from poverty also may lack the reading or communication skills to help their children develop theses skills. Children w/ this form of intellectual disability may respond dramatically when provided w/ enriched learning experiences, especially at an early age. Social programs, such as Head start, have helped many children at risk of cultural-familial intellectual disability to function within the normal range of mental ability.

Understanding and treating Learning Disorders

Much of the research on learning disorder focuses on dyslexia, evidence pointing to brain abnormalities that affect how visual and auditory information is processed. People w/ dyslexia have trouble distinguishing sounds (ba and da) Genetic influence- appears to involve defects in neural circuitry in the brain that readers use to process sound. Dyslexic kids w/ this defect compensate by relying on other brain capabilities, although they continue to read slowly Environmental influence- neural circuitry is in tact but people rely more on memory than on decoding strategies to understand written words. this is more prevalent in children w/ disadvantage educational background and is associated w/ more persistent reading abilities. linking learning disorders to defects in brain circuitry responsible fro processing sensory (visual and auditory) info, shows that children need treatment programs that help children adjust to their sensory capabilities. Therapists need to design strategies based on the particular educational needs of the children. EX: child can work work better w/ auditory than visual will be taught verbally. Language specialists can help children w/ dyslexia grasp the structure and use of words.

Treatment of Autism

NO cure, early, intensive behavioral programs that apply learning principles in the child's environment can significantly improve learning and lang. skills and socially adaptive behavior in autistic children.- called Applied behavior analysis or ABA treatment models. using operant conditioning methods, therapists and parents use rewards and mild punishment to increase the child's ability to play w/ other children, develop academic skills, and reduce or eliminate self-mutilation. O. Ivar Lovass- most widely used behavior treatment programs are intense and structured, great deal of individual, one-to-one instruction. he demonstrated impressive gains over in autistic children who received more than 40 hours of on-to-one behavioral treatment each week for 2 years. this method is expensive and often parents have to wait, but toddler is a more effective age for treatment so the waiting list is bad.

Cognitive learning perpective on autism

O. Ivar Lovaas- suggest that children w/autism have perceptual deficits that limit them to processing only one stimulus at a time. as a result, they are slow to learn by means of classical conditioning (association of stimuli). from this theory, children become attached to their primary caregiver through association w/ primary reinforces such as food and hugging. they connect w/ the food or cuddling no the parent.

Prenatal Factors

Some cases of ID are caused by maternal infections or substance abuse during pregnancy. EX: Rubella(German Measles) in the mother can be passed along an unborn child, causing brain damage and resulting in intellectual disability. Syphilis, cyromegalovirus, and genital herpes also may cause mental retardation in the child. efforts to prebent these from effecting the child include testing for the disease beforehand, and C-section so baby doesn't come in contact w/ herpes. Drugs mother ingests during pregnancy may pass through the placenta to the child- can cause severe birth deformities and ID. Oxygen deprevation and head injuries, place children at increased risk for neurological disorders, ID. Prematurity also places children at risk of ID and developmenntal problems. Brain infections, such as encephalitis and meningitis or traumas during infancy and early childhood, can result in ID and other health problems. children who ingest toxins like paint chips containing lead, may also suffer brain damage that leads to ID.

Stimulant drugs

Stimulant drugs help calm them down at school (prefrontal cortex). Ritalin and longer acting stimulant called Concerta, which is a one-a-day dose drug. reduce disruptive, hyperactive behavior and also improves attention spans in children w/ ADHD. even used on preschooler ages 3-5. these drugs may not improve academic performance. rate of relapse if a person stops taking the medication. side effects, shorterm (loss of appetite or insomnia) usually subside in a few weeks or eliminated by lowering the dose, use of stimulant drugs lead to other effects like slowing down of physical growth. they catch up to growth with ther peers eventually.

Nonstimulant drugs

Strattera (atomoxetine)-first non stimulant drug approved for treating ADHD, it is a selective norepinephrine reuptake inhibitor- it increases the availability of neurotransmitter norepinephrine in the brain. we don't know how the drug works on ADHD, the increased livability if norepinephrine may enhance brain's ability to regulate impulsive behavior and attention. Like Ritalin, Strattera works better than placebo but not as well as Ritalin.

Theoretical perspectives on ODD and CD

The casual factors in ODD remain obscure. Some theories. Oppositionality is an expression of an underlying temperament described as the "difficult-child" type. others believe that unsolved parent-child conflicts or overly strict parental control lie at the root of the disorder.

Interventions

The services that children w/ ID need depend on the level of severity and type of retardation. W/ appropriate training, children w/ mild forms of intellectual disability may approach a sixth-grade level of competence. they can acquire vocational skills and support themselves minimally through meaningful work. Many such children can be put in regular classes. At the other extreme , children w/ severe ID may need institutional care or placement in a residual care facility in the community, such as a group home. Placement in an institution is often based on the need to control destructive or aggressive behavior, not because of the severity of the individual's intellectual impairment. Consider the case of a child w/ moderate level of intellectual disability.

Understanding and treating Childhood anxiety

Theoretical perspectives on anxiety in children parallel to some degree explanations of anxiety disorders in adults. Psychoanalytic theorists- argue that childhood anxieties and fears, like their adult counterparts, symbolize unconscious conflicts. Anxious children can benefit from Cognitive behavioral techniques for treating anxiety as adults such as gradual exposure to phobic stimuli and relaxation training. Cognitive techniques help children identify anxiety-generating thoughts and replace them w/ calming alternative ones. CBT has shown good results in treating various anxiety disorders in children and adolescents. Antidepressants of the class of selective serotonin reuptake inhibitors (SSRI's) such as fluvoxamine (Luvox), sertraline (Zoloft), and fluoxetine (Prozac) work well in treating anxious children and adolescents. Children who CBT had less insomnia, fatigue, sedation and restlessness to have those receiving medication

Phenylketonuria (PKU)

a genetic disorder that occurs in 1 in 10000 to 15000 births. is caused by a recessive gene that prevents the child from metabolizing the amino acid phenylaline, which is found in many foods. phenylaline and phenylpyruvic acid accumulate in the body, causing damage to the CNS, resulting in severe intellectual disability. Can be detected in newborns by analyzing blood and urine samples. no cure for PKU children w/ the disorder suffer less damage or develop normally if they are placed on a diet low in phenylalinine son after birth and they receive protien suppliment to compensate for their nutrition loss

Social (pragmatic) Communication Disorder

a newly recognized disorder in DSM-5, diagnosis applies to children who have continuing and profound difficulties communicating verbally and nonverbally w/ other people in their natural contexts- in school or at home, or in play. have trouble communicating and may fall silent in groups of children. have difficulty acquiring and using both spoken and written language. yet they do not show low level of language or mental disabilities that might explain their difficulty communication w/ others. Can't fully participate in social interactions and effects their school or work performance poorly.

Fragile X syndrome

affects about 1 out of 1000 to 1500 males and about 1 out of 2000-2500 females. 2nd most common form of ID, after Down syndrome. Caused by mutation on a single gene in an area of the X chromosome that appears fragile. effects range from mild learning disorder to ID so profound that those affected can hardly speak and function. females have two X chromosomes males have 1. Females having 2 X chromosomes seems to provide some protection against the disorder if the defective gene turn up on one of the two chromosomes, which results in a milder form of intellectual disability. many males and females carry the fragile X mutation w/o showing any clinical signs, such carriers can still pass the syndrome to their offspring. A genetic test can detect the genetic defect that casues fragile X syndrome. currently no treatment for the syndrome, genetic research focused on identifying the molecular cause of the disorder may someday lead to effective treatments

Genetic Factors

also appear to contribute to the development of anxiety disorders in children, including separation anxiety and specific phobias.

Genetic factors and environmental factors

environmental influences are currently unknown, possibly involving exposure to certain toxins or viruses or prenatal influences. even before symptoms emerge we see evidence of abnormal brain development in infants who go on to develop autism. greater risk of ASD to certain prenatal risk factors like influenza , infection or prolonged fevers in the mother during pregnancy. these factors may effect the brain of the developing fetus. also children w/ autism the part of the brain responsible for language and social behavior grow much more slowly than in other children. Can't find one specific gene,found three genes related

Conduct Disorder

also involves disruptive behavior, (CD) differs from ADHD. children w/ CD purposely engage in antisocial behavior that violates social norms and the right of others. Like antisocial adults, many conduct-disorder children are callous and apparently do not experience guilt or remorse for their misdeeds. they may lie or con in order to get what they want, steal or destroy property, start fires, break into people's houses, as they get older commit serious crimes such as rape, armed robbery, or even homicide. may cheat in school, and lie to cover it up. frequently engage in substance abuse and early sexual activity. Surprisingly common problem- affecting 12% of males and 7% of females (9.5% overall).not only more common inhibits than girls, but takes different forms. In boys, CD is more likely to be exhibited in stealing, fighting, vandalism, or disciplinary problems at school. In girls, more liekely to involve lying, truancy, running away, substance use, and prostitution. Children w/ CD often have other disorders including ADHD, major depression, and substance use disorder. CD in childhood also linked to antisocial behavior and development of antisocial personality disorder in adulthood. average onset is 11.6 yrs, although it can develop at younger or older ages. is chronic or persistent disorder. closely linked to social behavior, other commonly found traits include callousness (being uncaring, mean, cruel) and an emotional way of relating to others. Areas of conduct problems* 1. aggression to ppl or animals 2. property destruction 3. lying or left 4. serious rule violation whereas children w/ ADHD seem literally incapable of controlling behavior, children w/ CD...

Family factors

are also implicated in the development of CD, The disorder develops in the context of negative parenting, such as failure to positively reinforce or praise the child for appropriate behavior and use of harsh and inconsistent discipline following misbehavior. family interactions of families of CD children are often characteristics by negative, coercive interactions. CD children are often very demanding and noncompliant w/their parents and other family behaviors. family members often reciprocate by using inappropriate or harsh behaviors, such as threatening or yelling at the child or using physical means of coercion. parental aggression includes pushing, grabbing slapping, spanking, hitting, or kicking. CD often occurs with Parental distress such as divorce.

Psychological interventions

are needed aside from drugs for the treatment of ADHD. help child develop more adaptive behaviors. EX: behavior modification programs to train parents and teachers to use contingent reinforcement for appropriate behaviors ( a teacher praising child for siting quietly) may be combined w/ cognitive modification (training child to silently talk him or herself through the steps involved in solving challenging academic problems.

Childhood Anxiety and depression

childhood fears like scared of the dark are normal. no normal to have anxiety that is excessive and interferes w/ normal academic or social functioning or becomes troubling or persistent. Like adults, children suffer from anxiety disorders like Generalized AD, phobic disorders, OCD, and PTSD. Anxiety disorders are the most common type of psychological disorder affecting adolescents. theya re often co-morbid /w depressive disorders. Anxiety and depressive disorder occur more commonly among ethnic/minority groups. Anxiety problems may go undetected and untreated as it is hard to distinguish them from regular fears from more extreme problems associated w/ anxiety disorder. Another issue children only report physical issues such as stomach or head ache. unable to express feelings of "worry" or :fear". untreated anxiety disorder can affect later in life.

Problems w/ Arithmetic reasoning skills

children may have problems understanding basic arithmetic facts, such as addition or subtraction operation, or performing calculations or learning multiplication tables or solving math reasoning problems. apparent age 6 (1st grade) not recognized until about 2nd or 3rd grade.

Working memory

children w/ ADHD have problems w/ this - holding information in mind in order to work on it, which makes it difficult to keep one's mind on a task at hand.

Fetal alcohol syndrome

children who's mothers take alcohol during pregnancy, one of the most prominent forms of ID.

The Developmentally Disabled Assistance Bill of Rights Act

congress passed in1975 provided tat people w/ mental retardation (now ID) have the right to receive appropriate treatment in the least-restrictive treatment setting. Nationwide people in institutions shrunk 2/3rds within a year. Those who do not need t be institutionalized can live in homes which they share responsibility and are encouraged to participate in meaningful daily activities such as training programs and sheltered workshops. Others live with their families and attend structured day programs.

Problems w/ reading

deficiency is characterized by errors in spelling, grammar, or punctuation; by problems w/ legibility or fluent handwriting; or by difficulty composing clear, well organized sentences and paragraphs. become apparent age 7 (2nd grade), milder cases may not be recognized until age 10 (5th grade) or later.

Level of severity

depends on the child's adaptive functioning , or ability to meet the expect able demands children face at school and home. Most children w/ ID (85%) fall into the mild range. these children are capable of meeting basic academic demands, like learning to read simple passages. as adults they are capable of independent functioning, although they may require some guidance and support. Table 13.2 Pg.492.

Understanding and Treating childhood depression

depression and suicidal behavior in childhood are frequently related to family problems and conflicts. children and adolescents exposed to stressful life events affecting the family, such as parental conflict or unemployment, stand an increased risk of depression. In girls, disturbed eating behaviors and body dissatisfaction after puberty often predict the development of major depression during adolescence. Don't know if children become depressed because of depressive mindset or whether depression leads to distorted, negative thought. or vice versa. Adolescent girls tend to show greater levels of depressive symptoms than adolescents boys do, girls who adopt a passive, ruminative coping styles (brooding and obsessing about their problems) may be at greater risk of developing depression.

Genetic and environmental

early experiences of physical abuse and hash parenting increase the risk of CD, but only in children w. a certain genetic profile. Genetic factors may also play a role in ODD

Problems w/ executive fundtions

executive function skills are a set of higher mental abilities involved involved in organizing, coordinating, and planning tasks needed to manage one's task or assignments.children struggle w/ these types of challenges, children w/ executive function deficits have marked and sustained difficulties organizing and coordinating their school related activities. they may frequently fall behind in school work, fail to keep track of homework assignments, or fail to plan ahead on order to complete assignments in time.

Distorted patterns of thinking

expecting the worst (pesimism) catastrophizing the consequences of negative events Blaming themselves fro disappointments and negative outcomes, even when this is unwarranted Minimizing their accomplishments and focusing only on negative aspects of events.

Enuresis

failure to control urination after one has reached the "normal" age for attaining such control.to be Diagnosed with this according to the DSM, the child mus be at least 5 years of age or at an equivalent development level and meet these criteria: -repeatedly wetting or clothes (whether intentionally or involuntary) -wetting occurs at least twice a week for three months or causes significant distress or impairment in functioning -there is no medical or organic basis to the disorder; nor si it caused by use of a drug or medication. more common among boys, Bed-wetting affects upward of seven million children age 6 yrs and over in the US. 5-10% of children meet diagnostic criteria for enuresis at age 5. Disorder usually resolves itself by adolescents, if not earlier, 1% of cases continues into adulthood. wetting may occur during nighttime sleep only - this is the most common type. the younger the child id the more likely for bed-wetting at night. occurs usually during the deepest level of sleep may reflect immature nervous system. Diagnosis: applies in cases of repeated bed-wetting or daytime wetting of clothes by children of at least 5 yrs.

cognitive theorists

focus on the role of cognitive biases, anxious children tend to show the types of cognitive distortions found in adults w/ anxiety disorders, including interpreting social situations as threatening and expecting bad things to happen. engae in negative self-talk. avoidance of feared activities- with friends and school.Negative expectations can heighten feeling of anxiety and to the point of impairment in school and athletics.

autistic traits

generally continue into adulthood to one degree or another. some autistic children go onto earn college degrees and function independently. others need continuing treatment throughout their lives, even institutionalized care. small subset who can overcome the disorder.

Risk factors for childhood disorder

genetic susceptibility, environmental stressors (living in decaying neighborhoods)and family factors (harsh discipline, neglect sexual and physical abuse) Children of depressed parents also stand higher risk of developing psychological disorders. Ethnicity and Gender are other discriminatory factors-unclear why, ethnic minority children are more at risk to psychological disorders, ADHD and anxiety and depressive disorders. Boys are more at risk for developing childhood disorders like autism to hyperactivity to elimination disorder also anxiety and depression. Girls anxiety and depression is more common and remains throughout adulthood. Physical and sexual abuse and neglect are linked to a wide range of psychological disorders in childhood and adulthood, such as depression, substance abuse, anxiety disorder, ADHD, PTSD. even milder forms of punishment like spanking may increase risk of anxiety and mood disorders in adulthood. Physically abused or neglected children- have trouble forming healthy relationships and attachments. lack empathy, or concern for welfare of others. they may act out in ways that mirror the pain they've experienced in their lives by lighting fires, killing animals or picking on smaller kids. Also have lower self-esteem, depression, immature behavior like bed wetting and thumb-sucking, suicide attempts and suicidal thinking, poor school performance,behavior problems, failure to venture outside of home areas/ explore outside world. childhood abuse symptoms can extend into adulthood. Childhood Sexual and physical abuse-international study 8% of men and 20% of women had suffered sexual abuse before the age of 18. more than 1.5 million children in US each year are victims of of child abuse or neglect. 1 - 2,000 children in US die each year as a result of abuse or neglect, more than twice the rate of Great Britain, France, Canada, or Japan. Verbal abuse is serious, parents harshly scolding, belittling and swearing at their children. exposure to domestic violence or spousal abuse in the home is also associated w/ higher levels of behavioral and emotional problems in children.

Behavioral methods

have been shown to be helpful when enuresis endures or causes or causes children or parents great distress. These methods condition children to wake up when their bladder is full. O. Hobart Mower- urine alarm method, involves a moisture-activated alarm that is placed beneath the sleeping child. A sensor sounds when the child wets the bed which awakens the child. after several times the child learns to awaken before the alarm sounds and wetting the bed.- technique is classical conditioning. Tension in children's bladder is paired repeatedly w/ a stimulus(an alarm) that wakes them up when they wet the bed. the bladder tension ( a conditioned stimulus) elicits the same response ((waking up-the conditioned response) that is elicited by the alarm (the unconditioned stimulus) Highest cure rates and the lowest relapse rates.

Cognitive-behavioral therapists

help ADHD children learn to "stop and think" before getting angry and acting out aggressively. the effects of these may not be as string as stimulant medication. some children do well w/ only drugs or only therapy (CBT) some benefit from both.

Role of genetics

higher concordance of ADHD among monozygotic twins than DZ twins ADHD may be attributed to a breakdown in executive control of the brain functions, involving processes of attention and restraint of impulsive behaviors needed to organize and follow through on goal directed behaviors. Brain-imaging studies showed abnormalities or delayed maturation in parts of the brain in children w/ ADHD, especially in prefrontal cortex.

Neurodevelopmental disorders

involve impairment of brain functioning or development that affects the child's psychological, cognitive, social or emotional development. Includes Autism spectrum disorder, Intellectual disability, specific learning disorder, Communication disorders, Attention-defeciet/hyperactivity disorder.

Language disorder

involves impairments in the ability to produce or understand spoken language. May be specific impairments, such as slow vocabulary development, errors in tenses, difficulties recalling words, and problems producing sentences of appropriate length and complexity for the individual's age. Affected children may also have speech sound (articulation) disorder, compounding their speech problems. children w/ this may also have trouble understanding words or sentences, they strugle w/ undersdtanding certain word types (EX: expressing difference in quantity-large, big or small) spatial terms (sucha as near or far), or sentence types (such as sentences that begin w/ the word "unlike"). or difficulty understanding simple words or sentences.

Secondary enuresis

is apparently not genetically influenced and characterizes children w/ occasional bed-wetting who develop the problem after having established urinary control.

Encopresis

lack of control over bowel movements that is not caused by an organic problem. The child must have a chronological age of at least 4. about 1% of 5 yr olds have this. most common among boys. soiling may be voluntary or involuntary and is not caused by an organic problem, except in cases in which constipation is involved. Predisposing factors- inconsistent or incomplete toilet training and psychosocial stressors, such as the birth of a sibling or beginning in school. soiling is more likely to happen during the daytime which can be embarrassing to children. hard to ignore becasue it smells, parents may demand self control and punish fro failure. children may hide soiled underwear or fake being sick to avoid school.

Diagnostic criteria for ODD

lasting 6 months during which 4+ of the following: 1. often loses temper 2. often arugues w/ adults 3. defies or refuses to comply w/ adults' requests or rules 4. deliberatrly annoys peopel 5. often blames others fr his or her mistakes or misbehaviors 6. often touchy or easily anoyed by ithers 7/ angry and resentful 8. spitefuk or vidicitive clinically significant impairment i

chromosomal abnormalities on sex chromosome

less common than down syndrome, result in intellectual disabilities such as Klinefelter's syndrome and Turner's syndrome. Klinefelter's syndrome- only occurs in males and is characterized by the presence of an extra X chromosome, resulting in an XXY chromosomal pattern rather than normal XY pattern. 1-2 per cases per 1,000 male births. these men fail to develop appropriate secondary sex characteristics, resulting in small underdeveloped testes, low sperm production, enlarged breasts, poor muscular development, and infertility. learning disabilities are also common.

Biomedical treatments

limited largely to the use of antipsychotic drugs to control disruptive behavior-tantrums, aggression, self injury, and stereotyped behavior in autistic children. these work better when treatments include parents in a training program that teaches them how to respond to the child's disruptive behavior. drugs do not produce consistent improvement in cognitive and language development in autistic children, drugs may play a role in fostering lang. development.

Environmental influences/ Factors

linked ADHD include maternal smoking and emotional stress during pregnancy, high levels of family conflicts, and poor parenting skills in handling children's misbehavior. Lead exposure to children w/ ADHD symptoms (hyperactivity and inattention)

Psychodynamic Theorists

look at ODD as a sign of fixation at the anal stage of psychosexual development, when conflicts between the parent and child emerge over toilet training. leftover conflicts may become expressed in forms of rebelliousness against parental wishes

Childhood depression

many adolescents and children suffer from diagnosable mood disorders, including major depression and bipolar disorder. Major depression is most common affecting 5% of children 5-12.9 years and 20% of adolescents from 13-17.9 years of age. rarely occurs among preschoolers. Girls are more likely to experience a first major depressive episode during childhood or adolescents, no gender difference between in likelihood of having a recurrent episode. like adults depressed children have feelings of hopelessness; distorted thinking patterns and tendencies to blame themselves for negative events and lower self-esteem, self-confidence, and perception of competence. they report episodes of sadness and crying, feeling of apathy, as well as insomnia and fatigue. weight is affected and feelings and thoughts of suicide/ attempts. Distinctive features- refusal to attend school, fears of parents' dying, and clinging to parents. Conduct and academic problems ,physical complaints, and hyperactivity may stem from unrecognized depression. adolescents aggression and sexual acting out. children aren't capable of recognizing their depression until the age of 7. isolated from friends, lack academic or physical or social skills. depressed children may find it hard to concentrate in school and may suffer from impaired memory, making it difficult for them to keep their grades up. Keep their feelings to themselves, which may prevent their parents from recognizing the problem and seeking help. Express negative feelings in the form of anger, sullenness, or impatience, leading to conflicts with parents that in turn can prolong depression. Major depressive episode in childhood or adolescents may last upward of a year longer and may reoccur later in life. Depressed children often have other significant psychological problems, including anxiety disorders, CD, ODD, and among adolescent girls, eating disorders. 20%-40% of depressed adolescents also develop bipolar disorder later.

Autism

more common in boys than girls about 4-5x as common the disorder generally starts to become evident in children between 12-28 months reliably diagnosed 2-3 yrs, but avg children is not diagnosed until about age 6 delays in diagnosis can be detrimental;, ...

Down syndrome

most frequently identified cause of ID, characterized by an extra chromosome on the 21st pair of chromosomes resulting in 47 chromosomes rather than the normal 46. Occurs in about 1 of 800 births. occurs when the 21st pair of chromosomes in either egg or sperm fails to divide normally , resulting in an extra chromosome. chromosome abnormalities become more likely as parents age . Down syndrome can be traced to mother's egg cell in about 90% of cases, w/ about 10% attribute to father's sperm. People w/ Down syndrome are recognizable by distinctive physical features: round face, broad, flat nose, and small, downward-sloping folds of skin at inside of the corners of the eyes, giving the impressions of slanted eyes. A protruding tongue; small. squarish hands and short fingers, a curved 5th finger; and disproportionately small arms and legs. Nearly all these children have ID and many suffer from physical problems, such as malformations of the heart and respiratory difficulties. Avg, life expectancy of Down syndrome is 49. later in life people w/ down syndrome suffer memory loss and experience childish emotions that represent a form of dementia. Treatment- no treatment scientists are working on ways to improve brain functioning. They suffer deficits in learning and development, tend to be uncoordinated and lack proper musical tones, which makes it difficult for them to carry out physical tasks and play like other children. suffer memory deficits making it difficult for them to learn in school. difficulty following instructions and expressing thoughts through speech. most can learn to read and write and perform simple math if they receive appropriate schooling and encouragement.

Culteral beliefs about what is normal and abnormal

normality is filtered through a culteral lens. American and Thai parents described two children one w/ problems of "overcontrol" (shyness, fears) and one w/ problems of "undercontrol" (disobedience, fighting) Tahi parents rated both problems less serious than Americans did. Treatments- differ children, Children may not have the speech capable of describing their feelings or the attention span to sit through a therapy session.

Turner's syndrome

occurs in only females, characterized by presence of a single X chromosome instead of the normal two. girls w/ this develop normal external genitals, ub their ovaries remain poorly developed, producing less estrogen. short stature, infertile, have endocrine and cardiovascular problems. mild intellectual disability (skills w/ math and science)

Oppositional Defiant Disorder (ODD)

often combined under the general heading of "conduct problems". it is seperate bu similar to CD. involves more nondelinquet (oppositional or negativistic) forms of conduct disturbance. ODD typically develops earlier than CD, may lead to the development of CD at later ages, only some go on to develop CD. Children w/ this defy authority by frequently arguing w/ parents and teachers and refusing to follow requests or directives. They may deliberately annoy other people, become easily angered or lose their temper, become touchy or easily annoyed, blame others for their mistakes or misbehavior, feel resentful towards others, or act in spiteful or vindictive or irritable mood. they also acts spiteful towards others they feel have wronged them. disorder begins before 8 yrs old and develops gradually over a period of months or years. starts in home environment by may extend to school. ODD is one of the most common diagnosis among children. affects 1% to 11% of children and adolescents. More common for among boys than girls before age of 12, unclear whether gender difference in adults. A psychological disorder in childhood and adolescence characterized by excessive opositionality ore tendencies to refuse requests from parents and others Children w/ this tend to be negativistic or oppositional they defy authority by arguing w/ parents and techers refusing to follow directions

Communication Disorder

persistent difficulties in understanding or using language or speaking clearly and fluently. because of how essential lang. is in daily life these disorders can greatly interfere w/ the person's ability to succeed in school, work, or social situations.

Childhood-onset fluency disorder

persistent stuttering, which is characterized by impaired fluency of speech, is classified in DSM-5 as a type of communication disorder. stuttering begins between age 2 and 7. disorder is characterized by on or more of the following characteristics: a. repetition of sounds and syllables b. prolongations of certain sounds c. interjections of appropriate d. broken words, such as pauses within a word e. blocking of speech f. cicumlocutions (substitutions of alternative words to avoid problematic words) g. displaying an excess of physical tension when emitting words h. repetitions of monosyllabic whole words (e.g., "I-I-I am glad to meet you"). stutters occur in 3x as many males as females. 80% overcome the problem w/ no treatment before age 16. genetic factors -may play a role in stuttering, perhaps involving genes that influence the control of the muscles involved in producing speech. reported discovering mutations on specific gene linked to persistent stuttering. Emotional component- children who stutter are more emotionally reactive when faced w/ stressful or challenging situations, they become upset or excited. they also tend to be troubled by social anxiety stemming from over concern about how other evaluate them.

Criteria for Autism Spectrum Disorder

pg. 486.

Learning theorists

point out that enuresis occurs most commonly in children who's parents attempt to train them early. Early failures may have connected anxiety w/ efforts to control the bladder.

Drug therapy

psychiatric drugs such as fluvoxamine (Luvox), an SSRI-type antidepressant that works on brain systems that control urination. high relapse rates, do not teach new skills or adaptive behaviors that can be retained beyond the active treatment period.

Play therapy

psychodynamic therapists developed this technique in order to cater to the level of children's cognitive, social, and emotional development. children enact family conflicts symbolically through play activities, like puppets and dolls. or drawing materials to draw out what therapists believe to be their underlying feelings. therapists Need to tend to cultural needs

Some possible additional features

shun affectionate behavior (some very affectionate) uses gestures or pointing instead of words appear unaware of others, not responsive to verbal cues; seem deaf Odd/stereotyped movements like hand flapping prefer to be alone abnormal responses to senses (sight, hearing, touch, smell, taste, reaction to pain) -sniff or lick toys -unable to tolerate a material -show no sensitivity to burns or bruises..

features of Autism

some features include language and communication problems, ritualistically or stereotyped behavior. difficulty forming traditional relationships w/ others, or ability to respond appropriately.. echolia (parroting back what the child has heard in a high-pitched monotone); pronoun reversals (using "you" or "he" instead of "I"); use words that have meaning only to those who have intimate knowledge of the child; and tendencies to raise the voice at the end of sentences, as if asking a question. May be unresponsive. express strong negative emotion like anger or fear. primary feature of autism is repetitive, purposeless movements- flapping hands, or rocking back and forth with arms around knees. Some children inflict pain on themselves, bang heads, slap face. preservation of sameness- another feature of autism is aversion to environmental changes. when familiar objects are moved, even slightly from their usual places, children w/ Austism may throw tantrums or cry continually. Bound to rituals, eat same food everyday. appear to lack a differentiated self-concept, sense of themselves as distinct individuals, often have an "intelligent look". usually below average on IQ, problems inteacting with others.

Learning Theorists

suggest that generalized anxiety disorders may arise from fears of rejection or failure that carry across situations. Underlying fears of rejection or feelings of inadequacy generalize to most areas of social interaction and achievement.

Psychodynamic of enuresis

suggest that it misrepresents the expression of hostility towards children's parents because of harsh toilet training. It may represent regression in response to the birth of a sibling or some other stressor or life change, such as starting school or suffering the death of a parent or relative

Suicide in children and adolescents

suicide is rare in children and early adolescents but becomes more common in late adolescents and early childhood. 1 person per 10,000 (0.01%) in 15-24 yr old age group commit suicide. In addition to increasing age , other factors in increasing risk of suicide: gender Geography Ethnicity Depression and homelessness Previous suicidal behavior prior sexual abuse family problems stressful life events substance abuse social cognition

Primary enuresis

the most prevalent form of the disorder, characterizes children w/ persistent nocturnal bed-wetting who have never established urinary control through the night. I is due to maturation delays that have genetic underpinnings. Not sure about genetics yet, could be motor control over eliminatory reflex in cerebral cortex. Environmental and behavioral factors also come into play in determining the development and course of the disorder

Asperger's disorder and childhood disintegrative disorder

these diagnostic terms were used in previous editions of the DSM to describe distinct disorders within the autism spectrum, but are now classified as forms of autism spectrum disorder id diagnostic criteria for ASD are met.Asperger's disorder refers to a pattern of abnormal behavior involving social awkwardness and stereotyped or repetitive behaviors but without the significant language or cognitive deficits associated w/ more severe forms of autistic spectrum disorder. children w/ Asperger's don't show the profound deficits in intellectual, verbal, and self-care skills we find in children w/ the classic from of autism. they have remarkable verbal skills, such as reading newspapers at age 5 or 6, and may develop an obsessive interest in, and body of knowledge about an obscure or narrow range of topics like highway systems, plane schedules. Childhood disintegrative disorder- prev version of DSM applies to children who show significant loss (disintegration) of previously acquired skills in areas such as understanding or suing lang., social or adaptive functioning, bowel or bladder control, play or motor skills/. child also shows impaired social interactions or communication and narrow, stereotyped, and repetitive, behaviors, interests or activities. rare condition, more common in boys.

Behavioral Therapy for treating encopresis

treatment generally involves the parents rewarding (by praise and other means) successful attempts at self-control and using mild punishments for continued accidents (gentle reminders to attend more closely to bowel tension and having the child clean their own underwear). when encopresis persists, through medical and psychological evaluation is recommended to determine possible causes and appropriate treatments.

Dyslexia

trouble reading, derives from Greek "bad word" most common type of learning disorder, 80% of cases. people w/ this have trouble reading even though they are at least average intelligence. may struggle to understand or identify basic words, comprehend what they mean, read slowly. affects about 4% of school-aged kids, more common in boys than girls. trouble decoding letters, and letter combinations and translating them into the right sound, trouble reading aloud. mispercieve letters, Upside down (M to W) or reverse (b-d). apparent by age 7 (sometimes 6)-second grade. people w/ this are prone to depression and, low self-worth, and ADHD Rates vary w/ lang. higher in English speaking and french speaking countries where the lang contains many ways of spelling words containing the same meaningful sounds ( "o" in toe and tow) Low in Italy where lang. has a smaller ratio of sounds to letter combinations.

Amniocentesis

usually conducted about 14-15 weeks following conception, a sample of amniotic fluid is drawn with a syringe from the amniotic sac that contains the fetus. Cells from the fetus can then be separated from the fluid, allowed to grow in a culture and examined for abnormalities, including Down syndrome . Blood tests are used to detect carriers of other disorders.

learning theorists

view oppositional behaviors as arising from parental use of inappropriate reinforcement strategies. In this view, parents may inappropriately reinforce oppositional behavior by giving in when the child refuses to comply w/ there wishes, which can become a pattern.

Causes of Autism

we don't know for sure. evidence points to to a neurological basis of brain abnormalities, perhaps involving parental influences lead to abnormal wiring in the circuitry of the developing brain. Brain-imaging studies show brain show malfunctions in complex circuitry networks of brain cells and structural damage involving loss of brain tissue.