Childhood Disorders Final Exam (PAST CHAPTERS)

maltreatment

"Any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse, or exploitation, or an act or failure to act which presents an imminent risk of serious harm" Child Welfare Information Gateway, 2011

Hindbrain

(medulla, pons, and cerebellum) provides regulation of autonomic activities

diencephalon

(thalamus, and hypothalamus) -regulates behavior and emotion -functions primarily as a relay between the forebrain and the lower areas of brain stem

parent teacher rated problems

(the more they have the more concerning) unhappy, sad, or depressed cant concentrate demands attention doesnt get along with others impulsive nervous poor schoolwork inattentive stubborn moody sulks temper

bipolar 1: (what symptoms? how long? what do they have for the rest of their life?)

**mania and maybe depression but not req * a week or more for the manic episode. spend hella $ etc *can have some manic eps but dep 4 rest of their lives

forebrain (basal ganglia)

*regulates, organizes, and filters info related to cognition, emotions, mood and motor function *is assoc w ADHD motor behaviors (tics tremors) and OCD

Evolving forms of treatment: Psychodynamic approaches

-1930 to 1950: psychodynamic approaches prevailed _most children w intellectual or mental disorders were institutionalized - Late 1940s: Spitz' studies pointed out the harmful impact of institutional life _Anaclitic depression -1945 to 1965: Institutionalization decreased _Placement in foster care and group homes increased

What is abnormal behavior in children and adolescents?

-Childhood disorders are accompanied by various layers of abnormal behavior or dev -Must also be sensitive to each child's stage of dev -Disorders are commonly viewed as deviancies from normal _Boundaries between normal and abnormal functioning are arbitrary

Before the 18th century (prior to 1700s but continued well into 1800s in some places)

-Children were subjected to harsh treatment and largely ignored .Mass. stubbord child act permitted parents to kill their stubborn children -Mental illness thought to be due to posession by the devil and supernatural forces, often put disabled children in cages

attachment theories

-Children with conduct problems have little internalization of parent and societal standards -There is a relationship between insecure attachments and the development of antisocial behavior

Research in abnormal child psych seek to:

-Define normal and abnormal behavior for children of different ages, sexes,m and ethnic/cultural backgrounds -ID cases & correlates of abnormal behavior -Make predictions about long-term outcomes -Dev. & evaluate methods for treatment &/or prevention

Early psych att (Psychoanalytic theory)

-Freud is 1st to link adult disorders to childhood experiences -Linked mental disorders to childhood experiences and surroundings _Focused on the interaction of dev. and situational processes -Purported that mental disorders can be helped with proper environment or therapy -Retains a role as a model for abnormal child psychology

Progressive legislation-IDEA

-IDEA (individuals with disabilities education act) requires: _Free and appropirate public education for children w special needs in the least restrictive env _Each child must be assessed w culturally appropriate tests _An individualized education program (IEP) for each child

Early psych att (Behaviorism)

-Laid the foundation for evidence-based treatments -key studies _Pavlov's research on classical conditioning _Watson's studies on the elimination of children's fears and the theory of emotions *Famous study Little Albert -Mary Cover Jones mother of behavior therapy _Famous study Little Peter

coersion theory

-Parent-child interactions provide a training ground for the development of antisocial behavior -Four-step escape-conditioning sequence •The child learns to use increasingly intense forms of noxious behavior to avoid unwanted parental demands (coercive parent-child interaction) -Children with callous-unemotional traits display significant conduct problems regardless of parenting quality

As adults, more likely to experience (SAD)

-Relationship difficulties -Other anxiety disorders and mental health problems -Functional impairment in social and personal life

Ancient greek/roman view

-The disabled were a burdern-scorned, abandoned, or put to death -Roman Rule of Chastisement "rule of thumb"

Obstacles to intervention and prevention services for maltreating families

-Those most in need are least likely to seek help -They are brought to the attention of professionals after norms or laws have been violated -Parents do not want to admit to problems for fear of losing their children or being charged with a crime

Features that distinguish child & adolescent disorders

-When adults seek services for children, it is not often clear who has what "prblem" -Many child & adolescent probs: involve a failure to show expected dev progess & Are not entirely normal -Interventions are often intended to promote further dev.

Emotions and affective expression

-are core elements of human psychological experience -Are central feature of infant activity & regulation -Tell us what to pay attention to/what to ignore -affect quality of social interactions and relationships -are important for internal monitoring & guidance

Dev tasks: infancy to preschool

-attachment to caregivers -differentiation of self from env -language

Bipolar 2:(what symptoms? how long? what other disorder does it look like in kids?)

-bipolar 2 disorder ** 4 days worth mania. Not as extreme **hypo same but less likely to spend $ have sex etc *more diff with children as well. looks like ADHD

classes of genetic disorders

-chromosomal abnormalities: the most common cause of severe MR -single gene: can be dominant, recessive or X-linked -multifactorial: most likely to be several genes interacting with env factors. Most children with mild to moderate MR have multifactorial causes, and we don't know the specific causes

cyclothymia: (how long? what is it?)

-cyclothymic disorder 2 yrs adults 1 yr children and adols. cycle between hypo and dysthymia

reasons for skepticism about research in abnormal child psych

-experts freq disagree -studies appearing in mainstream media are oversimplified -findings often conflict w 1 another -research has led to diff treatments- some have been helpful, some have no effect and some have been harmful

Child maltreatment:consequences

-financial consequences of abuse & trauma: $124 billion per year in the US More attention needs to be given to developing new ways to prevent and help those exposed to maltreatment & trauma

early bio att. (eugenics & sterilization)

-late 1800s & early 1900s society reverted to a belief that disorders couldnt be influenced by treatment or learning _there was a return to to custodial care & punishment of behaviors -led by views of genetics from theory of evolution (interestingly, not led by Darwin or Wallace but by others who expanded views of evol. like Spencer & Galton) -Mental dis viewed as diseases led to fear of contamination _eugenics (sterilization) & segregation (institutionalization) were implemented for both mentally ill & those w low intelligence *Hnery Goddard and "Kallikak" family (1912): Heredity of feeblemindedness *Galton's work on IQ and inheritance (Galton was Darwin's cousin)

early biological attributes

-late 19th century (late 1800s): mental illnesses were viewed as biological problems _however the prevailing bias was that the individual was at fault for deviant or abnormal behavior _masturbatory insanity: 1st mental illness ascribed to children -Clifford Beers' (1909) suffered from psychosis & believed mental illness was a disease-led efforts to detection & intervention

emotion regulation after - maternal moods or prolonged sadness (depression) (may have probs doing what? prone to what? use what strategies?

-may have probs regulating negative emotional states and may be prone to depression -may use avoidance or - beh regulate distress, rather than prob-focused and adaptive coping strategies

dev tasks: middle childhood

-self control and compliance -school adjustment (attendance appropriate conduct) -academic achievement (learning to read, arithmetic) -Getting along with peers -Rule gov conduct

Dev tasks: adolescence (5 total)

-successful transition to secondary schooling -Academic achievement (learning skills for higher education or work) -involvement in extracurricular activities -forming friendships within & across gender -forming cohesive sense of self ID

how the brain processes speech

1) the primary auditory cortex (shown in red) which is located on the top edge of each temporal lobe, receives electrical signals from receptors in the ears and transforms these signals into meaningless sound sensations, such as vowels & consonants in ba and ga 2.) the meaningless sound sensations are sent from the primary auditory cortex to another area in the temporal lobe, called the auditory association area. 3.) the auditory association area (shown in blue) which is located directly below the primary auditory cortex, transforms basic sensory info, such as noises or sounds, into recognizable auditory info, such as words or music. Here, sounds are matched with existing patterns that have been previously formed & stored.

common fears and anxieties (adolescence)

12-18 yrs pers rel, rej from peers, pers appearance, future, natural dis, safety fear of neg eval SAD

Family and twin studies asd

15-20% of siblings of individuals with ASD have the disorder -broader autism phenotype Concordae rates -70-90% in identical twins -Near 0% for fraternal twins -Heritability of an underlying liability for ASD is 90%

intellectual disability other years

1940s: parents increased humane care for their children 1950: National Association for Retarded Children was formed 1962: President John F. Kennedy formed the President's Panel on Mental Retardation

Evolving forms of treatment: Behavioral approaches

1950s and early 1960s: Behavior therapy emerged as a systematic approach to treatment of child & family disorders Behavior therapy is a prominent form of therapy

dsm5: disruptive, impulse control, and conduct disorders

2 dsm-5 disruptive behavior disorders -oppositional defiant disorder (ODD) -conduct disorder (CD) -both have been found to predict future psychopathology and eduring impairment in life functioning (CD may lead to APD) Three impulse control disorders (not reviewed in text but important to know they are included in this category) -intermittent explosive disorder -pyromania -kleptomania

accompanying disorders and symptoms (ASD)

2 most common disorders -intellectual disability -epilepsy other disorders-ADHD, conduct probs, anxieties and fears, and mood probs may engage in extreme and sometimes potentially life-threatening self injurious behaviors (SIB)

MDD DSM5 criteria (duration, must have symptoms, how many sympts?)

2 wk period, must have loss of interest & depressed mood, 5 or more sympts

psychological perspectives (CD)

conduct probs seen as falling on a continuous dimension of externalizing beh -children at the upper extreme, 1 or more SD above the mean, are considered to have conduct probs

Trisomy 18

2nd most common chromosomal abnormality. 3:1 female to male ratio. Typically die before 1st birthday due to heart disease.

autism across the spectrum

3 factors contribute to the spectrum nature of autism -children w autism may differ in level of intellectual ability, from profound disability to above average intelligence -children with autism vary in the severity of their language probs -the behavior of children w autism changes with age * everyone has social reciprocity probs *intellectual ability and severity of language probs are main 2 for differentiation *tantrums in bipolar as well *no treatment makes it all better, but there are those that improve it

MMPI-A profile

3 validity scores tell how you're answering. Are you lying? Are you trying to make yourself seem a certain way? Overly + etc Other 10 measure the amount of diff problems Not subject to interpretation

Risk factors ID

4 major categories of risk factorsd biomed social behavioral educational

common fears and anxieties (early childhood) 4-5

4-5 yrs separation from parents, fear of death or dead ppl excessive need for reassurance sep anx dis, GAD, panic dis

common fears and anxieties (late infancy)

6-8 m -shyness/anxiety with stranger, sudden unexpected or looming objects corr dsm 5 dis: separation anx dis

anxiety and depression

A child's risk for accompanying disorders will vary with the type of anxiety disorder -Depression is diagnosed more often in children with multiple anxiety disorders -Negative affectivity: persistent negative mood, -Positive affectivity: persistent positive mood ***Negatively correlated with depression, but is independent of anxiety symptoms and diagnoses Physiological hyperarousal (somatic tension, shortness of breath, dizziness, etc.) may be unique to anxious children Predictors and environmental influences are different

Specific Learning Disorder

A discrepancy of more than two standard deviations (but 2 SD can vary depending on other factors) between tye IQ findings and the actual achievement test findings in a child -different states have different discrepancies and move is to no discrepancies but low scores on achievement. Learning disorders include reading, mathematica, and writing The different learning disorders overlap and build on the same brain functions -a person can have more than one form of learning disorder

social anxiety disorder (social phobia) (what is it? whats most common fear? more likely to be what 5 things?)

A marked, persistent fear of social or performance requirements that expose the child to scrutiny and possible embarrassment -Anxiety over mundane activities -Most common fear is doing something in front of others -More likely than other children to be highly emotional, socially fearful; and inhibited, sad, and lonely

Protective factor

A personal or situational variables that mitigates a child dev. a disorder. Protective factors can help build resiliency.

single case experimental designs

ABAB and multiple baseline designs applicable in evaluating the impact of a clinical treatment involves systematic repeated assessment of behavior over time -the subject serves as own control limitations -possible interactions between treatment and subj characteristics; limited generalization of findings; and subjectivity in evaluating the data

Stimulant and non-stimulant medications for ADHD

ADHD stimulants: -Dexedrine, adderall -ritalin, metadate, concerta, focalin nonstim: -strattera

DSM-V diagnostic criteria for ADHD

A.) a persistent pattern of inattention and/or hyperactivity that interferes with functioning or dev, as characterized by (1) and/or (2): (1). inattention: six or more of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with dev level and that negatively impacts directly on social and academic/occupational activities: Note: the symptoms are not solely the manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least 5 symptoms are required. a.) often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (eg overlooks or misses details, work is inaccurate) b.) often has diff sustaining attention in tasks or play activities (eg had diff remaining focused during lectures, conversations, or lengthy reading.) c.) often does not seem to listen when spoken to directly, (eg mind seems elsewhere even in the absence of any obvious distraction) d.) often does not follow through on instructions and fails to finish schoolwork, even in the absence of any obvious distraction) e.) often has difficulty org tasks & activities (eg diff managing sequential tasks: diff keeping materials & belongings in order; messy, disorganized work, poor time management fails to meet deadlines f.) often avoids dislikes or is reluctant to engage in tasks that require sustained mental effort (eg schoolwork or homework; for older adolescents or adults preparing reports, completing forms, reviewing lengthy papers) g.) often loses things necessary for tasks & activities, (eg school materials, pencils, books tools wallets etc) h.) is often easily distracted by extraneous stimuli (for adol and adust may be unrelated thoughts) i.) is often forgetful in daily activities (eg doing chores, running errands, adults & adol: returning calls etc 2.) hyperactivity & impulsivity: 6 or more of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with dev level and that neg impacts directly on social and academic/occupational activities: note: the symptoms are not solely a manifestation of oppositional beh, defiance, hostility, or a failure to understand tasks or instructions. For older adults or adol ( 17 or older) at least 5 symptoms are required. a.) often fidgets with or taps hands or feet or squirms in seat b.) often leaves seat in situations when remaining seated is expected. (eg leaves his/her place) c.) often runs around or climbs in inap situations note: in adults or adol may be limited to feeling restless d.) often unable to play or engage in leisure activities quietly e.) often on the go as if driven by a motor f.) often talks excessively g.) often blurts out answers before a question has been completed (eg completes people's sentences cannot wait for a turn in convo) h.) often has difficulty waiting his or her turn ( eg while waiting in line) i.) often interrupts or intrudes on others ( eg, butts into conversation, 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) B.) several or inattentive or hyperactive-impulse symptoms were present before age 12 C.) Several inattentive or hyperactive-impulse symptoms are present in 2 or more settings (eg at home, school or work, with friends or relatives, in other activities D.) There must be clear evidence that the symptoms interfere with, or reduce the quality of, or reduce the quality of, social academic, or occupational functioning E.) The symptoms do occur exclusively during the course of schizo or another psychotic disorder and are not better explained by another mental disorder (eg mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication disorder) Specify whether: -combined presentation: if both criterion A1 (inattention) & Criterion A2 (hyperactivity-impuslivity) is not met for the past 6 months -predominantly inattentive presentation: If Criterion A1 (inattention) is met but criterion A2 (hyperact/impulsiv) is not met for the past 6 months -predom hyper/impusl presentation: if criterion A2(H-I) is met but criterion A1 is not met for the past 6 months specify if: -in partial remission: when full criteria were previously met, fewer than the full criteria have been met for the past 6 months, and the symptoms still result in impairment in social, academic or occupational functioning specify current severity: -mild: few, if any symptoms, in excess of those req to make the diagnosis are present, and symptoms result in no more than minor impairments in social or occupational functioning -moderate: symptoms or functional impairment between "mild" and "severe" are present -severe: many symptoms in excess of those required to make the diagnosis, or several symptoms that are particularly severe, are present, or the symptoms result in marked impairment in social or occupational functioning.

reactive attachment disorder

A.) consistent pattern of inhibited, emotionally withdrawn beh toward adult caregivers, manifested by both of the following: 1.) the child rarely or minimally responds to comfort when distressed 2.) the child rarely or minimally responds to comfort when distressed B.) a persistent social and emotional disturbance characterized by at least 2 of the following: 1.) minimal social and emotional responsiveness to others 2.) limited positive affect 3.) episodes of unexplained irritability, sadness or fearfulness that are evident even during nonthreatening interactions with adult caregivers C.) child has exp a pattern of extremes of insufficient care as evidenced by at least one of the following: 1.) social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stim, and affection by caregiving adults 2.) repeated changes of primary caregivers that limit opportunities to form stable attach (eg freq changes in foster care) 3.) rearing in unusual settings that severely limit opp to form selective att (eg institutions with high child to caregiver ratios) D.) care in crit C is presumed to be responsible for the disturbed beh in crit A (eg the disturbances in crit A began following the lack of adeq care in crit C) E.) the criteria are not met for autism spec dis F.) disturbance is evident before 5 yrs of age G.) child has a dev age of at least 9 months specify if: -persistent. the dis has been present for more than 12 months -severe: child exhibits all sympts of dis with each sympt manifesting at relatively high levels

SAD dsm 5

A.) dev inapp and excessive fear or anx concerning separation from those to whom the indiv is attached, as evidenced by at least 3: 1.) recurrent excessive distress when antic or exp sep from home or from major att figures 2.) persistent or excessive worry about losing major att fig or about poss harm to them 3.) pers and exc worry about exp an untoward event 4.) pers reluctance or refusal to go out 5.) pers and exc fear of or rel to being alone 6.) pers rel or refusal to sleep aqay from home or sleep w/o caregiver 7.) repeated nightmares inv theme of sep 8.) rep complaints of phys sympts (headahces stomach aches etc) when sep from major figures B.0 the fear anx or v is pers lsting at least 4 weeks in children and adols typically 6 m or more in adults C.) dist causes clin sig distress or impairment in social aca occ or other imp areas of funct D.) the dist is not better exp by another mental dis such as autism, hallucinations, agora, gad, or anx dis E.) crit and specify if should be deletd in their entirety. so subs for either

diagnostic criteria for GAD

A.) exc anx and worry (app expect) occ more days than not for at least 6 m, about a number of events or activities (such as work or school performance) B.) indiv finds it diff to control the worry C.) anx and worry are ass with 3 or more of the following 6 sympts (w at least some sympts present for more days than not for past 6 m) note: only 1 req for children 1.) restlessness or feeling keyed up or on edge 2. being easily fatigued 3 diff conc or mind going blank 4 irritability 5 muscle tensions 6 sleep dist (diff falling or staying asleep, or restless unsatisfying sleep) D.) anx worry or phys sympts cause clin sig dist or imp in social occ or other imp areas of funct e. dis is not due to the general physio effects of a subs or other med cond f.) dist not better exp by another ment dis

PTSD dsm5 (how long?)

A.) exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways: 1.) directly experiencing the traumatic event 2.) witnessing in person the event as it happened to others 3.) learning that the event has happened to a close rel or friend. in case of actual or threatened death of a family member or friend the event must have been violent or accidental 4.) experiencing repeated or extreme exposure to aversive details of traumatic events eg first responders, police note: crti A4 does not apply to exposure through electronic media etc unless exposure is work related B.) presence of one or more of following instrusion sympts assoc w the trauma beginning after trauma occured 1.) recurrent involuntary and intrusive distressing memories of the trauma. note: in young children repetitive play may occur in which themes or aspects of the trauma events are expressed 2.) recurrent distressing dreams in which content and or affect of the dream are related to trauma note: in children there may be frightening dreams without recog content 3.) dissociative reactions (eg flashbacks) in which the individual feels or acts as if the trauma events were recurring. Such reactions occur on a continuum, with the most extreme being a complete loss of awareness of present surroundings note: in young kids trauma spec reenactment may occur in play 4.) intense or prolonged psych distress at exposure to internal or external cues that symbolize or resemble an aspect of the trauma 5.) marked physiological reactions to internal or external cues that symbolize or resemble aspect of trauma c.) persistent avoidance of stim assoc with trsums begin after trauma as evidenced by one or both of the following; 1.) avoidance of or efforts to avoid distressing memories, thoughts, or feelings about closely assoc with the trauma 2.) avoidance of or efforts to avoid external reminders (ppl, places, conversations, activities, objects, situations,) that arouse distressing memories, thoughts, or feelings about or closely assoc with the trauma D.) neg alterations in cogn and mood assoc with trauma begin or worseining after event as evidenced by two or more: 1.) inability to remember an important aspect of the trauma typ due to dissoc amnesia 2.) persistent and exaggerated - beliefs or expectations of oneself other or world 3) persistent distorted cogs about cause or conseq of trauma that lead indiv to blame himself herself or others 4.) persistent - emo state 5.) markedly diminished interest or participation in sig activities 6.) feelings of detachment or estrangement from others 7.) persistent inability to exp + emotions e.)marked alterations in arousal and reactivity assoc w trauma beg or worsening after trauma. 2 or more: 1.)irritable beh and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward ppl or objects 2.) reckless or self dest beh 3.)hyperviligance 4.) exaggerated startle response 5.)probs w concentration 6.)sleep disturbance f.) duration of disturbance crit b,c,d, and e is more than 1 month g.) disturbance causes clin sig distress or impairment in social, occupational, or other important areas of functioning h.) disturbance is not attributable to the phys effects of a substance or other med cond specify if: with diss sympts: the indiv sympts meet criteria for PTSD in addition in response to stressor indiv experiences persistent or recurrent sympts of either of the following: 1.) depersonalization: as though one were in a dream 2.)derealization:unreality of surroundings note: to use this subtype the dissoc sympts must not be attributable to the phys effects of a substance with delayed exp: diagnostic threshhold is not exceeded till at least 6 m after event

social phobia dsm 5

A.) marked fear or anx about 1 or more social sits in which theindiv is exp to poss scrutiny by others ex inc social inter being obs or performing in front of others note: in kids anx must occur in peer settings and not just int w adults B.) indiv fears that he or she will act in a way or show anx sympt that will be - evaluated C.) social sits almost always provoke fear or anx Note: in kids the fear or anx may be expressed by crying tantrums freezing clinging shrinking away or failing to speak in soc sits D.) soc sits are av or end w intense fear or anx E.) fear or anx is out of prop F.) fear anx or av is pers typ lasting 6 m or more G.) fear anx and av causes clin sig dist or impair H.) fear anx or av is not att to direct physio effects of a substance or other med cond I.) fear anx or av is not better explained by another mental dis J.) if another mental cond is present the fear anx or av is clearly unrelated or exc specify if: performance only

diagnostic criteria specific phobia (how long)

A.) marked fear or anx about specific object or sit note: in kids fear or anx may be expressed by crying tantrums, freezing or clinging B.) phobic object or sit almost always provokes imm fear or anx c.) phobic object or sit is actively avoided or edured with intense fear or anx D.) fear or anx is out of prop to actual danger posed by spec obj or sit and to sociocultural context E.) the fear anx or av is pers typ lasting 6 m or more F.) fear anx or av causes clin sig distress or imp in social occup or other imp areas of funct G.) dis is not better exp by agoraphobia, OCD, SAD social anx dis specify if (code based on phobic stim) animal natural blood situational other: loud sounds, charactered costumes, sits that lead to choking or vomiting

Problems more commonly reported among males (7)

ADHD childhood conduct disorder intellectual disability autism spectrum disorder language disorder specific learning disorder enuresis Males more likely to have early developing issues Most likely to be organic in nature

disinhibited social engagement dis

A.) pattern of beh in which a child actively approaches and interacts with unfamiliar adults and exhibits at least 2 of the following: 1.) reduced or absent reticence in approaching and interacting with unfamiliar adults 2.) overly familiar verbal or physical beh (that is not consistent with culturally sanctioned and with age approp social boundaries) 3.) diminished or absent checking back with adult caregiver after venturing away, even in unfamiliar settings 4.) willingness to go off with unfamiliar adult with minimal or no hesitation B.) the behs in crit A are not limited to impulsivity (as in attention deficit hyperactivity disorder) but include socially disinh beh C.) the child has exp a pattern of extremes of insuff care as evidenced by at least 1 of the following 1.)social neglect 2.) repeated changes or primary caregivers 3.) rearing in unusual settings that limit selective attachment forming 4>0 care in crit C presumed to be resp for dist in crit A 5.) child has dev age of at least 9 m specify if pers: more than 12 m severe

DSM-5 diagnostic criteria for ASD

A.) persistent deficits in social comm and social interaction across mult contexts as manifested by the following, currently or by history (ex are illustrative not exhaustive) 1.) deficits in social emotional reciprocity, ranging for x from abnormal social approach and failure of normal back and forth conversation, to reduces sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions 2.) deficits in nonverbal comm beh used for social interaction, ranging fro ex from poorly integrated verbal & nonverbal comm to abnormalities in eye contact & body language or deficits in understanding and use of gestures, to a total lack of facial expressions and nonverbal communication. 3.) deficits in nonverbal communicative beh used for social interaction, ranging for ex from diff adj beh to suit various social contexts, to diff in sharing imaginative play or making friends, to absence of interest in peers -specify current severity based on social comm impairments and restricted, repetitive pattern of beh B/) restricted repetitive patterns of hev, interests, or activities, as manifested by at least 2 of the following, currently or by history (ex are illustrative not exhaustive) 1.) sterotyped or repetitive motor movements, use of objects, or speech (eg simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases) 2.) insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal beh (eg extreme distress at small changes, diff with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day) 3.) highly restricted, fixated interests that are abnormal in intensity or focus (eg strong attachment to or preoccupation w unusual objects, excessively circumscribed or pereverative interests) 4.) hyper or hyporeactivity to sensory input or unusual interest in sensory aspects of env (eg apparent indiff to pain/temp, adverse response to specific sounds or textures, excessive smelling or touching of objects visual fascination with light or movement) -specify current severity based on social comm impairments and restricted, repetitive patterns of behavior C.) symptoms must be present in early dev period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies later in life) D.) symptoms cause clinically sig impairment in social, occupational, or other important areas of current functioning E.) these disturbances are not better explained by intellectual disability or global dev delay. Intellectual disability and autism spectrum dis frq co-occur, to make comorbid diagnoses of autism spcetrum disorder and intellectual disability, social communication should be below that expected for general dev level Note: individuals with a well established DSM-IV diagnoses of autistic disorder, asperger's or pervasive dev dis, not otherwise specified, should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social comm, but whose symptoms do not otherwise meet criteria for autism spectrum dis, should be evaluated for social (pragmatic) comm disorder specify if with: -w or without accompanying intellectual impairment -w or wo acc language impairment -assoc w a known med or gentic condition or nv factor -assoc w another neurodev, mental, or beh disorder -with catatonia

diagnostic criteria for LD

A.) persistent difficulties in the acquisition and use of language across modalities (ie spoken, written, sign language, or other) due to deficits in comprehension or production that include the following: -reduced vocabulary (word knowledge & use) -limited sentence structure (ability to put words and word endings together to form sentences based on the rules of grammar and morphology) -impairments in discourse (ability to use vocab & connect sentences to explain or describe a topic or series of events or have a conversation) B.) language abilities are substantially and quantifiably below those expected for age, resulting in functional limitations in effective communication, social participation, academic achievement, or occupational performance, individually or in any combination. C.) onset of symptoms is in the early dev period D.) the difficulties are not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition and are not better explained by intellectual disability (IDD) or global dev delay.

diagnostic criteria of social comm disorder

A.) persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following: 1.) deficits in using comm for social purposes such as greeting and sharing info, in a manner that is appropriate for the social context 2.) impairment of the ability to change comm to match context or the needs of the listener, such as speaking diff in a classroom than on a playground, talking diff to a child than to an adult, & avoiding use of verly formal language. 3.) difficulties following rules for language & storytelling such as taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction 4.) difficulties understanding what is not explicitly stated (eg making inferences) and nonliteral or ambiguous meanings of language (eg idioms, humor, metaphors, multiple meanings that depend on the context for interpretation) B.) the deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance, individually or in combination. C.) The onset of the symptoms is early in the developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities) D.) the symptoms are not attributable to another medical or neurological condition or to low abilities in the domains of word structure and grammar, and are not better explained by autism spectrum disorder, intellectual disability (IDD) global dev delay, or another mental disorder

diagnostic criteria for panic disorder

A.) recc unex panic attacks. a panic att is an abrupt surge of intense fear or int disc that reaches a peak within mins and during which time 4 or more occur: note the abrupt surge can occur from a calm or anxious state 1. palpitations pounding heart or accel hr 2. sweating 3. trem or shaking 4. sens or shortness of breath or smothering 5. feelings of choking 6. chst pain or disc 7. nausea r abd distress 8. feeling dizzy unsteady light headed or faint 9. chills or heat sensations 10. paresthesias (numbness or tingling sens) 11.) derealization or depers 12. feal of losing control or going crazy 13. fear of dying note culture spec sympts. tinnitus neck soreness headache unc screaming or cying may be seen such sympts shoud not count as one of the 4 req B.) at least 1 of the attacks has been followed by 1 m or more of one or both of the following: 1.) pers concern or worry about add panic attacks of their cons 2.) sig maladaptive change in beh related to attacks c.) dist is not att to physio effects of substance or med cond d.) not better acc for by other mental dis

DSM5 diagnostic criteria for schizo

A.) severe disturbance in sensory functioning and or behavior. Two (or more) of the following, each present for a significant portion of the time during a 1-month period (or less if successfully treated). At least oneof these must be (1), (2), or (3) (1) delusions (2) hallucinations (3) disorganized speech (eg freq derailment or incoherence) (4) grossly disorganized or catatonic beh (5) negative symptoms (ie diminished emotional expression or avolition) B.) social/occupational dysfunction: For a a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas such as work, interpersonal relations, or self-care is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning.) C.) duration: continuous signs of the disturbance persist for at least 6 months. This 6-months period must include at least 1 month of symptoms (or less if successfully treated) that meet criterion A (ie active phase symptoms) and may include period of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by 2 or more symptoms listed in Criterion A present in an attenuated form (eg odd beliefs, unusual perceptual experiences) D.) schizoaffective and mood disorder exclusion: schizoaffective disorder and depressive or bipolar dis w psychotic features have been rules out because either 1) no major depressive or manic episodes have occurred concurently with the active-phase symptoms, or 2) if mood episodes have occurred during active phase symptoms, they have been present for a minority of the total duration of the active & residual periods of the illness E.) substance/med condition exclusion: the disturbance is not attributable to the physiological effects of a substance (eg a drug of abuse, a med) or another med condition F.) relationship to autism spectrum or communication disorder: if there is a history of autism spectrum disorder or a communication disorder of childhood-onset, the additional diagnosis of schizo is made only if prominent delusions or halls in addition to the other reqs of schizo are also present for at least 1 month (or less is successfully treated) specify if: with catatonia specify current severity: -severity is rated by a quantitative assessment of the primary symptoms of psychosis including delusions, halls, disorganized speech, abnormal psychomotor beh and neg symptoms. Each of these symptoms may be rated for its current severity (more severe in the last 7 days) on a 5 point scale ranging from 0 (not present) to 4 (present and severe) Note: Diagnosis of schizo can be made without using this severity specifier

ethical and legal considerations

AACAP and APA ethical code provide minimum ethical standards -select treatment goals and procedures that are in best interest of the client -ensure participation is active and voluntary -keep records to document treatment effectiveness -protect confidentiality -ensure therapist's qualifications and competencies determine when a minor is competent to make decisions be cautious about ineffective or potentially harmful treatment comply with federal, state, and local laws -Education for all handicapped children act (1975) -Individuals with disabilities act (2004)

description (ADHD) also how heritable %? more likely to be M or F? And what about prefrontal cortex?

ADHD is exhibited as persistent age-inappropriate symptoms of inattention, hyperactivity, and impulsivity that are sufficient to cause impairment in major life activities -characteristic behaviors vary considerably from child to child -different behavior patterns may have different causes If theyre on the go as if driven by a motor constantly talk constantly more likely to be boys 75% or more heritable Can't inhibit behavior prefrontal cortex makes you chill. stim meds increase dopa in prefrontal cortex become bored more quickly

late 1950s (ADHD)

ADHD was called hyperkinesis -led to definition of hyperactive child syndrome

agoraphobia

Fear or Anxiety about at least two of the following (6 months or more): -Using public transportation (including driving a car) -Being in open spaces (e.g., bridges, parking lot) -Being in enclosed spaces (e.g., theater, shops) -Standing in line or being in a crowd -Being outside home alone Fear and avoidance is due to thoughts that escape might be difficult or help might not be available if a panic attack occurs

behavioral and learning theories (anxiety) (mowrer's 2 factor theory)

Fears and anxieties learned through classical conditioning and maintained through operant conditioning (Mowrer's two-factor theory)

acute stress disorder (when does it dev? how many symptoms? 5 kinds of sympt)

Acute stress disorder is characterized by: -The development during or within 1 month after exposure to an extreme traumatic stressor of at least nine symptoms associated with intrusion, negative mood, dissociation, avoidance, and arousal Children who react to more common (and less severe) forms of stress in an unusual or disproportionate manner may qualify for a diagnosis of adjustment disorder

description & history ASD

ASD refers to pervasive dev disorders (PDDs) characterized by significant impairments in social and communication skills, and by stereotyped patterns of interests and behaviors Kanner (1943): coined the term "early infantile autism" to describe young children with autistic symptoms asperger(1944): defined a milder form of autism-asperger's disorder autism is a bio based lifelong neurodev disability present in the first few years of life

Dev considerations

Adaptational failure: unsuccessful progress in dev milestones -children w psych disorders differ from their peers in some aspect of normal dev -several causes are involved operating in dynamic and interactive ways

developmental psych perspective

Abnormal dev is multiply determined -must look beyond current symptoms -consider dev pathways and interacting events transactional view Abnormal dev involves continuities and discontinuities

severity level: profound

About 1%-2% of persons with ID identified in infancy due to marked delays in dev and biological anomalies learn only rudimentary communication skills require intensive training for: -eating, grooming, toileting, and dressing behaviors require lifelong care and assistance

Medical conditions and physical characteristics ASD: what % of kids with asd have coexisting med condition? what kind (4)? how many have sleep dist? how many have gastro? how many have larger head size?

About 10% of children with ASD have coexisting med condition -motor and sensory impairments, seizures, immunological and metabolic abnormalities sleep disturbances occur in 65% gastrointestinal symptoms occur in 50% about 20% have a sig larger than normal head size-more common in those who are higher functioning

PTSD: (what % of kids will exp trauma? by what age? % prevalence for what age & G vs B? % of comorbidity?)

About 2/3 of children in U.S. will experience one potentially traumatic event by age 16, but most do not develop PTSD In a large National sample - six-month prevalence rate for adolescents aged 12-17 was 3.7% for boys and 6.3% for girls Nearly 75% had comorbid depression and/or substance abuse Prevalence rates strongly correlated with direct exposure to traumatic event

(psychological testing) Achievement testing

Achievement tests are often administered with IQ tets when assessing learning differences Common achievement tests:(when you're looking @ learning disability) -Wechsler individual achievement test-3rd edition (WIAT-3) Most common -Woodcock Johnsosn Tests of achievement-3rd ed -Kaufman Tests of Educational Achievement-2nd edition Is there a difference between IQ and achievement

Genetic influences

Adhd runs in families -parents of children with adhd are 2-8 times more likely to have adhd themselves Adoption studies -rates of adhd closer to bio than adoptive parents Twin studies: -75% heritability estimates for hyperactive impulsive and inattentive behaviors Specific gene studies -genes may contribute to the expression of adhd focus on dpamine regulation

(what age abuse and neglect? What age sexual abuse? What % of sexual abuse M/F? Maltreatment? Racial %?)

Age -Younger children are more at risk for abuse and neglect, while sexual abuse is more common among older age groups (over 12) -Except for sexual abuse, the victimization rate is inversely related to the child's age Sex -80% of sexual abuse victims are female, but with that exception, boys and girls are victims of maltreatment almost equally little kids or early teens Racial characteristics -The majority of substantiated maltreated victims are white (44%), African-American (22%), or Hispanic (21%) -Compared to children of same race or ethnicity in the U.S. (conservative estimates) ***Highest rates of victimization are for children who are African-American (15.1/1000), American Indian or Alaska Native (11.6/1000), and multiple race (12.4/1000), White and Hispanic (8/1000), and Asian (2/1000)

specific phobia (definition, prevalence, onset age, outcome)

Age-inappropriate persistent, irrational, or exaggerated fear that leads to avoidance of the feared object or event and causes impairment in normal routine -Lasts at least 6 months -Extreme and disabling fear of objects or situations that in reality pose little or no danger or threat -Child goes to great lengths to avoid the object/situation Prevalence and comorbidity -About 20% of children are affected at some point in their lives, although few are referred for treatment -More common in girls Onset, course, and outcome -Onset at 7-9 years - phobias involving animals, darkness, insects, blood, and injury -Clinical phobias are more likely than normal fears to persist over time

OCD (what is it generally? obs vs comp? how many % have both?)

An unusual disorder of ritual and doubt -Characterized by recurrent, time-consuming and disturbing obsessions and compulsions **Obsessions: persistent and intrusive thoughts, urges, or images - experienced as intrusive and unwanted **Compulsions: repetitive, purposeful, and intentional behaviors or mental acts performed to relieve anxiety have one or the other. Dont have to have both bt 85% do OCD is extremely resistant to reason OCD children often involve family members in rituals Normal activities of children with OCD are reduced, and health, social and family relations, and school functioning can be severely disrupted

classical psychoanalytic theory (anxiety)

Anxieties and phobias seen as defenses against unconscious conflicts rooted in the child's early upbringing

normal anxieties

Anxieties are common during childhood and adolescence -Common examples **Separation anxiety **Test anxiety **Excessive concern about competence **Excessive need for reassurance **Anxiety about harm to a parent Girls display more anxiety than boys, but symptoms are similar Some specific anxieties decrease with age Nervous and anxious symptoms may remain stable over time

what is anxiety/ anxiety disorders

Anxiety: a mood state characterized by strong negative emotion and bodily symptoms of tension in anticipation of future danger or misfortune Anxiety disorders involve experiencing excessive and debilitating anxieties; occur in many forms Many children with anxiety disorders suffer from more than one type

anxiety versus fear and panic

Anxiety: future-oriented mood state -May occur in absence of realistic danger Fear: present-oriented emotional reaction -Occurs in the face of a current danger and marked by a strong escape tendency Panic -A group of physical symptoms of fight/flight response - unexpectedly occur in the absence of obvious danger or threat

social and emotional deficits (anxiety)

Anxious children -Display low social performance and high social anxiety -See themselves as shy and socially withdrawn, and report low self-esteem, loneliness, and difficulty initiating and maintaining friendships -Have deficits in understanding emotion and in differentiating between thoughts and feelings

panic attack specifier

Any DSM-5 diagnosis can have a specifier indicating the person has accompanying panic attacks Panic attack does not meet criteria for a Panic Disorder. -Person has a panic attack but does have the persistent concern of another attack or maladaptive behavior change for at least a month following the panic attack

New directions (ch 4)

As many as 70% to 80% of children and families with significant mental health needs do not receive any specialized assessment or treatment services New initiatives: -increase recognition of children's mental health needs -develop a wider range of service delivery models

child abuse & neglect(year it mattered, % sexual for B & G, kinds of neglect,which ones more common? non acc trauma, victimization)

Child abuse and neglect have been recognized as a significant problem since the early 1970s In North America, perhaps 10-15% of boys and 25-33% of girls experience some form of sexual victimization by an adult or peer by the time they reach adulthood -They also receive harsh physical punishment by a parent or other caregiver that puts them at risk of injury diff kinds of neglect spanking isnt helpful four primary acts of child maltreatment -physical abuse, neglect, sexual abuse and emotional abuse -neglect is the most common non accidental trauma -wide ranging effects of maltreatment on the childs physical and emotional dev victimization -abuse or mistreatment of someone whose ability to protect himself or herself is limited

The significance of Mental health problems among children and youth

At any given time, one in eight children (12.5%) has a mental health problem (North American studies) -many others are at risk for later dev of a psychological disorder -by the time people enter early adulthood, about 60% will have met criteria for a psychiatric diagnosis The majority of children needing mental health services do not receive them The demand for children's mental health services is expected to double over the next decade

OCD: avg age of onset? how many will have OCD how many years after initial diagnosis?

Average age of onset 9-12 years with peaks in early childhood and early adolescence Chronic disorder - as many as two-thirds continue to have OCD 2-14 years after initial diagnosis

onset course and outcome GAD

Average age of onset is early adolescence Older children have more symptoms Symptoms persist over time

developmental considerations-normative info

Basic info about child dev norms is crucial in understanding why a child may be referred to professionals -isolated symptoms show little correspondence with children's overall adjustment -age inappropriateness and symptoms typically define childhood disorders -impairment in the child's functioning is a key consideration

John Locke (17th century) (emergence of social conscience)

Believed children should be raised with thought & care not indifference and harsh treatment

Mood stabilizers and anticonvulsant meds

Bipolar disorder, severe mood symptoms & mood swings (manic depressive) aggressive behavior & impulse control disorders. -lithium -depakote/depakene -tegretol -lamictil -trileptal

bowlby's theory of attachment

Bowlby's theory of attachment -Fearfulness is biologically rooted in the emotional attachment needed for survival -Early insecure attachments lead children to view the environment as undependable, unavailable, hostile, and threatening Leading to development of anxiety and avoidance behaviors No single theory is sufficient

Sex differences

Boys and girls express problems differently Certain disorders are more common in boys than girls, and vice versa -for example, aggression is expressed more directly by boys; expressed more indirectly by girls (though this difference is changing quickly) Sex differences appear negligible in children under age three -disparities increase with age

neurobiological contributions

Brain structure and function -the brain stem handles most of the autonomic functions necessary to stay alive *hindbrain, midbrain and diencephalon

prevention (depression) treatments/initiatives

CBT and interpers are most effective at lowering risk for dep and for preventing recurrences school based initiatives may provide a comprehensive program to enhance protective factors in the env and to dev young peoples indiv resiliency skills -recent studies did not yield sig results

Treatment of COS

COS is a chronic disorder w a poor long term prognosis current treatments emphasize use of antipsych meds combined w psychotherapy & social & educational support programs Meds help control psychotic symptoms (aripiprazole & risperidone are two commonly used antipsychs in children) -There can be serious side effects

(Psych testing) Personality Testing

Central dimensions of personality-the Big 5 factors -Timid or bold -agreeable or disagreeable -dependable or undependable -tense or relaxed -reflective or unreflective In clinical assessment most of the personality tests actually measure disorders (eg depression, anxiety, conduct problems) rather than the 5 factors of general personality

The family & peer context

Child psychopathology research has increasingly focused on the role of: -the fam system -complex relationships within fam -the reciprocal influences among various family subsystems There is a need to consider the processes tht occur within disturbed fams -subsystems receiving most attention involve roles of mother child and marital couple -less attention is given to roles of sibs and fathers Family systems theorists argue that: understnding or predicting the behavior of a particular fam member cannot be done in isolation from other fam members The study of indiv factors alongside the child's context are mutually compatible and beneficial to both theory and intervention How the family deals with typical and atypical stress is crucial to a child's adjustment and adaptation -the outcome of stressful events depends on: *nature and severity of stress, level of family functioning prior to the stress, and the family's coping skills & resources -Major fam and individuals issues interfere w consistent and predictable child care and basic needs

family interventions (anxiety)

Child-focused treatments may have spillover effects into the family Addressing children's anxiety disorders in a family context may result in more dramatic and lasting effects Family treatment for OCD: -Provides education about the disorder -Helps families cope with their feelings have to cuz parents could make it worse

causes: neurobio dev (history of child abuse have alt in which 2 systems? what 3 brain areas? what body system?)

Children and adults with a history of child abuse show long-term alterations in the (HPA) axis and norepinephrine systems -These alterations have a significant affect on responsiveness to stress Affected brain areas: Include the hippocampus, prefrontal cortex, and amygdala Acute and chronic forms of stress associated with maltreatment may cause changes in brain development and structure from an early age -The neuroendocrine system becomes highly sensitive to stress ***Causing neurobiological changes that may account for later psychiatric problems

how stress affects children

Children and youths need a basic expectable environment to adapt successfully Stressful events affect each child in different and unique ways -Hyperresponsive reactions -Hyporesponsive reactions -Allostatic load: progressive "wear and tear" on biological systems due to chronic stress

Lifespan implications-solutions

Children can overcome major obstacles -when provided with circumstances and opportunities that promote healthy adaptation and competence Major initiatives for prevention and intervention have resulted from recognition of children's mental health problems

Looking ahead (ch 1)

Children cannot advocate on their own behalf Viewing the whole child is the best strategy in understanding abnormal child and adolescent psychology Efforts to change policies and programs directed toward children and youths are gaining momentum

normal worry in kids vs children w anx disorders

Children of all ages worry Worry serves a function in normal development -Moderate worry can help children prepare for the future Children with anxiety disorders do not necessarily worry more -They worry more intensely than other children

Keeping things in perspective

Children with adhd problems that should not be minimized Each child is unique and has assets and resources that need to be recognized and supported

assoc characteristics with anxiety disorders (4)

Children with anxiety disorders display a number of associated characteristics -Cognitive disturbances -Physical symptoms -Social and emotional deficits -Anxiety and depression

Benjamin Rush (1745-1813) EofSC

Claimed that children were incapable of adult-like insanity Moral insanity: emotional insanity (moral=emotional in 1700s)

Psychological testing (fairness, context, and development)

Code of fair testing practices -guidelines which increase clinician's sensitivity to cultural factors Test scores should always be interpreted in the context of other assessment info Developmental tests are used in: -screening, diagnosing, and evaluating infants and young children and identify those at risk

exploitation

Commercial or sexual exploitation, such as child labor and child prostitution Significant form of trauma for children and adolescents worldwide -As many as ten million children may be victims of child prostitution, the sex industry, sex tourism, and pornography

Antipsychotic meds

Controlling psychotic symptoms (delusions, hallucinations), disorganized thinking, motor tics, and tourette's syndrome. They are occassionally used to treat severe anxiety and may help in reducing very aggressive behavior First gen antipsychs: -thorazine -mellaril -prolixin -stelazine -navane -haldol 2nd gen antipsychs (also known as atypical or novel): -clozaril -risperidal -invega -seroquel -zyprexa -geodon -abilify -fanapt -latuda -saphris

acute stress disorder dsm 5

Criterion A. The person was exposed to one or more of the following situations -Experienced an event or events that involved a threat of death, actual or threatened serious injury, or actual or threatened physical or sexual violation of himself or herself -Personally witnessed an event or events that involved the actual or threatened death, serious injury, or physical or sexual violation of others -Learned of such harm coming to a close relative or close friend or underwent repeated or extreme exposure to aversive details of unnatural death, serious injury, or serious assault or sexual violation of others -Witnessed exposure or exposure to aversive details does not include events that are witnessed only in electronic media, television, video games, movies, or pictures Criterion B. Eight (or more) of the following symptoms are currently present that were not present before the traumatic event or have worsened since (1) A subjective sense of numbing, detachment from others, or reduced responsiveness to events that would normally elicit an emotional response (2) An altered sense of the reality of one's surroundings or oneself (e.g., seeing oneself from another's perspective, being in a daze, time slowing) (3) Inability to remember at least one important aspect of the traumatic event that was probably encoded (i.e. not due to head injury, alcohol, drugs) (4) Spontaneous or cued recurrent, involuntary and intrusive distressing memories of the event (5) Recurrent distressing dreams related to the event (6) Dissociative reactions in which the individual feels or acts as if the traumatic event were recurring (7) Intense or prolonged psychological distress or physiological reactivity at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event (8) Persistent and effortful avoidance of thoughts, conversations, or feelings that arouse recollections of the trauma (9) Persistent and effortful avoidance of activities, places, or physical reminders that arouse recollections of the trauma (10) Sleep disturbance (e.g., difficulty in falling asleep, restless sleep, or staying asleep) (11) Hypervigilence (12) Irritable, angry or aggressive behavior (13) Exaggerated startle response (14) Agitation or restlessness

The DSM

Current edition: 5 DSM IV used a multiaxial system consisting of 5 axes: -clinical disorders or conditions -personality disorders and intellectual disability -general medical conditions -psychosocial and environmental problems -global assessment of functioning The DSM5 does not use axes. Each diagnostic category has specifiers (to better describe symptoms for subgroups) and severity ratings -the diagnosis given is based on the most serious thing you have -autism/aspergers spectrums. small differences like IQ and verbal skills. But as they got closer together harder to tell. Changed to a spectrum -intel dis changed. Used to be IQ based mostly *IQ below normal *adaptive behavior *other 2 have to be low before age 18 -now score adaptive behavior -Just list diagnoses and put the on that needs most focus as #1.

trauma stress and maltreatmentL defining features

DSM 5 considers some forms of child stress and maltreatment under the category "other conditions that may be a focus of clinical attention" a child who was abused and also suffering from a clinical disorder (eg depression) -the maltreatment would be noted as part of the diagnosis in order to ensure proper treatment abused children still like their parents

Previous DSM-IV diagnoses

DSM-IV -autistic disorder -asperger's disorder -childhood disintegrative disorder -rett's disorder -pervasive dev NOS DSM-5 has one diagnosis-autism spectrum disorder -rationale for change and merging diagnoses: its like trying to cleave meatloaf at the joints

Additional interventions adhd

Family counseling & support groups -help family members dev new skills, attitudes, and ability to relate more effectively Individual counseling -helps children with adhd deal with their probs and feelings of isolation and abnormality -helps build their sense of self competence -may help more with comorbid disorders and social skills deficits than attention/hyperactivity problems Cbt not helpful in childhood. Better for adolescents.

Discontinuity

Dev changes are abrupt and qualitative; not predictive of future behavior patterns

hoarding disorder (definition? % prev? onset age, imp age, clincal age? )

Difficulty discarding or parting with items Perceived need to save items and distress with discarding them Accumulation clutters living areas (unless family members get rid of things) Prevalence - 2-6% Symptoms tend to first emerge ages 11-15 but don't usually cause functional impairment until mid-20's and clinical level of impairment in 30's perfectionistic if they cant do something perfectly they wont do it

Lifespan implications

Impact is most severe when problems go untreated for extended periods of time -about 20% of children with the most chronic and serious disorders: *are least likely to finish school *are most likely to have social problems & psychiatric disorders Lifelong consequences associated with child psychopathology are costly

Leta Hollingworth (1886-1939) EofSC

Distinguished indiviudals with mental retardation ("imbeciles") from those with psychiatric disorders ("lunatics") Pioneered work with gifted children Showed IQ was not just genetic but env (Zeitgeist of the time was that intelligence was totally inherited) .Children w normal cog. abilities but disturbing behavior suffer from moral insanity

intelligence & aca achievement, who drops out of school?, threat related cog biases, cog errors and biases (anxiety)

Disturbance in how information is perceived and processed Intelligence and academic achievement -Despite normal intelligence, deficits are seen in memory, attention, and speech or language -High levels of anxiety can interfere with academic performance -Those with generalized social anxiety may drop out of school prematurely Threat-related attentional biases -Selective attention is given to potentially threatening information -Anxious vigilance or hypervigilance permits the child to avoid potentially threatening events Cognitive errors and biases -Perceptions of threats activate danger-confirming thoughts -Children with conduct problems select aggressive solutions in response to a perceived threat -Children with anxiety disorders see themselves as having less control over anxiety-related events than other children

Special issues concerning adolescents and sexual minority youths

Early to mid adolescence is an important transitional period for healthy adjustment Issues during adolescence -Substance use, risky sexual behavior, violence, accidental injuries, & mental health problems Special needs and problems of adolescents are receiving greater attention

educational neglect

Educational neglect involves: -Allowing chronic truancy, failing to enroll a child of mandatory school age in school, or failing to attend to a child's special educational needs

Emotion reactivity and regulation

Emotion reactivity: indiv differences in threshold and intensity of emotional experience emotion regulation involves enhancing, maintaining, or inhibiting emotional arousal important signals of normal and abnormal dev -child-caregiver relationship plays a critical role; authoritative parents establish limits

emotional neglect? Kids beh patters vacillate between?)

Emotional neglect: -Marked inattention to a child's needs for affection, refusal or failure to provide needed psychological care, spousal abuse in the child's presence, and permission of drug/alcohol use by the child Neglected children show behavior patterns vacillating between undisciplined activity and extreme passivity

Dorothea Dix (1802-1887) EofSC

Established humane mental hospitals for youth & adults instead of caging chaining or locking them in cellars

Applied Behavior Analysis (ABA)

Explains behavior as a function of its antecedents & conseq (operant conditioning) 4 primary operant learning principles: -positive and neg reinforcement, extinction, and punishment

Norep

Facilitates or controls emergency reactions & alarm responses Plays role in emotional and behavioral regulation Not directly involved in specific disorders (acts generally to regulate or modulate behavioral tendencies)

selective mutism (definition? prev%? age of onset? may be an?)

Failure to talk in specific social situations, even though they may speak loudly and frequently at home or other settings Estimated to occur in 0.7% of children Average age of onset is 3-4 years May be an extreme type of social phobia, but there are differences between the two disorders

family and genetic risk (anxiety)

Family and twin studies suggest -About 1/3 of the variance in childhood anxiety symptoms is genetic -Serotonin and dopamine systems are related to anxiety -Genes are linked to broad anxiety-related traits (e.g., behavioral inhibition) ***No strong direct link between specific genetic markers and specific types of anxiety disorders

Jean Marc Itard (19th cent) Emergence of social conscience

Focused on the care, treatment, & training of "mental defectives" Victor "wild boy of aveyron"

exposure based therapy (abuse)

Following acute stress or trauma, such as motor vehicle accidents, shootings, bombings, and hurricanes -Early exposure intervention has reduced acute stress symptoms Many of these interventions are brief, ranging from 1 to 10 sessions -Are often delivered in groups to reach as many children as possible. Psychological First Aid (PFA) In-depth psychological interventions are for children who are severely affected by a traumatic event -The child typically begins by describing a particular traumatic incident and their feelings and thoughts about it Types -Grief and Trauma Intervention for Children -Trauma-focused cognitive-behavioral therapy (TF-CBT)

1917-1926 (ADHD)

Following the worldwide influenza epidemic -brain injured child syndrome

sexual abuse

Fondling a child's genitals, intercourse with the child, incest, rape, sodomy, exhibitionism, and commercial exploitation through prostitution or the production of pornographic materials May significantly affect behavior, development, and physical health of sexually abused children Reactions and recovery of sexually abused children vary, depending on the nature of the assault and responses of important others -Many acute symptoms resemble children's common reactions to stress

Culture & diversity

Important not to generalize research from one culture to another social and cultural beliefs &values influence: -the meaning given to behaviors -the way in which behaviors are responded to -the forms of expression and their outcomes

GAD(simple description) accompanied by at least?

Generalized anxiety disorder (GAD) -Excessive, uncontrollable anxiety and worry -Worrying can be episodic or almost continuous -Worry excessively about minor everyday occurrences Accompanied by at least one somatic symptom, such as: -Headaches, stomach aches, muscle tension, and trembling

Externalizing Problems

Higher in boys than girls in preschool and early elementary years -exhibited as acting-out behaviors eg aggression & delinquency Rates for boys and girls converge by age 18

gender ethnicity and culture (anxiety)

Higher incidence of anxiety disorders in girls suggests genetic influences and related neurobiological differences The experience of anxiety is pervasive across cultures Ethnicity and culture may affect the expression, developmental course, and interpretation of anxiety symptoms

Internalizing problems

Higher rates in girls Associated with: -anxiety, depression, or withdrawn behavior -somatic complaints -eating disorders -emotional disorders with peak age onset in adolescence

prenatal education & screening (ID)

ID related to fetal alcohol syndrome, lead poisoning, rubella) can be prevented if precautions are taken prenatal programs for parents caution about use of alcohol, tobacco, drugs, and caffeine during pregnancy

The controversial IQ

IQ is relatively stable over time -except when measures in young, normally-developing infants (stabilizes after age 8) Mental ability is always modified by experience The Flynn Effect" the phenomenon that IQ scores have risen about three points per decade Are IQ tests biased or unfair? IQ test compare you to others in your age range

changes in abilities (ID)

IQ scores can fluctuate in relation to the level of impairment major cause of ID affects the degree to which IQ and adaptive abilities may change slowing and stability hypothesis -IQ of children with down syndrome may plateau during middle childhood, then decrease over time

changes to anxiety dis classification in dsm 5

In DSM-IV all of the anxiety disorders were classified under one general category of Anxiety Disorders DSM-5 has three general categories: -Anxiety Disorders -Obsessive-Compulsive and Related Disorders -Trauma- and Stressor-Related Disorders

panic disorder and agoraphobia

In severe cases, high anticipatory anxiety and situation avoidance may lead to agoraphobia -Fear of being alone in and avoiding certain places or situations -Fear of having a panic attack in situations where escape would be difficult or help is unavailable -Does not usually develop until age 18 or older not being able to escape and get to safety stay at home

physical abuse & neglect (what do interventions focus on?)

Interventions for physical abuse usually involve ways to change how parents teach, discipline, and attend to their children Treatment for child neglect focuses on parenting skills and expectations, coupled with teaching parents how to improve their skills in organizing important family needs

Causes of ASD

It is now generally accepted that autism is a biologically based neurodev disorder with multiple causes -problems in early dev -genetic influences -brain abnormalities -a disorders of risk and adaptation

treatment of LD

LD & other similar comm disorders usually self correct by age 6 & may not require intervention strategies for parents to stimulate language development -Enroll child in a specialized school ** using a combo of computer and teacher assisted instruction to teach early academic skills -Build on the child's existing strengths

Special issues: LGBTQ youths

LGBT youths in middle and high schools are more likely to be victimized by their peers and family members LGBT youths have higher rates of mental health probs

social phobia (lifetime prev %? M/F? How many have another anx? How many suffer from MD? Common vs rare onset age?)

Lifetime prevalence of 6-12% of children Twice as common in girls Two-thirds also have another anxiety disorder 20% also suffer from major depression and may self-medicate with alcohol and other drugs Most common age of onset is early to mid-adolescence, and is rare under age 10

locus coeruleus

Locus Coeruleus (blue spot) in Pons (in brain stem) reactive to significant stress and trauma. Extreme or repeated stress or trauma may make it so that LC is unable to shut off even when stress is no longer present

loose/tangential/circumstantial

Loose associations: Someone's thoughts are only loosely connected to each other in the person's conversation. Tangential thinking: Someone gets off track onto other topics and never gets back to the original point. Circumstantial thinking: A less severe form of tangential thinking in which someone goes all around topics, but they still get back to the original point.

Four primary diagnoses in DSM5 (depression)

MDD persistent depressive disorder (dysthymia) premenstrual dysphoric disorder (new is DSM%) disruptive mood dysregulation disorder(new in DSM5) -initially proposed it to be called temper dysregulation disorder -many youth currently diagnosed with bipolar disorder will fit this new diagnosis

Common objective tests

MMPI-A MAPI MACI (first 3 are for adolescent T/F) Personality inventory for children

behavior therapy (anxiety) (main technique? SD? Flood? RP?)

Main technique is exposure to feared stimulus (exposure with response prevention) -While providing children with ways of coping other than escape and avoidance Systematic desensitization -patient has more control Flooding: prolonged repeated exposure -forces you Response prevention prevents child from engaging in escaping or avoidance stimuli Modeling and reinforced practice self defense training-rape victims have to hang in there until phys anx goes does

causes: emerging view of self and others (what kind of probs appear? what kind of feels? what signs for G vs B?)

Maltreated children's emerging views of self and their surroundings are not fostered by healthy parental guidance and control -Emotional and behavioral problems are likely to appear -Negative representational models of self and others develop based on a sense of inner "badness," self-blame, shame, or rage Feelings of powerlessness and betrayal are internalized as part of the child's self-identity Maltreated girls show internalizing signs of distress, such as shame and self-blame, while maltreated boys show heightened levels of verbal and physical aggression

causes: poor emotion reg

Maltreated infants/toddlers have difficulty establishing reciprocal, consistent interaction with caregivers -Exhibit insecure-disorganized attachment -Have difficulty understanding, labeling, and regulating internal emotional states -Learn to inhibit emotional expression and regulation, remaining more fearful and on alert

meds (anxiety) (SSRIs? what are they most effective for? benzos?)

Medications can reduce symptoms, especially for OCD -The most common and effective medications are selective serotonin reuptake inhibitors (SSRIs), especially for OCD ***Benzodiazepines (e.g., Xanax, Valium) often used with adult anxiety, but should not be used with children/adolescents -Medications are most effective when combined with CBT ***CBT (with exposure/response prevention) is the first line of treatment benzos chill you out but you dont feel the anxiety. most benzos not prescribed by psychiatrist but by OBGYNs women are more likely to tell their obgyns stuff for kids-SSRIS

Factors affecting rates of mental health disorders

Mental health problems are more likely in children: -from disadvantaged families -from abusive or neglectful families -receiving inadequate child care -corn with very low birth weight -whose parents have a mental illness or substance abuse problems new pressures and social changes may place children at increased risk for development of disorder Env stressors may: -Act as nonspecific stressors bring about poor adaptation or the onset of disorder -Affect the extent to which a child's problems are attenuated or exacerbated

experiencing anxiety

Moderate amounts of anxiety helps us think and act more effectively Excessive, uncontrollable anxiety can be debilitating The neurotic paradox is a self-defeating behavior pattern - fear with no threat Fight/flight response Immediate reaction to perceived danger or threat aimed at escaping potential harm

normal fears anxieties worries and rituals

Moderate fear and anxiety are adaptive -Emotions and rituals that increase feelings of control are common in children and teens Normal fears -Fears that are normal at one age can be debilitating a few years later -A fear defined as normal depends on its effect on the child and how long it lasts -The number and types of fears change over time

General approaches to treatment

More than 70% of clinicians use an eclectic approach psycho dynamic treatments: -view child psychopathology as determined by underlying unconscious and conscious conflicts -focus is on helping the child develop an awareness of unconscious factors contributing to problems

SLD with impairment in reading

Most common underlying feature is the inability to distinguish or separate sounds in spoken words Involves difficulty learning basic sight words such as: the, who, what, laugh, said Errors in: reversals (b/d, p/q) transpositions: (was/saw, scared/sacred) inversions: (m/w, u/n) omissions: (place for palace, section for selection) -These errors are common in young children core deficits in reading disorders are in decoding rapidly enough to read the whole word-coupled with problems reading single, small words

What is race?

Most cultural anthropologists see race as a socially constructed concept, not a biological one Minority children in the US are overrepresented in rates of some disorders -substance abuse, delinquency, and teen suicide

Age of onset (ASD)

Most often identified by parents in the months preceding child's second birthday -diagnosis is made in preschool period or later earliest point in dev for reliable detetion period is from 12-18 months -may be noticed as early as 4 months -diagnosesmade around 2-3 years are generally stable -AAP recommends that all childen be screened at 18-24 months

physical abuse (what is it, what is it due to? how are kids described?)

Multiple acts of aggression, including punching, beating, kicking, biting, burning, shaking, or otherwise physically harming a child Injuries are often the result of over discipline or severe physical punishment Physically abused children are often described as more disruptive and aggressive

Bio persp (ch 2)

Neurobiological persp -brain is seen as underlying cause of psych dis -fetal brain devs from all prupose cells into a complex organ -neurons with axons dev -synapses(axonal connections) form prenatatl dev by 5th month -most axons have reached their general destination During early childhood -synapses multiply then selective pruning reduces # of connections Throughout life, brains microanatomy is constantly redefined

Medications

Non stimulant -strattera -wellbutrin -catapres -intuniv,tenex Dev for dep but found to be effective for adhd. Takes 2 weeks to start working. Have to work it up.

normal rituals and repetitive beh (routines may help kids what? what do common kid routines involve? neuropsych mechanisms may be similar to?)

Normal routines help children gain control and mastery of their environment Many common childhood routines involve repetitive behaviors and doing things "just right" -Neuropsychological mechanisms underlying compulsive, ritualistic behavior in normal development and those in OCD may be similar

(psych testing) objective testing

Objective personality tests: considered objective because child answers specific questions yes/no, true/false, or on a likert scale and test admin scores based on formula. There are no assumptions about what the response/answer means.

Obsessive compulsive and related disorders (5)

Obsessive-Compulsive Disorder Body Dysmorphic Disorder Hoarding Disorder Trichotillomania (hair-pulling disorder) Excoriation (skin-picking) Disorder

Behavioral observation (behavioral assessment)

Parents or other observers record baseline data to provide info about behaviors in real-life settings recordings may be done by parents or others -may be difficult to ensure accuracy clinician may set up role-play simulation to observe children and their families

Poverty

One in 5 children 20% in the US and one in seven 14% in canada live in poverty -Native american/first nations and african american children are at greatest risk Poverty associated with: -impairments in learning ability and school achievement, less education, low paying jobs, inadequate health, single parent, poor nutrition, & exposure to violence

(panic) (age of onset? % of PD adols are? What is remission rate like?)

Onset, course, and outcome -Age of onset for first panic attack 15-19 years; 95% of PD adolescents are post-pubertal -Lowest remission rate for any of the anxiety disorders

treatment and prevention (anxiety) main line of attack is? treatments are directed at modifying what 4?)

Overview -Main line of attack for treating anxiety disorders is exposing children to anxiety producing situations, objects, and occasions Treatments are directed at modifying: -Distorted information processing -Physiological reactions to perceived threat -Sense of a lack of control -Excessive escape and avoidance behaviors talk about it and educate

assoc problems and adult outcomes ptsd

PTSD can become a chronic psychiatric disorder for some children and youths -May persist for decades and in some cases for a lifetime (Nader & Fletcher, 2014). -Children and youths with chronic PTSD may display a developmental course marked by remissions and relapses -In a less common delayed variant, children exposed to a traumatic event may not exhibit symptoms until months or years later

panic attacks (characteristics? Rare in who common in who?)

Panic attacks -Characteristics: sudden, overwhelming period of intense fear or discomfort accompanied by four or more physical and cognitive symptoms characteristic of the fight/flight response (e.g., sweating, shortness of breath, light-headed, "going crazy", numbness, fear of dying) -Are rare in young children; more common in adolescents ***Young children may lack cognitive ability to make catastrophic misinterpretations ***Are related to pubertal development

how common are panic attacks? How common is PD and what ages? Who are PA most common in? Comorbidity for PD?

Panic attacks are common (16% of teens) Panic disorder is less common (about 2.5% of teens 13-17 years) Panic attacks are more common in adolescent females than adolescent males Comorbidity adolescents with PD -Most commonly have another anxiety disorder or depression **At risk for suicidal behavior; alcohol or drug abuse

Defining psychological disorders

Patterns of behavioral, cognitive, emotional, or physical symptoms linked with one or more of the following: -distress -disability -increased risk for further suffering or harm Culture & circumstances matter The characteristics describes behaviors, not causes

physical neglect

Physical neglect includes: -Refusal or delay in seeking health care, expulsion from the home, or refusal to allow a runaway to return home, abandonment, and inadequate supervision

interrelated anxiety response systems (phys, cog, beh) (anx dis are some of the most?)

Physical system -The brain sends messages to the sympathetic nervous system, fight/flight response Cognitive system -Activation leads to feelings of apprehension, nervousness, difficulty concentrating, and panic Behavioral system -Aggression is coupled with a desire to escape the threatening situation anxiety dis are some of the most treatable dis albert ellis restaurant

Serotonin

Plays a role in info and motor coordination Inhibits childrens tendency to explore their behaviors, such as easting, sleeping and expressing anger Regulatory probs such as eating and sleeping disorders OCD Schizo and mood disorders

Molecular Genetics

Points to particular areas on many different chromosomes as possible locations for genes for ASD -causally implicated but not a direct cause -ASD is likely to be a complex genetic disorder -expression of ASD genes may be influenced by env factors occuring primarily during fetal brain dev -epigenetic dysregulation may be a factor

Socioeconomic disadvantages assoc with poverty

Poverty's impact on children -More conduct problems, chronic illness, school problems, emotional disorders, and cognitive/learning problems Poverty indirectly impacts children's adjustment, which affects learning and mental health

body dys disorder( what is it, prev, mean age onset)

Preoccupation with one or more perceived defects of flaws in physical appearance (most commonly with nose or skin, but can be any part of body) Repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking) or mental acts (e.g., comparing appearance to others) Prevalence - 2.4% (slightly more females than males) Mean age of onset 16-17, but commonly starts at ages 12-13. almost always nose or skin

(Psych testing) projective testing

Present the child with ambiguous stimuli and asking the child to describe what he or she sees -the child projects his or her own personality, including unconscious fears, needs, and inner conflicts, on the ambiguous stimuli Projective tests are among the most frequently used methods

OCD (lifetime prev? M/F? comorbidity?)

Prevalence and comorbidity -Lifetime prevalence in children and adolescents is 1-2.5% -Clinic-based studies find it twice as common in boys -Comorbidities most common are other anxiety disorders, depressive disorders, disruptive behavior disorders **Substance-use; learning and eating disorders; vocal and motor tics are also overrepresented

prevalence and comorbidity GAD (lifetime prev %? B vs G? Accompanied by?)

Prevalence and comorbidity -Nat'l survey: lifetime prevalence rate - 2.2% -Equally common in boys and girls -Accompanied by high rates of other anxiety disorders and depression

prevention (anxiety) (study)

Prevention study -Researchers identified children with a mean age of less than 4 years who were at-risk for later anxiety disorders ***Brief intervention (six 90-min group sessions) was carried out -Intervention group (compared with a control group) showed fewer anxiety disorders and lower symptoms severity ***Untreated children may be on a worsening developmental trajectory

panic disorder (what does it consist of)

Recurrent unexpected panic attacks (more than one full-symptom attack) At least one of the attacks has been followed by one month (or more) of: -Persistent concern about a return attack or their consequence (e.g., losing control, "going crazy") and/or -Maladaptive change in behavior

Parent managenent training (pmt)

Provides parents with a variety of skills -managing the child's oppositional and noncompliant behaviors -coping with emotional demands of raising a child with adhd -containing the problem so it does not worsen -keeping the problem from adversely affecting other family members Parents are: -taught to understand bio basis of adhd -given set of guiding principles -taught beh management principles and technique -encouraged to spend time each day sharing enjoyable activity with their child -taught how to reduce their own levels of arousal

trichotilomania: % prev? what gender is more likely? when is onset?

Pulling out hair, resulting in hair loss Repeated attempts to stop pulling hair Hair pulling causes distress or impairment Prevalence - 1-2% Females 10 times more likely than males Onset usually shortly after puberty

excoriation (skin picking) disorder % and age onset

Recurrent skin picking resulting in skin lesions Repeated attempts to stop Causes distress or impairment in life activities Prevalence - 1.4% Much more common in persons with OCD Onset usually in adoelscence

family context (abuse)

Relational disorders are an important factor for physical abuse and neglect -These forms of maltreatment occur most often during periods of stress Sexual abuse is primarily a premeditated act —the adult offender plays a purposeful and intentional role Maltreatment is seldom caused by severe forms of adult psychopathology

psychological emotional abuse

Repeated acts or omissions that may cause serious behavioral, cognitive, emotional, or mental disorders Exists in all forms of maltreatment Can be as harmful as to a child's development as physical abuse or neglect

SAD: about age of onset & referall

SAD has the earliest reported age of onset of anxiety disorders (7-8 months of age) and the youngest age at referral (preschool)

onset, course and outcome Sep Anx Dis

SAD has the earliest reported age of onset of anxiety disorders (7-8 months of age) and the youngest age at referral (preschool) Progresses from mild to severe Associated with major stress -Examples: moving to new neighborhood or entering a new school SAD persists into adulthood for more than 1/3 of affected children and adolescents

% prevalence and comorbidity SAD (how many have another anx disorder, how many another depressive?)

SAD is one of the two most common childhood anxiety disorders Occurs in 4-10% of children -It is more prevalent in girls than in boys More than 2/3 of children with SAD have another anxiety disorder and about half develop a depressive disorder

intellectual disability in the mid 19th century

Samuel G. Howe convinced others that training and educating the feebleminded was public responsibility. He opened the first humanitarian institution in North America in 1848: -Massachusetts School for Idiotic & Feeble-minded Youth: labeled from highest to lowest functioning-morons, imbeciles, or idiots Morons" looked like everyone else

school reluctance and refusal (Separation Anx Dis)

School refusal behavior -Refusal to attend classes or difficulty remaining in school for an entire day Occurs most often in ages 5-11 Fear of school may be fear of leaving parents (separation anxiety), but can occur for many other reasons Serious long-term consequences result if it remains untreated

anti anxiety meds

Selective serotonin reuptake inhibitors are used to treat anxiety in children and adolescents and are included above in the section on antideps. Other meds (presented here) used to treat anxiety in adults are rarely used w children and adolescents, but may be helpful for brief treatment of severe anxiety Benzodiazepines: -xanax -ativan -valium -klonopin antihistamines: -benadryl -vistaril atypical: -buspar -ambien

7 categories of anxiety disorders (in the following order in dsm5)

Separation Anxiety Disorder (SAD) Selective mutism Specific phobia Social anxiety disorder Panic disorder (PD) -Panic attack specifier Agoraphobia Generalized anxiety disorder (GAD)

separation anxiety disorder (SAD) why is it normal at first & from what ages? What does a lack mean? what is SAD distinguished by?

Separation anxiety is important for a young child's survival -It is normal from about age 7 months through preschool years -Lack of separation anxiety at this age may suggest insecure attachment SAD is distinguished by: -Age-inappropriate, excessive, and disabling anxiety about being apart from parents or away from home

sexual adjustment

Sexual abuse, in particular, can lead to traumatic sexualization, in which a child's sexual knowledge and behavior are shaped in developmentally inappropriate ways

Social learning and cog

social learning explanations consider overt behaviors and the role of possible cog mediators social cog relates to how children think about themselves and others -Bandura's bobo doll studies

physical symptoms (anxiety)

Somatic complaints, such as stomachaches or headaches, are more common in children with GAD, PD and SAD than in those with a specific phobia 90% with anxiety disorders have sleep-related problems, e.g., nocturnal panic High rates of anxiety in adolescence are related to reduced accidents and accidental deaths in early adulthood

Labels describe behavior, Not people

Stigmatization is a challenge -separate the child from the disorder -problems may be result of children's attempts to adapt to abnormal or unusual circumstances According to DSM5 guidelines -The primary purpose of using terms is to help describe and organize complex features of behavior patterns

Intensive interventions adhd

Summer treatment programs -maximize opportunities to build effective peer relations in normal settings and provides contuinity wity academic work so gains from school year aren't lost -are coordinated with simulantant medication trials, pmt, social skills training, and educational interventions

Mood & affect disturbances

Symptoms of depression, emotional distress, and suicidal ideation are common among children with histories of physical, emotional, and sexual abuse Teens with histories of maltreatment have a much greater risk of substance abuse Childhood sexual abuse also can lead to eating disorders, such as anorexia nervosa and bulimia nervosa In reaction to emotional and physical pain from abusive experiences, children or adults voluntarily or involuntarily may induce an altered state of consciousness known as dissociation

Educational intervention (adhd)

Teacher and child must set realistic goals and objectives Response cost procedures are used to reduce disruptive or off task behaviors Many strategies are basic good teaching methods School based interventions for adhd have received considerable support

psychological testing

Tests: tasks given under standard conditions -the purpose is to assess some aspect of the child's knowledge, skill, or personality A child's scores are compared with a norm group -The norm group may have limitations in terms of race, ethnicity, culture, SES, etc.

Resilience

The ability to fight off or recover from misfortune -associated with strong self-confidence, coping skills, avoiding risk situations -Connected to a "protective triad" of resources: *strength of the child *strength of the family *strength of the school/community

Competence

The ability to successfully adapt in the environment -successful adaptation is influenced by culture and ethnicity Abnormal child psychology considers: -the degree of maladaptive behavior -extent to which normal dev milestones are met *knowledge of dev tasks provides important background info

Bronfenbrenner's ecological model

The child's env is a series of nested and interconnected structures with the child at the center (see next slide for diagram)

Clinical issues

The decision making process -begins with a clinical assessment. Uses systematic problem solving strategies to understand children with disturbances and their family and school environments -flexible ongoing hypothesis testing assesses: *a child's emotional, behavioral, and cognitive functioning *the role of environmental factors *nature, causes, and likely outcomes of the problem

neurobio factors (anxiety)

The entire anxiety response system is controlled by several interrelated to produce anxiety -Hypothalamic-pituitary-adrenal (HPA) axis -Limbic system -Ventrolateral prefrontal cortex -Other cortical and subcortical structures -Primitive brain stem An overactive behavioral inhibition system (BIS) implicated -BIS may be shaped by early life stressors Brain abnormalities have been implicated in children who are anxious and/or behaviorally inhibited Primary neurotransmitter system implicated in anxiety disorders -γ-aminobutyric acidergic (GABA-ergic) system GABA has to do with slowing system down. primary inhibitory NT in body. In anxiety this system is overriden benzos for adults. never give to children. by keeping it open longer it slows things down

CBT (anxiety) Cat, is the most what? must include what? computer based?

The most effective procedure for treating most anxiety disorders -Must include exposure with response prevention as part of treatment Coping Cat Skills training and exposure combat problematic thinking Computer-based CBT has also been shown to be effective

Attachment

The process of establishing and maintaining an emotional bond with parents or other sig individuals -an ongoing process beginning between 6-12 months of age *provides infant with a secure, consistent base -An internal working model of relationships comes from a child's initial crucial relationship *carried forward into later relationships

Lesch-Nyhan syndrome

X linked type of cerebral palsy. HPRT gene-deficiency of HGPRT (guanine) enzyme, there is a build up of uric acid in all body tissues. Causes ID with severe self-mutilation. Always seen in males. 1 in 380,000 births. -new treatment is stimulating globus pallidus (part of basal ganglia & extrapyramidal motor system), reduces severe self mutilation. very rare you eat yourself in order to have a female, a male with it would have to mate with a carrier

Dev pathways

The sequence & timing of particular behaviors as well as the relationships between behaviors over time Two types of dev pathways Multifinality & equifinality

Key considerations in dev pathways

There are many contributors to disordered outcomes in each child Contributors vary among children who have the same disorder Children express features of their disturbances in diff ways Pathways leading to particular disorders are numerous and interactive

trauma and stress

Trauma and stressful experiences in childhood or adolescence may involve: -Actual or threatened death or injury, or a threat to one's physical integrity. Children exposed to chronic or severe stressors, e.g., major accidents, natural disasters, kidnapping, brutal physical assaults, war and violence, or sexual abuse, have an elevated risk of PTSD

intro to trauma and stressor related disorders (what are the 5 disorders? Which one is most diagnosed?what is trauma?)

Trauma- and stressor-related disorders is new category in DSM-5 Includes: -Reactive Attachment Disorder -Disinhibited Social Engagement Disorder -Acute Stress Disorder -Posttraumatic Stress Disorder (PTSD) -Adjustment Disorder **Adjustment disorders can be with depression, anxiety, disturbance of conduct or combinations ** most diagnosed of all DSM trauma=close brush with death, saw someone, heard about someone dying in violent way, repeated exposure to those things that arent close to you, and any kind of sexual abuse

special needs of maltreated children: sexual abuse

Treatment programs for children who have been sexually abused provide several crucial elements to restore the child's sense of trust, safety, and guiltlessness TF-CBT has been adapted for child sexual abuse victims and others with complex trauma symptoms

types of childrearing env that predict resilience for boys (3) vs girls (3)

Types of childrearing env that predict resilience -For boys: *male role model *Structure and rules *encouragement of emotional expressiveness -For girls: * households that combine risk taking and independence with support from female caregiver

prevalence and course of ASD

U.S.: 1 in 68 suffers from ASD (1.5%) -1 in 42 for boys -1 in 189 for girls -occurs in all social classes and identified worldwide * prev rates range from about 1% to 2.5% around the world -way more freq now than before this census -can ID as early as 4 months because of lack of eye contact -canner autism-refirgerator moms -asperger

Progressive legislation-The UN

United Nations General Assembly (2007) adopted a new convention to protect the rights of persons with disabilities _The convention supports the attitude of considering persons with disabilities as individuals with human rights

What is culture?

Values beliefs and practices that characterize a particular ethnocultural group -contribute to dev and expression of children's disorders -Affect how people/institutions react to children's problems _affect how problems problems are expressed

temperament

Variations in behavioral reactions to novelty result in part from inherited differences in the neurochemistry of brain structures -Amygdala - primary function is to react to unfamiliar or unexpected events -Projections of amygdala to the motor system, anterior cingulate and frontal cortex, hypothalamus, and sympathetic nervous system Behavioral inhibition (BI): a low threshold for novel and unexpected stimuli -Place an individual at greater risk for anxiety disorders Development of anxiety disorders in BI children depends on: -Gender, exposure to early maternal stress, and parental response

XXX, XXXX, XXXXX syndromes

XXX girls typically look normal & are not ID. XXXX and XXXXX girls often have severe ID.

1970s (ADHD)

deficits in attention and impulse control, in addition to hyperactivity, were seen as the primary symptoms

The effects of race and ethnicity

When controlling for other effects (SES gender, age, referral status) *few differences emerge in relation to race or ethnicity Barriers remain in access to, & quality and outcomes of, care for minority children *minority children face mult disadvantages including poverty and marginalization

phonology

deficits in phonology are a chief reason that individuals develop communication & learning disorders about 80% of children can use phonemes properly by the age of 7

self reg

a balance between emotional reactivity & self control -the best formula for healthy, normal adjustment

The changing picture of children's mental health

a better ability to distinguish among disorders has led to increased and earlier recognition of problems There is a greater awareness of younger children's and teens unique mental health issues Evidence based prevention and treatment programs are more prominent

identifying the sample

a careful definition of the sample is critical comorbidity: the simultaneous occurence of two or more disorders random selection is rare in child psychopathology studies child studies often use samples of convenience

Autism spectrum disorders (ASD)

a complex neurodev disorder characterized by abnormalities in social behavior, language, and communication skills, and unusual beh and interests underlying deficit. Give and take reciprocity is not understood by ppl w/autism. Recog your feelings and being able to mirror them no longer spectrum reciprocity joint social attention. You and someone else's attention focused on something. Kids w/ autism dont get this guess where they saw it put. Could be due to other factors tho

Theory

a language of science that allows us to assemble and communicate existing knowledge effectively - Allows us to make educated guesses and predictions about behavior based on samples of knowledge

Diagnostic criteria for oppositional defiant dis

a pattern of angry/irritable mood, argumentative/defiant beh or vindictiveness lasting at least 6 months as evidenced by at least 4 symptoms from any of the following categories, and exhibited during interaction with at least 1 indiv who is not a sibling -angry/irritable mood 1 often loses temper 2 is often touchy or easily annoyed 3 is often angry or resentful -argumentative/defiant beh 4 often argues w auth or for children and adol, with adults 5 often delib annoys others 6 often actively defies or refuses to comply w req from auth figures or with rules 7 often blames others for his or her mistakes or misbehavior -vindictiveness 8 has been spiteful or vindictive at least 2 within the past 6 months note: persistence and freq of beh should be used to dist a beh that is within normal limites from beh that is symptomatic. For children younger than 5 yrs, the beh should occur on most days for a period of at least 6 m unless otherwise noted *criterion a8). while these freq criteria provide guidance on minimal level of freq to define symptoms other factors should also be considered such as whether the freq and intensity of beh are outside a range that is norm for indiv dev level gender and culture B.) disturbance in beh is assoc w distress in indiv or others in immediate social context or it impacts negatively on social, edu occ or other important functioning c.) beh do not occur exclusively during course of a psych substance use dep or bipolar disorder. Also criteria are not met for dis mood dis specify severity: mild: sympt are confined to only 1 setting mod: some sympt present in at least 2 settings sev: some sympts present in 3 or more settings

depression (definition of it & experience of children who have it) (often accompanied by? Often goes?)

a pervasive unhappy mood disorder \-more severe than the occasional blues or mood swings everyone experiences children who are depressed cannot shake their sadness-interferes with their daily routines, social relationships, school performance, and overall functioning -often accompanied by anxiety or conduct disorders -often goes unrecognized and untreated

standardization

a process that specifies a set of standards or norms for a method of measurement

Intellectual disability

a significant limitation in intellectual functioning and adaptive behavior which begins before age 18

Are cog deficits found in all ASD?

a single cog abnormality cannot explain all the deficits present in children with ASD there is a view that children with ASD have an underlying impairment in social motivation

PTSD DSM 5 in children 6 and younger

a.) in children 6 and younger exposure to actual or threatened 1.) directly 2.) witnessing especially to primary caregivers note: does not include witnessed thru media 3.) learning about parent or caregiver b.) one or more beg after trauma 1.)recurrent inv and intrus distressing memories. spontaneous and int memories may not nec appear distressing and may be exp as play reenactment 2.) recurrent dist dreams may not be poss to ascertain 3.)diss reactions (flashbacks) feels or acts as if its occurring can occur in play 4.)intense or prolonged dist at exposure to internal or external cues 5.) marked phys reactions to reminders c.) one or more -persistent avoidant stim: 1.)avoidance or efforts to avoid activities, places or phys reminders 2.) avoidance of or efforts to avoid ppl, convos, or interpers sit -neg alterations in cog 3.) subs increased freq of neg emo state 4.) markedly diminished interest of partici in sig activities including construction of play 5.) socially withdrawn beh 6.) persis reduct in exp of + emo D.) alterations in arousal and reactiv assoc w trauma 1.) irritable beh and angry outbursts w little or no provoc verbal aggression toward ppl or objects including extreme temper tantrums 2.) hypervigilance 3.) exagg startle resp 4.) probs with concent 5.) sleep dist e.) duration of dis is more than 1 month f. dist causes clin sig dist or impairment in rel w parents sibs or peeros or with school beh g.) dis is not att to the physio effects of a substance specify if : with dissoc 1.) depersonalization 2.) derealization with delayed exp

diagnostic criteria for OCD (definitions of O & C? How long? specify if?)

a.) presence of obs, comp, or both: obsessions defined by 1 and 2 1.) recurr and pers thoughts urges or images that are exp at sometime during the dist as intrusive unwanted and that in most inds cause marked anx or dist 2. indiv attempts to ignore or suppress such thoughts urges or images or to neut them with some other thught r action (by perf a compulsion) compulsions def by 1 nd 2 1.) rep beh (hand washing, ordering, checking) or mental acts (praying counting etc) that the indiv feels driven to perf in response to an obs or according to rules that must be applied rigidly 2. behs or mental acts are aimed at prev or red anx or dist or prev some dreaded event or sit however these beh or mental acts are not conn in a realistic way w what they are designed to neut or prevent or are clearly exc note: young kids may not be able to artic the aims of these beh or mental acts b.) the obs or comp are time consuming (more than 1 hour per day) or cause clin sig distress or imp in social occ or other c.) obs comp sympts are not att to physio effects of drug or other med cond d.) dist not better exp by other mental dis specify if: -with good or fair insight: indiv rec that obs comp dis beliefs are def or prob not true or that they may not be true -poor insight: indiv thinks ocd beliefs are prob true -absent insight/delusional beliefs: indiv is completely convinced that ocd dis beliefs are true specify if: -tic related: indiv has a current or past hist of tic dis

neurobio influences depression (abnormalities where? NT & other dysregulations? What do antideps do?

abnormalities in the struture and function of several brain regions that regulate emotional functions -abnormalities in amygdala, cingulate, preforntal cortex, hippocampus -corical thinning in the right hemisphere -hpa AXIS DYSREGULATION, sleep abnormalities, variants in BDNF (brain dev neuro prot factor) and NT (sero, dopa, and norep) have also been implicated antideps may improve efficacy of BDNF

brain abnormalities (adhd)

abnormalities primarily in the frontostriatal circuitry are implicated -this region includes the prefrontal cortex and the basal ganglia -adhd children have smaller total and right cerebral volumes (by 3-4%), smaller cerebellum, and delayed brain maturation specific regions of the thalamus may also be involved basal gang: movement, initiating, coordinating & modifying movement

Severity level: moderate ID

about 10% of persons with ID usually identified during preschool years applies to many people with down syndrome benefit from vocational training can perform supervised unskilled or semiskilled work in adulthood

severity level: severe (ID) often associated with what causes? identified when? what features are seen? what other probs may they have?

about 3%-4% of persons with ID often associated with organic causes usually identified at a very young age -delays in dev milestones and visible physical features are seen may have mobility or other health problems -need special assistance throughout their lives -live in group homes or with their families

onset course outcome BP (% of patients have 1st episode prior to? what is rare age? typical mania? What does early onset mean?)

about 60% of patients with BP have a first episode prior to age 19 -onset before age 10 is extremely rare adolescents with mania typically have: -psychotic symptoms, unstable moods, and severe deterioration in behavior early onset is chronic and resistant to treatment -long term prognosis is poor

Intellectual deficits and strengths(ASD)

about 70% of autistic children with autism have co-occuring intellectual impairment a common pattern is low verbal scores and high nonverbal scores about 25% have splinter skills(really good better than most) or islets of ability. 5% (autistic savants) display isolated and remarkable talents. Above and beyond anyone. savant skills almost always memory, art, math or music savants are not seen in any other disprders just autism

severity level: mild

about 85% of persons with ID typically not identified until early elementary years overrepresentation of minority group members develop social and communication skills live successfully in the community as adults with appropriate supports

Child maltreatment & non-accidental trauma: prevalence

about one million confirmed cases of child abuse & neglect occur in the US each year (over 1.6 million reported) Estimate: more than one third of 10 to 16 year olds experience physical and or sexual assaults Acts of violence contribute to PTSD, major depressive disorder, or substance abuse/dependence

overview of child abuse and neglect (which one is most common & what %? Which ones next %?)

abused or neglected children face paradoxical dilemmas -the victim wants to stop the violence but also longs to belong to the family in which they are being abused -affection and attention may coexist with violence and abuse -violence intensity tends to increase over time, but in some cases physical violence may decrease or stop neglect is most common at 78.3, physical is next at 10.8 %

normal achievements/common beh porbs/clinical disorders 6-11

academic skills and rules, rule gov games, simple resp arguing, inability to concentrate, self consciousness, showing off ADHD, learning disorders, school refusal beh, conduct probs

socioeconomic status and culture (adhd)

adhd affects children from all social classes -slightly more prev among lower ses groups findings are inconsistent regarding relationships among adhd, race, and ethnicity adhs is found in all countries and cultures -rates vary cultural diff may reflect cultural norms and tolerance for adhd symptoms adhd is a universal phenomenon that is diagnosed more often in boys than in girls in all cultures -expression, associated features, impairments, and outcomes are quite similar wherever it occurs

gender (adhd)

adhd occurs more freq in boys overall rates decrease in adolescence for both sexes-ratio remains the same ratio in clinical samples is 6:1 with boys being referred more often than girls -adhd in girls may go unrecognized and unreported dsm criteria (cutoffs and symptoms) may be more app to boys than girls as you add them together boys get worse and worse. Girls usually dont get really bad unless they have all genetic markers girls with adhd may be more likely to display inattentive/disorganized symptoms clinic referred school age children with adhd display similar symptoms girls with adhd who display impulsive-hyperactive beh -more likely to dev eating disorder symptoms

Problems equally reported among M and F (4)

adolescent conduct disorder childhood depression feeding disorder physical abuse & neglect

neurobio influences

adverse bio conditions -ex: infections, traumas, and accidental poisonings during infancy and childhood fetal alcohol spectrum disorder (FASD) -fetal alcohol syndrome: a leading known cause of ID (2 out of 1,000 live births). 4 times higher in african american children and 16 times higher in NA children compared to majority populations. teratogens increase risk of ID

oppositional defiant disorder

age inapp recurrent pattern of stubborn, hostile, disobedient, and defiant beh usually appears by age 8 severe ODD beh can have neg effects on parent child interactions although always could have been diagnosed into adulthood, dsm-5 clarifies that ODD is often seen in adulthood and presence of these beh at any age predicts future beh and social probs dsm5 diff you can give ODD and cond dis at the same time. Can be given up through adulthood

description of conduct problems

age inappropriate actions and attitudes that violate family expectations, societal norms, and personal or property rights of others these disruptive and rule-violating behaviors range from: -annoying minor beh (eg temper tantrums) to serious antisocial beh (eg vandalism, theft, and assault) we must consider many types, pathways, causes, and outcomes of conduct problems are associated with unfortunate family and neighborhood circumstances -circumstances do not excuse the behavior, but help us prevent it and understand it

interrater reliability

agreement of observers

XXY syndrome

aka Kleinfelter syndrome. These boys have extra X chromosome. About 20% have ID

XO syndrome

aka Turner syndrome. Girls are missing second x chromosome. About 18% have ID

What is specific to ASD?

alck of theory of mind is one of the most specific to ASD -deficits in processing socio-emotional info and executive functioning deficits are less specific to ASD

HPA axis does what? too much cortisol does what & what does this do? Locus c does what?

alerts/prepares body for stress. Feedback loop where when cortisol levels reach a point the hypocamp tells hypothalamus that its enough. central nervous system & endo system. too much cortisol destroys hippocamp not storing new memories locus c part of activating system that scans for danger one of the 1st to know

prevalence rates

all cases (new ad existing) obs during specified time period

Behavioral assessment: checklists & rating scales

allow for a child's behavior to be compared with a known reference group economical to administer and score lack of agreement between informants is common, and is highly informative the Behavior Assessment System for Children (BASC) & Child Behavior Checklist (CBCL) are two commonly used checklists and give clinicians a useful profile of the variety and degree is the child's problems -some consider the BASC to be a behavior checklist, others a self-report personality questionnaire -CBC like a graph of internalizing vs externalizing

depression in young people (what is 1st symptom noticed? what % of kids and adols? When is suicide peak? % of impairment?)

almost all young people experience some symptoms of depression -withdrawal is often the 1st symptom noticed by others -perhaps 5% of children and 15-20% of adolescents suffer from diagnosable depression suicide among teens is a serious concern -13-14 is peak time for 1st suicide attempt 90% of youngsters with depression show significant impairment in daily functions

Angelman syndrome

also chromosome 15 (maternally inherited). May have normal dev for about 6 months then a decline. Moderate to severe ID. Most living much longer now.

temperament

an organized style of behavior that appears early in dev -shapes an individual's approach to his or her env and vice versa early infant temperament may be linked to psychopathology or risk conditions Empirical evidence links early behavioral styles to adult personality characteristics self reg

Functional analysis

antecedents: teased at school behaviors: school refusal consequences: no teasing (another ex) antecedents: "I'm no good at anything" behaviors: depressive symptoms consequences: confirms low self opinion

cotext (cond dis)

antisocial beh appear and decline during normal dev -behaviors vary in severity, from minor disobedience to fighting -some may decrease with age; others increase with age and opportunity -are more common in boys in childhood; but gender diff narrow in adolescence -children who are the most physically aggressive in early childhood maintain relative standing over time-aggression is highly stable over time only thing more stable than aggression is IQ

accompanying psych dis and symptoms anxiety disorders

anxiety dis: -about 25% of children w adhd experience excessive anxiety -co-occurring anxiety worsens symptoms or severity of adhd **findings are inconsistent -children with co-occuring adhd and anxiety: **display social & academic diff **exp greater long term impairment & mental health probs

Problems more commonly reported among females (4)

anxiety disorders adolescent depression eating disorders sexual abuse (1 out of 3)

BASC 2 self report personality scale definitions

anxiety: feelings of nervousness, worry and fear; the tendency to be overwhelmed by problems attitude to school: feelings of alienation, hostility, and dissatisfaction regarding school attitude to teachers: feelings of resentment and dislike of teachers; the belief that teachers are unfair, uncaring, or overly demanding atypicality: the tendency towards bizarre thoughts, or other thoughts and behaviors considered odd Depression: feelings of unhappiness, sadness, and dejection; a belief that nothing goes right interpersonal relations: the perception of having good social relationships and friendships with peers locus of control: the belief that rewards and punishments are controlled by external events or people relations with parents: a positive regard toward parents and a feeling of being esteemed by them self esteem: feelings of self esteem, self respect, and self acceptance

classification and diagnosis commonly ID dimensions

anxious/depressed: -cries alot -worries -feels worthless -nervous, tense withdrawn/depressed: -would rather be alone -refuses to talk -secretive -shy, timid social probs: -too dependent -doesn't get along with peers -gets teased somatic symptoms -feelz dizzy -overtired -aches, pains -headaches thought problems -hears things -sees things -strange behavior -strange ideas aggressive behavior -argues -mean to others -attacks people -destroy's other's things attention probs -inattentive -can't concentrate -can't sit still -confused rule-breaking behavior: -lacks guilt -bad companions -lies -runs away from home

additional dsm criteria (ADHD)

appears prior to age 12 persists more than 6 months occurs more often and with greater severity than in: -other children of the same age and sex Occur across 2 or more settings interferes with social or academic performance not explained by another disorder

ID prevalence

approx 1-3% of population (depending on cutoff) twice as many males as females among those with mild cases more prevalent among children of lower SES and children from minority groups, especially for mild cases -more severe levels: identified almost equally in different racial and economic groups

nature of genes

approx 20,000-25,000 protein coding genes -a gene is a stretch of DNA which produces a protein -protein coding genes code for millions of proteins, which result in identifiable traits -proteins produce tendencies (aka traits) to respond to the env in certain ways -these traist can be influenced by many other factors besides your genetic makeup -proteins produce tendencies to respond to the env in certain ways -genes contain genetic info from each parent dist on 22 matched pair of chromosomes and a single pair of sex chromosomes (XY male XX females ) -23 total pairs -some genetic influences are expressed early in dev while others show up yrs later -expression of genetic influences is malleable and responsive to social env

dev discoordination & tic disorders

as many as 30-50% of children with adhd display motor coordination difficulties -clumsiness, poor performance in sports, or poor handwriting overlap exists between adhd and dev coordination disorder (DCD) -marked motor incoordination and delays in achieving motor milestones tic disorders occur in 20% of children with adhd -sudden, repetitive, nonrhythmic motor movements or sounds such as eye blinking, facial grimacing, throat clearing, and grunting used to think meds made tics worse. Might be true. turrets=motor & verbal tic tic-quick motor movement can be prolonged though vocal ones can be words basal ganglia involved in most motor disorders

comorbidity (depression) % of ppl with another disorder, % with 2 or more, common disorders(6), % of another pers disorder

as many as 90% of young people with depression have one or more other disorders 50% have 2 or more Most common disorders include: -anxiety disorders (especially GAD), specific phobias, and separation anxiety disorders depression and anxiety are more visible as separate, co-occuring disorder: -as severity of the disorder increases and the child gets older other common comorbid disorders: -dysthymia, conduct probs, and substance use disorder 60% of adolescents with MDD have comorbid personality disorders, especially borderline personality disorder pathways to comorbid conditions may differ by disorder/sex

psychophysiological methods

asses the relationship between physiological processes and behavior -autonomic nervous system activity * ex: Heart rate, blood pressure, respiration, pupil dilation, and electrical skin conductance limitations: -inconsistent findings; inference often involved; and susceptibility to extraneous influences Electroencephalogram (EEG) measures the brains electrical activity

idiographic case formulation

assessments focus on obtaining detailed understanding of the child or family as a unique entity. 1 on 1 assessment of people

Behavioral treatments

assume that behaviors are learned focus is on re-educating the child procedures include: -positive reinforcement or time out -modeling -systematic desensitization -changes in the child's environment

(psych testing) Neuropsych assessment

attempts to link brain functioning with objective measures of behavior known to depend on and intact central nervous system involves use of comprehensive batteries -asses a full range of psychological functions (eg Halstead-Reitan)

phonemes

basic unit of phonology. About 44 phonemes in English (some say 42, others 46)

informed consent

before agreeing to participate all participants must be fully informed of the nature of the research including: -risks benefits expected outcomes alternatives and option to withdraw from study at any time Minor's consent must be obtained from parents or legal guardian

beh and cog treatments (LDs)

beh principles of learning are used to teach systematically -used in conjunction with complete program of direct instruction cog beh approaches -teach children to monitor their own thought processes -emphasize strategies such as self monitoring, self assessment, self recording, and self management of reinforcement

psychosocial interventions(4 diff therapies)

behavior therapy -focuses on increasing pleasurable activities and events, and providing the youngster with the skills necessary to obtain more reinforcement cog therapy -teaches depressed youngsters to ID, challenge, and modify - thought processes CBT -most common form of psychosoc intervention combining beh and cog therapies interpers psychotherapy for adol dep (IPT-A) -focus is on dep symptoms and social context in which they occur

Brain abnormalities

behavioral features of ASD may result from abnormalities in brain structure -lack of normal connectivity and communication across brain networks -multiple brain regions may be involved

benefits and limitations of structured obs

ben: cost effective allow for focused attention are useful for studying infrequent beh allow for greater control over the situation lim: uncertainty of whether the obs are a rep sample of behavior

treatment effectiveness (ch 4)

best practice guidelines -systematically dev statements to assist practitioners and patients two main approaches in dev best practice guidelines -the scientific approach derives guidelines from a review of current research findings The expert-consensus approach uses expert's opinions to fill gaps in scientific lit

prevalence (depression) (what % of children of what ages? what about in preschool & school age kids? why sharp increase?)

between 2% and 8% of children ages 4-18 experience MDD depression is rare among preschool and school aged children (1-2%) -increases two to threefold by adolescence the sharp increase in adolescence may result from biological maturation at puberty interacting with dev changes

perinatal causes (ID)

biomed: -prematurity -birth injury -neonatal disorders social: -lack of access to prenatal care behavioral: -parental rejection of caretaking -parental abandonment of child educational: -lack of medical referral for intervention services at discharge

Postnatal causes (ID)

biomed: -traumatic brain injury -malnutrition -meningoencephalitis -seizure disorders -degenerative disorders social: -impaired child-caregiver interaction -lack of adequate stimulation -family poverty -chronic illness in the family -institutionalization behavioral: -child abuse and neglect -domestic violence -inadeq safety measures -social deprivation -difficult child behaviors educational: -impaired parenting -delayed diagnosis -inadeq early intervention services -inadeq special education services -inadeq family support

Prenatal causes

biomedical: -chromosomal disorders -single gene disorders -syndromes -metabolic disorders -cerebral dysgenesis -maternal illness social: -poverty -maternal malnutrition -domestic violence -lack of access to prenatal care behavioral: -parental drug use -parental alcohol use -parental smoking -parental immaturity educational: -parental cognitive disability without supports -lack of preparation for parenthood

Public health perspectives (CD)

blends the legal, psychological, and psychiatric perspectives with public health concepts of prevention and intervention -goal **to reduce injuries, deaths, personal suffering, and economic costs associated with youth violence cut across disciplines to: -understand conduct probs in youths -determine how these probs can be treated and prevented

PTSD and acute stress disorder

both PTSD and acute stress dis req exposure to actual or threatened death, serious injury, or sexual violence through direct experience, direct experience, witnessing event, learning that traumatic event occurred to family or close friend, or repeated or extreme exposure to aversive details of trauma -While divorce, loss of a job, expelled from school, etc. are stressful, they do not meet criteria for "traumatic

phonological awareness

broad construct that includes recognition of the relationship that exists between sounds & letters -phonemes -detection of rhyme & alliteration -awareness that sounds can be manipulated within syllables

categories and dimensions

categorical classification systems are based primarily on informed professional consensus a classical/pure categorical approach -every diagnosis has a clear underlying cause -each disorder is fundamentally different from other disorders dimensional classification -many independent dimensions exist

structured interview questions

category and a few questions for ex Depressed mood and irritability: -do you feel sad? -do you get moody?

brain abnormalities (bio findings)

cerebral gray and white matter overgrowth structural abnormalities: -in the cerebellum and medial temporal lobe and related limbic system structures decreased blood flow in the frontal and temporal lobes elevated blood serotonin in 33% of cases atypical patterns of connectivity in default mode network

language disorder (LD)

characterized by deficits in expression despite normal comprehension of speech -LD occurs when a child's language matures at least 12 months behind his or her chronological age children with LD often have: -delayed/slowed speech dev; limited vocabulary; and speech marked by short sentences and simple grammatical structure linguistic abilities vary significantly among those with LD children with LD may have diff understanding particular types of words or statements speech sound disorder-diff with articulation or sound production

continuum of care

child care along a continuum -positive end-appropriate and healthy forms of child rearing actions that promote child dev -middle range-poor/dys actions represent irresponsible and harmful child care -negative end-parents who violate their childrens basic needs and dependency status in a physically sexually or emotionally intrusive or abusive manner or by neglect

IQ Differences black/white

child characteristics # 1 by 18 points home environment last with 11 points

prevention education treatment (ID)

child's overall adj is a function of -parental participation, family resources, social supports, level of intellectual functioning, basic temperament, and other specific deficits treatment involves a multi component, integrated strategy -considers children's needs within context of their indiv dev, their family & institutional setting, & their community

intellectual disability Prior to mid 19th century

children and adults with intellectual disabilities were ignored with intellectual disabilities were ignored or feared even by the medical profession

transactional view

children and env are interdependent -both children and the env as active contributors to adaptive and maladaptive behavior

Randomized controlled trials

children are randomly assigned to different treatment and control conditions

combined type (ADHD-C)

children who have symptoms of both inattention & hyperactivity-impulsivity Most often referred for treatment

early 1900s (ADHD)

children who lacked self control and showed symptoms of overacitivity/inattention in school were said to have poor "inhibitory volition" and "defective moral control"

associated characteristics

children with ADHD often display other problems in addition to their primary difficulties -cog defs -speech & language impairments -dev coordination and tic disorders -medical and physical concerns -social problems

Assoc characteristics of ASD

children with ASD display a # of assoc characteristics -intellectual deficits and strengths -sensory and perceptual impairments -cog and motivational deficits -medical conditions and physical characteristics

Problems in early dev

children with ASD experience more health problems during pregnancy, at birth, or immediately follwoing birth prenatal and neonatal complications have been identified in a small % of children with ASD -ex: parental age, in vitro fertilization, and maternal use of drugs

Course and Outcome ASD

children with ASD may develop along different pathways often gradual improvements with age -likely to continue to experience many problems -symptoms may worsen in adolescence complex obsessive-compulsive rituals may develop in late adolescence and adulthood

CD age of onset

children with childhood onset CD display at least 1 symptom before age 10 -more likely to be boys -show more aggressive symptoms -account for disprop amount of illegal activity -persist in antisocial beh over time children w adolescent onset CD - as likely to be girls as boys -do not show the severity or psychopathology characterizing the early onset group -are less likely to commit violent offenses or persist in their antisocial beh over time

+ findings (ch 4)

children's changes achieved through therapy are greater than changes for children not receiving therapy children receiving therapy are better off after therapy treatments are equally effective for internalizing and externalizing disorders treatment effects tends to be long lasting

Genetic influences

chromosomal ang gene disorders -Fragile X anomaly occurs in 2-3% of children with ASD (but about 30% of Fragile X have ASD) -ASD individuals have 5% elevated risk for chromosomal anomalies -about 25%of children with tuberous sclerosis have ASD

Classification and diagnosis

classification: a system for representing the major categories or dimensions of child psychopathology strategies for determining the best plan for a given individual -ideographic strategies -nomothetic strategies

client centered and family treatments

client centered: -view psychopathology as result of social or env circumstances imposed on the child -focus is creating a therapeutic setting that provides unconditional, nonjudgemental, and genuine acceptance of the child, often using play activities (young children) or verbal interaction (older children) to enhance personal growth and adaptive functioning Family treatments: -view individual disorders as manifestations of disturbances in family relations -focus on the family issues underlying children's problematic behavior

social and economic costs (CD)

conduct problems are the most mental health prob in NA early, persistent, and extreme antisocial beh occurs in about 5% of children -these children account 50% of all crime in the U.S. and approx 30-50% of clinic referrals -annual public costs (healthcare, juvenile justice, and educational systems) are $10,000 per child -lifetime cost to society per child who leaves HS for a life of crime is at least $2 million

Psychiatric perspectives (CD)

conduct probs are viewed as distinct mental disorders based on dsm symptoms -disruptive beh are described as persistent patterns of antisocial beh the diagnosis of antisocial personality dis (APD) is relevant to understanding childhood conduct and their adult outcomes, but APD can only be diagnosed after age 18

methods of assessment

clinical interview (standard one you always do) behavioral assessment psychological testing

specific learning disorder

co-co-occurring problems in: p-reading -Math -written expression determined by achievement test results that are lower than would be expected for one's age, schooling, and intellectual ability

social & psychological causes of SLDs

co-occurring emotional disturbances and other signs of poor adaptive ability -the overlap between dyslexia & ADHD ranges from 30-70% -reading disorder is assoc with deficits in phonological awareness -ADHD has effects on cog functioning, especially in rote verbal learning & memory -some children with learning disorders show symptoms similar to ADHD

cognitive deficits: executive functions

cog processes language processes motor processes emotional processes

Alfred binet and theophile simon (1900's)

comissioned by the french government to identify schoolchildren who might need special help in school dev. the first intelligence tests -measure judgement and reasoning of school children (became Stanford Binet sclae when Lewsi Terman at Stanford university re-normed it) -came up with child intelligence test. -incredibly stable. Most stable in all psychology. Age 8 on. After that falls + or - 7. -You can change IQ, but not really if you're high or low -People in the middle vary the most -musical instrument will always help -read alot -mare experiences increases IQ

between group comparison designs

compare exp and control groups

specific examples of adaptive behavior skills

conceptual skills: -receptive and expressive language -reading and writing -money concepts -self directions social skills: -interpersonal -responsibility -selfesteem -gullibility (likelihood of being tricked or manipulated) -naivete -follows rules -obeys laws -avoids victimization practical skills: -personal activities of daily living such as eating, dressing, mobility, and toileting -instrumental activities of daily living such as preparing meals, taking meds, using the telephone, managaing money, using transportation and doing housekeeping activities occupational skills: -maintaining a safe enviornment

midbrain

coordinates movement w sensory input; contains reticular activating system (RAS)

areas of the brain involved in language functions

cortex: thin layer of cells that essentially covers the entire surface of the forebrain. A well dev cortex allows a person to read, understand, talk about, and remember the concepts in this text. The vast majority of our neurons are located in the cortex. neurons: form a vast, miniaturized informational network that transmits info in the form of electrical signals. when electrical signals move through a neuron, the cell ejects chemicals called NT into the synapses (spaces between neurons). The NT then cross the synapses and act like switches to turn adjacent cells on or off. Parietal lobe: involved with perception & sensory experiences Occipital lobe: involved with processing visual info temporal lobe: involved with hearing & speaking

dev of SLDs

daily experience of being labeled and unable to keep up can cause children to withdraw or become angry and noncompliant three fourths of children with a reading disorder in elementary school continue to have problems in high school and young adulthood

Core deficits of ASD

debate about core deficits of ASD several deficits likely affect the child's: -social emotional dev -language dev -cog dev these aspects of dev are interconnected

cog and motivational deficits (ASD)

deficits in processing social emotional info -diff in situations that req social understanding -do not understand pretense or engage in pretend play -deficit in mentalization or theory of mind(ToM): difficulty understanding others and their own mental states *do not understand false-belief tests

social interaction impairments

deficits in social and emotional reciprocity unusual nonverbal beh social imitation, sharing focus of attention, make believe play limited social expressiveness atypical processing of faces and facial expressions joint social attention

discriminant validity

degree of correlation between unrelated measures

beck's cognitive model (how do indivs interpret life events? 3 areas of cog probs?)

depressed individuals make negative interpretations about life events -biased and negative beliefs are used as interpretive filters for understanding events -three areas of cog probs **info processing biases **negative outlook regarding oneself, the world(their interactions, global it will always be this way) and the future (negative cognitive triad) -negative cog schema aaron beck

psychodynamic theories depression

depression is viewed as the conversion of aggressive instinct into depressive affect -results from the actual or symbolic loss of a love object children and adols were believed to have inadequate dev of the superego or conscience -therefore, they do not become depressed depression turned inward object relations theory, losses

anatomy of depression (the symptom vs the syndrome)

depression(symptom): feeling sad or miserable -occurs without existence of serious problem, and is common at all ages depression (syndrome): a group of symptoms that occur together more often than by chance -mixed symptoms of anxiety and depression that tend to cluster on a single dimension of negative affect

Antidep meds

depression, school phobias, panic attacks, and other anxiety disorders, bed-wetting, eating disorders, obsessive-compulsive disorder, PTSD, and ADHD selective serotonin reuptake inhibitors (SSRI): -prozac -zoloft -paxil -luvox -effexor -celexa -lexapro. tricyclic antideps (TCAs): -elavil -anafranil -tofranil -pamelor Monoamine oxidase inhibitors (MAIOS): -nardil -parnate

continuity concept of development

dev changes are gradual and quantitative; predictive of future behavior patterns he path is a lot like the continuity view of development. Proponents of the continuity view say that development is a continuous process that is gradual and cumulative. For example, a child learns to crawl, and then to stand and then to walk. They are gradually learning how to walk. It's just like hiking up the mountain path: a slow, steady ascent that leads to the top.

prevalence and course of SLDs

estimates 2-10% of the population SLD with reading impairment -5-17% of school aged children -reading difficulties may be part of reading abilities continuum, rather than a discrete phenomenon SLD with impairment in math -20% of children with learning disorders (1% of school age children) SLD with impairment in written expression -rare by itself -overlap with reading and math disorders -may affect 10% of school age children often goes along with LD in math & written language

cultural considerations

dev of evidence based interventions has led to a growing awareness of children's and family's cultural contexts the cultural compatibility hypothesis -treatment is likely to be more effective when compatible with the cultural patterns of the child & family evidence based treatments have been adapted and implemented to meet the needs of specific cultural groups treatment services for children must: -attend to presenting problem -consider the specific cultural not to stereotype individuals of any cultural group

developmental course and adult outcomes

dev-versus-difference controversy -do all children regardless of intellectual impairments progress through the same dev milestones in a similar sequence, but at different rates? Dev position: -similar sequence hypothesis -similar structure hypothesis difference position: cognitive dev of children with ID is qualitatively different in reasoning/problem solving -familial vs organically based ID

Language and social behavior down syndrome

development follows a predictable and organized course characteristics displayed with down syndrome -the underlying symbolic abilities of children are believed to be largely intact -there is considerable delay in expressive language dev; expressive language is weaker than receptive language

MDD (is assoc with, duration nec, behaviors)

diagnosis in children -same criteria for school age children and adolescents depression is easily overlooked because other behaviors attract more attention some features (eg irritable mood) are more common in children and adolescents than in adults minimum duration of 2 weeks is associated with depressed mood, loss of interest, & other symptoms; and significant impairment in functioning

communication disorders (4)

diagnostic subcategories in DSM-5 -language disorder (formerly expressive & receptive-expressive disorders) -speech sound disorder(formerly phonological disorder) -childhood onset fluency disorder(formerly stuttering) social -pragmatic- communication disorder (new disorder in dsm5)

causes of SLDs

difficulties bringing info from various brain regions together to integrate and understand info recent findings suggest 2 distinguishable types of reading disorder -children who are persistently poor readers -children who are accuracy-improved heritability accounts for 60% of variance in reading disorders

SLD with impairment in math

difficulty in recognizing numbers and symbols, memorizing facts, aligning numbers, and understanding abstract concepts may include probs in comprehending abstract concepts or in visual spatial ability involves core deficits in arithmetic calculation and/or math reasoning abilities

conduct probs fall on 2 dimensions with 4 categories

dimensions: -overt-covert dimension -destructive-nondestructive dimension categories: -covert-destructive -overt-destructive -overt-nondestructive -covert-nondestructive

instructional methods

direct instruction best for children with LDs early interventions must address phonological and verbal abilities effective reading instruction focuses on: -phonemic awareness and phonemic decoding skills, fluency in word recognition, construction of meaning, vocab, spelling & writing

confidentiality and anonymity

disclosed info must be kept confidential individuals must be advised about any exceptions disclosures of abuse are a common prob in child research

(CD) with covert behaviors tend to be

distrustful lacking friends less social

causes of depression

due to the many interacting influences, multiple pathways to depression are likely -genetic risk influences neurobio process and is reflected in early temperament characterized by: **oversensitivity to - stimuli **high - emotionality **disposition to feeling - affect -these early dispositions are shaped by - exp in the fam diff kinds of sero receptors no gene for dep how long are amino acid chains if you get 2 longs youre not as suceptible diff childhood sets you up 30-35% has to do with genetic factors

Psychosocial treatments (ID)

early intervention: -one of the most promising methods for enhancing the intellectual and social skills of young children with dev disabilities -carolina abecedarian project provides enriched env from early infancy through preschool years -optimal timing for intervention is during preschool years

organization of dev

early patterns of adaptation evolve w structure over time Sensitive periods (times during which env influences on dev are enhanced) Dev is a process of increasing differentiation and integration -current abilities or limitations are influenced by prior accomplishments

Three primary dimensions of temperament

easy slow to warm up difficult

normal achievements/common beh probs/clinical disorders 0-2 yrs

eating sleeping attachment stubbornness, temper, toileting diff mental retardation, feeding disorders, autistic disorder

General deficits(ASD)

executive functions (higher order planning and regulatory behaviors) weak drive for central coherence (strong human tendency to interpret stimuli in a relatively global way to account for broader context) -do well on tasks req focus on parts of stimulus -autism sees parts not whole

behavioral theories depression

emphasize the importance of learning, environmental consequences, and skills and deficits during the onset and maintenance of depression depression is related to a lack of response contingent positive reinforcement. conseq of what is rewarded and punished learned helplessness-dog shock study. efforts have been met with failure why should I go out I havent had fun before

Nomothetic formulation

emphasizes general inferences that apply to large groups of individuals what is generally going on. Whats normal for children of that age.

overview of treatment strategies (ASD)

engaging children in treatment decreasing disruptive behaviors teaching appropriate social behavior increasing functional, spontaneous comm promoting cog skills teaching adaptive skills to increase responsibility and independence

nature and contribution of childhood disorders

epidemiological research is the study of incidence, prevalence, and co-occurence of disorders -incidence rates -prevalence rates

other ethical and pragmatic concerns

ethical concerns as outlines in code of ethics longitudinal research- may involve unexpected crises, unforseen consequences of research, and issues about continuing the research that affect a child's well being

Developmental considerations

ethnic minority youth are at greater risk of misdiagnosis cultural info is necessary to: -establish relationship with child and family -motivate family members to change -obtain valid info -arrive at accurate diagnosis -develop meaningful treatment recommendations

analogue research

evals a specific variable under conditions that approx the situation for which one wishes to generalize focus is on a circumscribed research question under well controlled conditions it is diff to know if similar effects would occur in real life circumstances

behavioral assessment

evaluates the child's thoughts, feelings, and behaviors in specific settings primary problems of concern -target behaviors and the factors that control of influence them ABCs of assessment" are to observe the: -Antecedents -Behaviors -Consequences of the behaviors a general approach to organizing & using assessment info in terms of the ABC's" -ID a wide range of antecedents and consequences -Develop hypotheses about which are most important and/or most easily changed

(psychological testing) Intelligence testing

evaluating a child's intellectual and educational functioning many definitions of intelligence The Wechsler Intelligence Scale for Children (WISC-V): one of the most frequently used intelligence scales -emphasizes fluid reasoning abilities, higher order reasoning, and info processing speed Other commonly administered tests: -Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) -Stanford Binet 5 (SB5) -Kaufman Assessment Battery for Children (K-ABC-2)

Prenatal, perinatal, and postnatal causes

ex of prenatal, perinatal, and postnatal causes: prenatal: genetic disorders and accidents in the womb perinatal: prematurity and anoxia postnatal: meningitis and head trauma

depressive disorders (dys, anhed)

excessive unhappiness (dysphoria) and loss of interest in activities (anhedonia)

depression and development (in children under age 7? as young as? spitz?)

experience and expression of depression change with age in children under age 7 (as young as 3-5) -tends to be diffuse and less easily ID -anaclitic depression (spitz)-infants **infants raised in a clean but emotionally cold institutional env showed depression like reactions, sometimes resulting in death -similar symptoms can occur in infants raised in severely disturbed families

face validity

extent to which a measure appears to assess the construct of interest

Prevalence (COS)

extremely rare in children under age 12 dramatic increase in adolescence, with a modal onset around 22 years of age estimated prev is less than 1 per 10,000 children COS has an earlier age of onset in boys by 2 - 4 years -gender diff disappear in adolescence

pregnancy birth and early dev (adhd)

factors that compromise dev of the nervous system before & after birth may be related to adhd mothers use of cigarettes, alcohol, or other drugs during pregnancy are associated with adhd -contributing factors, rather than a causal association -it is difficult to disentangle substance abuse influence and other env factors

The DSM criticisms

fails to capture the complex adaptations, transactions, and setting influences crucial to understanding and treating child psychopathology gives less attention to disorders of infancy/childhood fails to capture the interrelationships and overlap known to exist among many childhood disorders

mediating variables

impact the process, mechanism, or means through which a variable produces a particular outcome (psych or neurobiological processes) -account for some or all of the apparent relationship between two variables

social probs

family probs include: -negativity, child noncompliance, excessive parental control, sibling conflict, maternal depression, paternal antisocial beh, and marital conflict family diff may be due to co-occuring conduct probs more likely to run in family more likely to come from dad if you have adhd+conduct dis, may be most diff thing to treat & most costly ever 5% of ppl commit 60% of crimes mom depressed most common. If dad has adhd they might not be good at treating peer problems: -adhd children can be bothersome, stubborn, socially awk, and socially insensitive. **often disliked and uniformly rejected by peers, have few friends ** unable to apply their social understanding in social situations positive friendships may buffer negative outcomes

common fears and anxieties (primary/elementary school age) 5-7 yrs

fear of spec obj (animals monsters ghosts) fear of germs or of getting srs illness fear of nat dis, traumatic events, (eg getting burned being hit by truck) specific phobias OCD spec phobias, acute stress dis, ptsd, gad

slow to warm up

fearful or inhibited

common fears and anxieties (toddlerhood) 2-3 yrs

fears of thunder & lightning, fire, water, darkness, nightmares fear of animals crying clinging withdrawal freezing avoidance of salient stim (eg turning the light on) night terror, enuresis specific phobias (natural env) panic attacks

bipolar disorder general description

features striking period of unusually and persistently elevated, expansive, or irritable mood, alternating with or accompanied by one or more major dpressive episodes -elation and euphoria can quickly change to anger and hostility if behavior is impeded ** may be experiences simultaneously with depression some sort of mania or hypomania may look like theyre psychotic sometimes schizo affective if theyre having mood in between states

causes BP (what does genetic research suggest? ID twin chances? what if parents have it? how many genes involved? brain abnormalities where?)

few studies have looked at the causes of BP in children and adols research with adults suggests that BP is the result of a genetic vulnerability in combination with env factors (eg life stress and family disturbances) if one identical twin has BP 65% chance other twin will as well. % times greater chance of BP if parents have BP mult genes may be involved -genetic predis does nto nec mean a person will develop BP brain imaging studies suggest mood fluctuations are related to abnormalities in areas of the brain related to: -emotion regulation prefrontal and anterior cingulate cortex, hippocampus, amygdala, thalamus, and basal ganglia

characteristics displayed with down syndrome

fewer signals of distress or desire for proximity with primary caregiver delayed, but positive, development of self-recognition delayed and aberrant functioning in internal state language -reflects emergent sense of self and others deficits in social skills and social-cognitive ability; can lead to rejection by peers

- findings (ch 4)

fewer than 20% of treatments demonstrate evidence for reducing impairment in life functioning community based clinic therapy is far less effective than structured research therapy conventional services for children may have limited effectiveness

treatment of dep therapy, therapies vs eachother, drugs

fewer than half of children eith depression recieve help for their prob -rates vary by racial/ethnic background CBT -has shown the most success in treating children and adols with dep interpersonal psychotherapy for adol dep (IPT-A) -focuses on improving interpers communication and has also been effective psychophar treatments -with the exception os SSRIS which have prob side effects (all of them do), meds have been less effective than CBT and IPT-A 6-7 yrs out may be more eff than CBT interp takes longer CBT is quick a few weeks

(purposes of assessment) Description and diagnosis

first step: clinical description summarizes the child's unique behaviors, thoughts, and feelings that together make up the features of the child's psychological disorder Diagnosis involves analyzing info and drawing conclusions about the nature or cause of the problem

cognitive theorists

focus on how thought patterns dev over time -how they relate to beh strategies

cognitive theories depression

focus on relationship between negative thinking and mood emphasize depressogenic cognitions -negative perceptual and attributional styles and beliefs assoc with depressive symptoms hoplessness theory -depression prone individuals have negative attributional style (blame themselves for negative events in their lives) think negatively, thoughts lead to actions success as luck, failure as their fault

qualitative research

focuses on narrative accounts, description, interpretation, context, and meaning purpose is to describe interpret and understand the phenomenon of interest -in the context in which it is experienced may be biased by researcher's values and preferences findings cannot be generalized to other individuals

forebrain (cerebral cortex)

forebrain's largest part -allows us to plan, reason, and create -is divided into *left hem: cog processes eg veral *right hem: social perc. and creativity

speech and language impairments

formal speech and language disorders difficulty understanding others speech excessive and loud talking freq shifts and interruptions in conversation inability to listen inappropriate convos speech production errors

family probs (cd)

general family disturbances specific disturbances in parenting practices and family functioning high levels of conflict are common in the family, especially between siblings lack of family cohesion and emotional support deficient parenting practices parental social cog deficits

Defining and measuring children's intelligence and adaptive behavior

general intellectual functioning is now defined by an intelligence quotient (IQ or equivalent) ID is no longer defined on the basis of IQ -level of adaptive functioning is also important *adaptive functioning: how effectively individuals cope with ordinary life demands and how capable they are of living independently

Genetic contributions

genes contain genetic info from each parent -genetic influences may be expressed early in dev or show up years later Expression of genetic influences -malleable and responsive to social env rarely is one gene the single cause of a disorder

causes & treatment of childhood onset fluency disorder

genetic factors account for 70% of variance in causes environmental factors account for remaining influences possible treatments -parental changes: speak to the child slowly in short sentences -contingency management procedures -habit reversal procedures

inheritance and role of env (ID)

genetic influences are potentially modifiable by env genotype: a collection of genes that pertain to intelligence phenotype: the expression of the genotype in the env (gene-env interaction) heritabiltiy describes the proportion of the variation of a trait attributable to genetic influences in the population -ranges from 0%-100% -the heritability of intelligence is about 50-60% Major env variations affect cog performance and social adjustment in children from disadvantaged backgrounds cultural familial: something running in families or cultural but dont know what

causes of language disorder

genetics -temporal processing deficits brain -circular feedback loop in the left temporal lobe -problems in connections between brain areas and less brain activity in left temporal region

consent

giving permission to participate legally must be given by person 18 or older or by parent or legal guardian

precursors and comorbidities (COS)

gradual onset almost 95% have history of beh, social, and psych disturbances before onset of psychosis dev precursors other symptoms/disorders -70% meet criteria for another diagnosis:most commonly mood disorder or ODD/CD -COS and ASD may not be linked

HPA axis

has been implicated in several disorders, especially anxiety and mood disorders

forebrain

has highly specialized functions (limbic system-basal ganglia-cerebral cortex) New growth and restructuring during adolescence results in further maturation Frontal lobes important for thinking and maturation

Psychological perspectives

have value in explaining the dev of psychopathology -Transactions must be considered Emotions play a role in establishing an infants ability to adapt to new surroundings Behavioral & cog processes assist a young child in making sense of the world

other physical and health disabilities (ID)

health and dev are affected degree of intellectual impairment is a factor prevalence of chronic health conditions in ID populations is much higher than in the general population life expectancy for individuals with down syndrome is now approaching 60 years

med & physical concerns

health related probs: -higher rates of asthma and bedwetting **studies findings are inconsistent -sleep disturbances may be related to use of stimulant meds and or co occuring conduct or anxiety disorders accident proneness and risk taking: -over 50% are described as being accident-prone -at higher risk for traffic accidents -at risk for early initiation of cigarette smoking, substance use disorders, and risky sexual behaviors -reduced life expectancy -higher med costs

healthy families (abuse)

healthy parenting includes: -knowledge of child dev and expectations -adequate coping skills & ways to enhance dev through stimulation and attention -normal parent child attachment and communication home management shared parenting responsibilities provision of social and health services a fundamental and expectable env: -req protective and nurturing adults, as well as opp for socialization within a culture for infants -includes a supportive family, peer contact, and opp to explore and master their env for older children -provides a gradual shift of control from parent to the child and the community

family oriented strategies (ID)

help fams cope w demands of raising a child with ID some ID children and adolescents benefit from residential care or out of home placement the inclusion movement integrates individuals with disabilities into regular classroom settings -curriculum is adapted to indiv needs patterning doesnt work one on one the earlier you start doing this baby voice is important. These kids need twice as much

comorbidity BP (med probs? most kids with adhd? )

high rates of co-occuring disorders are extremely common -most typical are ADHD (90%+), ODD/CD (88%), separation anxiety disorders, and other anxiety disorders -suicidal thoughts and ideation -substance use disorders co-occuring med probs -cardiovascular and metabolic disorders, epilepsy, and migraine headaches Most children with ADHD do not have bipolar disorder bipolar dis-crushing depression. need meds for sure aside from therapy

criterion related validity

how well a measure predicts behavior in specific settings -at the same time (concurrent) -In the future (predictive validity)

Ideographic and nomothetic strategies

idiographic strategies highlight a child;s unique situation nomothetic strategies-employed to: -benefit from all the info accumulated on a given problem or disorder -determine the general category to which the problem belongs

DSM defining features of ASD

impairments in social interaction impairments in communication restricted repetitive and stereotyped patterns of behavior, interests, and activities -social comm almost always

family influences (adhd)

importance of fam influences -fam influences may lead to adhd symptoms or to a greater severity of symptoms -fam probs may result from interacting with a child who is difficult to manage -fam conflict is likely related to the presence, persistence, or later emergence of assoc oppositional and conduct disorder

endocrine system

important regulatory system that has been linked to anxiety & mood disorders -endocrine glands produce hormones adrenal glands, thyroid gland, pituitary gland, hypothalamic pituitary adrenal axis (HPA)

Usage of psych meds by children in U.S. (1987-1996)

in order: -any -stim -antidep all increased in usage

chronic health conditions among children w ID

in order: epilepsy cerebral palsy anxiety disorder oppositional deviant disorder down syndrome autistic disorder

History (depression)

in the past, it was mistakenly believed that depressionn did not exist in children in a from comparable to that in adults we now know: -children do experience recurrent depression -depression in children is not masked, but rather may be overlooked ** it freq co-occurs with other more visible disorders

inattention

inability to sustain attention, particularly for repetitive structured and less enjoyable tasks deficits may be seen in 1 or more types of attention -attention capacity -selective attention -distractibility -sustained attention/vigilance ***a core feature of ADHD __May be a prob in alerting (the ability to prep for what is about to happen)

hyperactivity-impulsivity

inability to voluntarily inhibit dominant or ongoing behavior hyperactive behaviors include: -fidgeting and difficulty staying seated -moving, running, touching everything in sight, excessive talking, and pencil tapping -excessively energetic, intense, inappropriate, and not goal directed impulsivity: -inability to control immediate reactionsor to think before acting -cog impulsivity includes disorganization, hurried thinking, and need for supervision -behavioral impulsivity includes diff inhibiting responses when situations require it -emotional impulsivity includes impatience, low frustration tolerance, hot temper, quickness to anger, and irritability

predom inattentive type (ADHHD-PI)

inattentive, drowsy, daydreamy, spacey, in a fog, and easily confused may have learning disability, process info slowly, have trouble remembering things, and display low academic achievement often anxious, apprehensive, socially withdrawn, and may display mood disorders

clinical assessment

info is obtained from diff informants, in a variety of settings, using various methods -the methods need to be reliable, valid costeffective and useful for treatment -clinical assessment reveals the childs thoughts, feelings, and behaviors -comprehensive assessment evaluates a childs strengths and weaknesses across many domains

when science is ignored

ineffective practices not based on scientific evidence may be used w potentially damaging effects pseudoscience demonstrates benefits through anecdotes or testimonials The diff between science and pseudoscience: quality of evidence how it was obtained and how it ws presented

course & outcome (adhd)

infancy: -signs of adhd may be present at birth-no reliable or valid methods exist to id it preschool: -hyperactivity-impulsivity symptoms become more visible and sig at ages 3-4 -children w symptoms for at least 1 year are likely to continue to have diff later in middle childhood and adolescence

insecure (anxious avoidant type)

infant engages in exploration but with little affective interaction with caregiver. Infant shows little wariness of strangers, and generally is upset only if left alone. As stress increases, avoidance increases. As children & adults individuals with an insecure, avoidant pattern of early att tend to mask emotional expression. They often believe they are vulnerable to hurt, and others are not to be trusted conduct disorders, aggressive behavior, depressive symptoms (usually as result of failure of self reliant image)

disorganized disoriented type

infant lacks a coherent strategy of att. Appears disorganized when faced w a novel situation and has no consistent pattern of regulating emotions. Indiv with disorganized disoriented style show an inability to form close att to others, may show indiscriminate friendliness (little selective att) No consensus but gen a wide range of personality disorders

secure

infant readily separates from caregiver and likes to explore. When wary of a stranger or distressed by separation, the infant seeks contact and proximity w caregiver, the infant then returns to exploration and play after contact individuals with secure att histories tend to seek out and make effective use of supportive relationships although individuals with secure att may suffer psych distress, their relationship strategy serves a protective function against disordered outcomes

Insecure (anxious resistant type)

infant shows disinterest or resistance to exploration and play, and is wary of novel situations or strangers. Infant has difficulty settling when reunited with caregiver, nd may mix active contct seeking with crying and fussiness as children and adults have diff managing anxiety. Tend to exaggerate emotions and maintain negative beliefs about the self. Phobias: anxiety, psychosomatic symptoms, depression

language development

infants selectively attend to parental speech sounds by age 1 they can recognize several words as well as say a few words to express needs and emotions -can say things like "dada" and "uh oh" -can understand things like "no" and "drink your milk" over the next 2 years, language dev increases exponentially, as does the ability to formulate complex ideas and express new concepts. -by age 2 can say "more milk", "want juice" and other brief phrases. 150-word vocabulary. **understand concepts such as "in" "under" and 2 step requests perceptual maps are formed in the brain when children hear phonemes (basic sounds) repetitively -by 6 months: infants differentiate their own language from other languages -by age 1: the map is complete and infants have lost the ability to discriminate sounds not important to their own language. early language problems are highly predictive of subsequent communication & learning disorders & should not be ignored

moderating variables

influence the direction or strength of the relationship between two variables

treatment strategies: initial stages

initial stages focus on building rapport and teaching learning-readiness skills -discrete trial training involves a step by step approaches to presenting stimulus and req a specific response -incidental training strengthens behavior by capitalizing on naturally occurring opportunities

Behavioral approaches (ID)

initially seen as a means to control or redirect negative behaviors association for behavior analysis (ABA) task force advocates that: -each individual has the right to the least restrictive effective treatment and the right to treatment that results in safe and meaningful behavior change

the inclusion moment

integrate children with special needs into the regular classroom -individuals with disabilities education improvement act (IDEA) in US and provincial educational acts in canada -no child left behind (2002) -14% of school age children in the US receive some level of support through special education, about 45-46% of these students suffer from specific learning disorders

associated characteristics of dep dis (academic) (probs on tasks req what 3 things?)

intellectual and academic functioning -difficulty concentrating, loss of interest, and slowness of thought & movement may have a harmful effect on intellectual and academic functioning **lower scores on tests, poor teacher ratings, and lower levels of grade attainment -interference with academic performance, but not nec related to intellectual deficits **may have probs on tasks requiring attention, coordination, and speed not due to low intelligence etc it is the depression the inatt type of ADHD seem depressed for rest of their life

cog deficits: intellectual & academic

intellectual deficits -most children with ADHD have at least normal intelligence-the diff lies in applying intelligence to everyday life situations impaired academic functioning: -children w ADHD freq have lower productivity, grades, and scores on achievement rates

DSM neurodev disorders

intellectual disabilities: (intellectual disability{intellectual dev dis} {mild, mod, severe, profound}, Global Dev Delay} Autism spectrum dis: (w or without accompanying intellectual or language impairment) Communication disorders: (language disorder, speech sound disorder, childhood onset fluency disorder {stuttering}, social {pragmatic} communication dis) specific learning dis: (with impairment in reading, written expression, or math) ADHD: (predom hyperactive/impulsive predom insattentive, or predom combined presentation) Motor dis: (dev coordination disorder, stereotypic movement disorder, Tourette's disorder, persistent (chronic) motor or vocal tic disorder)

diagnostic criteria for intellectual disability

intellectual disability (intellectual dev disorder) is a disorder w onset during the dev period that includes both intellectual and adaptive functioning deficits in social conceptual and practical domains. A. deficits in intellectual functions, such as reasoning, problem-solving, planning, abstract thinking, judgment, academic learning and learning from experience, confirmed by both clinical assessment and nidividualized, standardized intelligence testing B. Deficits in adaptive functioning that result in failure to meet dev and sociocultural standards for personal indep and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and independent living, across multiple environments, such as home, school, work, and community. C. Onset of intellectual and adaptive deficits during the dev period. specify current severity (mild mod severe or profound)

Early intervention ASD

intensive 25 hours a week and 12 months a year low student teacher ratio high structure family structure family inclusion peer interaction generalization

treatment dsm

interventions are planned by combining the most effective approaches to a particular problem the most useful treatments are based on what we know about a particular childhood disorder data is needed to show that interventions work multiple probs require mult solutions prob solving strategies are part of a spectrum of activities for treatment, maintenance, and prevention interventions are part of an ongiong decision-making approach

prevention & treatment

interventions rely primarily on educational and psychosocial methods no bio treatments exist issues of identification are important -there is a brief window of opportunity for successful treatment -approx 75% of children identified with a SLD still have an SLD after highschool prevention involves training children in phological awareness activities at an early age

measurement methods

interviews questionnaires checklists and rating scales psychophysiological recordings brain imaging performance measures direct obs of behavior intellectual academic and neuropsych tests

behavioral genetics

investigates connections between genetic predisposition and observed behavior (twin studies)

case study

involves an intensive, anecdotal, obs and analysis of an individual child rich source of descriptive info viewed as unscientific and flawed -characterized by uncontrolled methods and selective biases; by inherent difficulties integrating obs and drawing valid inferences; and by generalizations from one child to other children

classical conditioning

involves paired assoc between prev neutral stimuli and unconditioned stimuli

PDD (dysthymia) what is it? for how long? characterized by? also displays at least..?

is characterized by symptoms of depressed mood that occur on most days, and persist for at least 1 year (2 years for adults) -child with PDD also displays at least 2 somatic or cognitive symptoms characterized by poor emotion regulation -constant feelings of sadness, of being unloved and frolorn, self-deprecation, low self esteem, anxiety, anger, and temper tantrums -children with both MDD and P-DD are more severely impaired than children with just one disorder

legal perspectives (CD)

juvenile delinquency -legal definitions exclude antisocial beh of very young children occurring in home or school -legal can be just one act, while a disorder requires a pattern of beh -minimum age of responsibility is 12 in most states (often age 10 is sexual offense) -only a subgroup of children meeting legal definition of delinquency also meet def of a mental dis

core characteristics (ADHD)

key symptoms fall under 2 well documented categories -inattention'-hyperactivity impulsivity Using these dimensions to define ADHD oversimplifies the disorder -attention and impulse control are closely connected developmentally If its ID very early on its hyperactivity-impulsivity No ADD anymore its ADHD. Combined inattentive type & hyperactivity/impulsivity

Categories of communication disorders (4 total)

language disorder speech sound disorder childhood-onset fluency disorder social (pragmatic) communication disorder

prevalence & course of LD

language disorder affects 7% or younger school age children communication in disorders are identified twice as often in boys than girls most children acquire normal language by adolescence 50% fully outgrow the problems LD is associated with higher than normal rates of negative behaviors

normal attachments/common beh porbs/clinical disorders 2-5 years

language, toileting, self care skills, self control, peer relationships arguing, demanding attention, disobedience, fears, overactivity, resisting bedtime speech and language disorders, problems stemming from child abuse and neglect, some anxiety disorders, such as phobias

cog defs: learning disorders & self perceptions

learning dis are common for children with ADHD -prob areas: reading, spelling, and math distorted self perceptions: -positive illusory bias: exaggeration of one's competence -self esteem in children with adhd may vary with the subtype of adhd -distortions in perceptions of quality of life

Learning disability

learning problems that occur in the absence of other obvious conditions -the term has been replaced in the DSM5 by more specific terms, communication disorders & learning disorders -affects how individuals of at least normal intelligence take in, retain, or express info

social and psychological dimensions (ID)

least understood and most diverse factors causing ID env influences and other mental disorders account for 15-20% of ID -deprived physical & emotional care & stimulation of the infant -other mental disorders accompanied by ID such as autism parents are critically important

treatment (adhd)

less than half of the children with adhd recieve treatment -of those who receive treatment, many discontinue prematurely the primary treatment approach combines: -stim meds -parent management training -educational intervention

prevalence BP (lifetime prev % range? in what age? which two types are most common? more than how many mood states?)

lifetime estimates of BP range from 0.5-2.5% of youths 7-21 yrs old -it is diff to make an accurate diagnosis in youngsters, milder bipolar 2 and cyclothymic disorder are more likely than bipolar 1 -rapic cycling (called ultradian cycling) episodes are common extremely rare in young children -rate increases (near;y as high as that for adults) after puberty for kids close to .5 more than 4 mood states in a year, for adults rapid cycling

What DSM criteria dont tell us (ADHD)

limitations of DSM criteria for ADHD -dev insensitive -categorical view of ADHD dsm criteria shape our understanding of ADHD -DSM criteria are also shaped by, and in some instances lag behind, new research findings

cross sectional/longitudinal studies

look at change over time cross sectional: indiv at diff ages or periods of dev are studied at the same point in time longitudinal: indiv are studied over time at diff ages of periods of dev

prader willi syndrome: what chromosome is affected? inherited from who? between what ages? what % have ID?

mainly abnormality on chromosome 15 (paternally inherited). Between ages 2 and 6 begin extreme overeating & become obese. May be ID or LD (about 65% ID) chronically hungry

history and family context

major cultural traditions have condoned abuse of family members -absolute authority over the family by the husband **roman law os chastisement (753 bc) **english common law allowed moderate and reasonable chastisement -the right to fam privacy 1989 convention on the rights of children -spurred efforts to value the rights and needs of children, to recognize their exploitation and abuse in developed countries today, 42 countries have established official gov policy regarding child abuse and neglect

Neurotransmitters

make biochemical connections between diff parts of the brain -neurons more sensitive to a particular NT, such as serotonin cluster together & form brain circuits (paths from one part of the brain to another) Psycho active drugs work by either increasing, decreasing or modulating flow of various NT

Meds (ASD)

many children with ASD receive psychotropic meds -antideps, stimulants, and tranquilizers/antipsychs -benefits are limited *variable from child to child *core deficits of these children are not altered -Newer treatments *oxytocin (some respond, some don't)

course & outcome adolescence & adulthood adhd

many children with adhd do not outgrow probs and some can get much worse at least 50% of clinic referred elementary school children continue to suffer from adhd into adolescence adult challenges -some indiv either outgrow or learn to cope with their disorder by adulthood -adhd is established as an adult disorder

Motivation (ch 5)

many children with mild ID are able to learn and attend regular schools often susceptible to feelings of helplessness and frustration in their learning environments children who have mild ID are able to stay on task and dev goal-directed behavior -with stimulating env and caregiver support

theories and causes (adhd)

many explanations for adhd, and some are controversial and unproven: -trait from evolutionary past as hunters -adhd is a myth fabricated because society needs it -some theories *cog functioning deficits *reward/motivation deficits *arousal level deficits *self reg deficits Current research suggests that adhd is a neurodev disorder for which genetic & neurobio factors play a central role

associated characteristics (CD)

many factors are assoc with cd problems in youths -cog and verbal deficits -school and learning probs -self esteem deficits -peer probs -family probs -health related probs

Dopa: what does it do? what 3 disorders is it in?

may act as a switch that turns on various brain circuits allowing other NTs to inhibit or facilitate emotions or behavior is involved in exploratory, extroverted, and pleasure seeking activity schizo mood disorders ADHD

adult outcomes of SLDs

may continue into adulthood because of inadequate recognition and services many excel in nonacademic subjects men with learning disorders perceive lower levels of social support women with learning dis have more adj probs relationship probs, low income, and face greater risk of sexual assault & related forms of abuse

internal consistency

measurement method remains the same (cronbachs alpha) For example, a bank manager wants to assess customer satisfaction. The manager asks customers to respond to the following three statements using a 5-point scale to denote their level of agreement: I was very satisfied with the service. I am likely to buy from your company again. I am likely to recommend your company to others.

cool exec functions (cd)

mediated by dorsolateral and ventrolateral prefrontal cortex) -working memory, response inhibition, planning, sustained attention, attentional shifting

1940s-1950s (ADHD)

minimal brain damage" and "minimal brain dysfunction"

accompanying psych dis & sympt mood disorders: what illness at what ages is a risk factor for future depression and sucidal behavior? what % of kids with adhd experience dep?

mood dis: -adhd at 4-6 years is a risk factor for future depression & suicidal behavior -20-30% of children with adhd experience dep ** fam risk for one disorder may increase risk for the other **controversy regarding relationship between adhd & pediatric bipolar dis (bp)

bipolar disorder(just a description)

mood swings from deep sadness to high elation (euphoria) and expansive mood (mania)

cog & verbal deficits (cd)

most children with conduct probs have normal intelligence verbal deficits are present in early dev deficits in executive functioning -co-occuring adhd may be a factor -types of executive function exhibited may differ-cool vs hot executive functions -seem to have poorer verbal working memory and long term decision making, less response to punishment and even cues to punishment

PDD (age of onset? duration? comorbidity? PDD adols usually? onset usually? )

most common age of onset 11-12 years childhood onset dysthymia has prolonged duration generally 2-5 yrs most recover but are at high risk for developing other disorders: -MDD, anxiety dis, and conduct dis adolescents with PDD receieve less social support than those with MDD onset usually earlier with this one treatments lower severity and amount of time

Fragile X syndrome

most common cause of inherited MR (1 in 4,000 males, 1 in 8000 females) is assoc with the FMR-1 gene. Worse in males with almost all males being ID; only 50% females have ID. About 1/2 diagnosed with autism. -your text has fragile x as a chromosomal abnormality-it is cause by FMR-1 gene but it does cause a pinched chromosome (hence looking fragile) which is why the book calls it chromosomal

down syndrome

most common chromosomal abnormality (rarely inherited-an abnormality that occurs more as the mother ages) slightly more in boys than girls. -trisomy 21: most common and results from failure of the 21st pair of the mother's chromosomes to separate during meiosis -translocation: instead of having 3rd one, a tail breaks off & reattaches elsewhere -mosaicism: some cells have trisomy 21, some don't. Usually high functioning

depression and suicide (what half of kids attempt suicide? most common methods? 2 strongest risk factors? what age is peak?)

most youngsters with depression think about suicide, and as many as 1/3 who think about it attempt it -most common methods for those who complete suicide are firearms, hanging, suffocation, poisoning and overdose -worldwide, the strongest risk factors are having a mood disorder and being a young female -ages 13 and 14 are peak periods for a first suicide attempt by those with depression

Research process

multistage process: -dev hypothesis on the basis of obs, theory, and prev studies -ID the sample to be studies, selecting measurement methods, and dev research design and procedures -Gathering and analyzing the data and interpreting the results

are CD and ODD separate

nearly half of children with CD have no prior ODD diagnosis (just over half with CD did have prior ODD) most children who display ODD do not progress to more severe CD for most children, ODD: -is an extreme dev variation -is a strong risk factor for later ODD -does not signal an escalation to more serious conduct probs

(CD) overt behaviors tend to be

negative irritable resentful

Difficult

negative affect of irritability

Neural plasticity and role of exp

neural plasticity(brain's anatomical differentiation is use-dep -nature and nurture both contribute Exp plays critical role in brain dev -ex of env exp: prenatal dev: childhood illness & diet, early caregiving, including maltreatment, inadequate stimulation, and attachment Maturation of brain -areas gov basic sensory and motor skills mature during first 3 yrs of life -perceptual and instinctive centers are strongly affected by early childhood experiences -prefrontal cortex and cerebellum are not rewired until 5-7 yrs old -major restructuring occurs from ages 9-11 due to pubertal dev and again in adolescence conseq of traumatic exp may be diff to change -probs occuring at a younger age are assoc with more severe organic dis and complications -safeguards are important in reducing the risk of complications and lifelong disabilities *ex: proper prenatal care, proper nutrition, and avoidance of alcohol or tobacco during pregnancy

Causes (COS)

neurodev model: -defective neural circuitry increases a child's vulnerability to stress Biological factors -strong genetic contribution *molecular genetic studies have identified several potential susceptibility genes -CNS dysfunction and improvements with meds suggest it is a disorder of the brain Environmental factors - familial disorder and nongenetic factors may play a role through interaction with a genetic susceptibility -high comm deviance -stress, distress, and personal tragedy experiences by fams of children w schizo

social (pragmatic) communication disorder

new addition to DSM5 Persistent difficulties in pragmatics (social use of language and communication)

neuropsych & neurochem assoc (adhd)

no consistent differences have been found between children with and without adhd -some NT may be involved **dopamine, norep, epinephrine, and serotonin may be involved ** most evidence suggests a selective deficiency in availability of dopa and norep using meds for effective treatment of adhd symptoms does not prove that deficits are the cause of symptoms

gender differences (depression) puberty vs after puberty? whats similar vs diff?

no gender differences until puberty -after puberty females are 2-3 times more likely to suffer from depression symptom presentation is similar for both sexes, although correlates of depression differ for the sexes physical, psychological, and social changes are related to the emergence of sex differences in adolescence

An integrative approach (ch 2)

no single theoretical orientation explains various behaviors or disorders -models considering more than one primary cause are still limited by the boundaries of their discipline or orientation Abnormal child behavior best studied from a multi theoretical perspective Knowledge increases through research

developmental coordination disorder

not a learning disorder disorder when youre not coordinated. Often drop things, clumsy. Sometimes gross motor skills or fine motor skills. Clumsy vs holding pencil

mental status exam (clinical interviews)

often included as part of an interview. Assesses for person's orientation, attitude, affect (whats my presentation. Is it appropriate to situtation?) , mood, thinking, memory, and judgment sample questions: -orientation: what is your name? What day of the week is it? (worst to lose) -attention: count backwards from 10 by twos -language: name-pencil, watch -visual motor (shapes) not knowing the situation is not that weird for kids

nonexp and exp research

one goal is to simplify and isolate variables to study them more closely correlational studies examine relationships among variables -causality cannot be determined random assignment of participants to treatment conditions: -helps control for participant characteristics natural exp involve comparisons between conditions that already exist

communication impairments

one of the first signs of language impairment is inconsistent use of early preverbal comm -use protoimperative gestures (express needs) rather than protodeclarative gestures (direct attention of others to objects of shared interest) Miss other declarative gestures, such as showing gesture about 50% do not dev any useful language those who begin to speak may regress between 12-30 months children with ASD who dev lamnguage usually do so before age 5 qualitative language impairments -pronoun reversals (he instead of I)-really common -echolalia (repeat other's words/sentences) -perseverative speech (repeat same sound of or word) -impairments in pragmatics (prag is how we speak/understand one another. We all get what you're asking. Can you...yes. but just sits there. Dont get humor)

age of onset, duration, recurrence, comorbidity, outcome (depression)

onset may be gradual or sudden -usually a history of milder episodes that do not meet diagnostic criteria age of onset usually between 13-15 years average episode lasts 8 months(for adults 9 months) -longer duration if a parent has a history of depression non child related onset: early 20's most children recover from initial episode but the disorder does not go away -chance of recurrence is 25% within one year, 40% within 2 years, and 70% within 5 years (avg 5 episodes in life) -about 1/3 develop bipolar disorder within 5 yrs after onset of depression (bipolar switch) overall outcome is not optimistic

The two group approach

organic group: there is a clear bio basis -assoc with severe and profound MR cultural-familial group: there is no clear organic basis -assoc w mild MR

examples of impaired executive functions

organize, prioritize, activate -trouble getting started diff org work misunderstand directions focus, shift, and sustain attention: -lose focus when trying to listen Forget what has been read and need to reread easily distracted regulate alertness, effort & processing speech: -excessive daytime drowsiness diff completing a task on time Slow processing speech manage frustration & modulate emotion: -very easily irritated, feelings hurt easily, overly sensitive to criticism working memory and accessing recall: -forget to do a planned task diff following sequential directions quickly lose thoughts that were put on hold monitor & regulate action: -find it hard to sit still or be quiet rush things, slapdash often interrupt, blurt things out

treatment goals dsm

outcomes related to child functioning -reduce or eliminate symptoms -reduce degree of impairment in functioning -enhance social competence -improve academic performance outcomes related to family functioning: -reduce level of family dysfunction -improve marital and sibling relationships -reduce stress -enhance family support outcomes of societal importance: -improve child's participation in school-related activities -decrease involvement in juvenile justice system -reduce need for special services -reduce accidental injuries or substance abuse -enhance physical and mental health

sensory and perceptual impairments (ASD)

oversensitivities or oversensitivities to certain stimuli overselective and impaired shifting of attention to sensory input impairments in mixing across sensory modalities sensory dominance stimulus overselectivity

Effective treatments for children with cd

parent management training problem solving skills training multisystemic therapy

family factors (anxiety)

parenting practices -parents of anxious children are seen as overinvolved, intrusive, or limiting child's independence prolonged exposure to high doses of family dys assoc with extreme trajectories of anxious beh low SES insecure early att

voluntary participation

participation in research must be voluntary researcher must balance successful recruiting with not placing pressure on potential participants

features of intellectual disabilities

persons with ID have varying range of abilities and interpersonal qualities DSMs prior to DSM5 had similar criteri, but level of severity was based on IQ level DSM5 was adjusted to better fit with American Assoc in intellectual and dev disabilities Now severity level is based on adaptive behavior level -DSM5 diagnostic criteria *deficits in intellectual functioning *concurrent deficitis or impairments in adaptive functioning *below average intellectual and adaptive abilities must be evident prior to age 18

Evolutionary degeneracy theory

pervasive in 19th century (1800's) intellectual and social problems of children with mental retardation were viewed as regression to an earlier period in human evolution J. Langdon H. Down (Down syndrome) interpret "strange anomalies" as throwbacks to the Mongol race

antisocial pers dis (ADP) and psychopathic features

pervasive pattern of disregard for and violation of the rights of others; involvement in mult illegal behaviors -as many as 40% of children with CD later dev APD -adolescents wth APD may display psychopathic features -signs of lack of conscience occur as young as 3-5 years a subgroup of children with CD are at risk for extreme antisocial and aggressive acts and for poor long term outcomes (those with limited prosocial emotions specifier noted previously) -display callous and unemotional (CU) interpersonal style **lack guilt & empathy; do not show emotions; display narcissism and impulsivity; and alck beh inhibition -different dev processes nay underlie beh and emotional probs

XYY syndrome

phenotypically normal boys except taller than average hypermales

types of neglect

physical emotional educational

Easy

positive affect and approach

DSM-5 positive and negative symptoms

positive symptoms -delusions -hallucinations most common for children are auditory: occur in 80% of cases with onset prior to age 11 * 40 to 60% experience visual hallucinations, delusions, and thought disorder Negative symptoms -slowed thinking, speech, movement, emotional apathy; and lack of drive

ADHD presentation types

predom inattentive presentation- (ADHD-PI) predom hyper-impuls presentation (ADHD-IH) combined presentation (ADHD-C)

depression expression: preschool, school age, and preteen

preschoolers: may appear extremely somber & tearful, lacking exuberance; may display excessive clinging and whiny behavior around mothers school aged children: the above plus increasing irritability, disruptive behavior, and tantrums. Irritability is seen in most youth depression preteens: the above, plus self blame, low self esteem, persistent sadness, and social inhibition

prevalence & courses (adhd)

prev rates vary widely w sampling methods -estimates 6-7% of school age children & adolescents in NA and 5% worldwide have adhd -adhd is one of the most common referral probs seen at clinics

DSM pros and cons

pros: -help clinicians summarize and order observations -facilitate communication among professionals -aid parents by providing recognition and understanding of their child's problem cons: -disagreement about effectiveness of labels to achieve their purposes -negative effects and stigmatization -can negatively influence children's views of themselves and their behavior

predom hyper-impulsive type (ADHD-HI)

primarily symptoms of hyperactivity-impulsivity: (rarest group, but may be dev earliest signs) primarily includes preschoolers and may have limited validity for older children may be a distinct subtype of ADHD-C

structural brain imaging

procedures study brain anatomy -MRI-radio signals produce fine-grained analyses of brain structures -CT scan reveals various brain structures

Adrenal glands

produce epinephrine (adrenaline) and cortisol (aka stress hormone) -response to stress

Pituitary gland

produces regulatory hormones like estrogen and testosterone -implicated in variety of disorders

thyroid gland

produces thyroxine -implicated in certain eating disorders

(Purposes of assessment in treatment) Prognosis and treatment planning

prognosis: the formulation of predictions about future behavior under specified conditions treatment planning and evaluation apply assessment info to generate a treatment plan and to evaluate its effectiveness -you can calculate % wise, best psychologists can do

clinical interviews

provide a large amount of info during a brief period include a developmental or family history most interviews are unstructured -may result in low reliability and biased info semistructured interviews are more reliable (ask all the same questions but does not have to be in the same order) -include specific questions

computer assisted learning (LDs)

provides more academic engagement & achievement than traditional pencil and paper methods -compute programs slow down grammatical sounds allowing young children to process them more slowly & carefully.

Social and env contexts

proximal (close by) and distal (further removed) events shared/nonshared env -shared: env factors that produce similarities in dev outcomes among siblings in the same family -Non shared env: env factors that produce beh diff among siblings in same family

emotional and behavioral problems ID

rate is 3-7 times greater than in typically dev children -largely due to limited communication skills, additional stressors, and neuro deficits Most common psychiatric diagnoses: -impulse control disorders, anxiety disorders, and mood disorders internalizing problems and mood disorders in adolescence are common ADHD related symptoms are common Pica is seen in serious form among children and adults with ID Self injurious behavior (SB) -can be life threatening -affects about 8% of persons across all ages and levels of ID

prevalence of PDD

rates of PDD are lower than MDD -approx 1% of children and 5% of adolescents display PDD most common comorbid disorder is MDD -nearly 70% of children with DD may have an episode of major depression about 50% of children with PDD -also have 1 or more nonaffective disorders that preceded dysthymia, eg anxiety disorders conduct dis, or ADHD double deprssion: MDD and dysthymia, chronically sad not nec imapired

common fears and anxieties (toddlerhood) 12-18 months

separation from parents injury, toileting, strangers sleep disturbances nocturnal panic attacks, oppositional defiant beh separation anx dis, panic attacks

NT most commonly implicated in psychopathology include (4)

serotonin GABA Norep Dopa

neuro bio causes of SLDs

reading & language based probs assoc with cellular abnormalities in brain's left hemisphere, especially in the planum temporale in Wernicke's area -lower activation of inferiori frontal, parieto-temporal, and occipito-temporal gyri, which are responsible for understanding phonemes, analyzing words, and automatically detecting words -problems with neuro processing and storage of phonology -beh and physiological abnormalities in the processing of visual info -nonverbal learning disabilities may result from deficits in right hemisphere brain functioning, and have been linked to prenatal and early childhood disease and trauma beh and physiological abnormalities in the processing of visual info non-verbal learning disabilities are associated with deficits in right hem brain functioning

other causes of language disorder

recurrent middle ear infections (otitis media) in 1st year of life may lead to speech & language delays Home environment -it is unlikely that communication disorders are caused by parents **except in cases of extreme neglect/abuse

culture bound syndromes

recurrent patterns of maladaptive behaviors and/or troubling experiences associated with different cultures or localities for example: -mal de ojo (evil eye): fitful sleep, diarrhea, vomiting, fever -ataque de nervious (attack of nerves): screaming, crying, trembling, dissociaton -koro: overwhelming fear genitals are retracting and will disappear what is considered normal may vary between cultures

GABA

reduces arousal and moderates emotional responses, such as anger hostility, and aggression. Is linked to feelings of anxiety and discomfort Anxiety disorder

convergent validity

reflects the correlation between related measures

forebrain (limbic system)

regulates emotional experiences and expressions, plays a sig role in learning and impulse control regulates basic drives of sex, aggression, hunger, and thirst

normal achievements/common beh porbs/clinical disorders 12-20

relations with opposite sex, personal ID, separation from family, increased resp arguin, bragging, anger outbursts, taking risks anorexia, bulimia, delinquency, suicide attempts, drug and alcohol abuse, schizo, depp

diagnostic criteria for conduct disorder

repetitive & persistent pattern of beh in which the basic rights of others or major age app societal norms or rules are violated, as manifested by the presence of at least 3 of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in past 6 months -aggression to ppl & animals: 1. often bullies threatens intimidates others 2 often initiates physical fights 3 has used weapon that can cause serious phys harm 4 has been phys cruel to ppl 5 stolen while confronting 7 forced sexual -dest of property 8 fire setting with intention 9 destroyed others property -deceitfulness or theft 10 broken into someone elses 11 lies to obtain good or favors etc 12 stolen without confronting a victim -srs violation of rules 13 often stays out at night despite 14 has run away from home at least twice 15 truant from school beginning before 13 yrs B.) disturbance in beh causes clinically sig imapirment in social aca or occ C.) indiv is 18 or older, criteria are not bet for anti pers dis specify whether: childhood onset type: at least 1 sympt prior to age 10 adolescent type: indivs show no sympt prior to age 10 unspecified: criteria for diag of cd are met but theres not enough info available to determine specify if: with limited prosocial emotions: to qualify for this ______

conduct disorder

repetitive, persistent pattern of severe aggressive and antisocial acts -may have co-occurring problems, such as ADHD, academic deficiencies, and poor peer relations -family child-rearing practices may contribute to proms -parents feel the children are out of control and feel helpless to do anything about it

Scientific approach

req that a claim be based on theories backed up by empirical evidence from well designed studies before conclusions are drawn Is espeically important in abnormal child psych -a simple connection between cause and effect may be obscured by complex interactions and a combo of variables

neurobio factors (adhd)

research shows diff on: -psychophysiological measures **diminished arousal or arousability -measures of brain activity during vigilance tests **underresponsiveness to stimuli/deficits in response inhibition -blood flow to prefrontal regions and pathways connecting them to limbic system **decreased blood flow to these regions cant stop beh. prefrontal areas are predom for monitoring beh in real world may not be the prob. prob would be decreased activity which is what calls for less blood flow

characteristics of true exp

researchers have max control over the indep variable subjects are randomly ass needed control conditions are applied possible bias sources are controlled

test-retest reliability

results between tests are stable over time

what anti dep is used as adj

rexulti

stimulant meds adhd

ritalin,methylin, concerta, metadate, daytrana patch, quillivant oral suspension Focalin, attenade Dexadrine Desoxyn Adderall Vyvanse (Ritalin etc) blocks reuptake. Keep you awake decrease your appetite The rest up dopa release They dont all work the same -when you change stims the effects are diff 75% will respond to 1st med Patches aren't as good as other methods Vyvanse: dev cuz ppl were crushing their pills & selling them. Vyvanse cant be snorted. Prodrug. Inert until liver transforms it. Not as much rebound. Cant abuse it. Easier on/off

Commonly administered projective tests

rorschach inkblot test: -different kinds of depression and psych processes -not very good @ personality -should never be used w children. No reliability or validity with them. -Exner scoring: very good for certain issues in adults -neologisms, confabulations -as good as mmpi @ picking up psychosis House tree person: -ask them about their drawings Kinetic family drawing Incomplete sentences Thematic apperception test: -look for patterns -tell a story w/ beginning, middle and end -no reliability, validity but still helpful Roberts apperception test robert/mary stories

retrospective designs

sample is ID at current time and asked for info relating to an earlier time data are highly susceptible to bias and distortion in recall

real time prospective designs

sample is id and followed over time -data is collected at specified time intervals probs related to bias and distortion in recall are minimized these designs are time consuming and susceptible to sample attrition

1980s (ADHD)

saw increased interest in ADHD -rise in stimulant use generated controversy

childhood onset schizo (COS)

schizophrenia is a neurodev disorder of the brain-expressed in abnormal mental functions and disturbed behavior -characterized by severe psychotic symptoms bizarre delusions, hallucinations, thought disturbances, grossly disorganized behavior or catatonic behavior, extremely inappropriate or flat affect, and significant deterioration or impairment in functioning COS is rarer and possibly more severe (not distinct) form of schizo Key features -occurs during childhood -has a gradual, rather than sudden onset -is likely to persist into adolescence and adulthood -Has profound negative impact on dev social and academic competence

common fears and anxieties (prim elementary school age) 5-11 yrs

school anx, perf anx, phys appearance, social concerns withdrawal, timidity, extreme shyness w unfam adults and peers feelings of shame Social phobia

Causes of ID

scientists cant account for the majority os cases, especially the milder forms genetic or env causes are known for almost 2/3rds of individuals with moderate to profound ID

Infant caregiver attachment (4 patterns)

secure insecure-anxious avoidant insecure-anxious resistant disorganized, disoriented (not an organized strategy) -insecure attachments are implicated in a number of childhood disorders

cog biases and distortions depression

selective attentional biases feelings of worthlessness negative beliefs attributions of failure self critical and auto thoughts depressive ruminative style, pessimistic outlook, and negative self esteem negative thinking and faulty conclusions generalized across situations, hopelessness, and suicidal ideation

other theories of depression

self control theories interpersonal models (led to interpersonal therapy. almost as effective as CBT) socioenv models -diathesis stress model neurobio models

cog beh therapy (ID)

self instructional training & metacognitive training verbal instructional techniques teaching the child to be strategical and metastrategical

disruptive mood dysregulation disorder (how often are outbursts?how long are sympt present? How long sympt free? onset age/ diagnosis age?)

severe temper outbursts of great intensity that occur three or more times a week mood between temper outbursts is typically irritable or angry and noticeable by others outside the family symptoms present for at least 12 months with no more than 3 months symptom free onset before age 10 but diagnosis should only be made between ages 6 and 8 no mania, and irritability and temper outbursts not just seen during MD episode rationale for new diagnosis: -many youth currently diagnosed with bipolar disorder do not go on to become adults with bipolar-they look more like ODD and MDD together -youth with DMDD usually have characteristics of ODD, but most ODD youth do not have symptoms of DMDD

nonharmful procedures

should not cause physical or psychological harm

equifinality

similar outcomes stem from different early experiences and dev pathways...End state can be reached via many means

PKU

single gene condition inborn errors of metabolism cause 3-7% of cases of severe ID PKU results in lack of liver enzymes necessary to metabolize phenylalanine, causing build up of phenylpyruvic acid, which causes brain damage -can be treated successfully with diet

questionnaire

sit: highly structured responses: highly structured no opportunity for probes or clarification req: little investigator time needed for admin sources of bias: relies on participants perceptions and willingness to report data red: little data red needed

observation

sit: structured or un resp: vary from very inclusive obs of all behaviors to highly selective coding of very specific behaviors res: extensive time needed for obs and coding and summarizing obs bias: does not rely on participants providing specific info but what is obs may be influenced by presence of obs data red: highly influenced by the complexity of the obs system

interview

situation: semistructured or structured resource req: considerable time needed for interviewing and coding responses and scoring sources of bias: relies on participants perceptions and willingness to report; responses may be influenced by interviewer characteristics and mannerisms data reduction: requires analysis or recording of narrative responses

cultural class and gender variations in SLDs

social & cultural factors are less relevant to LDs than other types of cog and beh probs -the disorders reflect an interaction between a child's inherent abilities and resources/ opportunities available **when learning to read, some teaching approaches neglect specific ethnic sound-symbol relationships SLDs are more common in males

social peer and family probs depression

social and peer probs -few close friendship, feelings of loneliness, and isolation -social withdrawal and ineffective styles of coping in social situations (key, often 1st symptom) FAMILY PROBS-CHILD WITH DEPRESSION: -HAS LESS Supportive and more conflicted relationships with parents and siblings -feels socially isolated from families and prefer to be alone

informant report measure

someone who knows the child well provides info based on obs -inaccuracies may occur-failure to recall events, selective recall or bias etc -req verbal ability not reliable with young children -must be sensitive to the language and cultural background of person being evaluated

an integrated model of physical child abuse

stage 1: reduced tolerance for stress & disinhibition of aggression ***destabilizing factors: -poor child rearing prep -low sense of control and predictability -stressful life events ***compensatory factors -supportive spouse -socioeconomic stability -success @ work and school -social supports and healthy models stage 2: poor management of acute stress & provocation ***destabilizing factors: -conditioned emotional arousal to child behavior -mult sources of anger and agression -belief that child's behavior is threatening or harmful to parents ***compensatory factors -improvement in child beh -community programs for parents -coping resources stage 3: habitual patterns of arousal and aggression with family members ***destabilizing factors -child habituates to physical punishment -parent is reinforced for using strict control techniques -child increases problem behavior ***compensatory factors -parental diss with physical punishment -child responds favorable to noncoercive methods -community restraints/services

steps in thinking and beh of aggressive children in social situations

step 1: encoding: socially aggressive children use fewer cues before making a decision. When defining and resolving an interpersonal situation, they seek less info about the event before acting step 2 interpretation: socially aggressive childtren generate fewer and more aggressive responses and have less knowledge about social problem solving step 3 response search: socially agg child generate fewer and more agg responses and have less knowledge about social prob solving step 4 response decision: soc ag chil are more likely to choose agg solutions step 5 enactment: socially agg children use poor verbal comm and strike out physically

restricted and repetitive behaviors and interests

stereotyped body movements: -repetitive sensory and motor beh -insistence on sameness behaviors self stim beh(helpful notgood to cut it out) -different theories *a craving for stimulation to excite their nervous system *a way of blocking out and controlling unwanted stim from env that is too stimulating *maintained by sensory reinforcement it provides aspergers want social interactions one theory is that they dont prune

meds (adhd)

stims have been used to treat adhd since the 1930s -among the most used stims are dextroamphetamine and methylphenidate **may help normalize frontostriatal structural abnormalities and functional connections -effects are temp and occur only while med is taken; beneficial in short term ** questions surround long term benefits and later adj stim meds are primary.increase dopa, increase activity level benefits are short term

psychological and social adj

students with reading disorders feel less support from parents, teachers, and peers difficulty in managing a child with SLD -behavior porbs are about 3 times higher than the norm by age 8 -co-occuring probs across ages; CD, ODD, and ADHD -about three of every four students have significant deficits in social skills

functional brain imaging

study brain functioning -fMRI: registers neural activity in functioning areas of the brain -PET: scans assess cerebral glucose metabolism Diffusion MRI: produces images showing connections between brain regions

Clifford Beers' (1909)

suffered from psychosis & believed mental illness was a disease-led efforts to detection & intervention

diet allergy and lead (adhd)

sugar is not the cause of hyperactivity allergic reactions and diet -possible moderating role of genetic factors may explain why food additives affect the behavior of some children low levels of lead may be associated with adhd symptoms the role of diet, energy, and lead as primary causes of adhd is minimal to nonexistent brain disorder affected by dopa

course & outcome elementary school (adhd)

symptoms are especially evident when the child starts school- most likely to be diagnosed at this time oppositional defiant behaviors may increase or dev -by age 8-12, defiance and hostility may take the form of serious problems -increased probs may encompass self-care, personal responsibility, chores, trustworthiness, independence, and academic performance

bipolar disorder symptoms and types

symptoms include restlessness, agitation, sleeplessness, pressured speech, flight of ideas, racing thoughts, sexual disinhibition, surges of energy, expansive grandiose beliefs three subtypes -bipolar 1 disorder **mania and maybe depression but not req * a week or more for the manic episode. spend hella $ etc *can have some manic eps but dep 4 rest of their lives -bipolar 2 disorder ** 4 days worth mania. Not as extreme **hypo same but less likely to spend $ have sex etc *more diff with children as well. looks like ADHD -cyclothymic disorder 2 yrs adults 1 yr children and adols. cycle between hypo and dysthymia

combined treatments (ch 4)

the use of 2 or more interventions, each of which can stand on its own as a treatment strategy More communities are now implementing comprehensive mental health programs for children -often delivered through schools

assent

the child agrees to participate should be obtained if child is around 7 or older not a legal req but an ethical one

reliability

the consistency or repeatability of results

external validity

the degree to which findings can be generalized to other people, settings, times, measures, and characteristics

internal val

the extent to which a particular variable, rather than extraneous influences, accounts for the findings

what are incidence rates

the extent to which new cases of a disorder appear over a specified time period

ASD as a disorder of risk and adaptation

the relationship between the child's early risk for ASD and later outcomes -is mediated by alterations in how the child interacts with and adapts to his or her env different children will follow diff dev pathways

childhood onset fluency disorder

the repeated and prolonged pronunciation of certain syllables that interferes with communication (stutter) prevalence and course -gradual onset between ages 2 and 7, peaks at age 5 -about 3% of children are affected -Affects males about three times more often than females -80% of those who stutter before age 5 stop after a year in school

eugenics: who came up with it? what did it lead to people thinking? who did the kallikak family study?

the science dealing with all influences that improve the inborn qualities of a race-sir francis galton..correlation coefficient -led to the view that individuals with intellectual deficits (then called morons, imbeciles, or idiots) were threats to society -Kallikak family-study of feeblemindedness by henry goddard 1912

overview of mood disorders (from what to what does the spectrum run? 2 general categories?)

the specturm runs from severe depression to extreme mania DSM5 divides mood disorders into 2 general categories -depressive disorders -bipolar disorder

Simon Baron Cohen

theory of mind: we understand other people's states autistic ppl cant He did sally anne study. Shows cartoon 2 kids. Put marble under one basket, girl walks out and the other girl changes its place. Ask kid where the sally anne would say the marble was. The kids respond as they would since they saw the change.

Treatment of ASD

there are about 400 diff treatments for ASD (eg ABA, TEACCH, meds, occupational therapy) There is no known cure treatment goals -minimize core probs -maximize independence and quality of life -help the child and family cope more effectively with the disorder

treatment for BP (meds used? multimodal plan includes 5? Psychother focuses on? what what was og med used? why doesnt og med work on kids? was 1st atidep?)

there is no cure for BP a multimodal plan includes: -monitoring symptoms closely -educating the patient and the family -matching treatments to individuals -administering meds eg lithium -addressing symptoms and related psychosoc impairments with psychotherapeutic interventions meds: -antipsychs are now most common **abilify, risperidal -lithium is og med for BP, used more in adults than in children -depakote was very poplaur but results are generally poor psychotherapy-focuses on symptoms and related psychosocial impairments -social rhythm therapy: helpful. rhythms for child's day, changing up day to deal. lithium not helpful if youre rapid cycling. kids usually are. narrow therapeutic index tofranil 1st antidep multiple meds for kids with bipolar is common

stressful life events (4 triggers for depression)

triggers for dep may involve: -interpers stress & actual or percieved personal losses (eg death of a loves one and abandonment) -life changes (eg moving to a new neighborhood) -violent fam env -daily hassles and other nonsevere stressful life events

genetic & family risk depression (heritability %? risk for children whos parents have it? what is actually being inherited?)

twin & other genetic studies suggest moderate genetic influence with heritability estimates ranging from 30-45% children of parents with depression have about 3 times the risk of having depression what is inherited is likely a vulnerability to depression and anxiety -with certain env stressors needed for these disorders to be expressed

school & learning probs (cd)

underachievement, grade retention, special ed placement, dropout, suspension and expulsion relationship between conduct probs and underachievement is firmly established by adolescence -may lead to anxiety or depression in young adulthood

Looking ahead (ch 2)

understanding of healthy, normal dev has evolved toward more health promoting orientation recognizing: -multicausal and interactive nature of many psychological disorders -the importance of contextual factors -the importance of balancing the individual's abilities with the challenges and risks of their environments

speech sound disorder

when the problem is one of articulation or sound production, rather than word knowledge, child may meet the criteria for a speech sound disorder 5 different subtypes but most common are pronouncing sounds incorrectly such as pronouncing "r" as "w"

meds (depression)

up to 60% of dep youngsters respond to placebo tricyclic antideps consistently fail to demonstrate any advantage over placebo in testing dep in youth -they have potentially serious cardiovasc side effects SSRIS (eg prozac, zoloft, celexa, viibryd) are the more commonly prescribed for treating childhood dep -despite support for their efficacy side effects include suicidal thoughts and self harms as well as a lack of inof about long term effects on the dev brain -prozac (ages 8 and up) and lexapro (ages 12 and up) are only FDA approved antideps for youth prozac was first lexapro has least side effects of them all none are as effective as CBT or interp for children you have to include fam therapy with whatever youre doing zoloft leave more serotonin there dr can prescribe whatevs like zoloft cuz it has research

accompanying psych disorders and symptoms

up to 80% of children with adhd have a co-occuring psych disorder oppositional defiant dis(ODD) and conduct disorder (CD) -role of COMT gene -a common genetic contribution for adhd, odd, an cd -family connections: there is evidence for a contribution from a shared env COMT gene: enzyme that breaks down NT. No gene for adhd. but gene that effects how well things do. for ex how well comt works moms are more likely to repeat. Dads more effective @ dealing with adhd. less likely to wait. most common co-morbid disorder (odd & cd) never threat. carry through with whatever youre saying. spanking=not good. especially adhd. dont learn from punishment. psychopathic genes could be triggered. heightened emotions prevent learning, create an emotional memory

molecular genetics

used to ID specific genes for childhood disorders -long term goal is to determine how genetic mutations alter how genes function *genetic influences are probabilistic not deterministic *most forms of abnormal behavior are polygenic

fam influences (when children are depressed vs when parents are)

when children are depressed -fams display more critical and punitive beh toward the dpressed child than toward other children when parents are depressed -dep interferes with the parents ability to meet needs for the child -child exp higher rates pf dep, panic dis, and alcohol dependence as adols and adults view them as being oppositional/overly irritable

Risk factor

variable that precedes a negative outcome of interest -examples: chronic poverty, care giving deficits, parental mental illness, death of a parent, disasters, and family breakup

correlates

variables ass at a particular point in time -no clear proof that one precedes the other

protective factors

variables that precede an outcome of interest -decrease the chance of a negative outcome

risk factors

variables that precede an outcome of interest -increase chance of a - outcome

Multifinality

various outcomes may stem from similar beginnings

hot exec functions (cd)

ventromedial pathways-amygdala and striatum (part of limbic system) to ventromedial prefrontal cortex) -affect regulation, motivation, incentive/reward

Cognitive treatments

view abnormal behavior as the result of deficits and or distortions in the child's thinking focus is on changing faulty cognitions

Bio treatments

view child psychopathology as resulting from psychobiological impairment or dysfunction rely primarily on pharmacalogical and other bio approaches to treatment

Cog beh treatments

view psychological distrubances as the result of: -faulty thought patterns -faulty learning and env experiences focus on: -ID and changing maladaptive cognitions; teaching the child to use cog and beh coping trategies; and helping the child learn self-reg

treatment efficacy

whether a treatment can produce changes under well controlled (research) conditions

construct validity

whether scores on a measure behave as predicted...degree to which something measures what it claims to be measuring

treatment effectiveness

whether the treatment can be shown to work in clinical practice

new CD specifier

with limited proscoial emotions is a new specifier for CD (more likely to be seen in early onset CD) child must evidence at least 2 of the following: -lack of remorse or guilt -callous-lack of empathy -unconcerned about performance -shallow or deficient affect

common fears and anxieties (early infancy)

within first weeks: -loss of phys contact with caregiver -loss of phys support 0-6 months: -intense sensory stim (loud noise)

SLD with impairment in written expression

writing disorders are often associated with problems with eye/hand coordination -leads to poor handwriting children with writing disorders: -produce shorter, less interesting, and poorly organized essays -are less likely to review spelling, punctuation, and grammar to increase clarity

peer probs (cd)

young children with conduct probs display poor social skills and verbal and physical aggression toward peers often rejected by peers, although some are popular -children rejected in primary grades are five times more likely to display conduct probs as teens -some become bullies often form friendships with other antisocial peers -predictive of conduct probs during adolescence -deviant peer friendships and early antisocial beh are best predictors of continued CD into adulthood underestimate own aggression and its negative impact, and overestimate others' aggression toward them reactive-aggressive children display hostile attributional bias proactive aggressive view their aggressive actions as positive

bipolar disorder in young people (what they display)

young people with BP display: -significant impairment in functioning, including previous hospitalization, MDD, med treatment, cooccuring disruptive behavior and anxiety disorders history of psychotic symptoms, and suicidal ideation/attempts are common H to L: -mania -hypo -normal -dys -MD

bipolar mania symptoms in young people

youngsters with mania may present with atypical symptoms-volatile and erratic changes in mood, psychomotor agitation, and mental excitation -irritability, belligerence, and mixed manicdepressive features occur more freq than euphoria classic sympts for children with mania include pressures speech, racing thoughts, and flight of ideas

Causes of children's problems

• Children's problems must be considered in relation to multiple levels of influence (individual, family, community, culture) rather than be attributed to any one factor - Factors may be contained within the child or at various distances from child's immediate surroundings • Possible causes of a child's behavior: - Biological influences - Emotional influences - Behavioral and cognitive influences - Family, cultural, and ethnic influences • Factors in each area impact and interact with the other areas

Theoretical foundations

• Defining child abnormality involves: - The context of children's ongoing adaptation and development - Sorting out the causes of identified problems • Abnormal behavior studies require: - An understanding of development and individual events that can impact a child's life • Studying normal development informs our theories of abnormal development • Clinical and research activity begins with theoretical formulations for guidance and information Multiple, interactive causes help in understanding the complexity of disorders

Etiology

• Etiology: the study of the causes of childhood disorders - Considers how biological, psychological, and environmental processes interact to produce outcomes observed over time

Adult outcomes (cd)

•50% of active offenders decrease by early 20s, and 85% decrease by late 20s •Negative adult outcomes are seen, especially for those on the LCP path (typically childhood onset CD) -Males - criminal behavior, work problems, and substance abuse -Females - depression, suicide, and health problems

Cultural factors (cd)

•Across cultures, socialization of children for aggression is one of the strongest predictors of aggressive acts •Rates of antisocial behavior vary widely across and within cultures •Antisocial behavior is associated with minority status in the U.S. -Likely due to low SES

Genetic influences (cd)

•Aggressive and antisocial behavior in humans is universal -Run in families within and across generations •Adoption and twin studies -Indicate 50% or more of variance in antisocial behavior is hereditary -Suggest contribution of genetic and environmental factors •Genetic factors: -May increase likelihood for child's exposure to environmental risk factors -Genotype and neurobiology may moderate susceptibility to environmental insults -Possible gene-environment interactions •DRD4 (dopamine) Receptor - linked to thrill seeking, excitability, impulsivity •Low-active MAO-A genotype in maltreated children •Brain imaging studies: individuals with low-active MAO-A genotype show arousal in brain regions associated with aggression

Accompanying dis and symptoms (cd)

•Depression and anxiety -About 50% of children with conduct problems also have depression or anxiety •ODD best accounts for the connection between conduct problems and depression •Increasing severity of antisocial behavior is associated with increasing severity of depression and anxiety •Anxiety may serve as a protective factor to inhibit aggression •Attention-Deficit/Hyperactivity Disorder -More than 50% of children with CD also have ADHD -Possible reasons for overlap •A shared predisposing vulnerability may lead to both ADHD and CD •ADHD may be a catalyst for CD •ADHD may lead to childhood onset of CD -Research suggests that CD and ADHD are distinct disorders

General progression (cd)

•Earliest sign is difficult temperament in infancy •Hyperactivity and impulsivity during preschool ad early school years •Oppositional and aggressive behaviors peak during preschool years •Diversification - new forms of antisocial behavior develop over time •Covert conduct problems begin during elementary school •Problems become more frequent during adolescence •Some children break from the traditional progression -About 50% of children with early conduct problems improve -Some don't display problems until adolescence -Some display persistent low-level antisocial behavior from childhood/adolescence through adulthood

Causes (cd)

•Early theories focused on a child's aggression •No single theory explains all forms of antisocial behavior •Today conduct problems are seen as resulting from: -The interplay among a predisposing child, family, community, and cultural factors operating in a transactional fashion over time

Other family factors (cd)

•Family instability and stress -High family stress may be both a cause and an outcome of child's antisocial behavior •Unemployment, low SES, multiple family transitions, instability, and disruptions in parenting practices are stressors -Amplifier hypothesis •Parental criminality and psychopathology -Aggressive and antisocial tendencies run in families within and across generations •Father being in jail is best predictor of boy going to jail

Problem solving skills training

•Focuses on cognitive deficiencies and distortions in interpersonal situations •Five problem-solving steps are used to: -Identify thoughts, feelings, and behaviors in problem social situations •Children learn to: -Appraise the situation -Identify self-statements and reactions -Alter their attributions about others' motivations -Learn to be more sensitive to others

Gender cd: gender diff evident by what age? during child hood how many times higher is cd present in boys? who has earlier age of onset and greater persistence? what are early symptoms for boys vs girls?

•Gender differences are evident by 2-3 years of age -During childhood, rates of conduct problems are about 2-4 times higher in boys -Boys have earlier age of onset and greater persistence -Early symptoms for boys are aggression and theft; early symptoms for girls are sexual misbehaviors

Health related probs (cd)

•High risk for personal injury, illness, drug overdose, sexually transmitted diseases, substance abuse, and physical problems as adults •Rates of premature death (before age 30) -Are 3 to 4 times higher in boys with conduct problems •Early onset and persistence of sexual activity and sexual risk-taking by age 21 •Substance use disorders and adolescent antisocial behavior are strongly associated -Sensation seeking seen in both disorders •Childhood conduct problems are a risk factor for adolescent and adult substance abuse -Mediated by drug use and delinquency during early and late adolescence

Societal factors (cd)

•Individual and family factors interact with the larger societal and cultural context in determining conduct problems •Social disorganization theories •Adverse contextual factors are associated with poor parenting •Neighborhood and school -Social selection hypothesis •Media

Multisystemic therapy

•Intensive family- and community-based approach -For teens with severe conduct problems who are at risk for out-of-home placement •Attempts to empower caregivers to improve youth and family functioning •Effective in reducing long-term rates of criminal behavior -Reduces association with deviant peers Functional Family Therapy (FFT) is a related treatment approach that also shows positive results

2 common pathways (cd)

•Life-course-persistent (LCP) path begins early and persists into adulthood -Antisocial behavior begins early •Subtle neuropsychological deficits heighten vulnerability to antisocial elements in social environment -Complete, spontaneous recovery is rare after adolescence -Associated with family history of externalizing disorders •Adolescent-limited (AL) path begins at puberty and ends in young adulthood -Less extreme antisocial behavior, less likely to drop out of school, and have stronger family ties -Delinquent activity is often related to temporary situational factors, especially peer influences

self esteem deficits (cd)

•Low self-esteem is not the primary cause of conduct problems -Instead, problems are related to inflated, unstable, and/or tentative view of self •Youths with conduct problems may experience high self-esteem -Over time may permit them to rationalize their antisocial conduct

Preventive interventions CONDUCT

•Main assumptions -Conduct problems can be treated more easily and effectively in younger than older children -Counteracting risk factors/strengthening protective factors at young age limits/prevents escalation of problem behaviors -Costs to educational, criminal justice, health, and mental health systems are reduced •Incredible Years intensive multifaceted early-intervention program for parents and teachers -Support for effectiveness of early interventions in reducing later conduct problems and maintaining positive outcomes •Fast Track program to prevent development of antisocial behavior in high-risk children focuses on improving child competencies, parenting effectiveness, school context and school-home communications

Prevalence cd

•ODD is more prevalent than CD during childhood; by adolescence, prevalence is equal •Lifetime prevalence rates -12% for ODD (13% for males, 11% for females) -8% for CD (9% for males, 6% for females) •Prevalence for CD and ODD across cultures of Western countries are similar

Neuro bio factors

•Overactive behavioral activation system (BAS) and underactive behavioral inhibition system (BIS) •Variations in stress-regulating mechanisms •Structural and functional brain abnormalities in amygdala, prefrontal cortex, anterior cingulate, and insula •Early findings suggest three neural systems are involved: -Subcortical neural systems •Aggressive behavior - dysfunction in the integrated functioning of brain circuits involving the amygdala -Prefrontal cortex •Decision-making circuits and socioemotional information processing circuits -Frontoparietal regions •Emotions and impulsive motivational urges

Explaining gender diff (cd)

•Possible explanations -Genetic, neurobiological, environmental risk factors, and definitions of conduct problems that emphasize physical violence •Girls use indirect, relational forms of aggression •Early maturing boys and girls are at risk for recruitment into delinquent behavior by peers

Prenatal factors and complications

•Pregnancy and birth factors -Low birth weight -Malnutrition (possible protein deficiency) during pregnancy -Lead poisoning -Mother's use of nicotine, marijuana, and other substances during pregnancy -Maternal alcohol use during pregnancy

Family factors

•Severe forms of antisocial behavior -Are associated with a combination of child risk factors and extreme deficits in family management skills •Influence of family environment is complex •Reciprocal influence -Child's behavior is influenced by and influences the behavior of others •Child behaviors exert greater influence on parenting behavior than the reverse •Coercion theory •Attachment theories

Social cog factors

•Social-cognitive abilities: skills involved in attending to, interpreting, and responding to social cues •Immature forms of thinking (e.g., egocentrism and lack of social perspective taking) •Cognitive deficiencies (e.g., inability to use verbal mediators to regulate behavior) •Cognitive distortions (e.g., interpreting neutral events as hostile) •Deficits in facial expression recognition and eye contact

Treatment and prevention cd

•Some treatments are not very effective -Office-based individual counseling and family therapy -Group treatments can worsen the problem -Restrictive approaches often worsen the problem ***residential treatment ***inpatient hospitalization ***boot camps ***Incarceration ***Scared straight programs Comprehensive two-pronged approach includes -Early intervention/prevention programs -Ongoing interventions

Parent management training

•Teaches parents to change the child's behavior in the home and in other settings using contingency management techniques •Focus is on: -Improving parent-child interactions -Promoting positive behavior -Decreasing antisocial behavior •Makes numerous demands on parents