chapter 14 psych

copy number variants

Genes that are deleted as a result of mutations; these deletions may play a role in the development of ADHD and other disorders. example of how environmental factors can contribute to ADHD: researchers found that children with a specific mutation involving the dopamine system were more likely to exhibit the symptoms of ADHD if their mothers smoked during pregnancy.

down syndrome

Type of intellectual disability caused by a chromosomal aberration (extra 21st chromosome) and involving characteristic physical appearance. Sometimes known as trisomy 21 or mongoloidism. the incidence of children born with down syndrome has been tied to maternal age, as the age of the mother increases, so does her chance of having a child with this disorder.

pervasive developmental disorder not otherwise specified

Wideranging, significant, and long-lasting dysfunctions that appear before the age of 18.

Lesch-Nyhan syndrome

X-linked disorder (only males are affected) characterized by intellectual disability, signs of cerebral palsy, and self-injurious behavior.

psychosocial interventions for ADHD

focuses on improving academic performance, decreasing disruptive behavior and improving social skills. teaches families how to respond constructively to their children's behaviors and how to structure the child's day to help prevent difficulties.

impulsivity in adolescence with ADHD

over time, children with ADHD seem to be less impulsive, although inattention persists. during adolescence the impulsivity manifests itself in different areas: teens with ADHD are at greater risk for pregnancy and contracting sexually transmitted diseases and are more likely to have driving difficulties, such as crashes, to be cited for speeding and to have their licenses suspended.

2013 estimates that an average of __ in __ school aged children in the US had a diagnosis under the category of ASD

1 in 50

it is estimated that approximately __ of individuals with ASD have intellectual disabilities

38% (defined as a IQ score less than 70 present before the age of 18). language abilities and IQ scores are reliable predictors of how children with ASD will fare later in life: the better the language skills and IQ test performance, the better the prognosis.

intellectual disability (ID)

A diagnosis received when one achieves a significantly below-average score on a test of intelligence and by limitations in the ability to function in areas of daily life. DSM-5 identifies difficulties in three domains: conceptual, social and practical. used to be called "mental retardation" in the DSM-IV.

chorionic villus sampling (CVS)

A genetic test conducted during early pregnancy that samples cells found in the placenta (chorionic villi) and assesses possible genetic or chromosomal problems in the fetus. some estimate that a prenatal diagnosis of down syndrome leads to a choice for a elective abortion about 25% of the time.

language disorder

An individual's problems in spoken communication, as measured by significantly low scores on standardized tests of expressive language relative to nonverbal intelligence test scores. Symptoms may include a markedly limited vocabulary or errors in verb tense. communication disorder

joint attention

Attention shared by two persons toward an object after one person has indicated interest in the object to the other person; this social interaction is limited or absent in people with autism spectrum disorder. (the example of a toddler who sees a toy that she likes, she might look at her mother and smile and then look at the toy and then look at her mother again)

attention-deficit/hyperactivity disorder (ADHD)

Developmental disorder featuring maladaptive levels of inattention, excessive activity (motor hyperactivity), and impulsiveness. one of the most common reasons children are referred for mental health services in the US. either the first (inattention) or the second and third (hyperactivity and impulsivity) set of symptoms must be present or someone to be diagnosed with ADHD.

Tourette's disorder

Developmental disorder featuring multiple dysfunctional motor and vocal tics.

childhood-onset speech fluency disorder (stuttering)

Disturbance in the fluency and time patterning of speech (for example, sound and syllable repetitions or prolongations). communication disorder

naturalistic teaching strategies

Instructional techniques that are used with children having neurodevelopmental disorders and that move away from traditional desk instruction toward more natural social interactions.

cultural-familial intellectual disability

Mild intellectual disability that may be caused largely by environmental influences.

specific learning disorder

Neurodevelopmental disorder characterized by academic performance that is substantially below what would be expected given the person's age, intelligence quotient (IQ) score, and education.

autism spectrum disorder (ASD)

Neurodevelopmental disorder characterized by significant impairment in social interactions and communication and restricted, repetitive patterns of behavior (maintenance of sameness), interest, and activity. (pervasive developmental disorders) it is the degree of impairment in each of these characteristics that distinguishes from people with the separate disorders of autistic disorder, aspergers disorder and pervasive developmental disorder- not otherwise specified.

neurodevelopmental disorders

Neurologically based disorders that are revealed in a clinically significant way during a child's developing years. these difficulties often persist through adulthood and are typically lifelong problems, not problems only unique to children.

fragile X syndrome

Pattern of abnormality caused by a defect in the X chromosome resulting in intellectual disability, learning problems, and unusual physical characteristics. fragile x primarily affects males but women who cary fragile x syndrome display mild to severe learning disabilities. estimates that 1 of every 4,000 males and 1 of every 8,000 females are born with fragile x syndrome

childhood disintegrative disorder

Pervasive developmental disorder involving severe regression in language, adaptive behavior, and motor skills after a 2- to 4-year period of normal development.

amniocentesis

Prenatal medical procedure that allows the detection of abnormalities (for example, Down syndrome) in the developing fetus. It involves removal and analysis of amniotic fluid from the mother.

Rett disorder

Progressive neurodevelopmental disorder featuring constant handwringing, intellectual disability, and impaired motor skills. affects mostly females and is diagnosed as ASD with qualifier "associated with Rett syndrome".

phenylketonuria (PKU)

Recessive disorder involving the inability to break down a food chemical whose buildup causes intellectual disability, seizures, and behavior problems. PKU can be detected by infant screening and prevented by a specialized diet. (genetic influences)

prosody

Vocal characteristics such as tone and stress; people with autism spectrum disorder often have trouble recognizing and interpreting these vocal cues.

Robert is a 4-year-old boy who is unusual in many ways. One of them is the fact that he does not demonstrate an aspect of social reciprocity called ________ . As an example, when he comes across a favorite toy he does not look to his mother or father and smile, and then look back to the toy, thus communicating a desire to share his interest with his parents. This absence is often seen in people with autism spectrum disorder. a. joint attention b. delayed echolalia c. stereotypy d. perseveration

a

social (pragmatic) communication disorder

a disorder new to DSM-5: includes the difficulties in social communication seen in ASD, but without restricted, repetitive patterns of behavior. these people do not easily learn the social rules when communicating with others.

the criteria for a diagnosis of ID

a must person must have significantly subaverage intellectual functioning- a IQ score of 70 or lower. and a person must have significant difficulty in areas such as communication, self-care, home living, social and interpersonal skills, use of community resources, self-direction, functional academic skills, work, leisure, health and safety. these characteristics must be evident before the person is 18.

discrimination training

a procedure used in the 1960s that was used to get nonspeaking children to imitate others verbally. they first taught the children to imitate other people's speech, they began by reinforcing a child with food and praise for making any sound while watching the teacher. after the children mastered that step, they reinforced the child only if she made a sound after the teacher made a request

echolalia

a sign of delayed speech development, when someone repeats the speech of others and intonation.

gender differences in ASD

average reported male to female estimate being 4.4 to 1.

In the 1960s, Ivar Lovaas and his colleagues took a monumental first step in addressing the fact that children with more severe forms autism spectrum disorder would not respond to verbal instructions. This step involved using ________ to teach these children to imitate the verbalizations of others. a. stimulus generalization b. shaping and discrimination training c. physical punishment d. classical conditioning

b

Research into neurological underpinnings of autism spectrum disorder (ASD) has focused on the amygdalae. Which of the following is one suggestion of how the amygdala might be involved in the development of ASD? a. The amygdala is separated from the hypothalamus in a pathological way, and thus the response of fear cannot be appropriately connected to the endocrine system. b. The amygdala is enlarged causing excessive anxiety and fear and this contributes to the social withdrawal that typifies autism spectrum disorder. c. The amygdala is shrunken in those with autism spectrum disorder, resulting in an absence of ability to properly process threatening and/or foreign stimuli. d. The surface of the amygdala is shriveled and contoured in those with autism spectrum disorder in a way that is not seen in those without ASD.

b

Which of the following would be considered an autism spectrum disorder? a. ADHD b. Asperger's disorder. c. Pica d. Intellectual developmental disorde

b

Why has DSM-5 combined learning disorders in different academic areas (as found in DSM-IV-TR) into one diagnosis called "specific learning disorder?" a. Because in most cases the learning disability was actually indicative of a more severe issue, such as an autism spectrum disorder or an intellectual disability. b. Because there was significant overlap in the disabilities of different subject areas. c. Because it was found that some topic areas, when diagnosed as a learning disability, brought enhanced social stigma to the student afflicted. d. Because the diagnosis of a learning disorder in specific areas was found to cause teachers in those topics to put forth less effort in treating students with such diagnoses.

b- remember that difficulties with reading are the most common of learning disorders

treatment of ID

biological treatment is currently not a viable option. treatment focuses on teaching these people the skills they need to become more productive and independent (participate in community life, attend school, and later hold a job) and a reduction in tantrums and self harm. communication training is important, including sign language and augmentative communication strategies (may use picture books, teaching the person to make a request by pointing to a picture).

gender differences in ADHD

boys are 3 times more likely to be diagnosed with ADHD than girls. boys tend to be more aggressive, which will more likely result in attention by mental health professionals. girls with ADHD, tend to display more behaviors referred to as internalizing, specifically anxiety and depression.

Although Adam has consistently earned scores in the mid-80s on intelligence tests, he seems to have some significant impairments in his adaptive skills. He does not live independently even though he is in his twenties, and he has difficulty relating to others and learning new skills. He does hold a job where he is given basic responsibilities and he is generally accepted by his co-workers, but when his job is done he always rushes out the door to walk home. With regard to the diagnosis of intellectual disability (ID), which of the following would be most appropriate? a. Adam has an intellectual disability of the autism spectrum type. b. Adam has an intellectual disability of the cultural-familial type. c. Adam has no diagnosable intellectual disability. d. Adam has an intellectual disability of the organic type.

c

Jeanie has been either abused or neglected for the better part of her childhood. She was never given any love or social validation, was often made to go without adequate food, and never had a stimulating environment with toys or books. She now suffers from a rather significant case of intellectual disability. How would her case be best classified? a. prenatal b. substance-induced c. cultural-familial d. diathesis-based

c

Most efforts at constructing effective treatments for those suffering from autism spectrum disorder focus on a. resolution of all autistic symptoms by age 18. b. immediate cessation of ritualistic behaviors. c. reduction in tantrums and enhancement of communication skills. d. development of normal social skills by age 18.

c

To accommodate the range of difficulties in the two symptom clusters of autism spectrum disorder (social/communication interaction and restricted, repetitive patterns of behavior, interests, or activities), DSM-5 introduced three different levels of severity. Which of the following is not one of them? a. "Requiring very substantial support." b. "Requiring substantial support" c. "Requiring moderate support" d. "Requiring support"

c

Which of the following is a true statement with regard to ADHD? a. the frequency of diagnosis has been steadily declining over the past decade. b. appears be related to the neurotransmitter acetylcholine. c. It is considered to be highly influenced by genetics with a relatively small role played by environmental influences. d. It has been found to be caused to be found by a single gene on the y-chromosome, which is why it is almost never seen in girls.

c

Which of the following is not one of the typical symptoms experienced by a person suffering from attention-deficit/hyperactivity disorder? a. Inattentiveness b. Hyperactivity c. Aggressiveness d. Impulsivity

c

Clotille is very concerned about giving her son Mario medication to treat his hyperactivity. She read that several of the medications used to treat ADHD are actually stimulants. She is willing to try medication, but does not want to give her son a stimulant. Given Clotille's feelings which of the following prescriptions should the pediatrician avoid providing? a. Strattera b. Tenex c. Adderall d. Clonidine

c - because adderall is a stimulant

Intellectual disability (ID) involves both significantly below-average intellectual and adaptive function, as assessed over three different domains. They include all but which of the following? a. social b. conceptual c. practical d. affective

d

Johnitta suffers from intellectual disability, but she is able to do certain tasks with minimal assistance and others with regular supervision. Because she wants to work and feels better about herself when she is able to make a contribution, Johnitta participates in ________ employment, which involves getting help with finding and participating in a job in a satisfactory manner. a. sheltered b. augmented c. assisted d. supported

d

One of the most common causes of intellectual disability is ________ syndrome, which at one time was called mongoloidism and is caused by the presence of an extra of the 21st pair of chromosomes. a. Klinefelter b. Turner c. Asperger d. Down

d

Which of the following environmental influences has NOT been found to have a direct contribution to the development of ADHD? a. Parental marital instability and discord b. Prenatal smoking c. Maternal Stress d. An absence of vitamin B-12 in the newborn's diet.

d

With regard to different geographic regions and the prevalence of attention-deficit/hyperactivity disorder, which of the following is an accurate statement? a. ADHD is seen almost exclusively in North America, including the United States and Canada. For that reason it is considered a "cultural" (or culture-bound) syndrome. b. Contrary to popular belief, the rate of diagnosis of ADHD in children is highest in Japan and China, where any inattentiveness of impulsivity is regarded as pathological. c. In the United States ADHD is seen more in boys than in girls, but in virtually every other society examined it is seen more in girls than in boys. d. The prevalence of ADHD in children is about 5.2% across all regions of the world.

d

________ communication strategies may include the use of picture books and computer assisted devices that help people with expressive difficulties overcome the frustration of being unable to communicate their thoughts, feelings, and desire to other people. a. Prospective b. Adjunctive c. Componential d. Augmentative

d

Ron is a 9-year-old boy recently diagnosed with attention deficit/hyperactivity disorder. His parents have chosen a form of treatment that will involve both medication and behavior therapy. This would be referred to as ________ treatment and was validated by a 14-month study of nearly 600 children. a. eclectic b. polyphasic c. biopsychosocial d. multimodal

d- the study suggested that the combination of behavioral treatments and medication, and medication alone, were superior to behavioral treatment alone (not much of a difference between medical treatment combined with behavioral treatment and just medical treatment).

biological contributions to ASD

deficits in skills such as social communication and the characteristic restricted and repetitive behaviors and interests appear to be biological in origin. families that have one child with ASD have about a 20% chance of having another child with the disorder- and this risk increases among older parents.

causes of ID

environmental: deprivation, abuse and neglect. prenatal: exposure to disease or drugs while still in the womb perinatal: difficulties during labor and delivery. postnatal: infections and head injury. * most research focuses on biological dimensions.

tuberous sclerosis

genetic influence of ID, relatively rare occurring in 1 of every 30,000 births. about 60% of people with this disorder have ID, and most have seizures and characteristic bumps on their skin that resembles acne.

causes of ADHD

is considered to be highly influenced by genetics. environmental influences play a relatively small role in the cause of this disorder- but can be maternal smoking and pregnancy complications such as maternal alcohol consumption and low birth weight.

prevalence of specific learning disorder

it is estimated that 6.5 million students between the age of 3 and 21 were receiving services for specific learning disorder between 2009 and 2010. 1% of white children and 2.6% of black children were receiving services for problems with learning in 2010 (this research suggests that the differences were related to the economic status of the child, not the ethnic background).

medication for ADHD

it is estimated that more than 4 million children in the US are being treated with medication for symptoms of ADHD: drugs such as methylphenidate (stimulants) (ritalin, adderall) and several nonstimulant medications such as atomoxetine (strattera) and also some antidepressants (imipramine) and a drug used for treating high blood pressure (clonidine). most clinicians recommend them temporarily, in combination with psychosocial interventions to help improve children's social and academic skills.

3 aspects of social communication and interaction that must be present to be diagnosed with ASD

problems with social reciprocity (failure to engage back and fourth in social interactions), nonverbal communication, and initiating and maintaining social relationships. about 25% of people with ASD do not develop speech proficiency sufficient to communicate their needs effectively.

comorbidity in ADHD

several other DSM-5 disorders, also found in children, appear to overlap significantly: specifically oppositional defiant disorder (ODD), conduct disorder and bipolar disorder (this is why diagnosing children with ADHD is difficult)

neurobiological influences in ASD

studies showed that adults with ASD had the same size amygdala as other adults, but with fewer neurons in the structure. young children with ASD have a larger amygdala which causes excessive anxiety and fear at a early age- with continued stress, the release of the stress hormone cortisol damages the amygdala causing the relative absence of neurons in adulthood (which may account for the different ways people with ASD respond to social situations). research on children with ASD found lower levels of oxytocin in their blood (important social neurochemical that is found to increase trust and reduce fear).

prevalence of ADHD

the disorder is found in about 5.2% of the child populations across all regions of the world. *(children were more likely to receive the label of ADHD in the US than anywhere else). data suggests that 3% to 9% of the worldwide population currently meet the criteria for ADHD.

biological interventions for ADHD

the goal is to reduce the child's impulsivity and hyperactivity and to improve their attention skills. along with medication.

brain structure in children with ADHD

the overall volume of the brain in those with this disorder is slightly smaller (3% to 4%) than in children without the disorder.

prevalence of ID

the total population of people with this disorder represents 2% of the general population. approximately 90% of people with ID fall under the label of mild intellectual disability (IQ 50 to 70). the course of ID is chronic, but the prognosis for people with this disorder varies considerably.

treatment for ASD

to date, there is no completely effective treatment that exists. most efforts at treating people with ASD focus on enhancing their communication and daily living skills and on reducing problem behaviors, such as tantrums and self injury.

treatment of ADHD

treatment has proceded on two fronts: psychosocial and biological interventions. current thinking in this area points to using parents and/or teacher delivered behavioral interventions for young children before attempting medication