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					Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders




                                    Chapter 14

                            Developmental Disorders
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

        Nature of Developmental Psychopathology: An
                          Overview

        Normal vs. Abnormal Development
        Developmental Psychopathology
           Study of how disorders arise and change with time
           Disruption of early skills can affect later
            development
        Developmental Disorders
           Diagnosed first in infancy, childhood, or
            adolescence
           Attention deficit hyperactivity disorder (ADHD)
           Learning disorders
           Autism
           Mental retardation
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                      Attention Deficit Hyperactivity
                      Disorder (ADHD): An Overview

        Nature of ADHD
           Central features – Inattention, overactivity, and
            impulsivity
           Associated with numerous impairments
               Behavioral
               Cognitive
               Social and academic problems
        DSM-IV and DSM-IV-TR Symptom Types
           Inattentive type
           Hyperactive type
           Impulsive type
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                         ADHD: Facts and Statistics


        Prevalence
           Occurs in 6% of school-aged children
           Symptoms are usually present around age 3 or 4
           68% of children with ADHD have problems as
            adults
        Gender Differences
           Boys outnumber girls 4 to 1
        Cultural Factors
        Probability of ADHD diagnosis
           Greatest in the United States
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

        The Causes of ADHD: Biological Contributions

 Genetic Contributions
    ADHD seems to run in families
    DRD4, DAT1, and DRD5 genes have been implicated
 Neurobiological Contributions
    Smaller brain volume
    Inactivity of the frontal cortex and basal ganglia
    Abnormal frontal lobe development and functioning
    Precise neurobiological mechanisms remain unclear
 The Role of Toxins
    No evidence that allergens and food additives are causes
    Maternal smoking increases risk
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

     The Causes of ADHD: Psychosocial Contributions


        Psychosocial Factors
           Can influence the nature of ADHD
           ADHD children are often viewed negatively by
            others
           Constant negative feedback from peers and adults
           Peer rejection and resulting social isolation
           Such factors foster low self-esteem
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                       Biological Treatment of ADHD

 Goal of Biological Treatments
    To reduce impulsivity and hyperactivity
    To improve attention
 Stimulant Medications
    Reduce core symptoms in 70% of cases
    Examples include Ritalin, Dexedrine
 Other Medications With More Limited Efficacy
    Imipramine and Clonidine (antihypertensive)
 Effects of Medications
    Improve compliance in many children
    Decrease negative behaviors in many children
    Do not affect learning and academic performance
    Benefits are not lasting following discontinuation
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

         Behavioral and Combined Treatment of ADHD


        Behavioral Treatment
           Involve reinforcement programs
           To increase appropriate behaviors
           Decrease inappropriate behaviors
           May also involve parent training
        Combined Bio-Psycho-Social Treatments
           Are highly recommended
           Superior to medication or behavioral treatments
            alone
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                    Learning Disorders: An Overview

 Scope of Learning Disorders
    Academic problems in reading, mathematics, and writing
    Performance substantially below expected levels
 DSM-IV and DSM-IV-TR Reading Disorder
    Discrepancy between actual and expected achievement
    Performance significantly below age or grade level
    Cannot be caused by sensory deficits
 DSM-IV and DSM-IV-TR Mathematics Disorder
    Achievement below expected performance
 DSM-IV and DSM-IV-TR Disorder of Written Expression
    Achievement below expected performance in writing
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

        Learning Disorders: Some Facts and Statistics


        Prevalence of Learning Disorders
           5-10% prevalence in the United States
           Highest in wealthier regions of the United States
           About 32% of these students drop out of school
           5-15% prevalence for reading difficulties
           School experience tends to be generally negative
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                                       Growth Area




Figure 14.1 Growth area. More than half of all schoolchildren classified as disabled
have learning disabilities. Twenty-one years ago, the proportion was around 25%.
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                                Uneven Distribution




Figure 14.2 Uneven distribution. The highest percentages of schoolchildren
diagnosed with learning disabilities are in the wealthiest states.
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

               Biological and Psychosocial Causes of
                         Learning Disorders


        Genetic and Neurobiological Contributions
           Reading disorder runs in families
           100% concordance rate for identical twins
           Evidence for subtle forms of brain damage is
            inconclusive
           Overall, contributions are unclear
        Psychosocial Contributions are Largely Unknown
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                     Treatment of Learning Disorders


        Requires Intense Educational Interventions
           Remediation of basic processing problems
           Improvement of cognitive skills
           Targeting skills to compensate for problem areas
        Data Support Behavioral Educational Interventions
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

     Pervasive Developmental Disorders: An Overview


        Nature of Pervasive Developmental Disorders
           Problems occur in Language, Socialization, and
            Cognition
           Pervasive – Problems span many life areas
        Examples of Pervasive Developmental Disorders
           Autistic disorder
           Asperger’s syndrome
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

         The Nature of Autistic Disorder: An Overview


        Autism – Significant Impairments
           Social interactions and communication
           Restricted patterns of behavior, interest, and
            activities
        Three Central DSM-IV and DSM-IV-TR Features of
         Autism
           Qualitative impairment of social interaction
           Problems in communication
              50% never acquire useful speech
           Restricted patterns of behavior, interests, and
            activities
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                Autistic Disorder: Facts and Statistics

  Prevalence and Features of Autism
     Affects 1 in every 500 births
     More prevalent in females with IQs below 35
     More prevalent in males with higher IQs
     Occurs worldwide
     Symptoms usually develop before 36 months of age
  Autism and Intellectual Functioning
     50% have IQs in the severe-to-profound range
     25% test in the mild-to-moderate IQ range
     Remaining test in the borderline-to-average IQ range
  Reliable indicators of good prognosis
     Language ability and IQ
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

Causes of Autism: Early and More Recent Contributions

 Historical Views
    Bad parenting
    Unusual speech patterns
    Lack of self-awareness
    Echolalia
 Current Understanding of Autism
    Medical conditions – Not always related with autism
    Genetic component is largely unclear
    Neurobiological evidence of brain damage
    Substantially reduced cerebellum size
 Psychosocial Contributions Are Unclear
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

    Asperger’s Disorder: Part of the Autistic Spectrum


 The Nature of Asperger’s Disorder
    Show significant social impairments
    Restricted and repetitive stereotyped behaviors
    May be clumsy
    Often quite verbal
    No severe language and/or cognitive delays
 Prevalence of Asperger’s Disorder
    Often under diagnosed
    Affects about 1 to 36 persons per 10,000 people
 Causes of Asperger’s Disorder Are Somewhat Unclear
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                Treatment of Pervasive Developmental
                    Disorders: Example of Autism

        Psychosocial “Behavioral” Treatments
           Skill building
           Reduction of problem behaviors
           Target communication and language problems
           Address socialization deficits
           Early intervention is critical
        Biological and Medical Treatments Are Unavailable
        Integrated Treatments: The Preferred Model
           Focus on children, their families, schools, and
            home
           Build in appropriate community and social support
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

               Mental Retardation (MR): An Overview


  Nature of Mental Retardation
     Disorder of childhood
     Below-average intellectual and adaptive functioning
     Range of impairment varies greatly across persons
  DSM-IV and DSM-IV-TR criteria
     Significantly sub-average intellectual functioning
     Deficits or impairments in present adaptive functioning
     Must be evident before the person is 18 years of age
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

   DSM-IV and DSM-IV-TR Levels of Mental Retardation
                        (MR)

        Mild MR
           IQ score between 50 or 55 and 70
        Moderate MR
           IQ range of 35-40 to 50-55
        Severe MR
           IQs ranging from 20-25 up to 35-40
        Profound MR
           IQ scores below 20-25
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

    Other Classification Systems for Mental Retardation
                            (MR)
 American Association of Mental Retardation (AAMR)
    Defines MR based on levels of assistance required
    Levels of assistance
       Intermittent
       Limited
       Extensive
       Pervasive
 Classification of MR in Educational Systems
    Educable (IQ of 50 to 70-75)
    Trainable (IQ of 30 to 50)
    Severe (IQ below 30)
 Implications of Different MR Classification Systems
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

   Mental Retardation (MR): Some Facts and Statistics


        Prevalence
           About 1-3% of the general population
           90% are labeled with mild mental retardation
        Gender Differences
           MR occurs more often in males
           Male-to-female ratio of about 1.6:1
        Course of MR
           Tends to be chronic
           Prognosis varies greatly from person to person
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                  Causes of Mental Retardation (MR):
                      Biological Contributions
 Hundreds of known causes
    Environmental – Deprivation, abuse
    Prenatal – Exposure to disease or a drug / toxin
    Perinatal – Difficulties during labor
    Postnatal – Head injury
 Genetic Research
    Multiple genes, and at times single genes
 Chromosomal Abnormalities
    Down syndrome and Fragile X syndrome
 Maternal Age and Risk of Having a Down’s Baby
 Nearly 75% of Cases
    Cannot be attributed to any known cause
    Are thought caused by social and environmental factors
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                     Rates of Down Syndrome Births




Figure14.3 The increasing likelihood of Down Syndrome with maternal age (based on
data from Hook, 1982).
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                  Causes of Mental Retardation (MR):
                     Psychosocial Contributions

        Cultural-Familial Retardation
           Believed to cause about 75% of MR cases
           Is the least understood
           Associated with
               Mild levels of retardation on IQ tests
               Good adaptive skills
        Difference vs. Developmental Views
           Difference view - Kind and degree of impairment
           Developmental view – Rate of developmental
            delay
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                 Treatment of Mental Retardation (MR)


        Parallels Treatment of Pervasive Developmental
         Disorders
        Teach Needed Skills
           To foster productivity
           To foster independence
           Educational and behavioral management
           Living and self-care skills via task analysis
           Communication training – Often most challenging
        Community and Supportive Interventions
           Persons with MR can benefit from such
            interventions
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

                Summary of Developmental Disorders

 Developmental Psychopathology
 Attention Deficit Hyperactivity Disorder
    Deficits in attention, hyperactivity, or impulsivity
    Disrupt academic and social functioning
 Learning Disorders
    Deficits in performance below expectations
 Pervasive Developmental Disorder
    All share deficits in language, socialization, and cognition
 Mental Retardation
    Sub-average IQ, deficits in adaptive functioning
    Onset before age 18
 Prevention and Early Intervention Are Critical
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

           Exploring Developmental Disorders (ADHD)
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

Exploring Developmental Disorders (Learning Disorders)
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

        Exploring Developmental Disorders (Pervasive
                  Developmental Disorders)
Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow, V. Mark Durand
Chapter 14: Developmental Disorders

Exploring Developmental Disorders (Mental Retardation)

				
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