Chapter 13 Flashcards

Question

Prenatal factors in ID -5

Answer 1

1. Some cases of ID caused by maternal infections like: Rubella, syphilis, cytomegalovirus, genital herpes but Immunizations in women before pregnancy have reduced risk of transmission 2. Fetal alcohol syndrome is one of the most prominent causes of ID 3. Birth complications (oxygen depreivation) place children at risk of ID; Prematurity also increases 4. Brain infections (encephalitis, meningitis) can result in ID 5. Toxins like paint chips can cause it also

Answer 2

* Most cases of ID fall in the mild range of severity and have no apparent biological cause or distinguishing feature * These cases are cultural-familial roots like impoverished homes or social enviro lacking stimulating activities * Lack of toys, books, economic burden of parent being away at work, all lead to underdevelopment of language skills and motivation to learn * Vicious cycle of poverty and impoverished intellectual development repeated from generation to generation (ID parent=ID child) * Children with family form of ID may respond dramatically when given chance to learn * Head start social program has helped many function in normal range

Answer 3

* With training, children with mild forms of ID may reach six grade level of competence. Other extreme cases placed in residential care – often based on need to control aggressive behavior not bc of severity of ID * Disagreement over whether ID children should be mainstreamed into reg classes—some improve others don’t * Trend towards deinstitutionalization of ppl with more severe ID motivated by public outrage over appalling conditions that formaly existed in many institutions Developmentally disabled assistance and bill of rights act, passed in 1975 gave ppl with ID the right to receive approp treatment in least restrictive treatment setting * Nationwide the pop of insituions for ppl with ID shrank by 2/3’s in years following bill * Those with ID stand high risk of developing other psych disorders like depression and anxiety. Emotional life of ppl with ID received lil attention—many assume that ppl with ID are somehow immune to these probs or lack verbal skills for therapy. However evidence shows that they can benfit from psych treatment

Answer 4

* Psych counseling with behavioral techs help them acquire skills in personal hygiene, work , social relationships * Structural behavioral approaches used to teach those with more severe ID to master basic hygiene like tooth brushing, dressing, hair combing

Answer 5

deficiency in a specific learning ability in context of normal intelligence and exposure to learning opportunities; Typically chronic disorders that affect into adulthood Children with this often viewed as failures; often have other probs like low self-esteem and high risk of developing ADHD - Specific learning disorder also problems with reading, writing, math, and executive functions

Answer 6

− DSM single diagnosis to encompass various LD’s involving deficits in skills of reading, writing, arithmetic and executive functions. - 5 to 15% school aged children − Deficits emerge during grade school years but may not be recognized until academic demands exceed the individuals abilities − Diagnosis also requires that learning deficits cannot be better explained by a generalized delay in intellectual development (ID) of by underlying neuro med conditions. − Commonly combo of specific deficits in academic, social, and occupational functioning

Answer 7

− Dyslexia- Most common type of LD accounting for 80% of cases; impaired reading ability with at least avg intelligence − DSM does not use term dyslexia although still used to describe probs with reading − Struggle to understand or recognized basic words or comprehend what they read; read slow, distort, emit words. Trouble decoding letters and translating to sounds; may misperceive letters as upside down or reversed − Affects 4% of school aged children; more common in boys − Boys more likely to show disruptive behavior and go for evaluation − Usually apparent by age of 7 (2nd grade) − Prone to probs with depression and ADHD − Rates are higher in English speaking and French speaking countries where language contains large number of ways of spelling words containing the same sounds (toe and tow) − Low in Italy

Answer 8

− Errors in spelling, grammar, or punctuations. Probs with legibility or fluent handwriting or difficulty composing sentences − Severe ones become apparent by age 7 − Milder cases not until 10 (5th grade)

Answer 9

− Apparent by age 6 (1st grade) but generally not recognized until 2nd or 3rd grade. − Include probs with addition, subtraction, learning multiplaction tables

Answer 10

− Sets of higher mental abilities involved in planning, organizing, coordinating tasks − Trouble organizing school related tasks and freq fall behind in school work or fail to plan assingments ahead

Answer 11

• Much of research focuses on dyslexia with evidence of brain abnormalities in visual and auditory info processing • Difficutly connecting sounds that correspond to letters and distinguishing speech sounds • Evidence points to genetic influence Dyslexia may take 2 general forms: on genetically influenced and one enviro •Genetic form appears to involve probs in neural circuits in brain that readers use to process speech sounds; these children compensated for this defect by reading slowly •Enviro form appears to be rely on memory more than decoding strategies to understand words; more prevalent in disadvantaged children and assoc with more persistent reading disability

Answer 12

* Linking learning disorders to defects in brain circuits for prosccessing sensory (visual and audio) info may point toward treatments programs that help children adjust to their sensory capabilities * Therapist’s need to design techs that tailor to particular type and edu background

Answer 13

persistent difficulties in understanding or using language, or speaking clearly include: language disorder, speech sound disorder, childhood onset fluency disorder, and social pragmatic comm disorder

Answer 14

impairments in ability to produce or understand spoken language include: slow vocab development, errors in tenses, difficulties recalling words, probs producing sentences of length/complexity • Affected children may also have a speech sound articulation disorder compounding speech problems • May have hard time understanding words; sometimes it’s a certain word type (quantity), spatial terms (near) or sentence types

Answer 15

(formerly called phonological disorder) difficulty in articulating speech in absence of defective oral speech mechanism or neuro impairment • Child may omit, sub, or mispronounce certain sounds • May sound as if they are uttering baby talk • Speech therapy often helpful and mild cases often resolve by age of 8

Answer 16

persistent stuttering; difficulty speaking fluently with appropriate timing of speech sounds - 1% •Usually begins between 2 and 7 years old •Occurs 3x as many males as females •Most who stutter 80% overcome prob without any treatment before 16 •Characterized by one or more of following: repetition of sounds, prolongations of certain sounds, interjections of inappropriate sounds, broken words, blocking of speech, circumlocutions (subbing alternative words to avoid problematic ones), excess of physical tension, repetitions of monosyllabic words. •Causes unknown but maybe genetics Genetics involved with controlling speech producing muscles • Recent disorvery of mutation on gene linked to stuttering •Emotional component –Children tend to be more emotionally reactive when faced with stress they become more upset Also tend to be troubled with social anxiety about what others think of them

Answer 17

difficutlites communicating with others in social contexts •New in DSM •Diagnosis only applys to children who have continiuing tourble communicating verbally and nonverbally with others in natural contexts (school)

Answer 18

* Often with specialized speech and language therapy or with fluency training which involves learning to speak more slowly and to regulate ones breathing * Stuttering may include psych counseling for anxiey

Answer 19

• ADHD, ODD, CD Useful to link all 3 together because they all involve problem behaviors that can seriously interfere with functioning in school or at home. •The disorders are socially disruptive and are more upsetting to others than to those children who are diagnosed •Rate of comorbidity very high

Answer 20

excessive motor activity and inability to focus attention; display impulsivity inattention, and hyperactivity • Affects between 7-9% of children and adolescents in US • More than 6 million children 4 thru 17 in US diagnosed • 2/3rds of those children are take medication • Diagnosed 2-9x more often in boys • Black and Hispanic children are less likely to receive the diagnoses than Whites • Usually first diagnosed in elementary school however the inattentive or hyperactive and impulsive features may arise at any time before the age of 12 • Freq occurs with LD, Conduct, anxiety, depression and communication disorders

Answer 21

• Usaully takes form of inattention, probs with working mem, distractibility rather than hyperactivity in adults - 4% of adults • Evidence shows benefits for adults treated with form of cognitive training focusing on organizational, planning, and time management skills

Answer 22

1. Role of genetics—higher concordance rates among MZ twins than DZ 2. Also enviro factors: maternal smoking, maternal emotional stress, family conflict, poor disciplining 3. Recent evidence showed lead exposure increased ADHD symptoms in children 4. Recently learned that genetic variations increase risk BUT only with inconcsistent parenting 5. ADHD may be attributed to executive functions in brain involving process of attention and restraint of impulsive behaviors need to organize and follow thru with goals –supported by brain imaging showing delayed maturation in parts of brain especially in PFC

Answer 23

1. drugs used to calm the children down are stimulants ( Ritalin, Concerta); stimulate the PFC which regs the intentional processes and impulsive behaviors Drugs even used for 3 to 5 year olds 2. Common prob with medication is high rate of relapse after stopping meds; also range of effectiveness; not sure if meds acutely improve academics 3. Short-term side effects: loss of appetitie, insomnia, usually go away in few weeks. 4. Can lead to slow down of growth; tho children eventually catch up 5. Strattera was the first nonstimulant drug used for ADHD. It is a SNRI (selective norepinephrine). Not sure how it works—norepine may enhance ability to regulate attention and impulses Strattera isn’t as effective as Ritalin 6. Psych interventions still needed to help develop adaptive behaviors Behavior modification programs to train parents and teachers to use contingent reinforcement for good behaviors combined with cognitive modification CBT helps them learn to stop and think before acting out aggressive impulses •Evidence backs up effectiveness although not as strong as drugs

Answer 24

disruptive antisocial behavior purposefully engage in antisocial behavior that violates social norms; intentionally aggressive; bullying and threatening; no remorse for others; lie and destroy property - Common and affects 12% males and 7%females (9.5% overall) - in boys it is exhibited as stealing, fighting, vandalizing where girls its is lying, truancy, running away, sub abuse, prostitution - ADHD, major depression, and sub abuse disorders • Average onset of CD is 11.6 years (although can happen earlier or later) Typically chronic and persistent

Answer 25

excessive oppositionality or tendencies to refuse requests from parents or others; Overly negativistic or oppositional; deliberately annoy others; easily angered or lost temper; feel resentful toward others or act in spiteful ways involves more nondeliquent forms of conduct disturbance. • Typically develops earlier than CD and may lead to CD later (only minority do) • Begins before 8 and develops gradually typically starting at home • One of the most common diagnoses and affects 1-11% of children • More in boys than girls before 12 but unsure in adolescents

Answer 26

•Both often show biased ways of processing social info (wrongly assuming that others did them wrong)and Quick to blame others • Cognitive deficits may include inability to generate alternative nonviolent responses to social conflicts 1. Behaviorally based parent-training programs often used to help parents reduce kid’s aggressive disruptive and oppositional behavior and increase adaptive behaviors. 2. Treatment goals: helping parents use more consistent rules and effective discipline techs, increase positive reinforcement, increase positive interactions with child 3. Anger control training also used 4. CD children Sometimes placed in residential programs that establish strict rules with clear rewards and mild punishments 5. CBT also used to teach aggressive children to re-conceptualize social provocations as problems to be solved rather than as challenges to use violence; use calming self-talk to inhibit impulsive behavior

Answer 27

•Casual factors unclear Maybe expression of underlying termperamnet described as difficult child type; Some believe its an unresolved parent child conflict or overly strict parental control • Psychodynamic theorists see as sign of fixtation at anal stage when conflicts happen over toilet training –later expressed as rebellion • Learning theorists see oppositional behaviors arising form parental use of bad reinforcements. Parents may reinforce opposition by giving in • Genes may contribute

Answer 28

1. Family factors implicated and often develops in context of negative parenting such as not postiviely reinforcing or praising child and use of harsh discipline. Family interactions often negative. Family members may reciprocate demanding and noncompliant behavior of children by yelling or physically threatening. Parent modeling of antisocial behaviors CD often develops in context of parental distress such as marital conflict 2. Genetic contribution interacting with enviro (physical abuse and harsh parenting increases risk only with certain gene profile)

Answer 29

* Children may suffer from phobic, GAD, OCD and PTSD * Anxiety disorders are most common type of psych disorders affecting adolescents * Anxiety probs often go unrecognized and undertreated bc hard to distinguish normal developmentally appropriate fears; also bc many report physical symptoms

Answer 30

extreme fear of separation from parents or other caretaker • Affects 4 to 5% of children and is most common anxiety disorder affecting children under age of 12 • Occurs more in girls and often assoc with school refusal • Freq occurs with social anxiety • Not a school phobia bc it can exist in preschool ages • School refusal in adolscesnts often linked to academic or social concerns so not SAD • Mary Ainsworth proposed development of attachment behaviors and found that separation anxiety normally begins in first year Sense of security provided by bond to parents encourages child to explore Strong attachment to mother help buffer effects of later stress. Insecure attacments lead to disorders in face of negative life events

Answer 31

* almost same as ones in adults 1. propose that childhood anxiety symbolize unconscious conflicts 2. say its cognitive biases—children tend to show cognitive distortions found in adults with anxiety; engage in neg self-talk; negative expectations heighten anxiety 3. suggests anxiety comes from fear of rejection or failure that generalize to situations 4. Genetic factors also contribute including specific phobias

Answer 32

1. CBT techs for adults like grad expo to phobic stimuli and relaxation training can benefit 2. Cognitive techs can help them identify anxiety generating thoughts and replace with calming alternative ones - CBT has shown good results for children and teens 3. Antideps: SSRIs work well 4. Study of 448 children with SAD, GAD or social phobia received CBT, meds, or both –greatest was both

Answer 33

* Major depression is most common mood disorder affecting about 5% of children 5-12.9 years old; Affects 20% of adolescents from 13-17 * Even can occur among preschoolers, although rare * Girls more likely to have first MD episode during childhood or adolescence but no gender diff in likelihood of having recurrent episode; teen girls tend to show more depress symptoms than boys * Same symptoms as adults although usually don’t have increased appetitie and weight gain * Can be masked by conduct, academic probems, physical complaints, and hyperactivity * May not report feeling sad; only bored or irritable –part of problem is cognitive development and being unable to recognizing internal feelings until about 7 * Becoming isolated form friends in late childhood predicts development of depression in early adolescenece * Major depressive episodes in children can last upward of year or longer yet childhood depression rearely occurs alone—anxiety, CD or ODD often occur and eating disorders

Answer 34

•Frequently related to family problems * Negative thinking styles being to enter the picture as children mature and cognitive abilities develop; distorted patterns include: Expecting the worst, catastrophizing consequences of neg events, blaming themselves for diappointments, minimizing accomplishments * Distorted thinking also in Chines children in Hong Kong school who minimized accomplishments and blew failures out of porpertion

Answer 35

1. Evidence supports CBT—75% of depressed youths no longer showed signs CBT typically involves social skills training, problem solving training, increasing rewarding activities, and countering depressive thoughts. 2. Family therapy may also help 3. Lithium can be used to treat bipolar but questions about effectiveness with children 4. SSRI (Prozac) show benefits in treating depression

Answer 36

- Is rare in children and early adolescence but becomes common in late adolescence - Among college students it’s the 2nd cuase of death - In 15-24 year old age group, suicide is the 3rd most common cause of death; Approx 1 per 10,000 (.01%) in this age range commits suicide

Answer 37

1. Gender- Girls 3x more likely to attempt however boys more likely to succeed 2. Geography- teens in less pop areas more likely to commit; teens in rural western regions of US have highest suicide rate 3. Ethnicity- rates for blacks, Asians, Hispaniacs are about 30%to 60% lower that white—yet highest rates in US among Native Americans 4. Depression and hoplessness 5. Previous suicidal behavior- one quarter of teens who attempt are repeaters; more than 80% who took life have talked about it 6. Prior sexual abuse- Australian sample childhood history of abuse gave rates more than 10x higher than national average; One third who have been abused attempted suicide 7. Family problems- Instability and conflict, loss of parent, poor communication 8. Stressful life events- Many suicides in you ppl preceded by traumatic stressful event such as breaking up or taking test 9. Substance abuse- in teen or family 10. Social contagion- romanticize suicide as heroic

Answer 38

failure to control urination after one has reached normal age for attaining control. • Bed-wetting most common and usually occurs during deepest sleep and may reflect immature nervous system - Child must be at least 5 years of age or at an equivalent level of development and meet following criteria: Repeatedly wet bed or clothes (intentionally or involuntarily), wetting occurs at least twice a week for three months Or cause significant distress, no medical organic cause - Affects 7 million children age 6 and over in US; more common in boys; 5-10% of children meet diagnostic criteria at age 5 1. Primary enuresis is the most prevalent form of the disorder; characterizes children with persistent bed-wetting who have never established urinary control thru night. Due to maturational delays with genetic underpinnings 2. Secondary enuresis is not genetically influences and characterizes those who occasionally wet bed after developing urinary control

Answer 39

1. represents the expression of hostility toward parents because of harsh toilet training. May represent response to birth of sibling or some others stressor in life. 2. point out that it occurs most commonly in children whose parents trained too early; early failures may have connected anxiety with efforts to control the bladder. Conditioned anxiety then induces rather than curbs urination 3. Genes implicated regulate development of motor control over eliminatory reflexes by cerebral cortex

Answer 40

•Behavioral methods shown to be helpful including waking up child when bladder is full (urine alarm – tech developed by O. Hobart Mowrer in 1930s) Urine alarm classical conditioning: Tension in bladder paired with stimulus (alarm) that wake them up when they wet bed. Bladder tension (CS) elicits waking response (CR) that is elicited by the alarm (UCS) Urine alarm has highest cure rates and lowest relapse rates •Luvox—an SSRI also used

Answer 41

lack of control over bowl movements that is not caused by organic problem in a child who is at least 4; voluntary or involuntary; When soiling is involuntary often involves constipation, impaction, or retention that results in subsequent overflow • 1% of 5 year old have this; Most common in boys - inconsistent toilet training, psychosocial stressors like new sibling.

Chapter 13 Flashcards

(65 cards)