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1

Intellectual-Mental Retardation

Symptoms

Population

  • Symptoms
    • Significant sub-average on general intellectual functioning
    • Concurrent deficits in adaptive behavior
  • Onset <18 YO
  • 3% of school-age children
  • Boys > girls 

2

Intellectual-Mental Retardation

Causes

Treatment

  • Causes
    • Lack of stimulation
    • Inadequate nutrition
    • Exposure to toxins (lead)
    • Chromosomal or metabolic abnormality (25%)
      • Down Syndrome, Fragile X
      • Phenylketonuria
    • Pregnancy trauma
      • Drugs, radiation, toxemia, alcohol
      • Infection (German measles)
    • Infections (encephalitis)
  • Treatment
    • Parental support/guidance
    • Special programs 

3

Developmental: Pervasive Development Disorders

Symptoms

Types (2)

  • Distortions in timing, rate, sequence of many basic psychological functions involved in the development of social skills & language 
  • Types
    • Autism
    • Asperger's Disorder

4

Autism

Characteristics

Causes

  • Characteristics
    • Impaired non-verbal behaviors (eye contact, gestures)
    • Failure to develop age appropriate peer relations
    • Lack of social reciprocity
    • Delay or lack of spoken language
    • Lack of make-believe play
    • Restricted stereotyped patterns of behavior
  • Causes: genetics, infections

5

Asperger's Disorder

Characteristics

Treatment 

  • Characteristics
    • Impaired social interaction
    • Restricted, stereotyped patterns of behavior
  • Treatment
    • Parental support
    • Special programs 

6

Specific Developmental Disorders (Learning Disorders)

Symptoms

Population

Treatment 

  • Symptoms
    • Delay in rate of learning a specific function so that children behave as though they are passing through an earlier normal developmental stage substantially below expected for chronologic age
    • May be one or more in areas of arithmetic, expressive writing, reading, articulation, expressive language, receptive language, coordination
  • 10% of children
  • Boys > girls
  • Treatment: remedial work 

7

Unclassified Speech Disfluencies

Symptoms

Cause 

Treatment 

  • Symptoms
    • Stuttering (sound & syllable repetition)
    • 3-4 YO
  • Cause: developmental
  • Treatment
    • Ignore
    • 1% persists & require speech therapy 

8

Behavioral: Oppositional Defiant Disorder

Symptoms

Pattern of negativistic, hostile & defiant behavior

(at least 6 mo)

  •  + Signs
    • Often loses temper
    • Often argues w/ adults
    • Defied or refuses to comply
    • Deliberately annoys
    • Blames others
    • Resentful, spiteful & vindictive 

9

Behavioral: Oppositional Defiant Disorder 

Population

Cause

Treatment 

  • Children & adolescents
  • Boys > girls
  • Cause
    • Environmental (parents over-assert control)
  • Treatment
    • Parent training program
    • Psychotherapy
    • Social skills training
    • Cognitive behavior therapy 

10

What are the symptoms of Attention Deficit Disorder?

  • Fidgety or restless
  • Unable to sit for a long time
  • Always on the go
  • Easily distracted
  • Can’t concentrate well on work
  • Impulsively acting before thinking
  • Forgetting what was said or not listening
  • Difficulty finishing work on time
  • Often losing personal things
  • Difficulty waiting in lines or jumping ahead of others 

11

Attention Deficit Disorder

Population

Causes

  • 5% of children
  • Many times children w/ ADD have other learning problems
  • Often starts in kindergarten or 1st grade & continues for years
  • Causes
    • Children are born w/ ADD & can’t control symptoms easily
    • Often runs in families (hereditary)
    • Not caused by allergies or too much sugar 

12

How is Attention Deficit Disorder treated?

What happens if ADD is untreated?

  • Medications
    • Ritalin (methylphenidate), Metadate, Concerta, Dexedrine (dextroamphetamine), Adderall, Cylert (pernoline), Pamelor (nortriptyline), Norpramin (desipramine), Catapres (clonidine), Strattera
  • Psychotherapies
    • Behavioral therapy
    • Parent management training
    • Family therapy
  • Educational
    • Special education classes
  • Untreated
    • Can lead to difficulty w/ learning, classroom behavior, making friends, following rules at home
    • Many children don’t outgrow ADD when they get older & benefit from long-term medication 

13

What are the symptoms of Conduct Disorder?

  • Frequent lying, stealing, truancy
  • Running away from home
  • Frequent fighting/bullying
  • Property destruction
  • Fire-setting
  • Being mean to animals or people
  • Breaking & entering into someone’s house or car 

14

What is the population of Conduct Disorder?

  • Older children & teenagers
  • Boys > girls
  • Most children w/ CD have other problems
    • ADD
    • Depression
    • Alcohol abuse
    • Family problems 

15

What are the causes of Conduct Disorder?

What are teenagers at risk of?

  • Causes
    • Exact cause unknown
    • Many factors may contribute to behavioral problems
      • Drugs
      • Family problems
      • Low self-esteem
      • Physical abuse
      • Impulsivity
  • Teenagers at risk…..
    • Dropping out of school
    • Being seriously injured in flights
    • Getting hooked on street drugs
    • Trouble w/ the police 

16

What is the treatment for Conduct Disorder?

What happens if untreated?

Without treatment, many children/teenagers continue to have similar problems as adults (may become imprisoned)

  • Medication
    • Meds for depression
    • Lithium for aggressive & impulsive behavior
  • Psychotherapy
    • Behavioral therapy
    • Group therapy
    • Family therapy
  • Special programs
    • Probation programs
    • Residential programs 

17

What are the symptoms of Generalized Anxiety Disorder (GAD)?

  • constant worrying
  • unable to relax
  • aches & pains (headaches, stomachaches)
  • self-consciousness
  • nightmares about the same things that cause worry 

18

What are the symptoms of Separation Anxiety Disorder (SAD)?

  • unable to leave parents b/c of worries that something bad may happen to them
  • fear of going to sleep
  • reluctant to go to school
  • fear of being kidnapped 

19

GAD & SAD

Population

Causes

  • Children & teenagers
    • SAD = younger children (7-10 YO)
    • GAD = teenagers (12-15 YO)
  • Causes
    • Exact cause unknown
    • Tendency to develop severe anxiety runs in some families (hereditary)
    • Stress can play a role (death, parent’s illness, another medical problem, learning problems)

20

How are GAD & SAD treated?

  • Medications
    • Tofranil (imipramine)
    • Xanax (alpraxolam)
    • BuSpar (Buspirone)
    • Paxil (paroxetine)
    • Zoloft (sertraline)
  • Psychotherapy
    • Behavioral therapy
    • Cognitive behavioral therapy
    • Family therapy 

21

What are the symptoms of Obsessive Compulsive Disorder (OCD)?

  • Obsessions – thoughts or images (memories/pictures) that keep coming into one’s mind even though the person wants the thoughts to stop
  • Compulsions – actions & behaviors that one feels need to be done over & over again; one can’t stop doing them
  • Worries & anxiety occur if one tries to stop the obsessions or compulsions 

22

Obsessive Compulsive Disorder

Population

Causes

  • Children & teenagers (1%)
  • Causes
    • Exact cause unknown
    • Some parts in the brain don’t seem to work well in OCT (basal ganglia) post strep infection 

23

How is OCD treated?

  • Medication
    • Anafranil (clomipramine)
    • Prozac (fluoxetine)
    • Zoloft (sertraline)
    • Luvox (fluvoxamine)
  • Psychotherapy
    • Behavioral therapy
    • Cognitive behavioral therapy 

24

What are the symptoms of Panic Disorder?

Periods of extreme anxiety or fear that begin suddenly (min to hrs)

  • Shortness of breath
  • Feeling dizzy or faint
  • Racing heartbeat
  • Feeling shaky
  • Stomach upset
  • Sweating
  • Thinking one may lose control
  • Big fear of getting another period of anxiety 

25

What is the typical population of Panic Disorder?

  • Rare in young children
  • More frequent in teenagers
  • Tendency to have PD runs in families (hereditary)

26

What causes Panic Disorder?

  • In a very frightening situation, the symptoms of panic attack (extreme anxiety or fear) would be normal or expected
  • In people w/ PD, the part of the brain that controls anxiety (locus coeruleus) reacts for no apparent reason, giving the person extreme anxiety even though he/she is not in a frightening situation 

27

How is Panic Disorder treated?

  • Medication
    • Tofranil (imipramine)
    • Xanax (alprazolam)
    • Paxil (paroretine)
  • Psychotherapy
    • Cognitive behavioral therapy 

28

What are the symptoms of Post-Traumatic Stress Disorder (PTSD)?

  • Nightmares or flashbacks (re-experiencing the trauma in one’s mind, along w/ a sudden feeling of fear that the trauma is happening again)
  • Avoid situations that bring the trauma back into memory
  • Difficulty remembering the trauma
  • Losing interest in things
  • Hopelessness (the future doesn’t look good)
  • Constant fear about not being safe
  • Severe anxiety & depression 

29

People w/ PTSD have had a very bad experience (physically or sexually abused, natural disasters, seriously injured), which leads to intense & continuing feelings of _____& ________. 


PTSD may also be seen in ______ who have witnessed a serious accident or saw someone get badly injured


Anyone, of any age, who has lived through a traumatic event might show ______________. 

threat, helplessness 

children 

PTSD symptoms 

30

What are the causes of PTSD?

  • Trauma that caused PTSD is so intensely frightening that the fears & memories are present for a long time
  • It is almost as if some parts of the brain, such as the parts involved in remembering things, become over-charged & stay too active
  • It is not clear why some people who experience trauma get PTSD & why others don’t