Freud proposed that each child goes through the same five phases:
oral, anal, phallic, latency, and genital stages
___of all the children in the US have multiple fears, particularly concerning ____ (3)
Half
school, health, and personal safety
today's teens vs yesteryear teens
Today's teens feel less trusting, more sensitive, and more isolated from their families than adolescents of decades past
At least __ of all children and adolescents in North America experience a diagnosable psychological disorder
?
boys or girls more psych disorders? adults?
Boys > girls in who has more disorders, even though most of the adult psychological disorders are more common among women
Oppositional defiant disorder-
a childhood disorder in which children argue repeatedly with adults, lose their temper, and swear, feeling intense anger and resentment
They are hostile, disobedient, and display negative behaviors (like annoying people)
___% of children have oppositional defiant disorder
who gets it more: boys or girls?
8
Boys get it more before puberty, but then it's equal
Conduct disorder-
more severe than oppositional defiant disorder. A childhood disorder in which the child repeatedly violates the basic rights of others, displaying aggression and sometimes destroying others' property, stealing, or running away from home
Often commit crime
how do crimes change with age?
when does conduct disorder usually begin?
As kids with conduct disorder get older, their crimes may include rape and, in rare cases, homicide
Usually begins between 7 and 15
__% of children,___ of them boys, have conduct disorder
10
�
conduct disorder : course of mild and severe
Cases of mild conduct disorder may improve over time, but severe cases may continue into adulthood and develop into antisocial personality disorder or other psychological problems
The earlier the onset of conduct disorder, the worse the outcome
__% of people with conduct disorder first show a pattern of oppositional defiant disorder
80
Many clinical researchers believe that there are different kinds of conduct disorder.
Four kind of conduct disorder (for example):
Overt-destructive pattern- individuals display openly aggressive and confrontational behavior
Overt-nondestructive- dominated by openly offensive but nonconfrontational behaviors such as lying
Covert-destructive pattern- characterized by secretive destruc
how many kinds can you have?
1 or more
Others distinguish another pattern of conduct disorder called what? explain it. who has it more?
relational aggression- the individuals are socially isolated and primarily display social misdeeds such as slandering others, spreading rumors, and manipulating friendships.
girls
More than ? of boys and � of girls with conduct disorder also have ADHD
explain ADHD's relationship to the disorder.
if you have both?
ADHD is thought to precede and help cause the conduct disorder
Individuals with both disorders usually have more severe symptoms, commit higher numbers of aggressive acts, and more violence when they become adults
onduct disorder typically precedes onset of what?
depression
the combination places kids at high risk for suicide
____ may also accompany conduct problems, especially among girls
anxiety
___ of the juveniles who are arrested are recidivists - what does this mean?
�
they have records of previous arrests
DSM conduct disorder:
A receptive and percents pattern of behavior in which the basic rights of others or major age-appropriate societal norms and rules are violated, with at least three of the following present:
Frequent bullying
Frequent provoking physical fights
Use of dang
Many cases of conduct disorder are linked to ___ factors. other cases have been linked to what other kinds of things?
MORE often, conduct disorder has been tied to what?
Many cases of conduct disorder are linked to genetic and biological factors. Other cases have been linked to drug abuse, poverty, traumatic events, and exposure to violent peers or community violence
troubled parent-child relationships, inadequate parenti
Treatments for conduct disorder are generally most effective when begun when? why?
under the age of 13 because violent behaviors become locked in with age
success for treatment of conduct disorder
Various therapies only have modest success for treating conduct disorder
Parent-child interaction therapy
therapists teach parents to work with their child positively and to establish more appropriate expectations regarding the child. Also teach child better social skills
Video tape modeling
works toward same goal of parent-child interaction therapy but is for younger children and uses videos
Parent management training-
when children reach school age. Parents are taught more effective ways to deal with children. Parents in children meet together in behavior oriented family therapy. They focus on a problem area and parents are taught how to reward only good behaviors
Treaments for conduct disorder in school and residential treatment have showed some success
Treatment foster case
delinquent boys and girls are assigned a foster home in the community. The children, foster parents, and real parents all receive training and treatment interventions, including family therapy. Individual treatment for child, meetings with school, parole,
Institutionalization in juvenile training centers -effective?
has not been successful. They strengthen delinquent behaviors
______have been successful for conduct disorder
Cognitive-behavioral interventions that focus on the child
Problem-solving skills training
therapists combine modeling, practice, role-playing, and systematic rewards to hep teach children constructive thinking and positive social behaviors
Anger Coping and Coping Power Program
children participate in group sessions that teach them to manage their anger more effectively, view situations in perspective, solve problems, become aware of their emotions, build social skills, set goals, and handle peer pressure. Helps decrease aggress
what kind of drugs may be helpful in reducing aggressive behaviors at home and school ?
Stimulant drugs, such as Ritalin,
describe pevention programs for conduct disorder
Prevention programs for conduct disorder begin in the earliest stages of childhood, they try to change unfavorable social conditions before the disorder can develop. They offer training, recreation, poverty alleviation, and parenting skills
Bullying was a factor in ___ of school shootings since 1997. Shooters most often victims of bullying
30% of American kids have been involved in bullying
?
___% of American kids are abused every year
5-26
Child abuse
the nonaccidental use of excessive physical or psychological force from adult to child with intention of hurting child
Girls and boys are physically abused at the same rate. true/false
true
when are boys and girls most at risk for child abuse?
Boys most at risk below 12. Girls most at risk above 12
Abuse is more common among the poor
...
Effects of childhood abuse:
Lack of social acceptance
More medical illness and psychological disorders
More substance abuse
Greater risk of being criminally violent
? abuse their own children
Psychological abuse
may include severe rejection, excessive discipline, scapegoating, and ridicule, isolation, and refusal to provide help for a child with psychological problems
Psychological abuse probably accompanies all forms of physical abuse
Treatments for child abuse: (2)
Parents Anonymous
Focus is given to help teach children about it, including to report it
Attention-deficit/hyperactivity disorder
define
normally appears when?
a disorder marked by inability to focus attention or overactive and impulsive behavior, or both
Normally appears before a child starts school
__ of kids with ADHD have learning or communication problems
�
__% of schoolchildren have ADHD. ___% are boys
5
90
Progression of ADHD:
Usually persists through childhood
Most show a lessening in mid-adolescence
35-60% are still affected as adults, but symptoms of restlessness and overactivity are not usually as pronounced in adult cases
ADHD is thought to have several interacting causes :
biological
socio
three other explanations
Abnormal activity of dopamine and abnormalities in the frontal-stratal regions of the brain
Linked to high levels of stress and family dsyfunctioning
Three other explanations:
Caused by sugar or food additives
Caused from environmental toxins, such as lea
Most common approach to treating ADHD:
stimulant drugs, such as Ritalin
Ritalin.
Methyphenidate
Stimulants have quieting effects on -_% of kids with ADHD
80
See DSM ADHD on page 508
...
____ therapy is used widely for ADHD
give example
successful when?
Behavioral
Often use a token economy. Parents and teachers reward attentiveness
Especially successful when used with stimulant drugs
When kids have ADHD and conduct disorder- what is best treatment?
ADHD and anxiety-
With all three-
meds
meds or behavioral
both medication and behavioral
____% of all American boys take Ritalin for ADHD
10-12
In 2006 the FDA decided not to put a black box in Ritalin for heart attacks and psychotic symptoms
...
Af Am and Hispanic children with significant attention and activity problems are less likely than white American children to be assessed for ADHD, diagnosed with ADHD, and given treatment
difference in treatment for minority kids
what drugs do minorities
Minority kids are less likely to be treated with stimulant drugs or a combination of stimulant and behavioral therapy
Minorities that do get stimulant drugs are less likely to get the promising long-acting stimulant drugs that have recently be developed (
Children with elimination disorders do what?
frequently urinate or pass feces in their clothes, in bed, or on the floor
Enuresis
a childhood disorder marked by repeated bed-wetting or wetting of one's clothes (in some cases intentional). Must be older than 5
Enuresis may be triggered by what?
stressful events, such as entrance into school
Prevalence of enuresis:
10% of 5 year olds
3-5% of 10 year olds
1% of 15 year olds
is enuresis genetic?
Those with enuresis typically have a close relative who has had the same disorder
Research has not favored a particular explanation for enuresis:
psychodynamic
family theorists
behaviorists
biological
Psychodynamic - a symptoms of broader anxiety and underlying conflict
Family theorists- disturbed family interactions
Behaviorists- the result of improper, unrealistic, or coercive toilet training
Biological - small bladder capacity and inadequacy o the m
course of enuresis
Most cases of enuresis correct themselves without treatment
Bell-and-battery technique
a bell and battery are wired to a pad consisting of two metallic foil sheets, and the entire apparatus is placed under the child at bedtime. A single drop of urine will sound off the bell. Classical conditioning
Dry-bed training
children receive training in cleanliness and retention control, are awakened periodically during the night, practice going to the bathroom, and are appropriately rewarded
Encopresis
a childhood disorder characterized by repeated defecating in inappropriate places, such as one's clothing. Seldom occurs during sleep. Must be over 4
__% of 5 year olds have encopresis. It is more common in ___
1
boys
Encopresis stems from what?
stress, improper toilet training, constipation, or a combination of these
Most children with encopresis have a history of what?
constipation, which likely causes improper intestinal functioning
The most common and successful treatments of encopresis
behavioral and medical approaches or a combination of the two. Doctors try to eliminate constipation and increase regularity
Family therapy is also helpful
See table page 514
...
Two groups of disorder that emerge during childhood are likely to continue unchanged throughout life:
the pervasive developmental disorders and mental retardation
Pervasive developmental disorders
group of disorders marked by impaired social interactions, unusual communications, and inappropriate responses to stimuli in the environment. Includes autistic disorder, Asperger's disorder, Rett's disorder, and childhood disintegrative disorder
Pervasive developmental disorders are often referred to as what? why?
autistic-spectrum disorders because autism receive the most initial attention
`
Autistic disorder
pervasive developmental disorder marked by extreme unresponsiveness to others, poor communication skills, and highly repetitive and rigid behavior
who first recognized autism? when?
Leo Kanner first recognized autism in 1943
Autistic symptoms appear before age ____
3
prevalence of autism
what percent is boys?
what percent disabled in adulthood?
1 in 600 kids have autism
80% of all cases of autism are in boys
90% of people with autism remain extremely disabled into adulthood
Even the highest functioning adults with autism have a hard time doing what?
expressing closeness, empathy, and support in social interactions
Features of autism: central one, etc
The lack of responsiveness is the central feature of autism
Includes extreme aloofness, lack of interest in other people, lw empathy, and inability to share attention with others
Language and communication problems.
Also marked by limited imaginative or a
how many fail to speak?
half
Echolalia-
the exact echoing of phrases spoken by others
Delayed echolalia-
repeat a sentence days after hearing it
DSM autism page 516
...
Pronominal reversal
confusion of pronouns
perseveration of sameness
extreme upset if things are changed, such as when furniture is rearranged
`
Many with autism become attached to particular objects. They collect them, carry them, or play with them constantly
...
Self-stimulatory behaviors
include jumping, twisting hands and fingers, spinning, and making faces
Self-injurious behaviors
such as repeatedly lunging into wall
The symptoms of autism suggest what?
t a very disturbed and contradictory pattern of reactions to stimuli. Sometimes they are overstimulated and sometimes they are understimulated
Savant
a person with a major mental disorder or intellectual handicap who as some spectacular ability. Often they are remarkable in light of the handicap but they are also sometimes remarkable for anyone
A common savant skills is calendar calculating
Savant skills may be what two things? (causes)
special cognitive functioning, or they may just be consequences of deficit
Asperger's disorder/syndrome
a pervasive developmental disorder in which individuals display a profound social impairment yet maintain a relatively high level of cognitive functioning and language skills. Many want to fit in with others but can't
There are several subtypes of Asperger's that each has a particular set of symptoms
Three subtypes:
Rule boys - those with Asperger's who need to have a set of rules that govern their lives. Typically able to respect authority figures and structures
Logic boys- primary interested in the reasons behind rules. Want to know how the world works. Typically u
Asperger's disorders are more/less prevalent than autism
less
prevalence of autism. % that are bosy
1 in 250 people has Asperger's, 80% of them are boys
describe ideal treatment context for Aspergers
People with Asperger's must be treated young and can attain good education and even marriage
pervasive developmental disorders are caused by what?
similar things that cause autism.
____ and ____ are the primary causes of autism. what has been overemphasized?
Cognitive limitations and brain abnormalities are the primary causes of autism. Sociocultural has been overemphasized
Sociocultural causes
At first, people thought that family dysfunction and social stress were the primary causes of autism
Personalty characteristics of parents were thought to be intelligent but cold - refrigerator parents
Sociocultural explanations are not really right
Psychological causes
Some think that people with autism have a central perceptual or cognitive disturbance
They failed to develop a theory of mind- awareness that other people base their behaviors on their own beliefs, intentions, and other mental states, not on information t
Biological causes
Genetics and chromosomal abnormalities are thought to be causes of autism
Prenatal difficulties or birth complications are also linked to autism
Higher chances if mother had rubella during pregnancy, was exposed to toxic chemicals before or during pregnan
Biological abnormalities may also cause autism
Cerebellum- an area of the brain that coordinates movement int eh body and perhaps helps control a person's ability to shift attention rapidly (problem in autism?)
There is abnormal development of cerebellum in people with autism
Many children with autism
what can treatment for autism do? which therapies are helpful? (4)
Treatment can help people with autism adapt to environment but nothing can totally reverse it
Treatments that help are behavioral therapy, communication therapy, parent training, and community integration. Psychotropic drugs and vitamins have helped when
behavioral therapy
Therapists use mostly modeling and operant conditioning to teach autistic people new, appropriate behaviors, including speech, social skills, classroom skills, and self-help skills, while reducing dysfunctional ones
Longitudinal study of behavioral therapy from 3-7.
Treatment group did better in school and scored higher on intelligence tests. Many were able to be in regular classrooms
what is preferred treatment for autism?
Because of this, many now consider behavioral treatment to be the preferred treatment for autism
Learning Experiences...An Alternative Program (LEAP)
A behavioral treatment program for preschoolers with autism. 4 autistic children are placed in a classroom with 10 normal children. The normal kids use modeling and operant conditioning to teach the autistic kids. Great improvement
Therapies for people with autism are most beneficial when they are started when?
early in life
The Disabilities Education Act
lists autism as one of the ten disorders for which school districts must provide a free education until the age of 22
who provides care of autism? at what ages?
Services are provided by education, health, or social service agencies until 3 and then schools take over
The most fortunate kids are sent to special skills with highly trained teachers. Some are integrated into the normal classroom
Aspergers's treatment in schools
Once diagnosed, kids with Asperger's are normally assigned to special programs in their school or at special schools, in which they receive a combination of educational and cognitive-behavioral therapy
Cognitive social integration therapy
children are taught to be more flexible with regard to social rules, problem solving, and behavioral choices. Uses role playing, group sessions, and rehearsal
alternative ways of speaking if you have autism
Many children with autism that can't speak are taught alternative forms of communication, including sign language and simultaneous communication, which is a method of combing sign language and speech
Augmentative communication systems
a method for enhancing the communication skills of individuals with autism, mental retardation, or cerebral palsy by teaching them to point to pictures, symbols, letters, or words on a communication board or computer
Child-initiated interactions-
seeks to identify and use intrinsic reinforces rather than trivial ones like food or candy. Children choose items they like and then must ask questions about them to get them
can parents help as much as teachers? resources for parents
The behavioral gains produced by trained parents are equal to or greater than those by trained teachers.
Parents receive behavioral training and instruction manuals. Individual therapy and support groups are also available
where can teens and adults with autism go? (2)
Group homes and sheltered workshops
Developmental disability =
less stigmatizing term for mental retardation
_/100 people are mentally retarded. __ of them are male and the vast majority are considered mildly retarded
3
?
Mental retardation
a disorder marked by intellectual functioning and adaptive behavior that are well below average
IQ of 70 or below
Symptoms must appear before 18
Intelligence quotient (IQ)
a score derived from intelligence tests that theoretically represents a person's overall intellectual capacity
Correlating between IQ and school performance:
.5
People in middle and upper classes have an advantage on IQ tests...why?
because they are familiar with question types and words used
Several scales have been developed to assess adaptive behavior, such as ___ (3)
the Vineland and AAMR adaptive behavior scales and Scales of Independent Behavior Revised
The most common characteristic of mental retardation
that the person learns slowly
DSM-IV-TR describes four levels of mental retardation
mild (IQ 50-70), moderate (35-49), severe (20-34), and profound (below 20)
The American Association of Mental Retardation prefers to distinguish different kinds of retardation according to what?
the level of support the person needs in various aspects of their life - intermittent, limited, extensive, or pervasive
___% of people with mental retardation are in mild category
80-85
Midl retardation
IQ between 50 and 70. People can benefit from education and can support themselves as adults. "educably retarded"
Show rather typical language, social, and play skills, but need assistance when under stress
The intellectual performance of people with mild
Research has linked mild mental retardation to what two kinds of causes?
sociocultural and psychological causes, particularly poor and unstimulating environments, inadequate parent-child interactions, and insufficient learning experiences during early years
how can mothers affect intellectual potential? (3)
A mother's moderate drinking, drug use, or malnutrition during pregnancy may lower the child's intellectual potential
Moderate retardation- define and what percent?
10%
IQ between 35 and 49. People can learn to care for themselves and can benefit from vocational training. Clear deficits in language development and play skills in early years
Severe retardation-define and what percetn
3-4%
IQ between 20 and 34. Individuals require careful supervision and can learn to perform basic work in structured and sheltered settings. Basic motor and communication deficits during infancy
Many show signs of neurological dysfunction and have an incr
Profound retardation-define and percent
IQ below 20. Individuals need a very structured environment with close supervision. May learn or improve basic skills such as walking, some taking, and feeding themselves.
1-2%
Severe and profound mental retardation often appear as what?
part of larger syndromes that include severe physical handicaps
Researchers have identified _____ (#)genetic causes of mental retardation, including chromosomal or metabolic disorders.
1,000
Down syndrome-define
prevalence if mother is over 35
the most common of the chromosomal disorders leading to mental retardation. Caused by an abnormality in the 21st chromosome.
People with Down syndrome have a small head, flat face, slanted eyes, high cheekbones, and protruding tongue. Often very affection
Amniocentesis
testing of amniotic fluid surrounding uterus in 4th month to identify Down syndrome and other chromosomal abnormalities
Several types of chromosomal abnormalities cause Down syndrome (3)
Most common - 94% - is trisomy 21- the individual has 3 free-floating 21st chromosomes instead of 2
Translocation- the person has two 21st chromosomes and a 3rd 21st chromosome fused with another chromosome
Mosaicism- rare. Cells with 2 and cells with 3 2
Most people with Down syndrome have and IQ in the range of what?
35-55
aging and Down syndrome
People with Down syndrome age early and some have dementia at 40
Fragile X syndrome
the second most common chromosomal cause of mental retardation
Children born with a fragile X chromosome - an X chromosome with a genetic abnormality that leaves it prone to breakage or loss - generally display midl to moderate degrees of intellectual dys
Metabolic disorder
the body's breakdown or production of chemicals is disturbed
The metabolic disorders that affect intelligence and development are usually caused by what?
a pairing of two defective recessive genes
Phenylketonuria (PKU)- define and prevalence
the most common metabolic disorder to cause mental retardation.
1/17,000 children
Can't break down amino acid phenylanine, which builds up and poisons system
Tay-Sachs disease- define and prevalence in Jews
a metabolic disorder resulting from a pairing of recessive genes. Progressively lose mental functioning, vision, and motor ability in the course of 2-4 years and eventually die.
1 in every 30 persons of Eastern Jewish ancestry carries the recessive gene f
Cretinism
when a mother has too little iodine in diet. Gives child an abnormal thyroid gland, slow development, mental retardation, and dwarflike appearance
Fetal alcohol syndrome can also cause retardation
Certain injuries and accidents before age 6 can lead to mental retardation, such as poisonings and excessive X rays
Rubella (German measles) and syphilis during pregnancy may also cause mental retardation
...
State school-
a state-supported institutions for people with mental retardation. Parents would send kids here as early as possible until recent decades
deinstitutionalization and mental retardation
In 60s and 70s the mentally retarded were also deinstitutionalized, but without adequate readiness
Reforms have led to the creation of small institutions and community residences
Normalization- define and where was it started?
the principle the institutions and community residences should expose people with mental retardation to living conditions and opportunities similar to those found in the rest of society. First started in Denmark and Sweden
The vasty majority of children with mental retardation today live where? where do adults live?
at home. Most spend adult lives in the family home or community residence
Special education
an approach to education in which the children are grouped together and given a specially designed education
Mainstreaming/inclusion
the placement of children with mental retardation in regular school classes
__% of people with mental retardation have a psychological disorder. Many are given psychotropic medications
25
Between __ and __ of people with mental retardation eventually marry
� and �
Mathematics disorder-
children who have markedly impaired mathematics skills
Disorder of written expression
make extreme and persistent errors in spelling, grammar, punctuation, and paragraph organization
Reading disorder/dyslexia
have great difficulty recognizing words and comprehending as they read
Phonological disorder-
consistently fail to make correct speech sounds at the right age
Learning, communication, and coordination problems are included in DSM because _____
of the additional problems they cause and their links to other psychological disorders