child psychopathology

Child Psychopathology

Different views of mental retardation

Developmental course and etiology

Issues in intervention

Reading for today: Chapter 9

Social Quiz

• Why do we have “unleaded” gasoline?• How did plumbing bring down the Roman Empire?• Why was the “Mad Hatter” mad?• Why is it frowned upon to consume large quantities

of alcohol when pregnant?• What color do we want newborn babies to be and

why?• Why does the dentist put an apron over your body

when X-raying your teeth?

History of assessment

• Binet & Simon hired to develop a test to determine if individuals could be educated

• Concept of “mental age” developed, which when expressed as a ratio MA/CA = IQ

• Test became widely used, revised at Stanford University, became “Stanford-Binet” Intelligence Test

• IQ designed to predict success in school

DSM-IV Criteria

• Significantly subaverage IQ (less than 70) • Concurrent deficits or impairments in

adaptive functioning• Characteristics evident prior to age 18• Ranges (and Educational Classifications):

– Mild: 50/55 to 70 (“Educable”)– Moderate: 35/40 to 50/55 (“Trainable”)– Severe: 20/25 to 35/40 (“Severe”)

Prevalence

• 1-3% of population, depending on cutoff used

• those with mild mental retardation are 85% of population, majority have idiopathic origin (cultural-familial)

• Those with organic MR are more likely to have genetic causes

• Slightly more males than females

• Low SES and minority groups at higher risk

Other characteristics

• Cultural-familial MR has global delays

• Organic MR has less sequential organized delays, medical problems such as heart malformation

• Mild MR may be associated with failure, lowering goals, and minimal success (learned helplessness)

• Comorbid developmental disabilities including epilepsy, speech, language, behavior, sensory

• attachments develop, but signals, proximity seeking, and even distress may be lower

• 10-40% have emotional or behavior problems (e.g., pica)

Biological Causes

• Heritability of IQ = 50%; “Polygenes”

• Chromosomal anomalies most common cause of more severe forms– Meiosis: Downs, Turners; Crossover

• Fragile X syndrome (inherited)

• Metabolism problems (PKU)

• Neurobiology: malnutrition, teratogens (lead, mercury), fetal alcohol, perinatal stress leading to physical damage (e.g., IVH)

Social and psychological causes

• Deprived physical care

• Poor emotional care

• Poor social stimulation

• Victor D’Avyron (feral child) was MR by environmental causes

• These interact with biology, e.g., poor housing may have paint chips, chips may have leaded paint, children may eat paint chips as they do not have toys to play with

Interventions for mental retardation

• Medications rarely, if ever, used• Prenatal & postnatal education & screening

– Vitamins, alcohol, PKU

• Community-based placements/ living situations: What are you aware of?

• Answers: Residential, Community-based, supported work environment, mainstreaming

• Variety of psychosocial interventions

Psychosocial interventions

• infant stimulation, developmental surveillance

• behavioral approaches include shaping, modeling, graduated guidance, both +/- beh.

• Self-regulation and metacognitive training

• Camp, other special programs (e.g., SMILE)

• family support: coping with parenting demands, stress

Stephanie Rogers