Child Psychopathology

Learning Disorders and Peers

Attention Disorders

Diagnostic Criteria for ADHD

Assessment and theories

Reading: Chapter 5

Learning Disorders and Peer Relations

Danielle Gervais

How do learning disorders effect peer relations?

• The term “children with learning disorders” refers broadly to children who are not performing at age expected academic level.

• It is estimated that 75% of children with learning disorders have some kind of social deficit.

• Children often experience rejection and are victimized by peers. This can lead to loneliness and possibly depression. Peer relations are vital to a child’s development

Social Deficits

• Reduced social and communicative competence

• Fewer initiated social interactions

• Less cooperative

• Less tactful in social situations

• Less developed concept of conflict

Social Deficits

• Adjustment difficulties

• Immaturities

• Difficulty distinguishing subtle cues

• Difficulty processing facial expressions and other social information

• If children with learning disorders are rejected by peers then they do not get the opportunity to practice social interactions.

• Friendships give these children a medium to learn skills and develop

Bullying and Rejection

• bullying can be direct (name calling) or indirect (gossiping)

• bullying may increase the child’s experience of emotional and social problems

• isolation only limits their opportunities to learn and practice skills

Bullying and Rejection

• Approximately 30% of children with learning disorders are rejected by peers in comparison to 8-16% of normal achieving children

• Learning disorders are often associated as a deficit of the individual and they are seen as abnormal which will reduce social acceptance.

• Children are often left vulnerable due to their complete lack of social networks and are also at risk for being victims of bullying and violence

Types of Peer Relationships

• More negative nominations than normal achieving peers

• Peer relationships are less stable

• More relationships with younger peers

• More friends who also have learning disorders

• Boys with learning disorders are more likely to have friends outside of school

Implications

• Children are at a much greater risk for experiencing loneliness and possibly depression and anxiety

• Children with learning disorders have a lower sense of coherence and a lower self esteem than their peers

• At least one friend is an important provider of social support and learning and reduces loneliness

Attention Deficit Disorders

C ore S ym p tom s o f a tten tion a l p rob lem s

A g e A p p rop ria teIn a tten tion

H yp erac tivity Im p u ls ivity

S ym p tom sA tten tion d e fic its

Additional criteria for ADHD

• Excessive, longterm, pervasive behaviors

• Significant problems in multiple settings

• Rule out other accounts of behavior

• Onset before age 7 and go on for 6 months

• Age inappropriate and persistant

• DSM-IV describes predominantly inattentive (ADHD-PI), hyperactive/ impulsive (ADHD-HI), and combined types

Associated Characteristics

• Deficits in metacognition and executive function

• Difficulty applying intelligence and social skills to everyday situations

• Comorbid (~50%) learning disabilities

• Health problems (allergies, ears, sleep)

• Accident prone, clumsy, risky behaviors

• Interpersonal problems with family, teachers. peers

• Can lead to ODD, CD, anxiety, depression, Tourettes

Assessment of attentional problems

• Behavioral ratings– Multiple reporters and contexts (e.g., parents, teachers)– Hyperactivity, inattention, impulsivity

• Behavioral observations– In vivo (home, school) and in offic; What is “off task”; How do we

compare to others?– Recording devices (e.g., “wiggleometer”)

• Specific tasks– Matching familiar figures– Continuous Performance Task (CPT)

• Medical, family, school histories

The CPT: Measures of sustained attention and vigilence

AACZAAAZAAAABZAAAZABZAAAZ

O O O

C C C

A sequence of letters flash on a computer screen. Press the key when a “Z” follows an A, and at no other time. Scores: Omissions (O), Commissions (C)

Correct response: X X X

Prevalence

• 3-5% of school children

• more common in boys than girls

• more common in low SES groups

• found in all cultures

• 25 to 50% “grow out” of the problems or learn to cope with the symptoms

• school environment crucial: what are the attentional demands? How much structure?

What does not cause ADHD

Old misconceptions about the causes of ADHD include - artificial flavoring and food additives- sugar and caffeine- “bad parenting”- food allergies- fluorescent lighting- misalignment of the spine

These theories were easily accepted by society,although there was little scientific evidence to back them up.

ADHD may be related to underarousal

The brain with ADHD has much less activity (red/orange/white) than the brain without ADHD. It shows that people with ADHD do not have enough activity in their brain to focus on what they are doing or control their thoughts

Theories of ADHD

• Deficits in arousal; underarousal, therefore hyperactivity for self stimulation

• Motivation deficits; low sensitivity to rewards and punishments

• Deficits in self regulation, metacognition; thus poor maintenance of effort

• Deficits in behavioral inhibition

• Deficits in temporal processing and awareness; “do this for 10 minutes”

Medication as a Treatment

Erica Stowbridge