Disorders of Childhood 12202 Pervasive Developmental Disorders Severe

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Disorders of Childhood 12/2/02

Disorders of Childhood 12/2/02

Pervasive Developmental Disorders • Severe childhood disorders characterized by impairment in verbal and non-verbal

Pervasive Developmental Disorders • Severe childhood disorders characterized by impairment in verbal and non-verbal communication and social interaction • Abnormalities occur in the developmental process itself • Examples: Autistic Disorder, Asperger’s Disorder

Autistic Disorder: 3 main areas of impairment • SOCIAL: “autistic aloneness” • Lack of

Autistic Disorder: 3 main areas of impairment • SOCIAL: “autistic aloneness” • Lack of interest in interacting with others (e. g. , through eye contact, smiling, gesturing, shared attention, playing, making friendships) • Strong attachments to objects, but not people • May not understand that other people have thoughts and feelings

Autistic Disorder: 3 main areas of impairment • COMMUNICATION (verbal and nonverbal): • Half

Autistic Disorder: 3 main areas of impairment • COMMUNICATION (verbal and nonverbal): • Half of autistic children do not develop language • Many have speech oddities (e. g. , echolalia = echoing the words of others) • Pronoun reversals: using “he” or “you” instead of “I”

Autistic Disorder: 3 main areas of impairment • ACTIVITIES / INTERESTS: • Repetitive/self-stimulatory behaviors(e.

Autistic Disorder: 3 main areas of impairment • ACTIVITIES / INTERESTS: • Repetitive/self-stimulatory behaviors(e. g. , spinning objects, hand flapping, whirling around) • Lack of imaginative behavior • Obsessive-compulsive / ritualistic behaviors (e. g. , preoccupation with schedules, routines, and sameness; lining up objects)

Autistic Disorder • A majority of individuals with autism have mental retardation (i. e.

Autistic Disorder • A majority of individuals with autism have mental retardation (i. e. , IQ score < 70) • Contemporary theories stress a biological etiology of autism, involving genetic factors and/or organic central nervous system impairment

Asperger’s Disorder • Milder / higher-functioning form of autism characterized by severe impairments in

Asperger’s Disorder • Milder / higher-functioning form of autism characterized by severe impairments in the SOCIAL domain, some impairment in the ACTIVITIES/INTERESTS domain, and no significant delays in COMMUNICATION and cognitive development

Disruptive Behavior Disorders • Characterized by undercontrolled, or externalizing behavior (i. e. , “acting

Disruptive Behavior Disorders • Characterized by undercontrolled, or externalizing behavior (i. e. , “acting out”; socially disruptive behavior that is inappropriate given the age of the child and/or setting of the behavior) • Behavior is typically distressing and/or annoying to those in child’s social environment • Examples: ADHD, ODD, Conduct Disorder

Attention Deficit / Hyperactivity Disorder (ADHD) • Involves attentional problems (e. g. , distractibility,

Attention Deficit / Hyperactivity Disorder (ADHD) • Involves attentional problems (e. g. , distractibility, inattention, trouble completing tasks) and/or hyperactivity (e. g. , impulsivity, high motor activity, interrupting) • Symptoms occur before age 7, and in at least 2 settings

ADHD • Research on the etiology of ADHD implicates biological, genetic, and psychological factors

ADHD • Research on the etiology of ADHD implicates biological, genetic, and psychological factors • A majority of kids with ADHD respond positively to stimulant medications; however, the benefits are only short-term. Cognitive-behavioral parenting and selfcontrol therapies are important for longterm benefits.

Oppositional Defiant Disorder (ODD) • Involves noncompliance, hostility, losing temper easily, arguing, irritability, deliberately

Oppositional Defiant Disorder (ODD) • Involves noncompliance, hostility, losing temper easily, arguing, irritability, deliberately annoying or blaming others • High comorbidity with ADHD • May be a precursor to Conduct Disorder

Conduct Disorder (CD) • Involves antisocial behaviors that violate others’ rights (e. g. ,

Conduct Disorder (CD) • Involves antisocial behaviors that violate others’ rights (e. g. , lying, stealing, fighting, bullying, truancy, cruelty to people or animals, criminal behaviors) • Prognosis for child-onset CD is worse than for adolescent-onset CD; worse for aggressive children

Anxiety Disorders • Characterized by overcontrolled, or internalizing behavior (i. e. , fears, worries,

Anxiety Disorders • Characterized by overcontrolled, or internalizing behavior (i. e. , fears, worries, shyness, nervousness, apprehensiveness) • Example: Separation Anxiety Disorder

Separation Anxiety Disorder • Involves excessive anxiety about separating from parents or home (e.

Separation Anxiety Disorder • Involves excessive anxiety about separating from parents or home (e. g. , fears about harm coming to parents, avoidance of being alone, distress and physical complaints when separation is anticipated; school phobia = refusal to go to school)

Tic Disorders • Tics are involuntary and repetitive movements or vocalizations • Motor tics

Tic Disorders • Tics are involuntary and repetitive movements or vocalizations • Motor tics often involve the face/head (e. g. , eye blinking, grimacing, head jerking), but may also involve limbs (e. g. , flexing elbows, tapping foot) • Vocal tics: throat clearing, coughing, sniffing, grunting, barking sounds

Tourette’s Syndrome • Involves multiple motor and vocal tics • Bodily sensations/urges frequently precede

Tourette’s Syndrome • Involves multiple motor and vocal tics • Bodily sensations/urges frequently precede tics • Coprolalia (compulsion to shout obscenities) is rare • High comorbidity with Obsessive. Compulsive Disorder and/or ADHD • Stimulant medication can bring on tics