pervasive developmental disorders and mental retardation

Pervasive Developmental Disorders and Mental Retardation

Pervasive Developmental Disorders Conditions that become apparent early

in a child's development and affect most or all major developmental systems (social, cognitive, and language)

Autistic disorder Asperser's disorder Childhood disintegrative disorder Rett’s disorder

Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Autistic Disorder (Autism)

Characteristics Usually noticed by age of 3 years Marked difficulty in social

interaction and communication Restricted range of interests Strong desire for routine 75% are mentally retarded


Deficits in Autistic Disorder Theory of mind – Inability to infer the mental

states of others and to think abstractly Executive functions – Cognitive operations

involved in planning and flexibility of response Language – Many never speak and those who

do have stereotypical, repetitive, idiosyncratic speech patterns

Joint attention behaviors – Inability to maintain eye contact and social interaction


Risk factors for Autistic Disorder

Brain abnormalities Genetic factors Stress or injury may interact with genetic

vulnerability


Hereditary Factors in Autistic Disorder


Treatment of Autistic Disorder

Behavioral therapy – Increase skills, reduce problem behaviors

Learning techniques to take into account cognitive strengths and weaknesses

Medications to treat some symptoms


Asperger’s Disorder

May be a mild form of autism Impaired social interaction Restricted and repetitive patterns of behavior

and interests Does not include language delays seen in

autism Does not include impaired cognitive

development seen in autism Usually not diagnosed until school age


Childhood Disintegrative Disorder Normal development until age 3 or 4, followed

by loss of previously acquired Areas affected may include language, social, and

motor skills and bowel and bladder control Changes thought to be associated with

deterioration in the nervous system Very rare – One in one million births More common in boys than girls Causes unknown


Rett’s Disorder

Progressive disorder appearing after normal development, at about 5 months of age

Head stops increasing in size, so becomes smaller than normal (microcephaly)

Loss of previously acquired developmental skills (language, social, and motor)

Typically affects only girls Most become severely retarded No specific treatment


Diagnosis of Mental Retardation


Risk Factors for Mental Retardation Incidence

Approximately 1%, lower for more severe levels Genetically based

Dominant genes Tuberous sclerosis

Recessive genes Genetic mutation

Phenylketonuria (PKU) Chromosomal abnormalities

Fragile X syndrome Down syndrome

Polygenetic


Fragile X Chromosome


Other Risks for Mental Retardation The fetal environment

Maternal infections Chronic conditions Blood incompatibilities between mother and child Chemicals in fetal environment

Alcohol- Fetal alcohol syndrome Radiation Malnutrition Factors associated with age and stress of

mother


Other Risks for Mental Retardation Birth-related Problems

• Prematurity• Low birth weight• Lack of oxygen during birth process• Too-rapid progress through the birth canal

Damage to the nervous system after birth• Infections (encephalitis)• Extreme malnutrition• Blows to the head• Tumors• Accidental Oxygen deprivation (e.g.near drowning)• Environmental poisons (e.g. lead paint; mercury)


Other Risks for Mental Retardation Psychosocial disadvantage

Impoverished environment 30-50% of variation in intelligence test

scores can be attributed to environmental influences


Prevention of Mental Retardation Primary prevention

Amniocentesis and ultrasound scanning that may lead to termination of pregnancy

Public education about need for prenatal care, dangers of pregnant women drinking, and dangers of exposure of children to toxins such as lead or mercury


Secondary Prevention of Mental Retardation Secondary prevention

Early assessment and treatment, as in special diet for PKU children

Children at psychosocial risk Home-based interventions Special centers with trained staffs,

supplemented by home visits


Outcomes in Mental Retardation


School-based programs for Mental Retardation

Individuals with Disabilities Education Act (IDEA; U.S.) guarantees free public education for all disabled children, including the mentally retarded Least-restrictive placement Mainstreaming versus special placement


Vocational and Skills Training for Mentally Retarded Individuals Maximizing child’s skills and potential Job preparation – Sheltered workshops Learning how to deal with personal, financial,

and sexual exploitation Teach social skills, and assertiveness Training in appropriate sexual behavior


Other Psychological Problems Associated with Mental Retardation

Approximately 40% of mentally retarded meet criteria for some other disorder

Severely and profoundly retarded often have Autism or Pervasive Developmental Disorder

Many adolescents have temper tantrums, aggressive and destructive behavior, and alcohol and drug abuse

Children with Fragile-X syndrome often have ADHD Children and adults with Down syndrome often suffer

from Major Depression Up to 25% of adults may have a personality disorder


pervasive developmental disorders and mental retardation

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