Psychology 142b Exceptional Children: Behaviour Disorders Class Time: Tuesdays, 7-10 p.m. Lecturer: Dr. Anne Krupka, Rm. 6409, SSC Office hours: Tuesdays, 5:00-6:00 p.m. TA: Mor Barzel E-mail: mbarzel@uwo.ca Office hours: Wednesdays, 12 to 1 p.m.

Outline: Lecture 1, Jan. 7, 2003 Chapter 1 Course introduction Defining & identifying disordered behaviour How common are behaviour disorders? Risk and resilience Historical influences & current practice

Which Behaviour is Abnormal? A university student whose girlfriend decides to break up with him - he becomes depressed, can’t sleep, loses appetite, stops going to classes, stops taking showers, stays in his room all day. A girl who several times a week secretly eats a half gallon of ice cream, a bag of cookies, a large pizza, then goes to bathroom and vomits - otherwise she is a successful university student. A boy walking in the hallway singing an operatic aria and oblivious to the stares of other students.

Defining Disordered Behaviour What does it mean to be Abnormal? Deviation from the average Common assumption: deviation is negative or harmful Determining what is normal and abnormal is an arbitrary process

Defining Disordered Behaviour What is Psychopathology? Traditionally defined as a pattern of behavioral, cognitive, or physical symptoms, that is associated with one or more of: distress disability increased risk for further suffering or harm

What determines if behaviour is abnormal? 1. Sociocultural Norms subcultural norms situational norms gender norms change over time 2. Developmental age norms 3. Subjective feelings of others

Competence Must consider not only the degree of maladaptive behavior, but also children’s competence (the ability to adapt in the environment and achieve normal developmental milestones) Knowledge of developmental tasks is fundamental for determining if there are impairments in developmental progress See Table 1.1 for examples of developmental tasks

Identifying Abnormality Need to account for: chronological age cognitive development social development family context cultural context View behaviour in light of: age appropriateness frequency, intensity & duration shifts or changes Is there a mismatch between the behaviour and the environment?

Developmental Pathways Refers to the sequence and timing of behaviors, and the relationship between them over time Two types of developmental pathways: Multifinality: similar early experiences lead to different outcomes Equifinality: different factors lead to a similar outcome See Figure 1.1 in text

Developmental Pathways There are many contributors to disordered outcomes in each child. Contributors vary among children who have the disorder. Children express features of their disturbances in different ways. Pathways leading to particular disorders are numerous and interactive.

Developmental Course of a Disorder Transient developmental crises time-limited, grow out of it disorder improves on its own, usually as a result of development Persistent behavioural disorder problem continues Episodic difficulties recovers from the disorder but relapses into the disorder at a later time

Epidemiology: Prevalence - no. of cases at any one time Study of the occurrence & distribution of a disorder in the general population Prevalence - no. of cases at any one time Incidence - no. of new cases that appear within specific time period Prevalence of mental health problems is unevenly distributed but epidemiological studies are plagued by methodological problems are there different ages of onset? are there gender differences? do contextual factors play a role?

General Findings 1 in 5 children has a significant mental health problem; 1 in 10 meets criteria for a specific psychological disorder. Fewer than 10% of children with mental health problems receive proper service.

Ontario Child Health Study (Offard et al., 1989) In 1989, roughly 468,000 (18.1%) 4 to 16 year olds were suffering from some type of psychiatric disorder. Two thirds of these children suffered from more than one disorder. Only 16% received therapeutic intervention.

Canadian Institute of Child Health 24% of boys and 17% of girls have one or more emotional or behavioural disorder. 5% of male youth and 12% of female youth 12-19 years of age have experienced a major depressive episode. 23% of boys and 10% of girls get into many fights, and 16% of boys and 11% of girls are cruel or mean to others or bully others.

General Findings Research demonstrates that 18% to 20% (or 1.5 million) of Canadian children and youth are at specific risk for mental, emotional, and behavioural problems. (Canadian Institute of Child Health, 1994)

The Role of Contextual Factors Poverty and Socioeconomic Disadvantage associated with greater rates of learning impairments & academic problems, conduct problems, chronic illness, hyperactivity, and emotional disorders Challenges Facing Minority Children very few differences in rate of disorders emerge in relation to race or ethnicity, once effects of SES, age, sex, & referral status are controlled Child Maltreatment adverse effects are particularly devastating with regard to adjustment at school, with peers, and in future relationships

Risk & Resilience Risk Factors (Vulnerability factors) increase vulnerability to psychopathology can be in child, environment, or in both Resiliency [Protective Factors] helps child fight off or recover from negative experiences Protective Triad of Resources individual, familial, & extra-familial

Factors Involved in Risk & Resiliency RISK FACTORS Constitutional (internal, biological) Family (economics, abuse, conflict, family size) Emotional & Interpersonal Intellectual & Academic Environmental/Ecological Non-normative Stressful Life Events RESILIENCIES Individual - intellect, self-esteem, disposition, talents Family - relationship with parents, parenting style, economic advantages, network of extended family Extra-familial - bonds outside the family, school, involvement with pro-social organizations see Figure 1.2

Historical Views of Child Psychopathology The Emergence of Social Conscience Historically, children often ignored or subjected to harsh treatment because of belief that they would die, were possessed, or were simply owned by parents John Locke (17thC) and Jean-Marc Itard (19thC) advanced the belief that children should be treated with kindness and compassion

Historical Views [cont’d] Psychiatric Disorder and Mental Retardation In late 19thC, distinction made between individuals with MR (“imbeciles”) and those with psychiatric disorders (“lunatics”) Children with normal cognitive abilities but disturbing behavior said to be suffering from “moral insanity” Advances in medical science led to replacement of moral insanity view by the organic disease model

Historical Views [cont’d] Early Biological Attributions Early attempts at biological explanations for abnormal behavior were biased in favor of locating the cause of the problem within the individual The view of mental disorders as “diseases” led to eugenics and segregation

Historical Views [cont’d] Early Psychological Attributions Psychological influences did not emerge until early 1900’s Psychoanalytic theory linked mental disorders to childhood experiences- for the first time mental disorders not viewed as inevitable Behaviorism laid foundation for studying conditioning and elimination of problematic behavior

Historical Views [cont’d] Evolving Forms of Treatment Until late 1940’s, most children with intellectual or mental disorders were institutionalized From 1945-1965, number of children in institutions decreased while number of children in foster families and group homes increased In 1950’s and 1960’s, behavior therapy was the systematic approach to treatment