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

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

Risk factors for Autistic Disorder Brain abnormalities Genetic factors  Stress or injury may interact with genetic vulnerability Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Hereditary Factors in Autistic Disorder Abnormal Psychology, 11/e by Sarason & Sarason © 2005

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

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

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

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

Diagnosis of Mental Retardation Abnormal Psychology, 11/e by Sarason & Sarason © 2005

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

Fragile X Chromosome Abnormal Psychology, 11/e by Sarason & Sarason © 2005

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

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

Other Risks for Mental Retardation Psychosocial disadvantage Impoverished environment 30-50% of variation in intelligence test scores can be attributed to environmental influences Abnormal Psychology, 11/e by Sarason & Sarason © 2005

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

Secondary Prevention of Mental Retardation 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 Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Outcomes in Mental Retardation Abnormal Psychology, 11/e by Sarason & Sarason © 2005

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

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

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