Attention Deficit Hyperactivity Disorder Features Classification PPPPredominantly Inattentive PPPPredominantly Hyperactive-Impulsive CCCCombined

ADHD Gender Differences BBBBoys outnumber girls 4 to 1 Cultural Factors PPPProbability of diagnosis is greatest in the United States Toxins as Cause? AAAAllergens and food additives NOT related MMMMaternal smoking increases risk

ADHD: Biological Factors Genetic Factors AADHD seems to run in families TThree specific genes have been implicated Neurobiological Factors SSmaller brain volume IInactivity of the frontal cortex and basal ganglia AAbnormal frontal lobe development and functioning

Biological Treatment of ADHD Stimulant Medications RRRRitalin, Dexedrine, Adderall, others PPPParadoxical Effect RRRReduce the core symptoms of ADHD in 70% of cases IIIImprove compliance and decrease negative behaviors DDDDo not affect learning and academic performance RRRRelapse following discontinuation

Behavioral Treatment of ADHD Behavioral Treatment Behavioral Treatment  Increase appropriate behaviors and decrease inappropriate behaviors  May also involve parent training Combined Biopsychosocial Treatments Combined Biopsychosocial Treatments  Highly recommended  Generally superior to either tx alone

Other Disruptive Behavior Disorders Conduct Disorder Oppositional Defiant Disorder

Learning Disorders Academic Performance Lower than IQ Predicts Academic Performance Lower than IQ Predicts  Reading Disorder  Arithmetic Disorder  Disorder of Written Expression Disorder vs. Disability? Disorder vs. Disability?

Autism Spectrum Disorders Autistic Disorder SSSSocial and Communication Impairment RRRRestricted Behavior Asperger’s Disorder SSSSimilar to Austism without Communication Impairment

Additional Pervasive Developmental Disorders Rett’s Disorder Rett’s Disorder  Initial Normal Development  Increasing Mental Retardation Childhood Disintegrative Disorder Childhood Disintegrative Disorder  Regression in language and motor skills at 2 to 4 years

Treatment of Autism Spectrum Disorders Biological and medical treatments are unavailable Behavioral treatments SSkill building RReduction of problem behaviors TTarget communication and language problems AAddress socialization deficits EEarly intervention is critical Integrated treatments: The preferred model FFocus on children, their families, schools, and home

Mental Retardation Mild IIIIQ from to 70 ~~~~85% Moderate IIIIQ from to ~~~~10% Severe IIIIQ from to ~~~~3-4% Profound IIIIQ below ~~~~1-2%

Other Classification Systems American Association of Mental Retardation LLevels of assistance required Intermittent, limited, extensive, pervasive Classification of MR in educational systems EEducable (IQ of 50 to 70-75) TTrainable (IQ of 30 to 50) SSevere (IQ below 30)

Mental Retardation Biological Factors CCCChromosomal Down Syndrome, Fragile X Syndrome NNNNeurological Injury Prenatal – exposure to disease or a drug/toxin Perinatal – difficulties during labor Postnatal – head injury Cultural-Familial EEEEnvironmental Deprivation, Abuse CCCConsidered to be about 75% of Cases

Treatment of Mental Retardation Parallels treatment of pervasive developmental disorders Teach needed skills TTo foster productivity and independence EEducational and behavioral management LLiving and self-care skills via task analysis CCommunication training Community and supportive interventions

Other Childhood Disorders Tic Disorders TTTTourette’s Syndrome Elimination Disorders Separation Anxiety Selective Mutism Others

Cognitive Disorders Nature of Cognitive Disorders BBroad impairments in memory, attention, perception, and thinking PProfound changes in behavior and personality Three Classes DDelirium DDementia AAmnesia

Dementia Gradual deterioration of brain functioning Affects judgment, memory, language, and advanced cognitive processes Dementia has many causes and may be reversible or irreversible Impairments have a marked negative impact on social and occupational functioning

DSM-IV Classes of Dementia Dementia of the Alzheimer’s type Vascular Dementia Dementia Due to Other General Medical Conditions PParkinson’s Disease HHuntington’s Disease PPick’s Disease CCreutzfeldt-Jakob Disease Substance-Induced Persisting Dementia Dementia Due to Multiple Etiologies Dementia Not Otherwise Specified

Range of Cognitive Deficits Aphasia SSpeech and word usage deficits Apraxia TTask and coordination deficits Agnosia/Facial Agnosia RRecognition deficits Executive Function DDeficits in planning, organizing, sequencing, or abstracting information

Treatment of Dementia Medical Treatment: Best If Enacted Early FFew medical treatments exist for most types of dementia AAttempt to slow deterioration Do not actually stop progression of dementia Psychosocial Treatments FFocus on enhancing the lives of dementia patients and their families/caregivers TTeach adaptive skills UUse memory enhancement devices (e.g., memory notebook) MMain emphasis of psychosocial interventions is on the caregivers (help caregivers cope and help them help the patient)