1. Child Psychopathology Different views of mental retardation Developmental course and etiology Issues in intervention Case Reading for today: Chapter 9

2. Social Quiz Why do we have “unleaded” gasoline? How did plumbing bring down the Roman Empire? Why was the “Mad Hatter” mad? Why is it frowned upon to consume large quantities of alcohol when pregnant? What color do we want newborn babies to be and why? Why does the dentist put an apron over your body when X-raying your teeth?

3. History of assessment Binet & Simon hired to develop a test to determine if individuals could be educated Concept of “mental age” developed, which when expressed as a ratio MA/CA = IQ Test became widely used, revised at Stanford University, became “Stanford- Binet” Intelligence Test IQ designed to predict success in school

4. DSM-IV Criteria Significantly subaverage IQ (less than 70) Concurrent deficits or impairments in adaptive functioning Characteristics evident prior to age 18 Ranges (and Educational Classifications): –Mild: 50/55 to 70 (“Educable”) –Moderate: 35/40 to 50/55 (“Trainable”) –Severe: 20/25 to 35/40 (“Severe”)

5. Prevalence 1-3% of population, depending on cutoff used those with mild mental retardation are 85% of population, majority have idiopathic origin (cultural-familial) Those with organic MR are more likely to have genetic causes Slightly more males than females Low SES and minority groups at higher risk

6. Other characteristics Cultural-familial MR has global delays organic MR has less sequential organized delays, medical problems such as heart malformation Figure 8.3: signs of other CNS problems Mild MR may be associated with failure, lowering goals, and minimal success (learned helplessness) Comorbid developmental disabilities including epilepsy, speech, language, behavior, sensory attachments develop, but signals, proximity seeking, and even distress may be lower 10-40% have emotional or behavior problems (e.g., pica)

7. Biological Causes Heritability of IQ = 50%; “Polygenes” Chromosomal anomalies most common cause of more severe forms –Meiosis: Downs, Turners; Crossover Fragile X syndrome (inherited) Metabolism problems (PKU) Neurobiology: malnutrition, teratogens (lead, mercury), fetal alcohol, perinatal stress leading to physical damage (e.g., IVH)

8. Social and psychological causes Deprived physical care Poor emotional care Poor social stimulation Victor D’Avyron (feral child) was MR by environmental causes These interact with biology, e.g., poor housing may have paint chips, chips may have leaded paint, children may eat paint chips as they do not have toys to play with

9. Interventions for mental retardation Medications rarely, if ever, used Prenatal & postnatal education & screening –Vitamins, alcohol, PKU Community-based placements/ living situations: What are you aware of? Answers: Residential, Community-based, supported work environment, mainstreaming Variety of psychosocial interventions

11. Psychosocial interventions infant stimulation, developmental surveillance behavioral approaches include shaping, modeling, graduated guidance, both +/- beh. Self-regulation and metacognitive training Camp, other special programs (e.g., SMILE) family support: coping with parenting demands, stress

12. Case Review What is the diagnosis? Intervention Planning?